Hatice UYGUN, Sibel YAVUZ, Nurettin ERDEM, Saniye Başak OKTAY, Mehmet TURĞUT

ÇOCUKLARDA SARS-COV-2 ENFEKSİYONUNDA İMMÜNOGLOBULİNLER HASTALIK ŞİDDETİ VE HASTANEDE YATIŞ SÜRESİNE ETKİLİ MİYDİ ?

AMAÇ: Hastaneye yatış gerektiren ciddi hastalığı olan çocuklarda başvuru sırasındaki immünoglobulin düzeylerinin hastalık şiddeti, SARS-CoV-2 RT-PCR testinin negatifleşmesine kadar geçen süre ve hastanede kalış süresi ile ilişkili olup olmadığını araştırdık. GEREÇ VE YÖNTEM: Hastaneye yatırılan ve COVID-19 tedavisi gören kırk dört pediatrik hasta dahil edildi. Hastalar değerlendirme kolaylığı açısından hafif-orta (n=35) ve ağır hastalığı olanlar (n=9) olarak iki gruba ayrıldı. İmmünoglobulin düzeylerinin hastalık şiddeti, SARS-CoV-2 RT-PCR testi negatifleşmesine kadar geçen süre ve hastanede kalış süresi ile ilişkisi incelendi. BULGULAR: Çalışma popülasyonunun ortanca (min-maks) yaşı 13 (1-18) olup, 25'i (%56,8) kız ve 19'u (%43,2) erkekten oluşmaktadır. Hafif-orta hastalığı olan çocukların %89.2'sinde (n=33) IgG seviyeleri normaldi ve %5.7'sinde (n=2) yükselmişti. Ağır hastalığı olan hastaların %44.4'ünde (n=4) IgG seviyeleri normaldi ve %55.6'sında (n=5) yükselmişti. IgG düzeyleri açısından gruplar arasında anlamlı fark bulundu (p=0,002). IgG düzeyinin hastanede kalış süresi ve SARS-CoV-2 RT-PCR testi negatifleşmesine kadar geçen süre ile ilişkisi incelendiğinde, SARS-CoV-2 RT-PCR test negatifleşmesine kadar geçen süre ile Ig G düzeyi arasında anlamlı bir ilişki gözlenmedi ( p=0.096, z=1.667). Ancak Ig G düzeyi yüksek olan hastalarda hastanede kalış süresi anlamlı olarak daha uzundu (p=0.096, p=0.002). SONUÇ: Normalden yüksek endojen IgG seviyeleri, COVID-19 nedeniyle hastaneye yatırılan çocuklarda ciddi hastalık gelişimi ve uzun süreli hastanede kalış süresi ile bağımsız olarak ilişkili olabilir.

Anahtar Kelimeler:

COVID-19, Çocuk, İmmünoglobulinler

WAS IMMUNOGLOBULINS EFFECTIVE IN DISEASE SEVERITY AND LENGTH OF HOSPITAL STAY IN CHILDREN WITH THE INFECTION OF SARS-COV-2 ?

OBJECTIVE: We investigated whether immunoglobulin levels on admission are associated with disease severity, time to negativization of SARS-CoV-2 RT-PCR test, and length of hospital stay in children with severe illness requiring hospitalization. MATERIAL AND METHODS: Forty-four pediatric patients hospitalized and treated for COVID-19 were included. The patients were divided into two groups as those with mild-to-moderate (n=35) and those with severe disease (n=9) for ease of evaluation. The relationship of immunoglobulin levels with disease severity, time to SARS-CoV-2 RT-PCR test negativization and length of hospital stay was examined. RESULTS: The study population had a median (min-max) age of 13 (1-18) years and consisted of 25 (56.8%) girls and 19 (43.2%) boys. IgG levels were normal in 89.2% (n=33) and elevated in 5.7% (n=2) of the children with mild-to-moderate disease. Among patients with severe disease, IgG levels were normal in 44.4% (n=4) and elevated in 55.6% (n=5). A significant difference was found between the groups in terms of IgG levels (p=0.002). When the relationship of IgG level with length of hospital stay and time to SARS-CoV-2 RT-PCR test negativization was investigated, no significant correlation was observed between time to SARS-CoV-2 RT-PCR test negativization and Ig G level (p=0.096, z=1.667). However, the length of hospital stay was significantly longer in patients with elevated IgG levels (p=0.096, p=0.002). CONCLUSIONS: Higher-than-normal endogenous IgG levels may be independently associated with the development of severe illness and prolonged hospital stay in children hospitalized for COVID-19.

Keywords:

COVID-19, Children, Immunoglobulins,

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