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COVID-19 PANDEMİSİNİN KRONİK VİRAL HEPATİT HİZMETLERİ ÜZERİNDEKİ ETKİSİ

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

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.

Kaynakça

  • Boettler T, Marjot T, Newsome PN, Mondelli MU, MojcaMaticic M, Cordero E, Jalan R ,Moreau R,Cornberg M,Berg T. (2020). Impact of COVID-19 on thecare of patientswithliverdisease: EASL-ESCMID positionpaperafter 6 months of the pandemic. JHEP Rep. Oct; 2(5): 100169.doi: 10.1016/j.jhepr.2020.100169
  • Centers for Disease Control and Prevention. Corona virüs Disease 2019 (COVID-19): Cleaning and disinfection for community facilities. Published February 11, 2020. https://www.cdc.gov/coronavirus/2019-ncov/community/organizations/cleaning- disinfection.html. Accessed April 2020
  • Efe C, Simşek C, Batıbay E, Calışkan AR, Wahlind S. (17 Sep 2020). Feasibility of telehealth in the management of autoimmune hepatitis before and during the COVID-19 pandemic. Expert Review of Gastroenterology & Hepatology. https://doi.org/10.1080/17474124.2020.1822734.
  • Fix OK, Hameed B, Fontana RJ, Kwok RM, McGuire BM, MulliganDC, Pratt DS, Russo MW, Schilsky ML, Verna EC, Loomba R, Cohen DE, Bezerra JA, Reddy KR, Chung RT. (April 16, 2020. Clinical best practice advice for hepatology and liver transplant providers during the COVID-19 pandemic: AASLD expert panel consensus statement. Hepatology. doi:10.1002/hep.31281.
  • Francisci D, Falcinelli F, Schiaroli E, Capponi M, Belfiori B, Flenghi L, Baldelli F. (2010). Man-agement of Hepatitis B Virus Reactivation in Patients with Hematological Malignancies Treated with Chemotherapy. Infection; 38: 58–61.
  • Ghany MG, Morgan TR. (2020.). Hepatitis C Guidance 2019 Update: Ameri- can.Association.for.the.Study of Liver.Diseases–Infectious.Diseases.Society of Ameri- ca.Recommendations.for.Testing, Managing, and.Treating.Hepatitis C Virus.Infection. Hepatology, Vol. 71, No. 2.
  • Gupta N, Desalegn H, Ocama P, Lacombe K, Njouom R, Afihene M, Cunha L, Spearman CW, Sonderup MW, Kateera F. (2020). Converging pandemics: implications of COVID-19 for the viral hepatitis response in sub-Saharan Africa. Lancet Gastroenterol Hepatol, 5: 634–36
  • Horton R. (2020). Offline: a dangerousvirus, but not theoneyouthink. Lancet (London, England), 395(10227):854.
  • Karimi-Sari H, Rezaee- Zavareh MS. (22 April 2020). COVID‐19 and viral hepatitis elimination programs: A rewestepping backward? Liver İnternational. https://doi.org/10.1111/liv.14486.
  • Lemoine M, Kim J U, Ndow G, Bah S, Forrest K, Rwegasha J, Bouyou M, Napon D, Somda S, Sawadogo A, Sombie R, Shimakawa Y. (September 17,2020). Effect of the COVID-19 pandemic on viral hepatitis services in sub-Saharan Africa. Lancet Gastroenterol Hepatol. https://doi.org/10.1016/ S2468-1253(20)30305-8.
  • Malik J K, kumar A, Soni H. (March-August, 2020). Epidemiology of novel.corona virüs (Covid-19): A review. Journal of Clinical/Pharmaco-Epidemiology.Research. Volume-2, Issue-2.
  • Mıstık R. Türkiye’de viral hepatit epidemiyolojisi yayınların irdelenmesi in: Tabak F, Balık İ, Tekeli E, (eds). Viral hepatit 2007. Viral hepatitle Savaşım Derneği, İstanbul, 1st edition: 10-51.
  • Pokorska-Śpiewak M, Śpiewak M. (2020 August 27). Management of hepatitis C in children and adolescents during COVID-19 pandemic. World J Hepatol; 12(8): 485-492.
  • Reddy KR. (2020). SARS-CoV-2 and the liver: considerations in hepatitis B and hepatitis C infec-tions. Clin Liver Dis (Hoboken), 15(5):191-194.
  • Reddy KR, Beavers KL, Hammond SP, Lim JK, Falck-Ytter YT. (2015). American Gastroentero-logical Association Institute Guideline on the Prevention and Treatment of Hepatitis B Virus Reactivation During Immunosuppressive DrugTherapy. Gastroenterology, 148:215–219.
  • Rezasoltani S , Hatami B, Yadegar A, Hamid Asadzadeh Aghdaei H, Zali M R. (2020). How Patients With Chronic Liver Diseases Succeed to Deal With COVID-19? Front Med (Lausanne), 7: 398. doi: 10.3389/fmed.2020.00398.
  • Roberton T, Carter ED, ChouVB, Stegmuller AR, Jackson BD, Tam Y, Sawadogo- Lewis T, Walker N. (2020). Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. Lancet Glob Health, 8: e901–08.
  • Su TH, Kao JH. (2020). The clinical manifestations and management of COVID-19- related liver injury. J Formos Med Assoc. 119:1016–8. doi: 10.1016/j.jfma.2020.04.020.
  • Şeker M, Özer A, Tosun Z, Korkut C, Doğrul M. (17 Nisan 2020). Covid-19 Pandemi Değer-lendirme Raporu. Türkiye Bilimler Akademisi.
  • Téllez L, Mateos RMM. (2020 ). COVID-19 and liver disease: An update (Actualización en COVID-19 y enfermedad hepática) Gastroenterol Hepatol, Oct; 43(8): 472–480. Spanish. doi: 10.1016/j.gastrohep.2020.06.006.
  • Terrault NA, Lok ASF, McMahon BJ, Chang KM, Hwang JP, Jonas MM, Brown Jr RS, Bzowej NH, Wong JB. (2018). Update on Prevention, Diagnosis, and Treatment of Chronic Hepatitis B: AASLD 2018 Hepatitis B Guidance. Hepatology, Vol. 67, No. 4.
  • Tosun S. (2013). Epidemiology of viral hepatitis in Turkey: a meta-analysis of all published pa-pers. In Tabak F, Tosun S, editors. Viralhepatitis 2013. Istanbul: Tıp Publisher. 27–79.
  • Toyoda H,Yasuda S, Kiriyama S, Tanikawa M, Hisanaga Y, Kanamori A, Kitabatake S, Yama-moto S, Shiota S, Furoi M, Koyabu T, Furukawa D, Kumada T, Sumida Y. (04 August 2020). Impact of COVID-19 pandemic on surveillance of hepatocellular carcinoma: a study in patients with chronic hepatitis C after sustained virologic response. Gastro Hep, doi: 10.1002/YGH2.418
  • Wang C, HorbyPW, Hayden FG, Gao G F. A novel coronavirus outbreak of global health concern. www.the lancet.com. Vol 395, February 15, 2020
  • WHO. COVID-19 significantly impact shealth services for noncommunicable disease. 1 June 2020 News release.
  • Zhai P, Ding Y, Wub X, Long J, Zhong Y, Li Y. (2020). The epidemiology, diagnosis and treatment of COVID-19. Int J Antimicrob Agents. 55:105955. doi: 10.1016/j.ijantimicag.2020.105955

