COVID-19 PANDEMİSİNİN KRONİK VİRAL HEPATİT HİZMETLERİ ÜZERİNDEKİ ETKİSİ

Yıl 2020, Cilt: 6 Sayı: 25, 685 - 693, 25.12.2020

Gülşen İskender

Öz

Aralık 2019’un sonlarında, Çin’in Hubei eyaletinde kendini gösteren yeni tip koronavirüs (Covid-19) kısa sürede tüm dünyaya yayılmış ve pandemi haline gelmiştir. Covıd-19'a karşı küresel mücadele, Türkiye de dahil olmak üzere tüm ülkelerde dikkati ve kaynakları, mevcut diğer sağlık sorunlarından uzaklaştırarak birçok hastalığın takip ve tedavisinde aksaklıklar yaşanmasına neden olmuştur. Pandemi ile birlikte bizim hastanede de birçok hastanede olduğu gibi acil olmayan hastalıkların takip ve tedavisi büyük oranda askıya alınıp, sağlık personeli ağırlıklı olarak covid-19 hastaların takip edildiği birimlere aktarılmıştır. Bu süreçte takip ve tedavisi aksayan hasta gruplarından biri de kronik viral hepatitli hastalar olmuştur. Burada rektrospektif olarak pandemi sürecinde hepatit polikliniğine başvurular ve istenilen karaciğer biyopsi sayıları pandemi öncesi benzer zaman dilimi ile karşılaştırılmıştır. Veriler hastane istatistik merkezinden elde edildi. Pandemi dö-neminde 1 Nisan-15 Ağustos 2020 tarihleri arası kronik hepatit B ve C tanılarıyla hepatit polikliniğimize başvuran hasta sayısı sırayla 374 ve 12 hasta, benzer tarihlerde 2019 yılında ise sırayla 740 ve 27 hasta olmuştur. Hepatit B başvurularında %49,45, hepatit C başvurularında ise %55,5 azalma yaşanmıştır. 1 Nisan-15 Ağustos 2020 tarihleri arası karaciğer biyopsisi 8 hastaya uygulanmışken pandemi önce-si döneminde (1 Nisan-15 Ağustos 2019), 22 hastaya uygulanmıştır. Karaciğer biyopsilerinde %63,63 azalma yaşanmıştır. Bu çalışmada Covid-19 pandemisi döneminde kronik hepatitli hastaların ayaktan tedavi hizmetlerinin kullanımında çarpıcı bir düşüş kaydettik. Covid-19 salgını karşısında, viral hepatit hizmetleri büyük bir ihmal riski altındadır. Viral hepatit hizmetlerinin aksaması, yeni tanı konulan hasta sayısında azalma, yeni tanı almış hastaların ileri tetkiklerinin aksaması, tedavi alması gereken hastaların tedavi endikasyonu konulması ve tedaviye alınmasında gecikme, tedavi alan hastaların takiplerinde aksama gibi istenmeyen sonuçları beraberinde getirmektedir.

Anahtar Kelimeler

Covid-19, pandemi, kronik viral hepatit

EFFECT OF THE COVID-19 PANDEMIC ON CHRONIC VIRAL HEPATITIS SERVICES

Öz

The Covid-19, which manifested in China in 2019, spread all over the world in a short time and became a pandemic. The global response to limit the Covid-19 has diverted attention from other health problems and treatment of non-urgent diseases were largely suspended and the health personnel were mainly transferred to the units where Covid-19 patients were followed. One of the patient groups whose follow-up and treatment was disrupted during pandemic was patients with chronic viral hepatitis. Here, the admissions to the hepatitis outpatient clinic during the pandemic and the desired liver biopsy numbers were compared with the similar time period before the pandemic. The data were obtained from the hospital statistic scenter. During the pandemic period, the number of patients who applied to hepatitis outpatient clinic between April 1 and August 15, 2020, with chronic hepatitis B and C were 374 and 12, respectively, and in 2019 on similar dates were 740 and 27 patients respectively. There was a 49.45% decrease in hepatitis B and a 55.5% decrease in hepatitis C applications. Liver biopsy was applied to 8 patients during the pandemic, and to 22 patients in a similar time period before the pandemic. There was a 63.63% reduction in liver biopsies. In this study, we found a dramatic decrease in the use of outpatient services of patients with chronic hepatitis during the Covid-19 pandemic. During pandemic, viral hepatitis services are at great risk of neglect. Disruption of viral hepatitis services bring undesirable con-sequences such as a decrease in the number of newly diagnosed patients, delay in further examinations of them, delay in the treatment and in the follow-up of patients receiving treatment.
This study was presented as an oral presentation at International Symposium on Social Sciences and Educational Sciences 2020 (USVES 2020).

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