Oğuz EVLİCE, Damla ÖRS ŞENDOĞAN, Öznur AK

Hemodializ Hastalarında COVID-19'un klinik seyri ve mortalite öngördürücüleri, tek merkez deneyimi

Özet Giriş Altta yatan sağlık sorunları ya da komorbiditesi olan COVİD-19 tanılı hastalar, hızlı ve şiddetli progresyon gösterme eğilimindedir. Hemodializ hastalarında üremi nedeniyle baskılanmış immun sistemleri ve eşlik eden hipertansiyon (HT), diyabetes mellitus (DM) ve koroner arter hastalığı (KAH) gibi komorbiditeleri hastalığın ağır seyretmesi için risk oluşturmaktadır. Bu çalışmada COVİD-19 tanısıyla takip edilen hemodializ hastalarının klinik ve laboratuar bulgularını ve prognozu etkileyen risk faktörlerini irdelemeyi amaçladık. Method 01.08.2020-15.11.2020 tarihleri arasında klinik, laboratuar ve radyolojik bulgularla COVID-19 tanısı konulan 58 erişkin hemodializ hastası retrospektif olarak değerlendirildi. Bulgular Çalışmaya dahil edilen 58 hastanın 37'si (% 63.8) erkekti. 54’ünde (%93.1) SARS-CoV-2 PCR testi pozitifti. 4 hastanın (%6,9) PCR testi negatif saptandı, ancak radyolojik ve klinik bulguları COVID-19 pnömonisiyle uyumluydu. En sık görülen semptomlar halsizlik/vücut ağrısı, nefes darlığı ve öksürük, en sık komorbiditeler sırasıyla HT, DM ve koroner arter hastalığıydı. Hastaların 47’si (%81) hayatta kalırken, 11’i (%19) mortalite ile sonlandı. Mortalite ile sonlanan olgular ile sağ kalan olgular karşılaştırıldığında mortalite olan olgularda başvuru esnasında vücut ısısının daha yüksek, oksijen satürasyonunun (p:0,02) , lenfosit sayısının daha düşük olduğu (p:0,03) ve akciğer tomografisinde daha şiddetli tutulum bulguları saptandı. Hastaların tümünde antiviral , destek tedavi yaklaşımı benzer iken mortalite gelişen grupta daha fazla ampirik olarak geniş spektrumlu antibiyotikle birlikte ve kortikosteorid kullanımı saptandı (p

Anahtar Kelimeler:

COVID-19, SARS-CoV-2, hemodiyaliz, mortalite, prognostik faktör

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