Hacettepe Üniversitesi Tıp Fakültesi Hastaneleri İç Hastalıkları Servislerinde Yatan Hastaların Başvuru Sonrasında Uzamış Covıd Sendromu Belirtileri Açısından Anket Yöntemi ile Araştırılması

Abstract

Yesilyurt B. Investigation of hospitalized COVID-19 patients after discharge from Hacettepe University Hospitals in terms of Long COVID Syndrome symptoms by Questionnaire Method. Hacettepe University, Thesis in Internal Medicine, Ankara, 2022. The novel coronavirus disease (COVID-19) pandemic caused by the virus named Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), which was first identified in 2019, has affected human communities and countries in many negative ways and still continues. In patients infected with SARS-CoV-2, it was observed that some signs and symptoms continued after the active disease had healed, and this picture was defined as ‘long COVID’. The long COVID syndrome has been a cluster of symptoms that can occur with more than 200 symptoms in cardiovascular, pulmonary, neurocognitive, psychiatric and other clusters in patients, and may progress with a different phenotype in each patient. In pathogenesis studies conducted with the aim of finding treatment, it has been shown that different pathogenetic pathways are effective. Its diagnosis is based on exclusion as it can be confused with other diseases frequently. The aim of this study is to examine the risk factors for long COVID-19 symptoms in hospitalized patients for COVID-19 after their discharge and to define a method that can help predict the high-risk patient groups for long COVID-19 at the time of diagnosis. Patients who were hospitalized with the diagnosis of COVID-19 in Hacettepe University Hospitals Department of Internal Medicine COVID-19 wards, and who were evaluated in the General Internal Medicine COVID-19 follow-up outpatient clinic after discharge, and whose information was collected within a prospective study, were interviewed on the phone, and a descriptive survey was conducted to determine the patients' prolonged symptoms of COVID-19. A total of 479 patients were included in the study. The cohort's total vaccination rate against COVID-19 was 91.9%. The median follow-up from the date of hospital admission was 21.7 months. At least one long COVID symptom was detected in 48.8% (n=234) of the patients. Most frequently observed symptoms were fatigue (28.8%), cough (12.7%), shortness of breath (11.7%), exertional dyspnea (11.3%), and lightheadedness/brain fog (11.1%). After discharge from hospitalization with COVID-19, patients declared the diseases that they have been newly diagnosed with as: 9.6% diabetes, 9.4% hypertension, 5.4% chronic kidney disease, 4.6% coronary artery disease and 3.3% heart failure. The mean age of patients with long COVID syndrome was higher than those without (p<0.001), and dyspnea was more common at the time of admission (p=0.01). Age, number of initial symptoms, serum C-reactive protein (CRP) level during hospitalization, and lobar consolidation on thorax computed tomography (CT) taken during hospitalization were observed as long COVID risk factors. And additionally; advanced age, female gender, serum CRP level, length of stay, monitoring of lobar consolidation in thorax CT taken during hospitalization and atypical or typical findings for COVID-19 in thorax CT were followed as risk factors for severe long COVID syndrome. In conclusion, in COVID-19 patients with certain risk factors, the long COVID probability can be predicted to a certain extent, and with a personalized approach, early treatment, therapy and rehabilitation needs of the patients can be met. Keywords: SARS-CoV-2, long COVID, risk, prevalence