Zehra Hilal ADIBELLİ, Ali Murat KOÇ, Seniz AKÇAY, Hülya OZKAN ÖZDEMİR, Nesibe DOĞAN

ROMATİZMAL KAS-İSKELET SİSTEMİ HASTALIKLARINDA COVID-19 PNÖMONİSİNİN BTŞİDDET ANALİZİ

Amaç: Bu çalışma, kas-iskelet sistemi tutulumlu romatizmal hastalıkları (RH) olan hastalarda covid-19 pnömonisinin radyolojik şiddetini vurgulamayı amaçlamaktadır. Materyal ve Metot: Toplam 342 Polimeraz Zincir Reaksiyonu (PCR) pozitif hasta geriye dönük olarak incelendi. Hastalar RH varlığı açısından iki gruba ayrıldı. Akciğer bilgisayarlı tomografi (BT) şiddet skorları, demografik özellikler, hastaneye yatış, yoğun bakım ünitesi (YBÜ) gereksinimi, hastanede kalış süresi RH ve RH olmayan grup arasında karşılaştırıldı. BT görüntülerinde tipik ve atipik bulgular, her iki hasta grubundaki görülme sıklıkları ile birlikte tanımlandı. Bulgular: Yaş ve kadın cinsiyet, RH grubunda RH olmayan gruba göre anlamlı olarak daha yüksekti (p=0,001, p=0,041). BT-şiddet skorunun ortalaması RH grubunda RH olmayan gruba göre daha yüksekti, ancak fark istatistiksel olarak anlamlı değildi (p=0,081). YBÜ'ye nakil ve ölüm oranları RH grubunda RH olmayan gruba göre daha yüksek bulunurken, hastanede yatış oranları ve kalış süreleri arasında fark saptanmadı (p=0,002, p=0,036, p=0,280, p=0,168). Her iki grupta da buzlu cam opasiteleri, üst üste bindirilmiş konsolidasyon ve kaldırım desenleri en yaygın tipik bulgulardı. Covid-19 pnömonisi için atipik BT bulguları, RH grubunda RH olmayan gruba göre daha yüksek bulundu. Sonuç: Kronik inflamasyon ve immünosupresif ilaçların kullanımı RH hastalarında enfeksiyonlara karşı hassasiyete neden olmaktadır. Bu çalışmada, RH'li hastalarda mortalite ve YBÜ gereksinimlerinin daha yüksek olduğu bulundu. Benzer şekilde, RH grubunda atipik akciğer BT bulgularının daha yaygın görülmesi, bu hasta grubunda covid-19 pnömonisinin tanı ve ayırıcı tanısında özellikle önemli olabilir.

CT-SEVERITY ANALYSIS OF COVID-19 PNEUMONIA IN RHEUMATIC MUSCULOSKELETAL DISEASES

Objectives: This study aims to focus on the radiological severity of covid-19 pneumonia in patients with rheumatic musculoskeletal diseases (RMD). Materials and Methods: A total of 342 Polymerase Chain Reaction positive patients were retrospectively reviewed. The patients were divided into two groups in terms of the presence of RMD. Chest Computed Tomography (CT) severity scores, demographic characteristics, hospitalization, intensive care unit (ICU) requirement, length of stay at the hospital were compared between RMD and non-RMD groups. Typical and atypical findings on CT images were identified with their incidence in both groups of patients. Results: Age and female gender were significantly higher in the RMD group (p=0.001, p=0.041). The average CT-severity score was higher in the RMD group, but the difference was not statistically significant (p=0.081). ICU transfer and mortality rates were higher in the RMD, whereas no difference was found in hospitalization rates and length of stay (p=0.002, p=0.036, p=0.280, p=0.168). Ground glass opacities, superimposed consolidation, and crazy paving patterns were the most common typical findings seen on both groups. Atypical CT findings for covid-19 pneumonia were found to be higher in the RMD group than in the non-RMD group. Conclusion: Chronic inflammation and the use of immunosuppressive drugs constitute a vulnerability to infections in RMD patients. In this study, mortality and ICU requirements were found to be higher in patients with RMD. Similarly, the higher rate of atypical chest CT findings in the RMD group may be of particular importance in the diagnosis and differential diagnosis of covid-19 pneumonia in this patient group.

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