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COVID-19 hastalığı seyrine yaş ve komorbid durumların etkisi; Antalya’dan pandemi ilk üç ay verileri

Year 2021, Volume: 15 Issue: 2, 366 - 374, 20.06.2021
https://doi.org/10.21763/tjfmpc.808648

Abstract

Amaç: Bu araştırmada; Antalya ilinde laboratuvar testleri ile konfirme edilmiş COVID-19 hastalarının demografik özelliklerinin, klinik seyirlerinin, tedavi ve sonuç verilerinin yaşa ve komorbid hastalıkların varlığına göre değerlendirilmesi amaçlanmıştır. Yöntem: Retrospektif, tanımlayıcı çalışmaya 16.03.2020 tarihi ile 15.06.2020 tarihleri arasında Antalya ilinde revers transkritaz polimeraz zincir reaksiyonu yöntemi ile COVID-19 tanısı konan 438 hasta dahil edildi. On sekiz yaş altında olan, eksik verileri olan ve özel hastanelerden hizmet alan hastalar çalışma dışı bırakıldıktan sonra 311 hasta ile çalışmaya devam edildi. Hastalar 65 yaş altı ve 65 yaş ve üzeri, kronik hastalıkları olan ve olmayan, yoğun bakım ünitesine yatışı olan ve olmayan şeklinde gruplara ayrılarak demografik özellikleri, klinik seyirleri, tedavi ve sonuç çıktıları açısından karşılaştırıldı. Bulgular: Çalışmaya SARS-CoV-2 revers transkritaz polimeraz zincir reaksiyonu yöntemi ile COVID-19 tanısı alan 311 hasta dahil edildi. Yaş ortalaması 47,48±18,08 (min: 18, maks: 94) yıldı ve 252 hasta (%81) 65 yaş altında, 52 hasta (%19) 65 yaş ve üzerindeydi. Hastaların %45’i kadın, %55’i erkekti. Geriatrik hastalarda non-geriatrik hastalara göre komorbid hastalıklar; hipertansiyon (p<0,001), diabetes mellitus (p=0,010), kronik akciğer hastalıkları (p=0,001) ve kardiyovasküler hastalıklar (p<0,001) anlamlı düzeyde daha sık görülmekteydi. Altmış beş ve üzeri yaş hastalar ile komorbiditesi olan hastalarda sırasıyla <65 yaş ve komorbiditesi olmayan hastalara göre dispne, pozitif akciğer bilgisayarlı tomografi bulguları, yoğun bakım ünitesinde yatış, mortalite oranları ve hastanede yatış süreleri anlamlı düzeyde artmıştı. Geriatrik hastalar ile komorbiditesi olan hastaların tedavisinde oseltamivir, favipiravir, levofloksasin anlamlı olarak daha çok kullanılmıştı. Altmış beş ve üzeri yaşta olmak hem yoğun bakım ünitesine yatış hem de mortalite için risk faktörü olarak tespit edildi. Sonuç: Sonuç olarak; 65 ve üzeri yaşta ve/veya komorbiditesi olan COVID-19 hastalarında yoğun bakım ihtiyacı ve mortalite artmaktadır. SARS-CoV-2’nin özellikle bu hasta grubuna yayılmasını önlemeye yönelik tedbirlerin alınması gerektiği açıktır.

Thanks

Bu araştırmanın istatistiksel analizinin hazırlanmasında sağladığı katkılardan dolayı Başak OĞUZ YOCULAR'a teşekkürlerimiz sunarız.

