Öz
Amaç:
Bu çalışmada, farklı coğrafi özelliklere sahip iki büyükşehirde şiddetli koronavirüs-19 (COVİD-19) enfeksiyonunun virülansının zamansal seyri ve semptomatolojisi karşılaştırıldı. Çalışmada, iki bölge arasında gözlenen farklılıkların olası etiyolojisine ışık tutulması amaçlandı.
Yöntem:
Mart-Haziran 2020 döneminde Türkiye’nin kuzey ve güney kesimlerinde bulunan iki farklı şehirde (İstanbul ve Diyarbakır) polimeraz zincir reaksiyonu ile doğrulanmış COVİD-19 olgularını geriye dönük olarak inceledik. Demografik özellikler, başvuru semptomları, geçmiş klinik öykü, radyolojik bulgular, laboratuvar parametreleri ve ortalama hastanede yatış süresi kaydedildi. Ayrıca çalışma dönemi için günlük sıcaklık, günlük sıcaklık değişimi, bağıl nem, rüzgar hızı, ortalama yağış, ultraviyole indeksi, yükseklik ve enlem gibi meteorolojik veriler de elde edildi.
Bulgular:
Toplam olgu sayısı İstanbul’da Mart ve Nisan aylarında daha yüksek iken, Diyarbakır’da Mayıs ve Haziran aylarında daha yüksekti (p=0,001). Çalışma süresi boyunca Diyarbakır’da günlük sıcaklık, günlük sıcaklık değişimi ve ultraviyole indeksi daha yüksek iken, İstanbul’da bağıl nem, rüzgar hızı, ortalama yağış miktarı daha yüksek bulundu (p=0,001). Diyarbakır’da hastalar daha çok nefes darlığı ile başvururken, İstanbul’da ise ateş, öksürük hakimdi. Diyarbakır’daki hastaların nötrofil, nötrofil/lenfosit oranı, D-dimer, laktat dehidrogenaz, ferritin ve C-reaktif protein değerleri İstanbul’daki hastalara göre anlamlı olarak yüksekti (p=0,018; p=0,006; p=0,001, p=0,001; p=0,001, p=0,001 sırasıyla). Diyarbakır’da baskın bilgisayarlı tomografi infiltrasyonu multisentrik ve bilateral crazy paving paterni iken, İstanbul’da tek taraflı buzlu cam opasitesi baskın paterndi.
Sonuç:
Sosyo-kültürel ve genetik faktörler, COVİD-19'un epidemiyolojik, klinik ve görüntüleme özelliklerini meteorolojik varyasyonlardan daha fazla etkileyebilir.
Anahtar Kelimeler: Coğrafi özellikler, COVID-19, etiyoloji
Kaynakça
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