Adnan YAMANOĞLU, Saylav BORA, Nalan Gökçe ÇELEBİ YAMANOĞLU, Cüneyt ARIKAN, Hüseyin ACAR

Covid-19 pnömonisinde ARDS ve mortaliteyi belirleyen faktörler

Giriş COVID-19, şiddetli akut solunum sendromu koronavirüs 2 (SARS-CoV-2) adı verilen yeni keşfedilen bir korona virüsten kaynaklanır. COVID-19 hastaları genellikle ateş, miyalji veya yorgunluk ve kuru öksürük ile başvurur. Çoğu hastanın prognoz’ unun selim seyirli olacağı düşünülse de yaşlı hastalar ve kronik altta yatan rahatsızlıkları olanlar da kötü sonuçların gözlenebildiği bilinmektedir Bu çalışmada amacımız COVID-19 pnömonisi olan hastalarda ARDS’ ye ilerleyen ve mortaliteye sebep olan faktörleri semptomlar, laboratuvar bulguları, Bilgisayarlı Tomografi (BT) bulguları, kronik hastalıklar ve kullandıkları devamlı ilaçlardan yola çıkarak araştırmaktır. Materyal Metod Covid-19 pnomonisi olan hastaların yaş, cinsiyet gibi demografik özellikleri, şikayetleri, vital bulguları, fizik muayene bulguları, sigara kullanımı ve diğer alışkanlıkları, kronik hastalık öyküleri kullandığı ilaçlar, laboratuvar ve görüntüleme tetkik sonuçları, hastanede uygulanan tedavi rejimi, hastanede ve yoğun bakımda yatış süreleri hastane kayıt sisteminde elde edildi ve kayıt altına alındı. Tüm hastaların klinik sonlanımları; Akut Respiratuvar Disitres (ARDS) gelişip gelişmemesi, taburcuk veya exitus olarak sınıfladırılarak kayıt altına alınmıştır. ARDS tanımı 2012 yılında güncellenen Berlin kriterlerine göre yapılmıştır. Bulgular ve Sonuç Bu çalışmada Covid-19 pnomonisi olan hastalarda başvuru sırasındaki oksijen saturasyonu düşüklüğü, kronik diüretik kullanımı, hipokalsemi, trombositopeni hem ARDS hem de mortalite için riski artıran anlamlı parametyreler olarak bulunmuştur. Ayrıca D-Dimer yüksekliği ARDS gelişimi içinm anlamlı risk faktörü olarak bulunurken, ileri yaş ise mortalite için anlamlı risk faktörü olarak bulunmuştur.

Anahtar Kelimeler:

Covid-19, ARDS, Diuretik kullanımı, Elektrolit bozuklukları

Factors determining ARDS and mortality in Covid-19 pneumonia

Introduction COVID-19 is caused by a newly discovered corona virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 patients often present with fever, myalgia or fatigue and dry cough. Although most patients' prognosis is thought to be benign, it is known that poor results can be observed in elderly patients and those with chronic underlying diseases. Our aim in this study is to investigate the factors that progress to ARDS and cause mortality in patients with COVID-19 pneumonia, based on symptoms, laboratory findings, Computed Tomography (CT) findings, chronic diseases and continuous medications they use. Material Method Demographic characteristics of patients with Covid-19 pneumonia such as age, gender, complaints, vital signs, physical examination findings, smoking and other habits, chronic disease histories, laboratory and imaging examination results, treatment regimen applied in the hospital, hospitalization and intensive care durations were obtained and recorded in the hospital registration system. Clinical outcomes of all patients; Acute Respiratory Disitress (ARDS) has been recorded by classifying it as discharge or exitus. The definition of ARDS was made according to the Berlin criteria updated in 2012. Result and Conclusion In this study, low oxygen saturation at admission, chronic diuretic use, hypocalcemia, thrombocytopenia were found to be significant parameters that increase the risk for both ARDS and mortality in patients with Covid-19 pneumonia. In addition, high D-Dimer was found to be a significant risk factor for the development of ARDS, while advanced age was found to be a significant risk factor for mortality.

Keywords:

Covid-19, ARDS, Diuretic use, Electrolyte disturbances,

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