References

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The impact of age and underlying comorbidities on the course of COVID-19 disease; First three months data of pandemic from Antalya, Turkey

Year 2021, Volume: 15 Issue: 2, 366 - 374, 20.06.2021
https://doi.org/10.21763/tjfmpc.808648

Abstract

Aim: This study aimed to evaluate the demographic characteristics, clinical course, treatment, and outcome data of COVID-19 patients confirmed by laboratory tests in Antalya province according to age and the presence of comorbid diseases. Methods: This retrospective, cross-sectional study included 438 patients diagnosed with COVID-19 as confirmed by PCR tests in Antalya between March 16th and June 15th, 2020. The study continued with 311 patients after exclusion of patients under the age of 18 as well as those with incomplete data and those receiving health care at private hospitals. The patients were divided into groups according to being under 65 years of age, with or without underlying comorbidities, with or without intensive care unit (ICU) admission, and were compared in terms of demographic characteristics, clinical course, treatment, and outcomes. Results: The study included 311 patients diagnosed with COVID-19 as confirmed by SARS-CoV-2 RT-PCR tests. The mean age was 47.48 ± 18.08 (min: 18, max: 94) years and 252 patients (81%) were under 65, while 52 patients (19%) were 65 and over years of age. Forty-five percent of the patients were women and 55% were men. Comorbidity, namely, hypertension (p<0.001), diabetes mellitus (p=0.010), chronic pulmonary diseases (p=0.001), and cardiovascular diseases (p<0.001) were significantly more common in geriatric patients compared to non-geriatric patients. Patients aged 65 and over, and patients with underlying comorbidities had significantly increased dyspnea, positive chest CT findings, ICU admission, mortality rates and hospitalization time compared to patients under 65 years of age and without comorbidities, respectively. Oseltamivir, favipiravir and levofloxacin were used significantly more in the treatment of geriatric patients and patients with underlying comorbidities. Being 65 and older was determined as a risk factor in univariate and multivariate models for both ICU admission and mortality. Conclusion: As a result, the need for intensive care and mortality rates have increased in COVID-19 patients who are older and/or have underlying comorbidities, indicating the necessity to take measures for preventing the spread of SARS-CoV-2, especially to patients who are older and/or have underlying comorbidities.

