COVID-19 Hastalarının Klinik ve Radyolojik Özellikleri: Eskişehir’de Tek Merkez Deneyimi

Giriş: Yeni koronavirüs hastalığı 2019 (COVID-19) dünya çapında bir pandemiye neden oldu. COVID-19'un çok çeşitli klinik belirtileri vardır. Eşlik eden hastalıkları olan 65 yaş üstü hastalar ciddi hastalıklara karşı daha savunmasızdır. Bu çalışma, hastalığın klinik, laboratuvar ve görüntüleme özelliklerini karakterize etmeyi amaçlamaktadır. Yöntemler: Bu çalışma Eskişehir Şehir Hastanesi'nde yapılmıştır. 15 Nisan 2020 ile 15 Haziran 2020 tarihleri arasında doğrulanmış COVID-19 olan 435 hastanın tıbbi kayıtları geriye dönük olarak analiz edildi. Hastalar yaşlarına göre <18 yaş, 18-64 yaş ve ≥65 yaş olmak üzere üç gruba ayrıldı. Bu grupların klinik, laboratuvar ve radyolojik verileri karşılaştırıldı. Bulgular: 435 hastanın ortalama yaşı 35.5 idi ve %59,5'i erkekti. Hastanede yatan hastalarda genel ölüm oranı %3,4 iken, yaşlı hastalarda daha yüksek oran (%23, p<0,001) kaydedilmiştir. En sık görülen semptomlar öksürük (%61,8) ve ateş (%54) idi. Yaşlı hastalar anlamlı olarak daha yüksek d-dimer ve daha düşük lenfosit seviyelerine sahipti. 184 hastada toraks bilgisayarlı tomografi (BT) anormaldi. BT'de COVID-19'un en yaygın özellikleri, çoğunlukla alt loblarda periferik dağılıma sahip bilateral multilobar buzlu cam dansiteleri (BCD) olarak saptandı. Sonuç: COVID-19, özellikle yaşlı hastalarda sağlık tesislerine önemli bir yük getirmektedir. Yaşlı COVID-19 hastaları farklı klinik, laboratuvar ve radyolojik özelliklere sahiptir. Öksürük ve ateşin en sık görülen klinik semptomlar olduğunu, lenfopeni ve yüksek d-dimer düzeylerinin yaygın laboratuvar bulguları olduğunu ve toraks BT'nin COVID-19 pnömonisinin değerlendirilmesinde yararlı bir araç olduğunu onaylıyoruz. Pandemi yeniden enfeksiyona neden olabilecek yeni koronavirüs varyantlarıyla devam ettiği için gelecekte bunun gibi çalışmaların tekrarlanması gerektiğine inanıyoruz.
Anahtar Kelimeler:

COVID-19, Pnömoni, SARS-CoV-2

Clinical and Radiological Characteristics of COVID-19 Patients: A Single Center Experience in Eskişehir

Introduction: The novel coronavirus disease 2019 (COVID-19) has caused a worldwide pandemic. COVID-19 has a wide range of clinical manifestations. Patients over the age of 65 who have comorbidities are more vulnerable to severe disease. This study aims to characterize the clinical, laboratory, and imaging features of the disease. Methods: This study was conducted in Eskisehir City Hospital, Turkey. Medical records of 435 patients with confirmed COVID-19 between 15 April 2020, and 15 June 2020, were analyzed retrospectively. The patients were divided into three groups according to age: <18 years old, 18 to 64 years old, and ≥65 years old. The clinical, laboratory, and radiological data of these groups were compared. Results: Of the 435 patients, the mean age was 35.5 years and 59.5% were male. The overall death rate was 3.4% in hospitalized patients, but among elderly patients a higher rate was noted (%23, p<0.001). The most frequent symptoms were cough (61.8%) and fever (54%). Elderly patient had significantly higher d-dimer and lower lymphocyte levels. Thorax computarized tomographies (CT) were abnormal in 184 patients. Most common features of COVID-19 on CT included bilateral multilobar ground-glass opafications (GGO) with a peripheral distribution mainly in the lower lobes. Conclusion: COVID-19 places a significant burden on healthcare facilities, particularly in elderly patients. Older COVID-19 patients had distinct clinical, laboratory and radiological features. We confirm that cough and fever are the most frequent clinical symptoms, lymphopenia and high d-dimer levels are common laboratory findings and, thorax CT is a helpful tool for evaluation of the COVID-19 pneumonia. As the pandemic continues with new coronavirus variants that could cause more reinfections studies like this should be repeated in the future.