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

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

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).

Kaynakça

  • Boettler T, Marjot T, Newsome PN, Mondelli MU, MojcaMaticic M, Cordero E, Jalan R ,Moreau R,Cornberg M,Berg T. (2020). Impact of COVID-19 on thecare of patientswithliverdisease: EASL-ESCMID positionpaperafter 6 months of the pandemic. JHEP Rep. Oct; 2(5): 100169.doi: 10.1016/j.jhepr.2020.100169
  • Centers for Disease Control and Prevention. Corona virüs Disease 2019 (COVID-19): Cleaning and disinfection for community facilities. Published February 11, 2020. https://www.cdc.gov/coronavirus/2019-ncov/community/organizations/cleaning- disinfection.html. Accessed April 2020
  • Efe C, Simşek C, Batıbay E, Calışkan AR, Wahlind S. (17 Sep 2020). Feasibility of telehealth in the management of autoimmune hepatitis before and during the COVID-19 pandemic. Expert Review of Gastroenterology & Hepatology. https://doi.org/10.1080/17474124.2020.1822734.
  • Fix OK, Hameed B, Fontana RJ, Kwok RM, McGuire BM, MulliganDC, Pratt DS, Russo MW, Schilsky ML, Verna EC, Loomba R, Cohen DE, Bezerra JA, Reddy KR, Chung RT. (April 16, 2020. Clinical best practice advice for hepatology and liver transplant providers during the COVID-19 pandemic: AASLD expert panel consensus statement. Hepatology. doi:10.1002/hep.31281.
  • Francisci D, Falcinelli F, Schiaroli E, Capponi M, Belfiori B, Flenghi L, Baldelli F. (2010). Man-agement of Hepatitis B Virus Reactivation in Patients with Hematological Malignancies Treated with Chemotherapy. Infection; 38: 58–61.
  • Ghany MG, Morgan TR. (2020.). Hepatitis C Guidance 2019 Update: Ameri- can.Association.for.the.Study of Liver.Diseases–Infectious.Diseases.Society of Ameri- ca.Recommendations.for.Testing, Managing, and.Treating.Hepatitis C Virus.Infection. Hepatology, Vol. 71, No. 2.
  • Gupta N, Desalegn H, Ocama P, Lacombe K, Njouom R, Afihene M, Cunha L, Spearman CW, Sonderup MW, Kateera F. (2020). Converging pandemics: implications of COVID-19 for the viral hepatitis response in sub-Saharan Africa. Lancet Gastroenterol Hepatol, 5: 634–36
  • Horton R. (2020). Offline: a dangerousvirus, but not theoneyouthink. Lancet (London, England), 395(10227):854.
  • Karimi-Sari H, Rezaee- Zavareh MS. (22 April 2020). COVID‐19 and viral hepatitis elimination programs: A rewestepping backward? Liver İnternational. https://doi.org/10.1111/liv.14486.
  • Lemoine M, Kim J U, Ndow G, Bah S, Forrest K, Rwegasha J, Bouyou M, Napon D, Somda S, Sawadogo A, Sombie R, Shimakawa Y. (September 17,2020). Effect of the COVID-19 pandemic on viral hepatitis services in sub-Saharan Africa. Lancet Gastroenterol Hepatol. https://doi.org/10.1016/ S2468-1253(20)30305-8.
  • Malik J K, kumar A, Soni H. (March-August, 2020). Epidemiology of novel.corona virüs (Covid-19): A review. Journal of Clinical/Pharmaco-Epidemiology.Research. Volume-2, Issue-2.
  • Mıstık R. Türkiye’de viral hepatit epidemiyolojisi yayınların irdelenmesi in: Tabak F, Balık İ, Tekeli E, (eds). Viral hepatit 2007. Viral hepatitle Savaşım Derneği, İstanbul, 1st edition: 10-51.
