COVID-19 pandemisinin epidemiyolojik ve klinik yönleri ve tedavide dünyanın ortak deneyimleri: Türkiye deneyimi

Yıl 2020, Cilt: 77 Sayı: 3, 355 - 366, 01.09.2020

Hasan Karageçili Zuhal Yıldırım

Öz

COVID-19 salgınının SARS ve MERS gibi Çin’de sona ereceği düşünülüyordu. Ancak öngörülemedi, İran’a, sonra İtalya’dan Avrupa kıtasına yayıldı ve kısa sürede ve yaygın şekilde Amerika’ya yayıldı. Türkiye’den Çin’e bakmanın bizim için çok uzak bir hikaye olduğu düşünülüyordu. İtalya üzerindeki ağır etkisini gösterdiğinde, bir sonraki fotoğrafımız olduğu fikrini verdi. Dünya Sağlık Örgütü ne kadar yavaş davranırsa davransın, hastalığı bu dönemde salgın olarak ilan etmesi ciddiyeti arttırdı. COVID-19, PCR testi ile onaylandıktan sonra, radyolojik görüntüleme göğüs tomografisi ile akciğerlerdeki yayılma tespit edilmektedir. Genel klinik bulguları ateş, öksürük, baş ağrısı ve kas güçsüzlüğü ile karakterizedir. Bu hastalığı hafif atlatanların olmasının yanında, semptom göstermeden bulaşıcılığının yüksek oranda olması hem iyi hem kötü, ikili bir durum doğurmaktadır. Hastalığın insandan insana bulaşmasını önlemek için temastan kaçınmak, kişisel mesafeyi korumak, maske takmak ve el hijyenine dikkat etmek çok önemlidir. Şüpheli hastalığı olanların kendilerini izole etmeleri, karantinaya alınmaları ve bir doktor gözetiminde tutulmaları önemlidir. Son üç gün aileleri ile temas halinde olan hastaların taranması ve gözlemlenmesi, kontaminasyon zincirini kırmanın en iyi yoludur. Ülkemizde filyasyon için kurulan ekipler çok çalışmaktadır. Hasta vaka sayısı Türkiye’de 22 Mayıs itibariyle 154.500 idi. Ölü sayısı 4276, mortalite oranı ise %2.8 idi. COVID-19 vaka sayıları ve mortalite oranları, 65 yaşın üzerindeki ve 20 yaşından küçüklerin sokağa çıkmalarının kısıtlanması ile azaldı. Tedavi protokolünde kullanılan hidroksiklorokin, favipiravir ilaçları ve destekleyici tedaviler ile Türkiye’de tedavinin başarılı olduğu belirtilmektedir.

Anahtar Kelimeler

COVID-19, pandemi, filyasyon, epidemiyoloji

Epidemiological and clinical aspects of the COVID-19 pandemic and world common experiences in treatment: Turkey experience

Öz

The COVID-19 outbreak like SARS and MERS would have been thought to end in China. But it has not been envisaged, spread in Iran then Italy to continental Europe and spread to America in very prevalant and in a very short time. It was thought that looking to China from Turkey was very distant story for us. When it showed that the heavy influence on Italy, gave us the idea to be our next photograph. No matter how slow the World Health Organization behaved, the fact that it declared the disease as a pandemic during this period, increased the seriousness. COVID-19, after confirmation with the PCR test, the detection of spread in the lungs with radiological imaging chest tomography is also done. Commonly presented clinical findings were characterized by fever, cough, headache and muscle weakness. Some person recovered with mild symptoms of this disease contrary to the high level of contagiousness without symptoms of this disease sign both a good and a bad condition. It is very crucial to avoid contact, to protect personal distance, to wear a mask and to pay attention to hand hygiene to prevent disease transmission from human to human. It is important for those with suspected diseases to isolate themselves, to be quarantined and to be kept under the supervision of a doctor. The screening and observation of patients with whom they have been in contact with their families for the last three days is the best way to break the chain of contamination. Teams established to contact tracing are working hard in our country. The number of patient cases in Turkey as of May 22, 154.500. The number of death was 4.276, with 2.8% ratio. COVID-19 case numbers and mortality rates declined with the curfew of over 65-year old people and younger than 20s. With the drugs that were used in the treatment protocol as hydroxychloroquine, favipiravir and supportive treatments, in Turkey, it is stated that the treatment was good

