Serap BULUT ÇÖBDEN, İbrahim ÖZCAN, Mustafa ALKAYA, Altan KAYA, Yunus KANTEKİN

Covid-19 Pnömonisinin Gelişiminde Tonsillerin Rolü

Amaç: COVID-19 hastalığı fizyopatolojisi ve klinik seyri yapılan pek çok bilimsel araştırmaya rağmen henüz tam olarak çözülememiştir. Yeni tip coronavirüs pandemisinde neden bazı hastalarda pnömoni gelişirken, bazı hastalarda sadece üst solunum yolu bulguları ile hatta bazen asemptomatik seyrettiği bilinmemektedir. Bu klinik farklılığın sebeplerinin ortaya konabilmesi için çalışmalara ihtiyaç vardır. Bu çalışmada üst solunum yolu ile vücuda giren mikroorganizmalara karşı ilk savunmayı sağlayan, immün sistemin bir elemanı olan tonsillerin COVID-19 pnömonisi gelişimini önlemedeki rolünün araştırılması amaçlanmıştır.Gereç ve Yöntem: Pandemi polikliniğine başvuran, yeni tip koronavirüs ile enfekte, 20-40 yaş arası, ek hastalığı olmayan 198 hasta çalışmaya dahil edildi. Hastaların akciğer tutulumlarının olup olmadığı, tonsillektomi olup olmadığı incelenerek akciğer tutulumu ile tonsillektomi öyküsü arasındaki ilişki değerlendirildi. Bulgular: Çalışmaya dahil edilen 198 hastanın 108’i erkek, 90‘ı kadın ve yaş ortalaması 34,73 idi. Hastaların 83’ünde akciğer tutulumu bulunmazken, 115’inde akciğer tutulu idi. Akciğer tutulumu olan hastaların 12‘sinde tonsillektomi öyküsü mevcut iken, akciğer tutulumu olmayan hastaların 3’ünde tonsillektomi öyküsü mevcuttu. Sonuç: Pnomoni gelişmesi ve tonsillektomi arasında istatistiksel olarak anlamlı sonuç bulunamadı (p0.05), ancak tonsillektomi olan 15 hastanın %80’inde pnömoni gelişirken %20’sinde gelişmediği görüldü. Bu nedenle tonsillektomi öyküsü olan hastalarda COVID-19 enfeksiyonu gelişmesi durumunda akciğer tutulumu açısından daha dikkatli olunmalıdır.

Anahtar Kelimeler:

covid-19, tonsillektomi, pnömoni, immünite

The Role of Tonsils in the Development of Covid-19 Pneumonia

Objective: Despite extensive research, the physiopathology and clinical course of novel coronavirus disease 2019 (COVID-19) is still not fully understood. It is not known why some COVID-19 patients develop pneumonia while others are asymptomatic or have only mild upper respiratory tract symptoms. The tonsils are an element of the immune system that provide first-line defense against microorganisms entering the body via the upper respiratory tract. This study aimed to evaluate the role of tonsils in preventing the development of COVID-19 pneumonia. Materials and Methods: The study included 198 patients aged 20-40 years who presented to the pandemic outpatient clinic, had confirmed COVID-19 infection, and had no comorbidities. The relationship between lung involvement and history of tonsillectomy was analyzed. Results: Of the 198 patients in the study, 108 were male, 90 were female, and the mean age was 34.7 years. Eighty-three (41.9%) of the patients did not have lung involvement and 115 (58.1%) had lung involvement. Twelve (10.4%) of the patients with lung involvement and 3 (3.6%) of the patients without lung involvement had a history of tonsillectomy. The prevalence of pneumonia did not differ statistically between the groups (p>0.05). Conclusion: Although there was no statistically significant relationship between COVID-19 pneumonia and tonsillectomy in this study, we observed that pneumonia developed in 80% of the 15 patients who underwent tonsillectomy. This suggests that greater caution in terms of lung involvement may be warranted for tonsillectomized patients with COVID-19.

Keywords:

covid-19, tonsillectomy, pnomonia, immunity,

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