COVID-19 Enfeksiyonunda Ağırlaştırıcı Risk Faktörlerinin Araştırılması

Abstract

Amaç: Koronavirüs hastalığı-2019, yaklaşık iki yıl önce Çin'de başlayan ancak tüm dünyayı etkisi altına alan bir salgına neden olmuştur. Koronavirüs hastalığı-2019 enfeksiyonu ile takip edilen hastaların değerlendirilmesi, ciddi enfeksiyon için risk faktörlerinin ve göstergelerinin belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Koronavirüs hastalığı-2019 enfeksiyonu ile 15 Mart- 01 Haziran 2020 tarihleri arasında yatarak tedavi gören hastalar araştırıldı. Hastalar oksijen satürasyonlarına göre iki gruba ayrıldı; oksijen satürasyonu % 90'ın üzerinde olan hastalar grup 1, % 90 ve altı olan hastalar grup 2 olarak belirlendi. Bu iki grup ağırlaştırıcı risk faktörleri açısından karşılaştırıldı. Bulgular: Bu çalışmaya 90 hasta (46 kadın, 44 erkek) dahil edildi. Bilgisayarlı toraks tomografisinde orta-şiddetli pnömonik tutulum (p=0,002) ve yüksek ateş (p<0,001) ciddi enfeksiyon belirteçleri olarak düşünüldü. Kronik hastalık (p=0.018) ve astım (p=0.041) varlığı ağırlaştırıcı risk faktörleri olarak bulundu. C-reaktif protein, eritrosit sedimentasyon hızı, ferritin, nötrofil-lenfosit oranı, laktat dehidrogenaz (p<0,001), prokalsitonin, D-dimer, kreatin kinaz, trigliserid gibi testlerin yüksek ve lenfosit, hemoglobin gibi testlerin düşük olmasının şiddetli hastalığı gösterdiği düşünüldü. Sonuç: Lenfosit düşüklüğü ve C-reaktif protein, D-dimer, ferritin yüksekliği gibi parametreler kötü prognoz göstergesi olarak sıklıkla kullanılmaktadır. Ancak prokalsitonin, laktat dehidrogenaz, eritrosit sedimentasyon hızı, kreatin kinaz vetrigliserid seviyelerinin yüksek, hemoglobin düzeylerinin düşük olmasının yanında astım ve yüksek ateş varlığının da kötü prognoz göstergesi olabileceği kanaatindeyiz.

Keywords

• Koronavirüs hastalığı 2019
• ağırlaştırıcı faktörler
• oksijen satürasyonu

Investigation of Aggravating Risk Factors in COVID-19 Infection

Abstract

Aim: Coronavirus disease-2019 caused an epidemic that started in China about two years ago but affected the whole world. It was aimed to evaluate patients followed up with coronavirus disease-2019 infection, to determine risk factors and indicators for severe infection. Material and Methods: Patients who received treatment as inpatient with coronavirus disease-2019 infection between March 15- June 01 2020 were investigated. Patients were divided into two groups according to their oxygen saturation; patients with oxygen saturation over 90% were group 1, patients with 90% or less were determined as group 2. This two groups were compared in terms of aggravating risk factors. Results: In this study, 90 patients (46 female, 44 male) were included. Moderate-severe pneumonic involvement in computed tomography of thorax (p=0.002) and high fever (p<0.001) were thought to be indicators for severe infection. Presence of chronic disease (p=0.018) and asthma (p=0.041) were found to be aggravating risk factors. High levels of tests such as C-reactive protein, erythrocyte sedimentation rate, ferritin, neutrophil-lymphocyte ratio, lactate dehydrogenase (p<0.001), procalcitonin, D-dimer, creatine kinase, triglyceride, and low levels of tests such as lymphocytes, hemoglobin were thought to indicate severe disease. Conclusion: Parameters such as low level of lymphocyte and high level of C-reactive protein, D-dimer, ferritin are frequently used as indicators of poor prognosis. However, we also believe that high level of procalcitonin, lactate dehydrogenase, erythrocyte sedimentation rate, creatine kinase and triglyceride, low level of hemoglobin, in addition the presence of asthma and high fever may be indicators of poor prognosis.

Keywords

• Coronavirus disease-2019
• aggravating factors
• oxygen saturation

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