Öz
Haziran 2020 tarihinde normalleşme sürecine geçilmesi ile koronavirüs hastalığı-2019 (COVID-19) tedavisi tamamlanan hastaların tedavi sonrası polimeraz zincir reaksiyonu testi negatifliği beklenmeden taburcu edilmesi kararı alınmıştır. Bu çalışmada uygulama öncesi ve uygulama sonrası birer aylık periyotlardaki hasta profili, hastanede yatış süresi ve maliyetin karşılaştırılması planlandı. 15 Haziran 2020 öncesi (birinci grup) ve sonrası (ikinci grup) birer aylık süreçlerde pandemi servisinde COVID-19 olası ve kesin tanısı ile takip edilen hastaların demografik verileri, ko-morbiditeleri, laboratuvar bulguları, tedavi, prognoz ve tedavi maliyetleri karşılaştırıldı. Çalışmaya birinci gruptan 46, ikinci gruptan 49 olmak üzere toplam 95 hasta dâhil edildi. Birinci grupta kesin vaka oranı %37 iken bu oran ikinci grupta %59’du (p=0.040).Kesin vaka tanımına uyan hastalarda birinci grubun hastanede yatış süresi ortancası ikinci gruba göre daha uzundu (Grup 1 için;10 (3-21), Grup 2 için; 6 (3-12) gün, p=0.003). İkinci gruptaki hastalarda COVID-19 ile uyumlu tipik tomografi bulgu oranı daha yüksekti (Grup 2 için %52 ve Grup 1 için%26, p=0.018). İlk grupta hidroksiklorokin ile tedavi oranı ikinci gruba göre daha yüksek iken (Grup 1 için %72 ve Grup 2 için %41, p=0.004) ikinci grupta favipiravir ile tedavi oranı daha fazla idi (Grup 2 için %55 ve Grup 1 için %17, p=0.001). Birinci grupta tedavi maliyeti ortancası 2798 (661-45465) TürkLirası(TL), ikinci grupta ise 1627 (748-4496) TL idi (p=0.001). COVID-19 tanılı hastaların tedavi sonrası izolasyon sürelerini hastane dışında tamamlaması hastane maliyetinin azaltılması açısından anlamlıdır.
Anahtar Kelimeler
Kaynakça
- Remuzzi A, Remuzzi G. COVID-19 and Italy: what next? The Lancet 2020; 395: 1225-1228.
- Liu J, Zheng X, Tong Q, et al. Overlapping and discrete aspects of the pathology and pathogenesis of the emerging human pathogenic coronaviruses SARS-CoV, MERS-CoV, and 2019-nCoV. J Med Virol 2020; 92: 491-494.
- T ü r k i y e C o v i d - 1 9 Ta b lo s u. h t t p s : / /covid19.saglik.gov.tr/; Erişim Tarihi: 25.09.2020.
- Adhikari SP, Meng S, Wu YJ,et al. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infect Dis Poverty 2020; 9: 29.
- Kampf G, Todt D, Pfaender S, et al. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. J Hosp Infect 2020; 104: 246-251.
- Lauer SA, Grantz KH, Bi Q, et al. The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: Estimation and application. Ann Int Med 2020; 172: 577.
- Lippi G, Simundic AM, Plebani M. Potential preanalytical and analytical vulnerabilities in the laboratory diagnosis of coronavirus disease 2019 (COVID-19). Clin Chem Lab Med 2020;58(7):1070-1076.
- Covid-19, Covid-19 Rehberi, Enfeksiyon Kontrolü ve İzolasyon.https://covid19.saglik.gov.tr/TR-66338/enfeksiyon-kontrolu-ve-izolasyon.html; Erişim Tarihi: 25.09.2020
- Temaslı Takibi, Salgın Yönetimi, Evde Hasta İzlemi ve Filyasyon. https://covid19.saglik.gov.tr/TR-66339/temasli-takibi-salgin-yonetimi-evde-hastaizlemi-ve-filyasyon.html; 25.09.2020.
- Living guidance for clinical management of COVID-19. https://www.who.int/publications/i/item/WHO-2019-nCoV-clinical-2021-2; Erişim tarihi: 16.08.2020.
- Li XZ, Jin F, Zhang JG, et al. Treatment of coronavirus disease 2019 in Shandong, China: A cost and affordability analysis. Infect Dis Poverty 2020;9(1):78.
- Coronavirus Disease 2019 (COVID-19) Treatment Guidelines [Internet]. Bethesda (MD): National Institutes of Health (US); 2021 Apr 21–2022 May 31. PMID: 34003615.
- Şimşek-Yavuz S, Komsuoğlu Çelikyurt FI. An update of anti-viral treatment of COVID-19. Turk J Med Sci. 2021;51(SI-1):3372-3390.
- Moghadas SM, Shoukat A, Fitzpatrick MC, et al. Projecting hospital utilization during the COVID-19 outbreaks in the United States. Proc Natl Acad Sci USA 2020; 117(16):9122-9126.
- Peak CM, Kahn R, Grad YH,et al. Individual quarantine versus active monitoring of contacts for the mitigation of COVID-19: A modelling study. Lancet Infect Dis 2020;20(9):1025-1033.