Anahtar Kelimeler

COVID-19, pandemic, contact tracing, epidemiology

Kaynakça

• 1. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun, 2020; 109: 102433.
• 2. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet, 2020; 395(10229):1054-62.
• 3. Li X, Geng M, Peng Y, Meng L, Lu S. Molecular immune pathogenesis and diagnosis of COVID-19. J Pharm Anal, 2020;10 (2): 102-8.
• 4. Zhao S, Lin Q, Ran J, Musa SS, Yang G, Wang W, et al. Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: a data-driven analysis in the early phase of the outbreak. Int J Infect Dis, 2020; 92: 214-7.
• 5. Yang W, Cao Q, Qin L, Wang X, Cheng Z, Pan A, et al. Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19): a multi-center study in Wenzhou city, Zhejiang, China. J Infect, 2020; 80(4): 388-93.
• 6. Ho LTF, Chan KKH, Chung VCH, Leung TH. Highlights of traditional Chinese medicine frontline expert advice in the China national guideline for COVID-19. Eur J Integr Med, 2020; 36: 101116.
• 7. Liu Y, Gayle AA, Wilder-Smith A, Rocklov J. The reproductive number of COVID-19 is higher compared to SARS coronavirüs. J Travel Med, 2020; 27(2): taaa021.
• 8. Desjardins MR, Hohl A, Delmelle EM. Rapid surveillance of COVID-19 in the United States using a prospective space-time scan statistic: detecting and evaluating emerging clusters. Appl Geogr, 2020; 118 (102202):1-7.
• 9. Thomas P, Baldwin C, Bissett B, Boden I, Gosselink R, Granger CL, et al. Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations. J Physiother, 2020, 66 (2): 73-82.
• 10. Wu D, Wu T, Liu Q, Yang Z. The SARS-CoV-2 outbreak: what we know. Int J Infect Dis, 2020; 94: 44-8.
• 11. Wang L, Wang Y, Ye D, Liu Q. A review of the 2019 Novel Coronavirus (COVID-19) based on current evidence. Int J Antimicrob Agents, 2020; 55(6):105948.
• 12. Fanzca AB, Loh MH, Tan CH, SU LL, Young BE, Lye DC, et al. Care of the pregnant woman with covid-19 in labor and delivery: anesthesia, emergency cesarean delivery, differential diagnosis in the acutely ill parturient, care of the newborn, and protection of the healthcare personnel. Am J Obstet Gynecol, 2020; 223 (1): 66-74.
• 13. Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Sevestre J, et al. Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study. Travel Med Infect Di, 2020; 34: 101663.
• 14. Liang K. Mathematical model of infection kinetics and its analysis for COVID-19, SARS and MERS. Infect Genet Evol, 2020; 82:104306.
• 15. Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. Int J Infect Dis, 2020. 94: 91-5.
• 16. Verity R, Okell LC, Dorigatti I, Winskill P, Whittaker C, Imai N, et al. Estimates of the severity of coronavirus disease 2019 : a modelbased analysis. Lancet Infect Dis, 2020; 20(6): 669-77.
• 17. Daily Table of COVID-19 For Turkey. https:// covid19.saglik.gov.tr. (Accessed Date: May 22, 2020).
• 18. Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature, 2020; 579: 270-3.
• 19. Kandeel M, Al-Nazawi M. Virtual screening and repurposing of FDA approved drugs against COVID-19 main protease. Life Sci, 2020; 15:117627.
• 20. Yi Y, Lagniton PNP, Ye S, Li E, Xu RH. Int J Biol Sci, COVID-19: what has been learned and to be learned about the novel coronavirus disease. 2020;16(10):1753-66.
