First wave in COVID-19 pandemic: a single center experience
Yükleniyor...
Tarih
2020
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
AVES
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çalışmamızda COVID-19 pandemisinin birinci dalgası sırasında Liv Hospital Ulus’ta yatırılarak izlenen COVID-19 tanılı hastaların epidemiyolojik ve klinik özellikleri, laboratuvar ve görüntüleme bulguları ve prognozlarının değerlendirilmesi amaçlanmıştır. Yöntemler: COVID-19 tanısıyla izlenen toplam 124 olgu retrospektif olarak değerlendirildi. Hastanın solunum yolu örneğinde SARS-CoV-2 RT-PCR testi sonucunun pozitif olması, kesin olgu; hastada SARS-CoV-2 RT-PCR testi negatif olmakla birlikte, uygun klinik şikayetlerin olması ve toraks bilgisayarlı tomografisi (BT)’nde viral pnömoniyle uyumlu bulgular saptanması ise olası olgu olarak kabul edildi. Oda havasında SpO2 ?%93 olup oksijen desteği veya mekanik ventilasyon (MV) veya ekstrakorporeal membran oksijenasyonu ihtiyacı uyulduğunda, hastada “ağır hastalık” olduğu kabul edildi. Klinik iyileşme ise 48 saat süreyle ateşin olmaması, lökopeninin düzelmesiyle birlikte lenfosit ve trombosit sayısının artması, oksijen desteği ihtiyacının azalması veya MV’den ayrılma olarak tanımlandı. Bulgular: Toplam 124 olgunun ortanca yaşı 54 (minimum-maksimum 17-98)’tü ve %59.7’si erkek hastalardan oluşmaktaydı. Olguların %58’ine çeşitli komorbiditeler eşlik etmekte olup, en sık hipertansiyon (%33.9) vardı; bunu diabetes mellitus (%16.1) ve kalp hastalıkları (%13.7) izliyordu. Sık rastlanan klinik şikayet grubu, ateş (%73.4), öksürük (%70.2) ve nefes darlığı (%30.7)’ydı. Hastaların 81 (%65.3)’inin SARS-CoV-2 RT-PCR testi pozitifti. Olguların 43 (%34.6)’ünde ağır hastalık vardı ve bu hastaların 18’i yoğun bakım ünitesinde takip edildi. Ağır hastalar, ağır olmayanlarla karşılaştırıldığında ortalama yaşları ve eşlik eden komorbiditeleri daha fazla, yatış süreleri de daha uzundu. Laboratuvar bulguları arasında lökopeniden çok, lökositoz saptandı. Gerek lenfopeni, trombositopeni ve hipoalbüminemi varlığı, gerekse kreatinin, D-dimer ve akut faz göstergelerinin yüksekliği ağır hastalıkta daha belirgindi. Hastaların toraks BT’sinde saptanan tutulumlar, çoğunlukla bilateral (%73), alt ve alt-orta loblarda (%48.7), periferik yerleşimli (%49.6) buzlu cam görünümünde opasiteler (%93.3) şeklindeydi. Sağlık Bakanlığı COVID-19 Rehberleri’ndeki önerilere göre tedavi edilen hastaların hiçbirinde ciddi bir yan etki gelişmedi. Hastalardan 4 (%3.2)’ü kaybedildi. Kaybedilen hastalardan 2 (%2.2)’si kesin olgu tanısı almıştı. Sonuçlar: Kullanımda olan RT-PCR testlerinin duyarlılıkları, COVID19’un tanısında ve tedavisinin yönlendirilmesinde yeterli değildir. Bu nedenle, sürecin yönetilmesinde aynı zamanda görüntüleme yöntemlerinin ve serum antikor testlerinin de kullanılması gerekmektedir. Klimik Dergisi 2020; 33(3): 223-9.
