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Diyabetik Covid-19 Hastalarında Hba1c ve Lipid Profili Yoğun Bakım İhtiyacını Belirlemede ve Mortalitede Prediktör Mü?

Year 2021, Volume: 11 Issue: 2, 293 - 298, 29.06.2021
https://doi.org/10.31832/smj.844810

Abstract

Amaç: Sars-Corona Virüsü (SARS-CoV-2), 2019 yılının aralık ayında ilk kez Çin’de görülen ve şiddetli akut solunum yetmezliğine neden olan bir korona virüstür. Diyabet tüm dünyada morbidite ve mortalitenin önemli sebeplerinden biri olmakla beraber diyabetik hastalarda koronavirüs enfeksiyonun morbidite ve mortalitenin daha yüksek olduğu saptanmaktadır. Biz bu çalışmamızda İç hastalıkları kliniğinde koronovirüs enfeksiyonu ve koronavirüs enfeksiyonu şüphesi ile takip edilen diyabetik hastalarda Hba1c, kan şekeri profilinin morbidite ve mortalite üzerine etkisinin retrospektif olarak analizinin yapılmasını amaçladık.
Gereç ve Yöntem: İç hastalıkları kliniğinde 15/03/20 ile 01/07/20 tarihleri arasında SARS-CoV-2 enfeksiyonu nedeniyle takip edilen diyabetik hastalar çalışmaya dahil edildi. Hasta dosyaları taranarak anamnez, labaratuvar, tedavi ve prognoz oluşturulan formalra kaydedildi. Diyabetik hastalardaki koronavirüs enfeksiyonlarında hastanın Hba1c, kan şekeri profili ve lipid profilinin yoğun bakım ihtiyacı için risk faktörü olarak kullanılmasının ek bir fayda getirip getirmediği istatistiksel yöntemlerle analiz edildi.
Bulgular: Hastanemiz dahiliye kliniğinde Covid-19 enfeksiyonu nedeniyle yatan daha önce diyabet tanısı alan oral antidiyabetik ve/veya insulin kullanan toplam 31 hasta retrospektif olarak incelenmiş olup hastaların demografik özellikleri Tablo-1 de belirtilmiştir. 31 hastanın tamamı boğaz ağrısı, öksürük, ateş ve nefes darlığı gibi tipik bulgular ile hastaneye başvurdu. Hastaların tamamına BT çekildi ve nasofarnegeal ve orofarengeal PCR alındı. PCR testi pozitif saptanan 18 hasta (%58.1) ve Tipik BT tutulumu olan 30 hasta (%96.8) saptandı. Covid-19 nedenli takip edilen diyabeti olan 31 hastanın 17 sinde; hipoksi, takipne ve hipotansiyon gibi sebepler ile yoğun bakım ihtiyacı gelişti. Yoğun bakım ihtiyacı olan 17 hastanın 10’u mortal seyretti. Açlık kan şekeri yüksekliği ile yoğun bakım ihtiyacı ve mortalite arasında anlamlı ilişki saptandı. HbA1C ve lipit profili ile yoğun bakım ihtiyacı arasında anlamlı ilşki yoktu. Mortal grupta LDL ve total kolesterol anlamlı düzeyde düşük tespit edildi.
Sonuç: Diyabetik hasta grubunda kötü glisemik kontrol ve lipit parametreleri prognostik faktör olarak dikkate alınmalıdır.

