COVID-19 pnömonisi nedeni ile tosilizumab uygulanan hastaların özellikleri

Bu makale için 23 Temmuz 2024 tarihinde bir düzeltme yayımlandı. https://dergipark.org.tr/tr/pub/ighd/article/1549928

Öz

1Samsun Eğitim Ve Araştırma Hastanesi, Göğüs Hastalıkları, Samsun 2Dörtyol Devlet Hastanesi, Anestezi ve Reanimasyon, Hatay, Türkiye 3Mustafa Kemal Üniversitesi Tıp Fakültesi, Anestezi ve Reanimasyon, Hatay, Türkiye 4Eskişehir Şehir Hastanesi Meslek Hastalıkları Kliniği, Eskişehir, Türkiye Amaç Sars-Cov2 (COVID-19) pnömonisi nedeni ile makrofaj aktivasyon sendromu(MAS) gelişen ve tedavide tosilizumab uygulanan hastaların özelliklerinin belirlenmesi Gereç ve Yöntem Kasım 2020-eylül 2021 tarihleri arasında yoğun bakım ünitesinde COVID-19 pnömonisine bağlı solunum yetmezliği nedeni MAS gelişen ve tedavide tosilizumab uygulanan 38 hastanın demografik verileri değerlendirildi. Hastaların komorbiditeleri, hastanede ve yoğun bakımda yatış süreleri, sağkalım durumları, tosilizumabın uygulandığı gün, tosilizumab sonrası sekonder enfeksiyon sıklığı ile tosilizumab uygulanan hastalarda yaşayan ve exitus olan hastaların tedavi öncesi ve uygulandıktan sonraki üçüncü gün laboratuvar değerleri karşılaştırıldı Bulgular Çalışmaya 38 hasta alındı. Hastaların 27’si erkek, 11’i kadındı. Yaş ortalaması 59,6±11,5 idi. 29 hastada komorbidite mevcuttu. En sık hipertansiyon, diyabet, astım saptandı. Tosilizumab tedavisi alan hastaların 18’sinin yaşadığı, 20’sinin (%52,6) exitus olduğu görüldü. Tosilizumab uygulanan hastaların hastanede kalış süresi yaşayan grupta 18,8 ± 9,1 gün, ex olan grupta 15,9 ± 7,6 gün idi. Yoğun bakımda kalma süresi yaşayan grupta 11,3 ± 6,6 gün, exitus olan grupta 13,9 ± 7,8 gün idi. Tosilizumabın yatışdan uygulanma gününe kadar geçen süre yaşayan grupta 5,8 ± 3 gün, exitus olan grupta 7,3 ± 4,3 gün idi Tosilizumab sonrası yedi hastada sekonder enfeksiyon saptandı. Tedavinin üçüncü gününde laktat dehidrojenaz (LDH), D-dimer, nötrofil yüzdesinin azaldığı, lenfosit sayısı ve yüzdesi arttığı saptandı Sonuç MAS gelişen hastalarda mortalitenin yüksek olduğu ve tosilizumab tedavisi uygulanan hastalarda erken dönemde LDH, D-dimer, nötrofil yüzdesinin azalmasının, lenfosit sayısı ve yüzdesinin artmasının yaşam göstergesi olabileceğini saptadık. Anahtar Kelimeler: COVID-19, tosilizumab, laboratuvar parametre, mortalite

Anahtar Kelimeler

• COVID-19
• tosilizumab
• laboratuvar parametre
• mortalite

Characteristics of patients administered tocilizumab for COVID-19 pneumonia

An Erratum to this article was published on July 23, 2024. https://dergipark.org.tr/tr/pub/ighd/article/1549928

Abstract

Aim Determination of the characteristics of patients who developed macrophage activation syndrome(MAS) due to Sars-Cov2(COVID-19) pneumonia and were treated with tocilizumab. Material and Methods Demographic data of 38 patients with COVID-19 pneumonia who developed MAS due to respiratory failure who were treated with tocilizumab in the intensive care unit between November 2020 and September 2021 were evaluated.The comorbidities of the patients, length of stay in the hospital and intensive care unit, survival status, the day of tocilizumab administration, the frequency of secondary infection after tocilizumab, and the laboratory values of the patients who survived and exited in patients treated with tocilizumab were compared before and on the third day after the application. Results 38 patients were included in the study.27 of the patients were men and 11 were women.The average age was 59.6±11.5. There were comorbidities in 29 patients. Hypertension, diabetes and asthma were most frequently detected. It was observed that 18 of the patients receiving tocilizumab treatment survived and 20(52.6%) exited.The hospital stay of patients treated with tocilizumab was 18.8±9.1 days in the surviving group and 15.9±7.6days in the exitus group.The duration of stay in the intensive care unit was 11.3±6.6 days in the group that survived and 13.9±7.8days in the group with exitus. The time from admission to the day of administration of tocilizumab was 5.8±3 days in the surviving group and 7.3±4.3days in the exitus group. Secondary infection was detected in seven patients after tocilizumab.On the third day of treatment, it was determined that LDH,D-dimer, and neutrophil percentage decreased, while the number and percentage of lymphocytes increased. We found that mortality is high in patients who develop MAS and that the decrease in LDH,D-dimer, neutrophil percentage and increase in lymphocyte number and percentage in the early period in patients treated with tocilizumab may be indicators of survival.

Keywords

• COVID-19
• tocilizumab
• laboratory parameter
• mortality

Kaynakça

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