• 21. Zhang H, Kang Z, Gong H, Xu D, Wang J, Li Z, et al. The digestive system is a potential route of 2019-nCov infection: a bioinformatics analysis based on single-cell transcriptomes.BioRxiv, 2020; 2020.01.30.927806.
• 22. Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses. J Adv Res, 2020; 24:91-8.
• 23. Tian S, Hu N, Lou J, Chen K, Kang Z, Ziang Z, et al. Characteristics of COVID-19 infection in Beijing. J Infect, 2020; 80(4): 401-6.
• 24. Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, Villamizar-Peña R, Holguin-Rivera Y, Escalera-Antezana JP, et al. Clinical, laboratory and imaging features of COVID-19: a systematic review and metaanalysis. Travel Med Infect Dis, 2020; 34: 101623.
• 25. Coronavirus Disease (COVID-19) events as they happen. World Health Organization. https:// www.who.int/emergencies/diseases/novelcoronavirus-2019/events-as-they-happen, (Accessed Date: April 30, 2020).
• 26. Li X, Wang L, Yan S, Yang F, Xiang L, Zhu J, et al. Clinical characteristics of 25 death cases with COVID-19: a retrospective review of medical records in a single medical center, Wuhan, China. Int J Infect Dis, 2020; 94: 128-32.
• 27. Huang C, Wang Y, Li X,Ren L, Zhaou J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 2020; 395(10223): 497-506.
• 28. Chen N, Zhou M, Dong X, Jieming Q, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet, 2020; 395(10223):507- 13.
• 29. Hsih WH, Cheng MY, Ho MW, Chou CH, Lin PC, Chi CY, et al. Featuring COVID-19 cases via screening symptomatic patients with epidemiologic link during flu season in a medical center of central Taiwan. J Microbiol Immunol Infect, 2020; 53(3): 459-66.
• 30. He R, Lu Z, Zhang L, Fan T, Xiong R, Shen X, et al. The clinical course and its correlated immune status in COVID-19 pneumonia. J Clin Virol, 2020; 127: 104361.
• 31. Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y, et al. Risk factors for severity and mortality in adult COVID-19 in Wuhan. J Allergy Clin Immunol, 2020 146(1): 110-8.
• 32. DengQ, Hu B, Zhang Y, Wang H, Zhou X, Wei Hu, et al. Suspected myocardial injury in patients with COVID-19: evidence from front-line clinical observation in Wuhan, China. Int J Cardiol, 2020; 311: 116-21.
• 33. Fu L, Wang B, Yuan T, Chen X, Ao Y, Fitzpaatric T, et al. Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: a systematic review and meta-analysis. J Infect, 2020; 80(6): 656-65.
• 34. Liu F, Xu A, Zhang Y, Xuan W, Yan T, Pan K, et al. Patients of COVID-19 may benefit from sustained lopinavir-combined regimen and the increase of eosinophil may predict the outcome of COVID-19 progression. Int J Infect Dis, 2020; 95:183-91.
• 35. Wong JEL, Leo YS, Tan CC. COVID-19 in Singapore-current experience: critical global issues that require attention and action. JAMA, 2020; online ahead of print.
• 36. Deng L, Li C, Zeng Q, Liu X, Li X, Zhang H, et al. Arbidol combined with LPV/r versus LPV/r alone against corona virus disease 2019:a retrospective cohort study. J Infect, 2020; 81(1): e1-e5.