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References

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  • Referans12. Klekotka RB, Mizgała E, Król W. The etiology of lower respiratory tract infections in people with diabetes. Pneumonol Alergol Pol. 2015;83(5):401-8. doi: 10.5603/PiAP.2015.0065. PMID: 26379004.
  • Referans13. Kinzel T, Smith M. Hyperglycemia as a predictor for mortality in veterans with pneumonia. Exp Aging Res. 1988 Summer-Autumn;14(2-3):99-102. doi: 10.1080/03610738808259730. PMID: 3069474.
  • Referans14. Liu SP, Zhang Q, Wang W, Zhang M, Liu C, Xiao X, Liu Z, Hu WM, Jin P. Hyperglycemia is a strong predictor of poor prognosis in COVID-19. Diabetes Res Clin Pract. 2020 Sep;167:108338. doi: 10.1016/j.diabres.2020.108338. Epub 2020 Jul 24. PMID: 32712122; PMCID: PMC7377976.
  • Referans15. Tien PC. Hepatitis C Virus-Associated Alterations in Lipid and Lipoprotein Levels: Helpful or Harmful to the Heart? Clin Infect Dis. 2017 Aug 15;65(4):566-567. doi: 10.1093/cid/cix360. PMID: 28444147; PMCID: PMC5848244.
  • Referans16. Erum U, Ahsan T, Khowaja D. Lipid abnormalities in patients with Rheumatoid Arthritis. Pak J Med Sci. 2017 Jan-Feb;33(1):227-230. doi: 10.12669/pjms.331.11699. PMID: 28367205; PMCID: PMC5368315.
  • Referans17. Zhang X, Patel A, Horibe H, Wu Z, Barzi F, Rodgers A, MacMahon S, Woodward M; Asia Pacific Cohort Studies Collaboration. Cholesterol, coronary heart disease, and stroke in the Asia Pacific region. Int J Epidemiol. 2003 Aug;32(4):563-72. doi: 10.1093/ije/dyg106. PMID: 12913030.
  • Referans18. Metabolic disturbances and inflammatory dysfunction predict severity of coronavirus disease 2019 (COVID-19): a retrospective study Shuke Nie, Xueqing Zhao, Kang Zhao, Zhaohui Zhang, Zhentao Zhang, Zhan Zhang medRxiv 2020.03.24.20042283; doi: https://doi.org/10.1101/2020.03.24.20042283
  • Referans19. Feingold KR. Lipid and Lipoprotein Levels in Patients with COVID-19 Infections. [Updated 2020 Nov 15]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK564657/

Is Hba1c and Lipid Profile A Predictor Of Determining Intensive Care Need and Mortality In Diabetic Covid-19 Patients?

Year 2021, Volume: 11 Issue: 2, 293 - 298, 29.06.2021
https://doi.org/10.31832/smj.844810

