.: ORİJİNAL ARAŞTIRMA
Yoğun Bakım Gerektirmeyen Hipoksemik Multilober COVID-19 Pnömoni Risk Faktörlerinin Kesitsel Bir Çalışma ile Değerlendirilmesi
Evaluation of Risk Factors for Non-ICU Hypoxemic Multilobar COVID-19 Pneumonia: A Cross-Sectional Study
Turkiye Klinikleri Arch Lung. 2024;23(1):1-8
doi: 10.5336/archlung.2024-103801
Makale Dili: TR
Tam Metin
ÖZET
Amaç: Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] enfeksiyonu Çin'de nedeni bilinmeyen pnömoni vakaları olarak bildirildi. Hastalık asemptomatik bir süreçten, pnömoni, akut solunum sıkıntısı sendromu ve ölüme kadar geniş bir yelpaze gösteriyordu. Birçok çalışma COVID-19'un prognozu ve mortalitesini etkileyen faktörleri araştırmıştır. Çalışmamızda yoğun bakım gerekliliği olmayan, hipoksemik, toraks bilgisayarlı tomografisinde multilober tutulum izlenen COVID-19 olguları için risk faktörlerini belirlemek istedik. Gereç ve Yöntemler: Olgular Dünya Sağlık Örgütü ve Sağlık Bakanlığımız sınıflamasıyla uyumlu olarak toraks bilgisayarlı tomografisinde (BT) lokal buzlucam tutulumu olup hipoksemisi olmayan hafif pnömonililer (lokal grup) ve multilober tutulumlu hipoksemik ağır pnömonililer (multilober grup) olarak iki gruba ayrıldı. Hastaların demografik özellikleri, eşlik eden hastalıkları, laboratuvar sonuçları, nötrofil lenfosit oranı (NLO), C-reaktif protein (CRP), prokalsitonin, D-dimer, fibrinojen, laktat dehidrogenaz (LDH), ferritin ve troponin sonuçları retrospektif olarak incelendi. Bulgular: Gruplar arasında yaş ortalaması 57±17, 65±12 (p=0,005), diabetes mellitus (DM) sıklığı %33,3, %66,7 (p=0,032), komorbidite sayısı 0,5, 1 (p=0,001), LogWBC 3,7607±0,15054, 3,8423±0,19578 (p=0,013), NLO 2,24, 5,30 (p=0,000), LogCRP 1,04, 1,92 (p=0,000)), prokalsitonin 0,04 µ/L, 0,11µ/L (p=0,000), LogFerritin 2,0137±0,46330, 2,5747±0,39441 (p=0,000), LDH 188 U/L, 309 U/L (p=0,000), LogD-dimer 2,3511±0,41071, 2,5828±0,34924 (p=0,001), fibrinojen 435 mg/dL, 568 mg/dL (p=0,000), troponin 0,003 ng/L, 0,009 ng/L (p=0,000) anlamlı farklılık gösterdiği saptandı. Sonuç: Yaşlı, DM ve koroner arter hastalığı eşlik eden, birden çok hastalığı olan, artmış inflamatuar ve koagülatif faktörlere sahip COVID-19 hastaları multilober hipoksemik pnömoni için artmış riske sahiptir.
Anahtar Kelimeler: COVID-19; pnömoni; hipoksemi; risk faktörleri
Amaç: Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] enfeksiyonu Çin'de nedeni bilinmeyen pnömoni vakaları olarak bildirildi. Hastalık asemptomatik bir süreçten, pnömoni, akut solunum sıkıntısı sendromu ve ölüme kadar geniş bir yelpaze gösteriyordu. Birçok çalışma COVID-19'un prognozu ve mortalitesini etkileyen faktörleri araştırmıştır. Çalışmamızda yoğun bakım gerekliliği olmayan, hipoksemik, toraks bilgisayarlı tomografisinde multilober tutulum izlenen COVID-19 olguları için risk faktörlerini belirlemek istedik. Gereç ve Yöntemler: Olgular Dünya Sağlık Örgütü ve Sağlık Bakanlığımız sınıflamasıyla uyumlu olarak toraks bilgisayarlı tomografisinde (BT) lokal buzlucam tutulumu olup hipoksemisi olmayan hafif pnömonililer (lokal grup) ve multilober tutulumlu hipoksemik ağır pnömonililer (multilober grup) olarak iki gruba ayrıldı. Hastaların demografik özellikleri, eşlik eden hastalıkları, laboratuvar sonuçları, nötrofil lenfosit oranı (NLO), C-reaktif protein (CRP), prokalsitonin, D-dimer, fibrinojen, laktat dehidrogenaz (LDH), ferritin ve troponin sonuçları retrospektif olarak incelendi. Bulgular: Gruplar arasında yaş ortalaması 57±17, 65±12 (p=0,005), diabetes mellitus (DM) sıklığı %33,3, %66,7 (p=0,032), komorbidite sayısı 0,5, 1 (p=0,001), LogWBC 3,7607±0,15054, 3,8423±0,19578 (p=0,013), NLO 2,24, 5,30 (p=0,000), LogCRP 1,04, 1,92 (p=0,000)), prokalsitonin 0,04 µ/L, 0,11µ/L (p=0,000), LogFerritin 2,0137±0,46330, 2,5747±0,39441 (p=0,000), LDH 188 U/L, 309 U/L (p=0,000), LogD-dimer 2,3511±0,41071, 2,5828±0,34924 (p=0,001), fibrinojen 435 mg/dL, 568 mg/dL (p=0,000), troponin 0,003 ng/L, 0,009 ng/L (p=0,000) anlamlı farklılık gösterdiği saptandı. Sonuç: Yaşlı, DM ve koroner arter hastalığı eşlik eden, birden çok hastalığı olan, artmış inflamatuar ve koagülatif faktörlere sahip COVID-19 hastaları multilober hipoksemik pnömoni için artmış riske sahiptir.