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  • 1. Zhu N, Zhang D, Wang W, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-33.
  • 2. Coronaviridae Study Group of the International Committee on Taxonomy of V. The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020;5(4):536-44.
  • 3. Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020;91(1):157-60.
  • 4. World Health O. COVID-19 weekly epidemiological update, edition 52, 10 August 2021. Geneva: World Health Organization; 2021 2021-08-10.
  • 5. Rothe C, Schunk M, Sothmann P, et al. Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. N Engl J Med. 2020;382(10):970-1.
  • 6. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
  • 7. Grant MC, Geoghegan L, Arbyn M, et al. The prevalence of symptoms in 24,410 adults infected by the novel coronavirus (SARS-CoV-2; COVID-19): A systematic review and meta-analysis of 148 studies from 9 countries. PLoS One. 2020;15(6):e0234765.
  • 8. Nie Y, Li J, Huang X, Guo W, et al. Epidemiological and clinical characteristics of 671 COVID-19 patients in Henan Province, China. Int J Epidemiol. 2020;49(4):1085-95.
  • 9. Zhang JJ, Cao YY, Tan G, et al. Clinical, radiological, and laboratory characteristics and risk factors for severity and mortality of 289 hospitalized COVID-19 patients. Allergy. 2021;76(2):533-50.
  • 10. Fang Y, Zhang H, Xie J, et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology. 2020;296(2):E115-E7.
  • 11. Adams HJA, Kwee TC, Yakar D, Hope MD, Kwee RM. Chest CT Imaging Signature of Coronavirus Disease 2019 Infection: In Pursuit of the Scientific Evidence. Chest. 2020;158(5):1885-95.
  • 12. Albtoush OM, Al-Shdefat RB, Al-Akaileh A. Chest CT scan features from 302 patients with COVID-19 in Jordan. Eur J Radiol Open. 2020;7:100295.
  • 13. Ashtari S, Vahedian-Azimi A, Shojaee S, et al. Computed tomographic features of coronavirus disease-2019 (COVID-19) pneumonia in three groups of Iranian patients: A single center study. Radiologia (Engl Ed). 2021;63(4):314-23.
  • 14. Vogel-Claussen J, Ley-Zaporozhan J, Agarwal P, et al. Recommendations of the Thoracic Imaging Section of the German Radiological Society for clinical application of chest imaging and structured CT reporting in the COVID-19 pandemic. Rofo. 2020;192(7):633-40.
  • 15. Rodrigues JCL, Hare SS, Edey A, et al. An update on COVID-19 for the radiologist - A British society of Thoracic Imaging statement. Clin Radiol. 2020;75(5):323-5.
  • 16. Zimmermann IR, Sanchez MN, Frio GS, et al. Trends in COVID-19 case-fatality rates in Brazilian public hospitals: A longitudinal cohort of 398,063 hospital admissions from 1st March to 3rd October 2020. PLoS One. 2021;16(7):e0254633.
  • 17. Maximiano Sousa F, Roelens M, Fricker B, et al. Risk factors for severe outcomes for COVID-19 patients hospitalised in Switzerland during the first pandemic wave, February to August 2020: prospective observational cohort study. Swiss Med Wkly. 2021;151:w20547.
  • 18. Farshbafnadi M, Kamali Zonouzi S, Sabahi M, Dolatshahi M, Aarabi MH. Aging & COVID-19 susceptibility, disease severity, and clinical outcomes: The role of entangled risk factors. Exp Gerontol. 2021;154:111507.
  • 19. Kocayigit H, Ozmen Suner K, Tomak Y, et al. Characteristics and outcomes of critically ill patients with covid-19 in Sakarya, Turkey: a single centre cohort study. Turk J Med Sci. 2021;51(2):440-7.
  • 20. Özger HS, Aysert Yildiz P, Gaygisiz Ü, et al. The factors predicting pneumonia in COVID-19 patients: preliminary results from a university hospital in Turkey. Turkish Journal of Medical Sciences. 2020;50(8):1810-6.
  • 21. Jiang F, Deng L, Zhang L, Cai Y, Cheung CW, Xia Z. Review of the Clinical Characteristics of Coronavirus Disease 2019 (COVID-19). J Gen Intern Med. 2020;35(5):1545-9.
