Hilal AKAY ÇİZMECİOGLU, Aysel OGUZ, Mevlüt Hakan GÖKTEPE, Pınar Diydem YILMAZ, Ahmet Emre HATIR, Ahmet CİZMECİOGLU

Lenfopenik Olan Hafif COVID-19 Vakalarında İmmun Plazma Tedavisi Ne Kadar Güvenliydi?

Amaç: 2019 Koronavirüs Hastalığı (COVID-19) pandemisi sırasında birçok tedavi yöntemi denenmiştir. Tıp dünyası, hastalık önleyici tedavilerin (özellikle aşıların) kullanıma girmesinden sonra göz ardı edilen immun plazma (İP) uygulamasında yeterli deneyime sahip olmuştur. Bu çalışmada, iyileşme sonrası pulmoner fibrozis ile enfeksiyon sırasındaki klinik süreçleri ve tedavileri karşılaştırdık. Gereç ve Yöntem: Bu prospektif, kesitsel çalışma COVID-19 hastaları ile yapılmıştır. Hastalar hastalık şiddetine göre iki gruba ayrıldı. Bunlardan altmış tanesi, iyileşme sonrası 6. ayda çekilen yüksek çözünürlüklü bilgisayarlı tomografi ile pulmoner fibrozis açısından yeniden değerlendirildi. Bulgular: Bu çalışmaya toplam 60 hasta (ortalama yaş=54.05±9.16) katıldı. Hem şiddetli hem de olmayan gruplarda hasta sayısı eşitti. Fibrozis skorlarının değerlendirilmesinde gruplar arasında fark yoktu. Ancak pulmoner fibrozisi olanlarda yaş, CURB-65 skorları ve D-dimer seviyeleri daha yüksek, hematokrit seviyeleri daha düşük bulundu. Lenfopenik hastalarda, İP tedavisi görenlerin yaklaşık %95'inde fibrozis vardı (p=0.013). Bu fibrozis oluşumu, şiddetli olmayan grupta daha belirgindi (p=0.028). Benzer fibrozis artışı diyabetiklerde sebat etti. Sonuç: Sonuçlara göre, COVID-19'un pulmoner tutulumu iyileşme sonrası kalıcı fibrozis oluşturabilir. Pulmoner fibrozisi artırabileceğinden, lenfopenisi olan hafif vakalarda İP uygulanmasının doğruluğu gözden geçirilmelidir.

Anahtar Kelimeler:

COVID-19, Konvalesan Plazma, Lenfopeni, Post-COVID sendrom, Pulmoner fibroz

How Secure was Convalescent Plasma Administration to Non-severe COVID-19 Cases with Lymphopenia?

Aim: Many treatment methods have endeavored during the Coronavirus Disease of 2019 (COVID-19) pandemic. Particularly before the vaccines came into use, the medical world gained adequate experience with convalescent plasma (CP) administration, which was ignored after preventive remedies. In this study, we compared the clinical conditions and treatments during the infection with pulmonary fibrosis after recovery. Material and Method: This prospective, cross-sectional study was conducted with COVID-19 patients. The patients were divided into two groups according to the severity of the disease. Sixty of them were reevaluated regarding pulmonary fibrosis via high-resolution computed tomography performed in the 6th month after recovery. Results: A total of 60 patients (mean age=54.05±9.16) participated in this study. Both severe and non-severe groups were equal in the number of patients. There was no difference between the groups in the evaluation of fibrosis scores. However, in those with pulmonary fibrosis, age, CURB-65 scores, and D-dimer levels were found to be higher, whereas hematocrit levels were lower. In lymphopenic patients, almost 95% of those who underwent CP treatment had fibrosis (p=0.013). This fibrosis formation was more prominent in the non-severe group (p=0.028). Comparable fibrosis increation persisted in diabetics. Conclusion: Based on the results, the pulmonary involvement of COVID-19 may form persistent fibrosis after recovery. The accuracy of administering CP treatment in non-severe patients with lymphopenia should be reviewed, as it might increase pulmonary fibrosis.

Keywords:

COVID-19, Convalescent Plasma, Lymphopenia, Post-COVID syndrome, Pulmonary fibrosis,

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