Anahtar Kelimeler: COVID-19; pnömoni; hipoksemi; risk faktörleri
ABSTRACT
Objective: The coronavirus disease-2019 (COVID-19) infection, was reported as pneumonia cases without a known causes. It has been reported that the disease can present a wide range of clinical manifestations from asymptomatic form to pneumonia, acute respiratory distress syndrome and death. Many studies have investigated the factors affecting the prognosis and mortality of COVID-19. In our study we want to describe risk factors for multober hypoxemic pneumonia cases without intensive care unit requirement. Material and Methods: The cases were divided into two groups as with local groundglass involvement without hypoxemia (local group) and with multilober and hypoxemia (multilobar group) according to World Health Organization and Turkish Health ministery suggestions. Demografics, comorbidities and laboratory results neutrophil lymphocyte ratio (NLR), C-reactive protein (CRP), procalcitonin, D-dimer, fibrinogen, lactate dehydrogenase (LDH), ferritin and troponin were analyzed retrospectively. Results: Between local and multilober groups age 57±17, 65±12 (p=0.005), diabetes mellitus (DM) frequency 33.3%, 66.7% (p=0.032), Comorbidity number 0.5, 1 (p=0.001), LogWBC 3.7607±0.15054, 3.8423±0.19578 (p=0.013), NLR 2.24, 5.30 (p=0.000), LogCRP 1.04, 1.92 (p=0.000), procalcitonin 0.04 µ/L, 0.11µ/L (p=0.000), LogFerritin 2.0137±0.46330, 2.5747±0.39441 (p=0.000), LDH 188 U/L, 309 U/L (p=0.000), LogDdimer 2.3511±0.41071, 2.5828±0.34924 (p=0.001), fibrinogen 435 mg/dL, 568 mg/dL (p=0.000), troponin 0.003 ng/L, 0.009 ng/L (p=0.000) were found signicantly different. Conclusion: Patients with advanced age, DM, coronary artery disease, concomitant multiple diseases, increased inflammatory and coagulative factors have increased risk for multilober hypoxemic pneumonia.
Keywords: COVID-19; pneumonia; hypoxemia; risk factors
Objective: The coronavirus disease-2019 (COVID-19) infection, was reported as pneumonia cases without a known causes. It has been reported that the disease can present a wide range of clinical manifestations from asymptomatic form to pneumonia, acute respiratory distress syndrome and death. Many studies have investigated the factors affecting the prognosis and mortality of COVID-19. In our study we want to describe risk factors for multober hypoxemic pneumonia cases without intensive care unit requirement. Material and Methods: The cases were divided into two groups as with local groundglass involvement without hypoxemia (local group) and with multilober and hypoxemia (multilobar group) according to World Health Organization and Turkish Health ministery suggestions. Demografics, comorbidities and laboratory results neutrophil lymphocyte ratio (NLR), C-reactive protein (CRP), procalcitonin, D-dimer, fibrinogen, lactate dehydrogenase (LDH), ferritin and troponin were analyzed retrospectively. Results: Between local and multilober groups age 57±17, 65±12 (p=0.005), diabetes mellitus (DM) frequency 33.3%, 66.7% (p=0.032), Comorbidity number 0.5, 1 (p=0.001), LogWBC 3.7607±0.15054, 3.8423±0.19578 (p=0.013), NLR 2.24, 5.30 (p=0.000), LogCRP 1.04, 1.92 (p=0.000), procalcitonin 0.04 µ/L, 0.11µ/L (p=0.000), LogFerritin 2.0137±0.46330, 2.5747±0.39441 (p=0.000), LDH 188 U/L, 309 U/L (p=0.000), LogDdimer 2.3511±0.41071, 2.5828±0.34924 (p=0.001), fibrinogen 435 mg/dL, 568 mg/dL (p=0.000), troponin 0.003 ng/L, 0.009 ng/L (p=0.000) were found signicantly different. Conclusion: Patients with advanced age, DM, coronary artery disease, concomitant multiple diseases, increased inflammatory and coagulative factors have increased risk for multilober hypoxemic pneumonia.
Keywords: COVID-19; pneumonia; hypoxemia; risk factors
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