  • 22. Wang Y, Liao B, Guo Y, et al. Clinical Characteristics of Patients Infected With the Novel 2019 Coronavirus (SARS-Cov-2) in Guangzhou, China. Open Forum Infect Dis. 2020;7(6):ofaa187.
  • 23. Li LQ, Huang T, Wang YQ, et al. COVID-19 patients' clinical characteristics, discharge rate, and fatality rate of meta-analysis. J Med Virol. 2020;92(6):577-83.
  • 24. Cui X, Zhao Z, Zhang T, et al. A systematic review and meta-analysis of children with coronavirus disease 2019 (COVID-19). J Med Virol. 2021;93(2):1057-69.
  • 25. de Souza TH, Nadal JA, Nogueira RJN, Pereira RM, Brandao MB. Clinical manifestations of children with COVID-19: A systematic review. Pediatr Pulmonol. 2020;55(8):1892-9.
  • 26. Feng Y, Ling Y, Bai T, et al. COVID-19 with Different Severities: A Multicenter Study of Clinical Features. Am J Respir Crit Care Med. 2020;201(11):1380-8.
  • 27. Meena J, Yadav J, Saini L, Yadav A, Kumar J. Clinical Features and Outcome of SARS-CoV-2 Infection in Children: A Systematic Review and Meta-analysis. Indian Pediatr. 2020;57(9):820-6.
  • 28. Korkmaz MF, Ture E, Dorum BA, Kilic ZB. The Epidemiological and Clinical Characteristics of 81 Children with COVID-19 in a Pandemic Hospital in Turkey: an Observational Cohort Study. J Korean Med Sci. 2020;35(25):e236.
  • 29. Ygberg S, Nilsson A. The developing immune system - from foetus to toddler. Acta Paediatr. 2012;101(2):120-7.
  • 30. Carsetti R, Quintarelli C, Quinti I, et al. The immune system of children: the key to understanding SARS-CoV-2 susceptibility? Lancet Child Adolesc Health. 2020;4(6):414-6.
  • 31. Muller L, Di Benedetto S, Pawelec G. The Immune System and Its Dysregulation with Aging. Subcell Biochem. 2019;91:21-43.
  • 32. Sadighi Akha AA. Aging and the immune system: An overview. J Immunol Methods. 2018;463:21-6.
  • 33. Medetalibeyoglu A, Senkal N, Kose M, et al. Older Adults Hospitalized with Covid-19: Clinical Characteristics and Early Outcomes from a Single Center in Istanbul, Turkey. J Nutr Health Aging. 2020;24(9):928-37.
  • 34. Wang L, He W, Yu X, et al. Coronavirus disease 2019 in elderly patients: Characteristics and prognostic factors based on 4-week follow-up. J Infect. 2020;80(6):639-45.
  • 35. Vrillon A, Hourregue C, Azuar J, et al. COVID-19 in Older Adults: A Series of 76 Patients Aged 85 Years and Older with COVID-19. J Am Geriatr Soc. 2020;68(12):2735-43.
  • 36. Frater JL, Zini G, d'Onofrio G, Rogers HJ. COVID-19 and the clinical hematology laboratory. Int J Lab Hematol. 2020;42 Suppl 1:11-8.
  • 37. Henry BM, Aggarwal G, Wong J, et al. Lactate dehydrogenase levels predict coronavirus disease 2019 (COVID-19) severity and mortality: A pooled analysis. Am J Emerg Med. 2020;38(9):1722-6.
  • 38. Rostami M, Mansouritorghabeh H. D-dimer level in COVID-19 infection: a systematic review. Expert Rev Hematol. 2020;13(11):1265-75.
  • 39. Chen G, Wu D, Guo W, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020;130(5):2620-9.
  • 40. Zhang G, Hu C, Luo L, et al. Clinical features and short-term outcomes of 221 patients with COVID-19 in Wuhan, China. J Clin Virol. 2020;127:104364.
  • 41. Sumer S, Ural O, Aktug-Demir N, et al. Clinical and Laboratory Characteristics of COVID-19 Cases Followed in Selçuk University Faculty of Medicine. Klimik Dergisi/Klimik Journal. 2020;33(2):122-7.
