首都の主要パンデミック対策センターのCOVID-19の経験。トルコでのパンデミックの最初の1ヶ月間の結果

COVID-19 experience of the major pandemic response center in the capital: Results of the pandemic's first month in Turkey.

• Rahmet Güner
• İmran Hasanoğlu
• Bircan Kayaaslan
• Adalet Aypak
• Ayşe Kaya Kalem
• Fatma Eser
• Burcu Özdemir
• Elif Mukime Sarıcaoğlu
• Müge Ayhan
• Yeşim Aybar Bilir
• Işıl Özkoçak Turan
• Deniz Erdem
• Nevzat Mehmet Mutlu
• Turan Buzğan
• Bedia Dinç
• Esragül Akıncı

抄録

背景・目的:

本研究の目的は，トルコでパンデミックが発生した最初の月にアンカラ市立病院に入院したCOVID-19患者の疫学的，臨床的特徴，臨床経過および予後を決定するパラメータを評価することである．

BACKGROUND/AIM: Aim of this study is to evaluate the epidemiological, clinical characteristics and the parameters that determine the clinical course and prognosis of the COVID-19 patients admitted to the Ankara City Hospital during the first month of the pandemic In Turkey.

材料および方法:

2020年3月10日から4月10日の間に入院したSARS-CoV-2 PCR陽性患者を対象とした。

MATERIALS AND METHODS: SARS-CoV-2 PCR positive patients who were hospitalized between March 10 and April 10, 2020 were included.

結果:

222人の患者のうち、平均年齢はSARI/重症急性呼吸器疾患群で高かった（p < 0,001）。発症から入院までの期間の中央値、併存疾患（特に冠動脈疾患と慢性閉塞性肺疾患）の有無は、重症急性呼吸器疾患（SARI）／重症急性疾患群で有意に高かった（p＜0.05）。症状は咳嗽と発熱が最も多く，無気力感と味覚障害はそれぞれ8.6％，7.7％であった。死亡率は5.4％であった。入院時の好中球/リンパ球比の高さ、リンパ球数、単球数、血小板数の低さ、肝酵素の上昇、低GFR、筋酵素、フェリチン、IL-6の高値は、SARI/危機的疾患と関連していることがわかった（p＜0.05）。両側の基底硝子体混濁とパッチ状浸潤は、SARI/重症患者群でより高頻度に認められた（p＜0.001）。65歳以上の患者ではSARI/重症化のリスクが8倍に増加していた。

RESULTS: Among 222 patients, mean age was higher in SARI/critical disease group (p < 0,001). Median time from illness onset to admission, presence of co-morbidity, especially coronary artery disease and chronic obstructive pulmonary disease, was significantly higher in severe acute respiratory illness (SARI)/critical disease group (p < 0.05). Cough and fever were the most common symptoms, while anosmia and loss of taste were observed in 8.6 % and 7.7 % patients, respectively. Mortality rate was 5.4 %. High neutrophil/lymphocyte ratio, low lymphocyte, monocyte and platelet count, elevated liver enzymes, low GFR, high levels of muscle enzymes, ferritin and IL-6 on admission were found to be associated with SARI/critical disease (p<0.05). Bilateral ground-glass opacity and patchy infiltration were more frequently seen in SARI/critical disease group (p < 0.001). Patients older than 65 years have 8-fold increased risk for development of SARI/critical disease.

結論:

トルコにおけるCOVID-19症例に関するこのコホート研究では、高齢、併存疾患の存在、CT上の両側浸潤、好中球/リンパ球比の高さ、単球および血小板数の低さ、肝酵素の上昇、低GFR、筋酵素の高値、入院時のフェリチンおよびIL-6の高値が、SARIおよび重症化の予測因子であることが明らかになった。

CONCLUSION: This cohort study regarding COVID-19 cases in Turkey reveals that older age, presence of co-morbidity, bilateral infiltration on CT, high neutrophil/lymphocyte ratio, low monocyte and platelet count, elevated liver enzymes, low GFR, high levels of muscle enzymes, and high levels of ferritin and IL-6 on admission are predictors of SARI and severe disease.