Clinical Evaluation of Patients with COVID-19 Within the Framework of Comorbidities

Objectives: Chronic systemic diseases (CSD) and cancer are closely related to the clinical course, severity and mortality of COVID-19 due to the immunosuppressive conditions caused by these diseases. The purpose of this study was to investigate the differences between the effects of cancer and CSD on the clinical and laboratory parameters of patients with COVID-19.
Methods: The study included patients who received inpatient treatment with the diagnosis of COVID-19 at Ondokuz Mayýs University between March 16, 2020, and December 1, 2020. The participants were divided into four groups as follows: Those without comorbidities (Group 1), those with only CSD (Group 2), those with only cancer (Group 3), and those with both CSD and cancer (Group 4). Comparative statistical evaluation was performed in terms of clinical symptoms, biochemical parameters, and admission to intensive care and survival.
Results: In total, 750 patients were included: 242 patients in Group 1, 442 in Group 2, 27 in Group 3, and 39 in Group 4. The mean age of the patients was 57.1±9.4 years and 53.7% were male. Patients of Group 1 were significantly different from those of the other groups in terms of age, requirement for intensive care and intubation, complications, survival, white blood cell and lymphocyte count, neutrophil/lymphocyte ratio and levels of hemoglobin, lactic acid dehydrogenase, ferritin, D-dimer, and C-reactive protein (for each p<0.001).
Conclusion: No difference was observed among laboratory parameters, intensive care admission, intubation need, complication frequency, and survival rates in patients with CSD or cancer. It was detected that all three groups with CSD and cancer were worse than Group 1 in terms of intensive care need, intubation, and survival.

COVID-19 Hastalarýnýn Komorbidite Çerçevesinde Klinik Deðerlendirilmesi

Amaç: Kronik sistemik hastalýklar (KSH) ve kanserler neden olduklarý immunsupresif durumlar nedeniyle COVID-19 hastalarýnda hastalýðýn klinik seyri, þiddeti ve mortalitesi ile yakýndan iliþkilidir. Bu çalýþmada kanser ve KSH’nin COVID-19 hastalarýnda klinik laboratuvar ve sað kalým üzerine etkileri arasýndaki farký incelemeyi amaçladýk.
Metod: Ondokuz Mayýs Üniversitesinde 16 Mart 2020 ile 1 Aralýk 2020 tarihleri arasýnda COVID-19 tanýsýyla yatarak tedavi gören hastalar çalýþmaya dahil edilmiþtir. Bunlar arasýnda; ek hastalýðý olmayanlar (Grup1), sadece KSH’si olanlar (Grup2), sadece kanser hastalýðý olanlar (Grup3) ve hem KSH hem de kanser hastalýðý olanlar (Grup4) olarak dört gruba ayrýlmýþtýr. Gruplar arasýnda klinik semptomlar, biyokimyasal parametreler, yoðun bakým yatýþý ve sað kalým açýsýndan istatistiksel olarak karþýlaþtýrmalý deðerlendirme yapýlmýþtýr.
Bulgular: Toplamda 750 hasta olup; Grup 1’de 242, Grup 2’de 442, Grup 3’te 27, Grup 4’te 39 hasta vardýr. Hastalarýn yaþ ortalamasý 57,1 ±9,4 (min: 18-max: 96) yýldýr ve %53,7’si erkektir. Yaþ, yoðun bakým, entübasyon, komplikasyon, sað kalým, WBC, hemoglobin, lenfosit, nötrofil/lenfosit oraný, LDH, ferritin, D-dimer, CRP açýsýndan Grup 1’in diðer gruplardan anlamlý oranda farklý olduðu belirlenmiþtir (her biri için p<0,001).
Sonuç: KSH veya kanser hastalýðý olan COVID-19 hastalarýnýn laboratuvar tetkikleri, yoðun bakým yatýþý, entübasyon ihtiyacý, komplikasyon sýklýðý ve sað kalým oranlarý açýsýndan klinik olarak anlamlý bir fark olmadýðý görülmüþtür. KSH ve kanser hastalýðý olan her 3 grubun da yoðun bakým ihtiyacý, entübasyon ve sað kalým parametreleri açýsýndan Grup 1’e göre daha olumsuz olduðu tespit edilmiþtir. (SETB-2021-10-303)