Objective: We aimed to evaluate the epidemiological and clinical characteristics, laboratory and imaging findings and outcome of patients with COVID-19 diagnosis who were hospitalized during the first wave of the COVID-19 pandemic. Methods: A total of 124 cases followed with the diagnosis of COVID-19 were evaluated, retrospectively. Patients with SARS-CoV-2 RT-PCR test result positivity in respiratory specimen were accepted as the confirmed cases. Despite of a negative RT-PCR test result, patients having a combination of compatible symptoms and typical findings of viral pneumonia on thorax computed tomography (CT) were accepted as possible cases. Severe illness was defined as SpO2 ?93% on room air and to need supplemental oxygen support or mechanical ventilation (MV) or extracorporeal membrane oxygenation. Patients achieving clinical improvement were defined by defervescence of fever for 48 hours, improvement of leukopenia and increase in lymphocyte and thrombocyte count, decrease in demand for oxygen support or weaning from MV. Results: The median age of 124 cases was 54 (minimum-maximum 17-98) years and 59.7% of them were male. Among the overall population, 58% had comorbidities. Most frequent was hypertension (33.9%) followed by diabetes mellitus (16.1%) and cardiac disorders (13.7%). Most common clinical complaints were fever (73.4%), cough (70.2%), and shortness of breath (30.7%). SARS-CoV-2 RT-PCR tests of 81 (65.3%) patients were positive. Severe illness was present in 43 (34.6%) patients and 18 of them were followed in the intensive care unit. Patients with severe illness had higher mean ages, more accompanying comorbidities, and prolonged hospitalization compared to the patients with non-severe illness. Among the laboratory findings, leukocytosis was more frequent than leukopenia. In addition to presence of lymphopenia, thrombocytopenia and hypoalbuminemia, increases in levels of creatinine, D-dimer, and acute phase reactants were more prominent in patients with severe illness. Main thorax CT findings were ground glass opacities (93.3%), often bilateral (73%), involving the lower and lower-middle lobes (48.7%) and showing a peripheral distribution (49.6%). No serious side effects developed during the treatment given according to the recommendations of Ministry of Health Guidelines. Overall mortality rate was 3.2%, and 2 (2.2%) patients died were confirmed cases. Conclusions: The sensitivity of available RT-PCR tests is not sufficient for diagnosis and management of COVID-19. Therefore, combining the imaging methods and serum antibody testing are also needed for management of the disease process. Klimik Dergisi 2020; 33(3): 223-9.
Objective: We aimed to evaluate the epidemiological and clinical characteristics, laboratory and imaging findings and outcome of patients with COVID-19 diagnosis who were hospitalized during the first wave of the COVID-19 pandemic. Methods: A total of 124 cases followed with the diagnosis of COVID-19 were evaluated, retrospectively. Patients with SARS-CoV-2 RT-PCR test result positivity in respiratory specimen were accepted as the confirmed cases. Despite of a negative RT-PCR test result, patients having a combination of compatible symptoms and typical findings of viral pneumonia on thorax computed tomography (CT) were accepted as possible cases. Severe illness was defined as SpO2 ?93% on room air and to need supplemental oxygen support or mechanical ventilation (MV) or extracorporeal membrane oxygenation. Patients achieving clinical improvement were defined by defervescence of fever for 48 hours, improvement of leukopenia and increase in lymphocyte and thrombocyte count, decrease in demand for oxygen support or weaning from MV. Results: The median age of 124 cases was 54 (minimum-maximum 17-98) years and 59.7% of them were male. Among the overall population, 58% had comorbidities. Most frequent was hypertension (33.9%) followed by diabetes mellitus (16.1%) and cardiac disorders (13.7%). Most common clinical complaints were fever (73.4%), cough (70.2%), and shortness of breath (30.7%). SARS-CoV-2 RT-PCR tests of 81 (65.3%) patients were positive. Severe illness was present in 43 (34.6%) patients and 18 of them were followed in the intensive care unit. Patients with severe illness had higher mean ages, more accompanying comorbidities, and prolonged hospitalization compared to the patients with non-severe illness. Among the laboratory findings, leukocytosis was more frequent than leukopenia. In addition to presence of lymphopenia, thrombocytopenia and hypoalbuminemia, increases in levels of creatinine, D-dimer, and acute phase reactants were more prominent in patients with severe illness. Main thorax CT findings were ground glass opacities (93.3%), often bilateral (73%), involving the lower and lower-middle lobes (48.7%) and showing a peripheral distribution (49.6%). No serious side effects developed during the treatment given according to the recommendations of Ministry of Health Guidelines. Overall mortality rate was 3.2%, and 2 (2.2%) patients died were confirmed cases. Conclusions: The sensitivity of available RT-PCR tests is not sufficient for diagnosis and management of COVID-19. Therefore, combining the imaging methods and serum antibody testing are also needed for management of the disease process. Klimik Dergisi 2020; 33(3): 223-9.
Açıklama
Anahtar Kelimeler
COVID-19, SARS-CoV-2, Tanı, Mortalite, Diagnosis, Mortality
Kaynak
Klimik Dergisi
WoS Q Değeri
N/A
Scopus Q Değeri
Q4
Cilt
33
Sayı
3
Künye
Karakoç, Z. Ç., Pınarbaşı-Şimşek, B., Asil, R., Dodurgalı, R., Çalışkaner, F., Özsarı, A., ... & Ece, F. (2020). COVID-19 Pandemisinde Birinci Dalga: Tek Merkez Deneyimi. Klimik Journal/Klimik Dergisi, 33(3).