Abstract

Project Number

yok

References

  • Referans1. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020 Feb 15;395(10223):507-513. doi: 10.1016/S0140-6736(20)30211-7. Epub 2020 Jan 30. PMID: 32007143; PMCID: PMC7135076.
  • Referans2.Galluccio F, Ergonenc T, Garcia Martos A, Allam AE, Pérez-Herrero M, Aguilar R, Emmi G, Spinicci M, Terrancle Juan I, Fajardo-Pérez M. Treatment algorithm for COVID-19: a multidisciplinary point of view. Clin Rheumatol. 2020 Jul;39(7):2077-2084. doi: 10.1007/s10067-020-05179-0. Epub 2020 May 29. PMID: 32472459; PMCID: PMC7255973.
  • Referans3. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200516-covid-19-sitrep-117.pdf?sfvrsn=8f562cc_2.%20[%C3%87evrimi%C3%A7i]
  • Referans4. https://covid19bilgi.saglik.gov.tr/tr/. (Çevrimiçi)
  • Referans5. Emerging Risk Factors Collaboration, Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, Di Angelantonio E, Ingelsson E, Lawlor DA, Selvin E, Stampfer M, Stehouwer CD, Lewington S, Pennells L, Thompson A, Sattar N, White IR, Ray KK, Danesh J. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010 Jun 26;375(9733):2215-22. doi: 10.1016/S0140-6736(10)60484-9. Erratum in: Lancet. 2010 Sep 18;376(9745):958. PMID: 20609967;
  • Referans6. https://www.who.int/news-room/fact-sheets/detail/diabetes. [Çevrimiçi]
  • Referans7. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2013 Jan;36 Suppl 1(Suppl 1):S67-74. doi: 10.2337/dc13-S067. PMID: 23264425; PMCID: PMC3537273.
  • Referans8. Li W, Katzmarzyk PT, Horswell R, Wang Y, Johnson J, Hu G. HbA1c and all-cause mortality risk among patients with type 2 diabetes. Int J Cardiol. 2016 Jan 1;202:490-6. doi: 10.1016/j.ijcard.2015.09.070. Epub 2015 Sep 26. PMID: 26440458; PMCID: PMC4656101.
  • Referans9. Lee YS, Min KH, Lee SY, Shim JJ, Kang KH, Cho WH, Jeon D, Kim YS. The value of glycated hemoglobin as predictor of organ dysfunction in patients with sepsis. PLoS One. 2019 May 6;14(5):e0216397. doi: 10.1371/journal.pone.0216397. PMID: 31059556; PMCID: PMC6502339.
  • Referans10. Jaiswal M, Schinske A, Pop-Busui R. Lipids and lipid management in diabetes. Best Pract Res Clin Endocrinol Metab. 2014 Jun;28(3):325-38. doi: 10.1016/j.beem.2013.12.001. Epub 2013 Dec 18. PMID: 24840262.
  • Referans11. https://covid19.saglik.gov.tr/Eklenti/39061/0/covid-19rehberieriskinhastatedavisipdf.pdf. [Çevrimiçi]
  • Referans12. Klekotka RB, Mizgała E, Król W. The etiology of lower respiratory tract infections in people with diabetes. Pneumonol Alergol Pol. 2015;83(5):401-8. doi: 10.5603/PiAP.2015.0065. PMID: 26379004.
  • Referans13. Kinzel T, Smith M. Hyperglycemia as a predictor for mortality in veterans with pneumonia. Exp Aging Res. 1988 Summer-Autumn;14(2-3):99-102. doi: 10.1080/03610738808259730. PMID: 3069474.
  • Referans14. Liu SP, Zhang Q, Wang W, Zhang M, Liu C, Xiao X, Liu Z, Hu WM, Jin P. Hyperglycemia is a strong predictor of poor prognosis in COVID-19. Diabetes Res Clin Pract. 2020 Sep;167:108338. doi: 10.1016/j.diabres.2020.108338. Epub 2020 Jul 24. PMID: 32712122; PMCID: PMC7377976.
  • Referans15. Tien PC. Hepatitis C Virus-Associated Alterations in Lipid and Lipoprotein Levels: Helpful or Harmful to the Heart? Clin Infect Dis. 2017 Aug 15;65(4):566-567. doi: 10.1093/cid/cix360. PMID: 28444147; PMCID: PMC5848244.
  • Referans16. Erum U, Ahsan T, Khowaja D. Lipid abnormalities in patients with Rheumatoid Arthritis. Pak J Med Sci. 2017 Jan-Feb;33(1):227-230. doi: 10.12669/pjms.331.11699. PMID: 28367205; PMCID: PMC5368315.
  • Referans17. Zhang X, Patel A, Horibe H, Wu Z, Barzi F, Rodgers A, MacMahon S, Woodward M; Asia Pacific Cohort Studies Collaboration. Cholesterol, coronary heart disease, and stroke in the Asia Pacific region. Int J Epidemiol. 2003 Aug;32(4):563-72. doi: 10.1093/ije/dyg106. PMID: 12913030.
  • Referans18. Metabolic disturbances and inflammatory dysfunction predict severity of coronavirus disease 2019 (COVID-19): a retrospective study Shuke Nie, Xueqing Zhao, Kang Zhao, Zhaohui Zhang, Zhentao Zhang, Zhan Zhang medRxiv 2020.03.24.20042283; doi: https://doi.org/10.1101/2020.03.24.20042283
  • Referans19. Feingold KR. Lipid and Lipoprotein Levels in Patients with COVID-19 Infections. [Updated 2020 Nov 15]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK564657/
There are 19 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Deniz Çekiç 0000-0002-7114-9334

Didar Şenocak 0000-0001-9840-9004

Kubilay İşsever 0000-0002-1376-1488

Sümeyye Çekiç This is me 0000-0002-0745-1766

Selcuk Yaylacı 0000-0002-6768-7973

Oğuz Karabay 0000-0003-1514-1685

Ali Tamer 0000-0003-2005-0737

Project Number yok
Publication Date June 29, 2021
Submission Date December 22, 2020
Published in Issue Year 2021 Volume: 11 Issue: 2

Cite

AMA Çekiç D, Şenocak D, İşsever K, Çekiç S, Yaylacı S, Karabay O, Tamer A. Diyabetik Covid-19 Hastalarında Hba1c ve Lipid Profili Yoğun Bakım İhtiyacını Belirlemede ve Mortalitede Prediktör Mü?. Sakarya Tıp Dergisi. June 2021;11(2):293-298. doi:10.31832/smj.844810

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