- Ture Z, Kalin-Unüvar G, Baran Ketencioğlu B, et al. Outcomes of COVID-19 Patients Hospitalized in a University Hospital, Turkey. Infect Dis Clin Microbiol 2020; 2: 61-70.
Öz
With the transition to the normalization process on June, 2020, it was decided to discharge the patients who completed the coronavirus disease 2019 (COVID-19) treatment without waiting for polymerase chain reaction test negativity. In this study, it was planned to compare the patient profile, length of hospital stays and cost in one-month periods before and after the decision. Demographic data, co-morbidities, laboratory findings, treatment, prognosis and treatment costs of the patients who were followed up with a probable and definitive diagnosis of COVID-19 in the pandemic service in the one-month period before 15 June 2020 (first group) and after (second group) were compared. A total of 95 patients, 46 from the first group and 49 from the second group, were included in the study. The definitive case rate in the first group was 37%, while this rate was 59% in the second group (p=0.040). The median length of hospital stay of the first group was longer than the second group 10 (3-21) days’ vs 6 (3-12) days p=0.003) in patients who confirm the definitive case definition. The rate of typical tomography findings compatible with COVID-19 was higher in the patients in the second group (52% for second group and 26% for first group) (p=0.018). While the rate of treatment with hydroxychloroquine was higher in the first group than in the second group (72% for the first group and 41% for the second group) (p=0.004), the rate of treatment with favipiravir was higher in the second group (55% for the second group and 17% for the first group) (p=0.001). The median treatment cost was 2798 (661-45465) Turkish liras (TL) in the first group and 1627 (748-4496) TL in the second group (p=0.001). It is significant in terms of reducing hospital costs that patients with a diagnosis of COVID-19 complete their post-treatment isolation period outside the hospital.
Anahtar Kelimeler
Kaynakça
- Remuzzi A, Remuzzi G. COVID-19 and Italy: what next? The Lancet 2020; 395: 1225-1228.
- Liu J, Zheng X, Tong Q, et al. Overlapping and discrete aspects of the pathology and pathogenesis of the emerging human pathogenic coronaviruses SARS-CoV, MERS-CoV, and 2019-nCoV. J Med Virol 2020; 92: 491-494.
- T ü r k i y e C o v i d - 1 9 Ta b lo s u. h t t p s : / /covid19.saglik.gov.tr/; Erişim Tarihi: 25.09.2020.
- Adhikari SP, Meng S, Wu YJ,et al. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infect Dis Poverty 2020; 9: 29.
- Kampf G, Todt D, Pfaender S, et al. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. J Hosp Infect 2020; 104: 246-251.
- Lauer SA, Grantz KH, Bi Q, et al. The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: Estimation and application. Ann Int Med 2020; 172: 577.
- Lippi G, Simundic AM, Plebani M. Potential preanalytical and analytical vulnerabilities in the laboratory diagnosis of coronavirus disease 2019 (COVID-19). Clin Chem Lab Med 2020;58(7):1070-1076.
- Covid-19, Covid-19 Rehberi, Enfeksiyon Kontrolü ve İzolasyon.https://covid19.saglik.gov.tr/TR-66338/enfeksiyon-kontrolu-ve-izolasyon.html; Erişim Tarihi: 25.09.2020
- Temaslı Takibi, Salgın Yönetimi, Evde Hasta İzlemi ve Filyasyon. https://covid19.saglik.gov.tr/TR-66339/temasli-takibi-salgin-yonetimi-evde-hastaizlemi-ve-filyasyon.html; 25.09.2020.
- Living guidance for clinical management of COVID-19. https://www.who.int/publications/i/item/WHO-2019-nCoV-clinical-2021-2; Erişim tarihi: 16.08.2020.
- Li XZ, Jin F, Zhang JG, et al. Treatment of coronavirus disease 2019 in Shandong, China: A cost and affordability analysis. Infect Dis Poverty 2020;9(1):78.
- Coronavirus Disease 2019 (COVID-19) Treatment Guidelines [Internet]. Bethesda (MD): National Institutes of Health (US); 2021 Apr 21–2022 May 31. PMID: 34003615.
- Şimşek-Yavuz S, Komsuoğlu Çelikyurt FI. An update of anti-viral treatment of COVID-19. Turk J Med Sci. 2021;51(SI-1):3372-3390.
- Moghadas SM, Shoukat A, Fitzpatrick MC, et al. Projecting hospital utilization during the COVID-19 outbreaks in the United States. Proc Natl Acad Sci USA 2020; 117(16):9122-9126.
- Peak CM, Kahn R, Grad YH,et al. Individual quarantine versus active monitoring of contacts for the mitigation of COVID-19: A modelling study. Lancet Infect Dis 2020;20(9):1025-1033.
- Ture Z, Kalin-Unüvar G, Baran Ketencioğlu B, et al. Outcomes of COVID-19 Patients Hospitalized in a University Hospital, Turkey. Infect Dis Clin Microbiol 2020; 2: 61-70.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Erken Görünüm Tarihi | 28 Mart 2023 |
| Yayımlanma Tarihi | 3 Nisan 2023 |
| Gönderilme Tarihi | 30 Ekim 2021 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 32 Sayı: 1 |