  • Pokorska-Śpiewak M, Śpiewak M. (2020 August 27). Management of hepatitis C in children and adolescents during COVID-19 pandemic. World J Hepatol; 12(8): 485-492.
  • Reddy KR. (2020). SARS-CoV-2 and the liver: considerations in hepatitis B and hepatitis C infec-tions. Clin Liver Dis (Hoboken), 15(5):191-194.
  • Reddy KR, Beavers KL, Hammond SP, Lim JK, Falck-Ytter YT. (2015). American Gastroentero-logical Association Institute Guideline on the Prevention and Treatment of Hepatitis B Virus Reactivation During Immunosuppressive DrugTherapy. Gastroenterology, 148:215–219.
  • Rezasoltani S , Hatami B, Yadegar A, Hamid Asadzadeh Aghdaei H, Zali M R. (2020). How Patients With Chronic Liver Diseases Succeed to Deal With COVID-19? Front Med (Lausanne), 7: 398. doi: 10.3389/fmed.2020.00398.
  • Roberton T, Carter ED, ChouVB, Stegmuller AR, Jackson BD, Tam Y, Sawadogo- Lewis T, Walker N. (2020). Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. Lancet Glob Health, 8: e901–08.
  • Su TH, Kao JH. (2020). The clinical manifestations and management of COVID-19- related liver injury. J Formos Med Assoc. 119:1016–8. doi: 10.1016/j.jfma.2020.04.020.
  • Şeker M, Özer A, Tosun Z, Korkut C, Doğrul M. (17 Nisan 2020). Covid-19 Pandemi Değer-lendirme Raporu. Türkiye Bilimler Akademisi.
  • Téllez L, Mateos RMM. (2020 ). COVID-19 and liver disease: An update (Actualización en COVID-19 y enfermedad hepática) Gastroenterol Hepatol, Oct; 43(8): 472–480. Spanish. doi: 10.1016/j.gastrohep.2020.06.006.
  • Terrault NA, Lok ASF, McMahon BJ, Chang KM, Hwang JP, Jonas MM, Brown Jr RS, Bzowej NH, Wong JB. (2018). Update on Prevention, Diagnosis, and Treatment of Chronic Hepatitis B: AASLD 2018 Hepatitis B Guidance. Hepatology, Vol. 67, No. 4.
  • Tosun S. (2013). Epidemiology of viral hepatitis in Turkey: a meta-analysis of all published pa-pers. In Tabak F, Tosun S, editors. Viralhepatitis 2013. Istanbul: Tıp Publisher. 27–79.
  • Toyoda H,Yasuda S, Kiriyama S, Tanikawa M, Hisanaga Y, Kanamori A, Kitabatake S, Yama-moto S, Shiota S, Furoi M, Koyabu T, Furukawa D, Kumada T, Sumida Y. (04 August 2020). Impact of COVID-19 pandemic on surveillance of hepatocellular carcinoma: a study in patients with chronic hepatitis C after sustained virologic response. Gastro Hep, doi: 10.1002/YGH2.418
  • Wang C, HorbyPW, Hayden FG, Gao G F. A novel coronavirus outbreak of global health concern. www.the lancet.com. Vol 395, February 15, 2020
  • WHO. COVID-19 significantly impact shealth services for noncommunicable disease. 1 June 2020 News release.
  • Zhai P, Ding Y, Wub X, Long J, Zhong Y, Li Y. (2020). The epidemiology, diagnosis and treatment of COVID-19. Int J Antimicrob Agents. 55:105955. doi: 10.1016/j.ijantimicag.2020.105955
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Politikası
Bölüm Araştırma Makaleleri
Yazarlar

Gülşen İskender Bu kişi benim

Yayımlanma Tarihi 25 Aralık 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 6 Sayı: 25

Kaynak Göster

APA İskender, G. (2020). COVID-19 PANDEMİSİNİN KRONİK VİRAL HEPATİT HİZMETLERİ ÜZERİNDEKİ ETKİSİ. Kesit Akademi Dergisi, 6(25), 685-693.