ÖZET

Amaç:

Koronavirüs hastalığı-2019 (COVID-19) enfeksiyonu dışı hastalıklar nedeniyle hastanede yatan hastalar arasında nozokomiyal COVID-19 olgu sıklığı ve seyri ile ilgili az sayıda çalışma mevcuttur. Çalışmamızda COVID-19 dışı hastalık nedeni ile acil servisten göğüs hastalıkları servisine yatırılan ve yatıştan sonra COVID-19 enfeksiyonu saptanan hastalar (indeks olgu) ve bu hastaların neden olduğu nozokomiyal bulaşma seyri ve sonuçları incelendi.

Yöntem:

Çalışmaya, COVID-19 pandemisinin birinci dalgası sırasında göğüs hastalıkları servisinde akciğer hastalığı tanısı ile yatan 44 hasta dahil edildi. Hastaneye yatış sırasında tüm hastalardan COVID-19 ters transkripsiyon-polimeraz zincir reaksiyonu (RT-PCR) testi için oro-nazofaringeal sürüntü örneği alındı. COVID-19 RT-PCR testi dört hastada pozitif bulundu. Test sonuçları negatif bulunan hastalar nozokomiyal bulaş riski nedeni ile klinik, radyolojik olarak ve RT-PCR testi (1-3 kez, ve/veya semptom geliştiğinde) ile COVID-19 açısından yeniden değerlendirildi. Hastaların tümü taburculuk sonrası 30 gün süreyle takip edildi.

Bulgular:

Çalışmaya dahil edilen hastaların %81’i (36) erkek, %19’u (8) kadın ve yaş ortalamaları 65,6±13,6 (31-93) yıl olarak bulundu. Hastaların 25’inde malignite, altısında kronik obstrüktif akciğer hastalığı alevlenmesi, dördünde idiyopatik pulmoner fibrozis alevlenmesi, üçünde enfekte bronşektazi, ikisinde pulmoner emboli ve dördünde farklı akciğer hastalıkları bulunmaktaydı. Dört hastanın COVID-19 RT-PCR testi sonucu pozitif bulundu. Yaklaşık iki hafta içinde 40 hastanın 16’sında COVID-19 enfeksiyonu gelişti ve bu hastaların onu (enfekte olanların %63’ü) hayatını kaybetti. COVID-19 enfeksiyonu gelişen hastaların RT-PCR test sonuçlarının ortalama 8.2. (6-13) günde pozitifleştiği saptandı.

Sonuç:

Akciğer hastalığı bulunan hastalarda nozokomiyal COVID-19 enfeksiyonu gelişimi ağır hastalık ve ölüm için ciddi bir risk oluşturmaktadır. Sağlık kurumlarında COVID-19 enfeksiyonu bulaşma riskini azaltmak için gerekli önlemler alınmalıdır.

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Solunum Hastalığı Nedeniyle Hastanede Yatan Hastalarda Nozokomial COVID-19 Hastalığının Etkisi

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References