  • 42. Soraya GV, Ulhaq ZS. Crucial laboratory parameters in COVID-19 diagnosis and prognosis: An updated meta-analysis. Med Clin (Engl Ed). 2020;155(4):143-51.
  • 43. Altunok ES, Alkan M, Kamat S, et al. Clinical characteristics of adult patients hospitalized with laboratory-confirmed COVID-19 pneumonia. J Infect Chemother. 2021;27(2):306-11.
  • 44. Wan S, Xiang Y, Fang W, et al. Clinical features and treatment of COVID-19 patients in northeast Chongqing. J Med Virol. 2020;92(7):797-806.
  • 45. Rodriguez-Morales AJ, Cardona-Ospina JA, Gutierrez-Ocampo E, Villamizar-Pena R, et al. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis. 2020;34:101623.
  • 46. Malas MB, Naazie IN, Elsayed N, Mathlouthi A, Marmor R, Clary B. Thromboembolism risk of COVID-19 is high and associated with a higher risk of mortality: A systematic review and meta-analysis. EClinicalMedicine. 2020;29:100639.
  • 47. Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients. AJR Am J Roentgenol. 2020;215(1):87-93.
  • 48. Tiryaki S, Dabeslim H, Aksu Y. Chest computed tomographic findings of patients with COVID-19-related pneumonia. Acta Radiol Open. 2021;10(2):2058460121989309.
  • 49. Soriano Aguadero I, Ezponda Casajus A, Mendoza Ferradas F, et al. Chest computed tomography findings in different phases of SARS-CoV-2 infection. Radiologia (Engl Ed). 2021;63(3):218-27.
  • 50. Zheng Y, Wang L, Ben S. Meta-analysis of chest CT features of patients with COVID-19 pneumonia. J Med Virol. 2021;93(1):241-9.
  • 51. Zhao W, Zhong Z, Xie X, Yu Q, Liu J. Relation Between Chest CT Findings and Clinical Conditions of Coronavirus Disease (COVID-19) Pneumonia: A Multicenter Study. AJR Am J Roentgenol. 2020;214(5):1072-7.
  • 52. Atalar M, Çaylak H, Atasoy D, Cetinkaya N, Dogan OT, Gul E. Thorax CT findings in novel coronavirus disease 2019 (COVID-19). Erciyes Medical Journal. 2021;43(2):110-6.
  • 53. Çinkooğlu A, Hepdurgun C, Bayraktaroğlu S, Ceylan N, Savaş R. CT imaging features of COVID-19 pneumonia: initial experience from Turkey. Diagn Interv Radiol. 2020;26(4):308-14.
  • 54. Yang H, Lan Y, Yao X, Lin S, Xie B. The chest CT features of coronavirus disease 2019 (COVID-19) in China: a meta-analysis of 19 retrospective studies. Virol J. 2020;17(1):159.
  • 55. Hashemi-Madani N, Emami Z, Janani L, Khamseh ME. Typical chest CT features can determine the severity of COVID-19: A systematic review and meta-analysis of the observational studies. Clin Imaging. 2021;74:67-75.
  • 56. Karacan A, Aksoy YE, Öztürk MH. The radiological findings of COVID-19. Turk J Med Sci. 2021 Aug 9. doi: 10.3906/sag-2106-203. Epub ahead of print. PMID: 34365783.
  • 57. Ozel M, Aslan A, Arac S. Use of the COVID-19 Reporting and Data System (CO-RADS) classification and chest computed tomography involvement score (CT-IS) in COVID-19 pneumonia. Radiol Med. 2021;126(5):679-87.
  • 58. Sanli DET, Yildirim D, Sanli AN, et al. A practical approach to imaging characteristics and standardized reporting of COVID-19: a radiologic review. Mil Med Res. 2021;8(1):7.
  • 59. Esme M, Koca M, Dikmeer A, et al. Older Adults With Coronavirus Disease 2019: A Nationwide Study in Turkey. J Gerontol A Biol Sci Med Sci. 2021;76(3):e68-e75.
  • 60. Sonmez A, Demirci I, Haymana C, et al. Clinical characteristics and outcomes of COVID-19 in patients with type 2 diabetes in Turkey: A nationwide study (TurCoviDia). J Diabetes. 2021;13(7):585-95.
Eskisehir Medical Journal-Cover
  • ISSN: 2718-0948
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 2020
  • Yayıncı: Eskişehir Şehir Hastanesi
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