Tüberküloz ve COVID-19 pnömonisi birlikteliği: Türkiye’den 16 hastanın klinik özellikleri ile sunumu

Giriş: Koronavirüs hastalığı 2019 (COVID-19) ve tüberküloz tüm dünyayı etkileyen ciddi ve ölümcül hastalıklardır. Tüberküloz ve COVID-19 pnömonisinin birlikteliği hakkında az sayıda çalışma vardır. Tüberküloz ve COVID-19 koenfeksiyon olgularının literatür eşliğinde sunulması amaçlanmıştır. Materyal ve Metod: Hastanemiz Tüberküloz polikliniğine 1 Eylül 2020-30 Eylül 2020 tarihlerinde başvuran tüberküloz hastaları ile, 1 Haziran 2020-30 Eylül 2020 tarihlerinde COVID-19 servisinde yatan hastalar retrospektif olarak tarandı. Tüberküloz ve COVID-19 koenfeksiyonu olan vakalar kayıt altına alındı. Hastaların klinik, radyolojik, laboratuvar verileri, tedavileri kaydedildi ve analiz edildi. Tüberküloz tanısı için balgam aside dirençli basil (ARB) yayması veya kültür pozitifliği veya patolojik tanı kullanıldı. COVID-19 tanısı için pozitif gerçek zamanlı ters transkripsiyon-polimeraz zincir reaksiyonu ve/veya tipik radyolojik bulgular arandı. Bulgular: Tüberküloz polikliniğindeki 751 hastanın, COVID-19 kliniğindeki 229 hastanın verileri tarandı. On altı hasta kriterleri karşılıyordu. Tüberküloz hastalarında COVID-19 enfeksiyon oranı %2.1 olarak saptandı. Hastaların %69’u COVID-19 tanısını tüberküloz tanısı ile beraber ya da tüberküloz tedavisinin inisiyal faz döneminde aldı. Anti-tüberküloz ilaçlar ile COVID-19 tedavisi arasında ilaçilaç etkileşimi saptanmadı. COVID-19 tedavisi sırasında bir hasta (%6) öldü, 15 (%94) hasta tedaviyi tamamladı. Sonuç: Çalışmamızda, tüberküloz ve COVID-19 birlikteliğinin, morbidite ve mortaliteye etkisi gözlenmedi. Hasta sayısı az olsa da, tüberküloz tedavisinin erken döneminde olmak ve yaygın tutulumun olmasının, COVID-19 enfeksiyonu için risk oluşturabileceği söylenebilir. Tüberküloz hastalarının sık hastane başvurusu da, COVID-19 içi risk oluşturabilir. Hastane başvurusu ve COVID-19 bulaşma riskini azaltmak için, tüberküloz hastalarının tanı ve tedavisinin ülkemizde olduğu gibi Verem Savaş Dispanserleri veya yetkili birimler tarafından yapılması faydalı olabilir.

Coexistence of tuberculosis and COVID-19 pneumonia: A presentation of 16 patients from Turkey with their clinical features

Introduction: Coronavirus disease 2019 (COVID-19) and tuberculosis are serious and mortal diseases worldwide. There are few studies about the association between tuberculosis and COVID-19 pneumonia. We aimed to describe the characteristics of tuberculosis and COVID-19 co-infection cases in light of the literature. Materials and Methods: Tuberculosis patients who applied to the tuberculosis outpatient clinic between September 1-September 30, 2020, and patients hospitalized in the COVID-19 service between June 1- September 30, 2020, were retrospectively screened. Patients with tuberculosis and COVID-19 co-infection were recorded. Clinical, radiological, laboratory data, and treatments were recorded and analyzed. For the diagnosis of tuberculosis, sputum acid-resistant bacillus (ARB) smear or culture positivity or pathological diagnosis were used. For the diagnosis of COVID-19, positive real-time reverse transcription-polymerase chain reaction and/or typical radiological findings were sought. Results: Seven hundred and fifty-one patients’ data at the tuberculosis outpatient clinic, 229 patients’ data at the COVID-19 clinic were screened. Sixteen patients meet the criteria. COVID-19 infection rate in tuberculosis patients was 2.1%. Sixty-nine percent of the patients had received COVID-19 disease during diagnosis or initial tuberculosis treatment phase. There were no drugdrug interactions between anti-tuberculosis drugs and COVID-19 treatment. During the COVID-19 treatment, one patient (6%) died, 15 (94%) patients completed the treatment. Conclusion: In our study, no effect of the coexistence of TB and COVID-19 on morbidity or mortality was observed. Although the number of patients is small, it can be said that patients with early TB disease and with widespread involvement may be riskier for COVID-19 infection. Frequent hospital visits by TB patients may be a risk for COVID-19. It may be beneficial to carry out the diagnosis and treatment of tuberculosis patients by tuberculosis dispensaries as in our country or authorized units to reduce the risk of hospital admissions and COVID-19 transmission.

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Tüberküloz ve Toraks-Cover
  • ISSN: 0494-1373
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1951
  • Yayıncı: Tuba Yıldırım