Hematoloji ve COVID-19

.: PREFACE
Ön Söz
Preface
Prof. Dr. Osman İLHANa, Doç. Dr. Selami Koçak TOPRAKa
aAnkara Üniversitesi Tıp Fakültesi, Hematoloji BD, Ankara
Article Language: TR
Aralık 2019'da Çin'in Wuhan eyaletinde tespit edilmesinin üzerinden daha 6 ay bile geçmeden, dünya çapında 9 milyonu aşkın vakaya ve neredeyse 500 binden fazla ölüme yol açan yeni tip koronavirüs ya da 'severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)'nin meydana getirdiği hastalık COVID-19, ülkemizle birlikte tüm dünyayı başa çıkılması oldukça zor bir halk sağlığı endişesiyle karşı karşıya bıraktı. Başlangıçta Dünya Sağlık Örgütü (DSÖ) ve gelişmiş pek çok ülkenin hastalığa karşı acil eylem planı oluşturmakta gecikmesi de bulaşıcılığı oldukça yüksek olan bu virüsün dünya çapında kıtalar arası hızla yayılmasında önemli bir rol oynadı. Nihayetinde DSÖ'nün 11 mart 2020'de bu hastalığı bir pandemi olarak ilan etmesi neticesinde; gerek Avrupa ve gerekse Amerika Birleşik Devletleri (ABD) hastalığa karşı daha radikal kararları hayata geçirmeye başladılar.

Ülkemizde ise sağlık otoritesinin hızlı ve planlı çalışması sonucunda; gerek bilim kurulu oluşturulup bu kurulun önerilerine göre hareket edilmesi ve gerekse hemen tüm basamaktaki sağlık kuruluşlarının gecikilmeden pandemi hastanesi statüsüne geçirilmesi ile kuşkulu ve kesin tanılı hastalara belirlenmiş ortak bir tedavi protokolü başlanması neticesinde dünya ölçeğine göre çok daha başarılı sonuçlar elde edildiği aşikardır.

Bu yeni virüs ve yaptığı hastalık COVID-19, solunum sistemi haricinde hematolojik sistem üzerine de doğrudan etki göstermekte, zeminde herhangi bir hematolojik hastalığı olan kişilerde ise bu hastalık belirgin olarak daha kötü seyretmektedir.

COVID-19 salgının daha ilk zamanlarında kamuoyunda oluşan bilgi kirliliği gerek hastaların ve gerekse hekimlerin kafasını karıştırmış ve hastalıkların nasıl yönetileceği hususunda görüş birliği oluşturulamamıştır. 'Evde kal' çağrıları ile tedavileri devam eden ya da şikâyeti olup normal koşullarda hastaneye başvurması gereken pek çok hasta sağlık kuruluşlarına gitmediği için tedavileri aksamış, tanıları koyulmakta gecikilmiş ve belki de hayatlarını kaybetmişlerdir. Uluslar arası hematoloji dernekleri de bu süreçte kılavuz bilgisi değil ama 'merkez görüşleri' açıklamışlar ve hematologları hasta bazında bireyselleştirilmiş tedavi kararına sevk etmişlerdir. Ancak hâlihazırda dünya çapında birbirinden farklı hasta takip ve tedavi yönetim önerilerine rastlanmaktadır.

Biz de bu noktadan hareketle, olağanüstü günlerden geçtiğimiz bu zamanda, hastalarımızın tedavilerinin aksamadan sürebilmesi, tanı ve tedavi süreçlerinin bilimsel kalitesinin standardizasyonu amacıyla ülkemizin önde gelen bilim insanlarının, konusunda fikir lideri öğretim üyelerinin, uluslararası derneklerin görüşlerini kendi deneyimleri ile harmanlayarak, COVID- 19 pandemisinde hematolojik hastalıklara yaklaşım ve tedavi önerilerini bizlerle paylaşmalarını istedik. Çok kısa bir sürede, konu güncelliğini yitirmeden, yoğun bir çalışma temposuyla 23 konu başlığında hematolojinin hemen tüm hastalıklarını kapsamaya çalıştık.

Daha uzunca bir süre aşısı ya da spesifik etkili bir tedavisi bulununcaya kadar birlikte yaşayacağımızı öngördüğümüz bu hastalık varlığında hematolojik hastalıkları nasıl yöneteceğimizi derlediğimiz bu kapsamlı ve yüksek bilimsel kalitedeki yayınımızın belki de ilk versiyonunu sizlerle paylaşmaktan büyük bir onur ve mutluluk duymaktayız. Emeği geçen tüm yazarlara ve Türkiye Klinikleri'ne teşekkürü bir borç biliriz.

Prof. Dr. Osman İLHAN
Editör

Doç. Dr. Selami Koçak TOPRAK
Editör
In the first 6 months after the detection in Wuhan, China on December 2019, the new type of coronavirus (SARS-CoV-2), which has led to more than 9 million cases and almost 500 thousand deaths worldwide, made the world and our country face with a very difficult public health concern. Initially, the World Health Organization (WHO) and many developed countries were late in developing an emergency action plan against the disease. So, this approach played a significant role in the rapid spread of this virus across the world. Finally, as a result of WHO declaring this disease as a pandemic on March 11, 2020, both Europe and the United States of America (USA) started to implement more radical decisions against the disease.

In our country; as a result of the rapid and planned work of the health authority, much more successful results were obtained compared to the world scale. These interventions were, initiating a common treatment protocol for suspicious and definite diagnosed patients, both by forming a scientific board and acting according to the recommendations of this board, and by putting health institutions at almost all levels, into a pandemic hospital status without delay. This new virus and its disease, COVID-19, also has a direct effect on the hematological system, such as the respiratory system, and it is significantly worse in people with any accompanying hematological disease.

The information pollution that occurred in the public in the early days of the COVID-19 pandemic affected the decisions of both the patients' and the physicians' and no consensus could be reached on how to manage the hematological diseases in this outbreak era. Because of "stay home" calls; many patients who continue their treatment or have complaints and who need to apply to the hospital under normal conditions, did not go to health institutions, so their treatments were disrupted, their diagnosis was delayed and perhaps they died.

International hematology associations also expressed 'center views' in this process and referred hematologists to individualized treatment decisions on a patient basis. However, different patient follow-up and treatment management recommendations are currently available worldwide.

In order to ensure that our patients' treatments continue without interruption and to standardize the scientific quality of diagnosis and treatment processes, we wanted the leading scientists of our country to share their ideas and approaches to hematological diseases in COVID-19 pandemic by collating the opinions of international associations with their own experiences. Therefore, we tried to cover almost all diseases of hematology in 23 subtopics.

We are honored to present this comprehensive and highly scientific publication in which we discuss how to manage hematological diseases during the COVID-19 pandemic. We would like to express our gratitude to all our contributors and to the Türkiye Klinikleri.

Prof. Dr. Osman İLHAN
Editör

Assoc. Prof. Selami Koçak TOPRAK
Editör

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