• 37. Wang L-S, Wang Y-R, Ye D-W, Liu Q-Q. A review of the 2019 novel coronavirus (COVID-19) based on current evidence. Int J Antimicrob Agents, 2020: 55(6): 105948.
• 38. Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Mailhe M, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents, 2020; 20: 105949.
• 39. Wu C-I, Postema PG, Arbelo E, Behr ER, Bezzina CR, Napolitano C, et al. SARS-CoV-2, COVID-19 and inherited arrhythmia syndromes. Hear Rhythm. 2020, 31; S1547-5271(20)30285-X.
• 40. Zheng C, Wang J, Guo H, Lu Z, Ma Y, Zhu Y, et al. Risk-adapted treatment strategy for COVID-19 patients. Int J Infect Dis. 2020, 94:74-77.
• 41. Zhu Z, Lu Z, Xu T, Chen C, Yang G, Zha T, et al. Arbidol monotherapy is superior to lopinavir/ ritonavir in treating COVID-19. J Infect, 2020; 81(1):e21-e23.
• 42. Zhang C, Wu Z, Li J-W, Zhao H, Wang G-Q. The cytokine release syndrome (CRS) of severe COVID-19 and interleukin-6 receptor (IL-6R) antagonist tocilizumab may be the key to reduce the mortality. Int J Antimicrob Agents, 2020; 55(5):105954.
• 43. Amrane S, Tissot-Dupont H, Doudier B, Eldin C, Hocquart M, Mailhe M, et al. Rapid viral diagnosis and ambulatory management of suspected COVID-19 cases presenting at the infectious diseases referral hospital in Marseille, France, - January 31st to March 1st, 2020: a respiratory virus snapshot. Travel Med Infect Dis, 2020; 20;101632.
• 44. Xie J, Covassin N, Fan Z, Singh P, Gao W, Li G, et al. Association between hypoxemia and mortality in patients with COVID-19. Mayo Clin Proc. 2020, 95(6): 1138-47.
• 45. Tosepu R, Gunawan J, Effendy DS, Ahmad LOAI, Lestari H, Bahar H. et al. Correlation between weather and Covid-19 pandemic in Jakarta, Indonesia. Sci Total Environ, 2020; 725: 138436.
• 46. Shahzad F, Shahzad U, Fareed Z, Iqbal N. Hashmi SH, Ahmad F. Asymmetric nexus between temperature and COVID-19 in the top ten affected provinces of China: a current application of quantile- on-quantile approach. Sci Total Environ, 2020; 736:139115.
• 47. Karageçili H. Vitaminler. In: Paşaoğlu H, ed. Temel - Klinik Tıbbi Laboratuvar. 1. Baskı. Ankara. Pelikan Tıp Teknik Yayıncılık - Akademik Kitaplar, 2018: 81-8.
• 48. Bozalioğlu S, Kılıç N, Yıldırım Z, Baştürk B, Kurukahvecioğlu O. The relationship between HLA-G levels and oxidative stress parameters in patients with breast cancer. Turk J Med Sci, 2013; 43(6): 870-7.
• 49. Yıldırım Z, Uçgun NI, Yıldırım F. The role of oxidative stress and antioxidants in the pathogenesis of age-related macular degeneration. Clinics (Sao Paulo), 2011; 66(5): 743-6.
• 50. Uçgun NI, Yıldırım Z, Abbasoğlu ÖE, Özel Ü, Fikret ZC, Bilgihan A, et al. Senil katarakt ilerlemesi ve askorbik asit. MN Oftalmol, 2005; 12: 10-2.
• 51. Biswal M, Rudramurthy SM, Jain N Shamanth AS, Sharma D, Jain K, et al. Controlling a possible outbreak of Candida auris infection: lessons learnt from multiple interventions. J Hosp Infect, 2017; 97: 363–70.
• 52. Schelenz S, Hagen F, Rhodes JL Abdolrasouli A, Chowdhary A, Hall A, et al. First hospital outbreak of the globally emerging Candida auris in a European hospital. Antimicrob Resist Infect Control, 2016; 5: 35.
• 53. Anonymous. http://www.promedmail.org/ post/20180425.5767936, (Erişim Tarihi: 15.05. 2019).