References

  • 1. Wang L, Wang Y, Ye D, Liu Q. Review of the 2019 novel coronavirus (COVID-19) based on current evidence. Int J Antimicrob Agents 2020;55(3):105948.
  • 2. Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents 2020;55(3):105924.
  • 3. Singhal T. A review of coronavirus disease-2019 (COVID-19). Indian J Pediatr 2020;87(4):281-6.
  • 4. WHO. Coronavirus-Overview. Available online: www.who.int/healthtopics/coronavirus#tab=tab_1 (accessed on 07 September 2020).
  • 5. Guo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak – an update on the status. Mil Med Res 2020;7(1):1-10.
  • 6. Gürsoy C, Doğan E, Togan T. Coronaviruses COVID-19 illness from the perspective of infectious disease. Ege Klin Tıp Derg 2020;58(1)Supp:19-23 (Turkish).
  • 7. WHO. Coronavirus - Symptoms. Available online: www.who.int/health-topics/coronavirus#tab=tab_3 (accessed on 07 September 2020).
  • 8. CDC. Diagnostic tests for COVID-19. Available online: https://www.cdc.gov/coronavirus/2019-ncov/lab/testing.html (accessed on 07 September 2020).
  • 9. Long C, Xu H, Shen Q, Zhang X, Fan B, Wang C, et al. Diagnosis of the coronavirus disease (COVID-19) rRT-PCR or CT? Eur J Radiol 2020;126:108961.
  • 10. Mukhtar B, Mukhtar MO, Malik B. Radiological changes observed in Covid-19 pneumonia and utilization of CT scan as a screening tool along with a real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) for effective diagnosis. Med Sci Discov 2020;7(8):578-83.
  • 11. Tahamtan A, Ardebili A. Real-time RT-PCR in COVID-19 detection: issues affecting the results. Expert Rev Mol Diagn 2020;20(5):453-4.
  • 12. Önal B. Current pharmacological approaches in SARS-CoV-2/ COVID-19. Ege Klin Tıp Derg 2020;58(1)Supp:30-4 (Turkish).
  • 13. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. COVID-19 (SARS-CoV-2 Enfeksiyonu) Erişkin Hasta Tedavisi. Bilimsel Danışma Kurulu Çalışması. Available online: https://covid19.saglik.gov.tr/TR-66926/eriskin-hasta-tedavisi.html (accessed on 07 September 2020) (Turkish).
  • 14. Mueller AL, McNamara MS, Sinclair DA. Why does COVID-19 disproportionately affect older people? Aging (Albany NY) 2020;12(10):9959-81.
  • 15. Galbadage D, Peterson BM, Awada J, Buck AS, Ramirez DA, Wilson J, et al. Systematic review and meta-analysis of sex-spesific COVID-19 clinical outcomes. Front Med 2020;7:348.
  • 16. Chen T, Dai Z, Mo P, Li X, Ma Z, Song S, et al. Clinical characteristics and outcomes of older patients with coronavirus disease 2019 (COVID-19) in Wuhan, China (2019): a single-centered, retrospective study. J Gerontol A Biol Sci Med Sci 2020;75(9):1788-95.
  • 17. Palmieri L, Vanacore N, Donfrancesco C, Noce CL, Canevelli M, Punzo O, et al. Clinical characteristics of hospitalized individuals dying with COVID-19 by age group in Italy. J Gerontol A Biol Sci Med Sci 2020;75(9), 1796-1800.
  • 18. Lee JY, Kim HA, Huh K, Hyun M, Rhee JY, Jang S, et al. Risk factors for mortality and respiratory support in elderly patients hospitalized with COVID-19 in Korea. J Korean Med Sci 2020;35(23):e223.
  • 19. Kutlu R. What we have learned about the new coronavirus pandemic, current diagnostic and therapeutic approaches and the situation in Turkey. TJFMPC, 2020;14(2):329-44 (Turkish).
  • 20. Niu S, Tian S, Lou J, Kang X, Zhang L, Lian H, et al. Clinical characteristics of older patients infected with COVID-19: A descriptive study. Arch Gerontol Geriat 2020;89:104058.
  • 21. Garg S, Kim L, Whitaker M, O’Halloran A, Cummings C, Holstein R. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019 – COVID-NET, 14 States, March 1–30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(15):458-64.
  • 22. Sümer Ş, Ural O, Aktuğ-Demir N, Cifci S, Turkseven B, Kilincer, et al. Clinical and laboratory characteristics of COVID-19 cases followed in Selçuk University Faculty of Medicine. Klimik Derg 2020;33(2):122-7 (Turkish).
  • 23. Parohan M, Yaghoubi S, Seraji A, Javanbakht MH, Sarraf P, Djalali M. Risk factors for mortality in patients with Coronavirus disease 2019 (COVID-19) infection: a systematic review and meta-analysis of observational studies. The Aging Male, 2020;8:1-9.
  • 24. CDC COVID-19 Response Team. Severe outcomes among patients with coronavirus disease 2019 (COVID-19) - United States, February 12–March 16, 2020. MMWR Morb Mortal Wkly Rep 2020;69(12):343-6. Available online: www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6912e2-H.pdf (accessed on 07 September 2020).
  • 25. Eraksoy H. How will the COVID-19 pandemic end? Klimik Derg 2020;33(2):110 (Turkish).
There are 25 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Orijinal Articles
Authors

Remziye Nur Eke 0000-0002-2410-0802

Mehmet Özen 0000-0002-6075-1733

Seren Taşkın This is me 0000-0003-0984-9644

Özge Abacı Bozyel 0000-0003-4633-3241

Publication Date June 20, 2021
Submission Date October 10, 2020
Published in Issue Year 2021 Volume: 15 Issue: 2

Cite

Vancouver Nur Eke R, Özen M, Taşkın S, Abacı Bozyel Ö. The impact of age and underlying comorbidities on the course of COVID-19 disease; First three months data of pandemic from Antalya, Turkey. TJFMPC. 2021;15(2):366-74.

English or Turkish manuscripts from authors with new knowledge to contribute to understanding and improving health and primary care are welcome.