Hafif/orta ve ağır COVID-19 pnömonisi: klinik seyri öngörmek mümkün mü?

Yıl 2021, Cilt: 13 Sayı: 3, 92 - 96, 31.12.2021

Aziz A. Hamidi , Yıldız Ulu

https://doi.org/10.35514/mtd.2021.55

Öz

Amaç: Bu çalışmada hafif/orta ve ağır pnömoni gelişen olgulardaki klinik ve laboratuvar özelliklerin karşılaştırılması ve ağır seyir ile ilişkili olan faktörlerin saptanması amaçlandı.
Yöntemler: COVID-19 pnömoni tanısıyla hastaneye yatırılan erişkin hastaların klinik ve laboratuvar özellikleri geriye dönük olarak incelendi. Çalışmaya gerçek zamanlı polimeraz zincir reaksiyonu (RT-PCR) ile SARS-CoV-2 nükleik asidi bulunan ve akciğer bilgisayarlı tomografisinde pnömoni saptanan hastalar dahil edildi.
Bulgular: Çalışmaya alınan 94 (41’i kadın ve 53’ü erkek) olgudan 71’i hafif/orta pnömoni olarak tanımlanırken 23’ü ağır pnömoni olarak sınıflandırıldı. Ağır pnömoni grubunda yaş ortalaması belirgin olarak daha yüksek bulundu (p<0.001). Başvuru esnasında öksürük ve nefes darlığı en sık (sırasıyla %53, %44) saptanan yakınmalar idi. Yapılan çok değişkenli lojistik regresyon analizinde nefes darlığı (p:0.039, OR:13.24, %95CI: 1.14-153.12), lökositoz (p=0.006, OR: 1.29, %95CI: 1.08-1.55), CRP yüksekliği (p=0.006, OR: 1.01, %95CI: 1.00-1.02) ve D-dimer yüksekliği (p=0.01, OR:1.80 %95CI: 1.15-2.81) ağır pnömoni için bağımsız risk faktörü olarak saptandı.
Sonuç: Çalışma sonuçları, başvuru esnasında hipoksi olmadan nefes darlığı yakınması olan, lökosit, CRP ve D-dimer değerleri yüksek olan hastalarda, COVID-19 pnömonisinin ağır seyredebileceğine dikkat çekmiştir

Anahtar Kelimeler

Covid-19, Pnömoni, SARS-CoV-2

Mild/moderate and severe COVID-19 pneumonia: Can the clinical course be predicted?

Öz

Objective: In this study, it was aimed to compare clinical and laboratory characteristics of cases with mild/moderate or severe COVID-19 pneumonia and to identify factors related to severe disease.
Methods: We retrospectively reviewed the clinical and laboratory characteristics of adult patients who were hospitalized with a diagnosis of COVID-19 pneumonia. The study included patients in whom SARS-CoV-2 nucleic acid was found by real-time polymerase chain reaction (RT-PCR) and pneumonia was detected chest computed tomography scan.
Results: Of 94 patients (41 women, 53 men), 71 were classified as mild/moderate pneumonia while 23 were classified as severe pneumonia. Mean age was significantly higher in severe pneumonia group (p<0.001). Cough and dyspnea were most common complaints at presentation (53% and 44%, respectively). In multivariate logistic regression analysis, dyspnea (OR: 13.24; 95% CI: 1.14-153.12; p: 0.39), leukocytosis (OR: 1.29; %95 CI: 1.08-1.55; p: 0.006), CRP elevation (OR: 1.01; 95% CI: 1.00-1.02; p: 0.006) and D-dimer elevation (OR: 1.80; 95%:1.15-2.81; p: 0.01) were identified as independent factors related to severe pneumonia.
Conclusion: Our results emphasized that COVID-19 pneumonia may show a severe clinical course in patients presented with dyspnea without hypoxia and had elevated leukocyte count, CRP, and D-dimer values.

Anahtar Kelimeler

Covid-19, pneumoniae, SARS-CoV-2

Kaynakça

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