COVID-19 ve Fiziksel Tıp ve Rehabilitasyon

Koronavirüs Hastalığı 2019 (COVID-19); temelde solunum sistemi enfeksiyonu şeklinde hafif hastalıktan ciddi sepsis tablosuna kadar değişebilmektedir. Hastalık; kas-iskelet, nörolojik, kardiyopulmoner gibi farklı sistemik tutulumlarla seyredebilmektedir. Birçok hasta yaygın kas ve eklem ağrıları tanımlamakta ve hastalık miyozit ve sarkopeni gibi kas problemlerine neden olabilmektedir. Uzun süreli hareketsizlik hastalarda sekonder komplikasyonlara yol açabilmektedir. Hastalıklara bağlı gelişebilecek engelliliği azaltmak, rehabilitasyonun en önemli amaçlarındandır. Pandemi, Fiziksel Tıp ve Rehabilitasyon (FTR) alanında; yatan ve ayaktan poliklinik hastalarına sunulan hizmetin değişmesi, hastalığın subakut ve kronik dönemde gerektirebileceği rehabilitasyon ihtiyacı ve devam eden pandemi sürecinde COVID-19 semptomlarını tanıma ve hareket sistemi sorunlarının ayırıcı tanısında yer verme bilincinin oluşması gibi sonuçlar yaratmıştır.

The Radiology of COVID-19 Pneumonia

Coronavirus disease 2019 (COVID-19) has reached a pandemic stage in March 2020 and currently more than 220 million patients worldwide are infected. The characteristic findings of COVID-19 pneumonia are bilateral, peripheral, rounded ground-glass opacities (GGO) which are dominantly located in the lower lobes and that may be accompanied by consolidation. The distribution of the parenchymal lesions was reported to be bilateral (88%), multi-lobar (78%) and peripheral (76%), with a tendency to involve the posterior regions of the lungs (80%). Several other chest CT findings, such as interlobular septal thickening, bronchiectasis, “crazy paving” and halo sign, have also been reported but with a lower frequency. RSNA has published consensus statements to reduce report variability among radiologists and defined 4 main categories: typical, indeterminate, atypical, and negative, to provide a relative likelihood that these findings are attributable to COVID-19 pneumonia. It is vital to understand that imaging may be normal in the early stages of COVID-19, and many conditions may present with imaging findings mimicking COVID-19 pneumonia. Chest CT may be also used as a useful tool for better identification of patients who will benefit from more aggressive therapy. In addition, CT may be used to evaluate patency of pulmonary and coronary vascular structures and myocardial damage. Although CT scan is not recommended as a diagnostic and screening tool, it can be helpful to clinician for a fast and accurate decision-making and has a crucial role in the diagnosis, risk stratifying, and follow-up of the progression of COVID-19 pneumonia.

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