Armağan KAYA, Ahmet Oğuzhan KÜÇÜK, Ömer TOPALOĞLU, Yılmaz BÜLBÜL, Tevfik ÖZLÜ, Ayşegül PEHLİVANLAR, Funda ÖZTUNA, Sevil AYAYDIN MÜRTEZAOĞLU, Kadir Çoban, Olcay AYÇİÇEK, Taha SEMERCİ, Semanur BALÇIK SAVAŞER, Büşra ÖZHAN ALDEMİR, Özlem GÜLER, Mehtap PEHLİVANLAR KÜÇÜK

Kritik 2019 SARS-CoV-2 hastalarında hastalık başlangıç anından itibaren zaman akış çizelgesi

Giriş: Çalışmada, Türkiye›de üçüncü derece yoğun bakım ünitesinden alınan ağır COVID-19 vakalarının epidemiyolojik, klinik, laboratuvar özellikleri ile tedavi ve klinik sonuçlarının değerlendirilmesi amaçlandı. Materyal ve Metod: Çalışma üçüncü seviye, 16 yataklı COVID yoğun bakım ünitesinde gerçekleştirildi. Araştırma geriye dönük ve gözlemsel bir çalışmaydı. Mart 2020-Mart 2021 tarihleri arasında yoğun bakım ünitesinde COVID-19 pnömonisi ve solunum yetmezliği ile yatırılan ve kritik hastalık nedeniyle takip edilen hastalar değerlendirildi. Bulgular: Çalışmaya COVID-19 pnömonisi tanısı ile yoğun bakım ünitesine yatırılan toplam 213 hasta dâhil edildi. Hastaların ortanca yaşı 66 (IQR 56.5-74) yıl ve 134'ü (%62.9) erkekti. Hastaların 166'sında (%77.9) en az bir komorbidite mevcuttu. Hastalar ağırlıklı olarak invaziv mekanik ventilasyon [104 (%48.8)] ve yüksek akımlı nazal kanül [%67 (%31.5)] ile takip edildi. İlk semptomdan yoğun bakıma yatışa kadar geçen süre ortanca gün sayısı 7 (IQR 4-10) idi. Entübasyon süresi 9 (IQR-15) gün ve yoğun bakım taburculuğuna kadar geçen medyan gün 16 (IQR 11-23) idi. Semptomlar başladıktan sonra ilk tocilizumab 9 (IQR 5-11) ve pulse steroid tedavisi 8 (IQR 3-11) birbirine yakın bulundu. Toplamda 213 hastanın 95'i (%44.6) kaybedildi. Sonuç: SARS-CoV2 ile ilişkili viral hastalık, basit semptomlardan sonra ortanca dördüncü günde hastaneye kabule ve ortanca dokuz günde entübasyon gerektiren yoğun bakıma yatışa kadar ilerleyebilir. COVID-19’un klinik seyrinin ve merkezler arasındaki değişiminin daha iyi anlaşılmasının farklı ülke ve merkezlerden bilgi paylaşımı ile ortaya çıkarılabileceğine inanıyoruz.

Timeline of critically ill 2019 SARS-CoV-2 cases after onset of illness: Intensive care data from Turkey

Introduction: This study aimed to evaluate the epidemiological, clinical, laboratory characteristics and treatment and clinical outcomes of severe COVID- 19 cases from a 3rd degree intensive care unit in Turkey. Materials and Methods: The study was conducted in a level three, 16-bed COVID intensive care unit. The investigation was planned as a retrospective and observational study. Patients who were admitted with COVID-19 pneumonia and respiratory failure in the intensive care unit between March 2020 and March 2021 and followed up due to critical illness were evaluated. Results: A total of 213 patients that were admitted to the intensive care unit with the diagnosis of COVID-19 pneumonia were included in the study. Median age of the patients was 66 (IQR 56.5-74) years, and 134 (62.9%) were males. One hundred and sixty-six (77.9%) of the patients had at least one comorbidity. Patients were followed up mainly with invasive mechanical ventilation [104 (48.8%)] and high flow nasal cannula [67 (31.5%)]. Median number of days was 7 (IQR 4-10) and included the first symptom onset to intensive care admission. The time to intubation was 9 (IQR 4-15) days, and the median day to intensive care discharge was 16 (IQR 11-23). After the symptoms started, first tocilizumab 9 (IQR 5-11) and pulse steroid treatment 8 (IQR 3-11) were found to be close to each other. In total, 95 (44.6%) of the 213 patients died. Conclusion: SARS-CoV-2 associated viral disease can progress after simple symptoms to hospital admission in a median of four days and to intensive care admission requiring intubation in a median of nine days. We believe that a better understanding of the clinical course of COVID-19 and its change between centers can be revealed through sharing information from different countries and centers.

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