Öz
Giriş:
COVID-19 çocuklarda hafif seyirli bir hastalık olmakla beraber, Kawasaki benzeri hastalık ya da hiperinflamatuar durumlar ile kendini gösterebilmektedir. Biz çalışmamızda COVID-19 pandemisinde çocuklarda kardiyak tutulum sıklığı ve şekillerini ortaya koymayı amaçladık.
Gereç ve Yöntem:
Mart 2020 ile Ekim 2020 arasında SARS-CoV-2 enfeksiyonu nedeni ile pediatri kliniğimizde tedavi gören 214 hastamızdan değişik şekillerde kardiyak tutulum gözlediğimiz 17 hastayı sunmak istiyoruz. Hastaların seçilme kriterleri laboratuar (artmış troponin I), elektrokardiyografik ve ekokardiyografik bulgulara dayanmaktadır. Hastalar tedavi gördükleri birimler olan pediatri servisi, yenidoğan yoğun bakım ünitesi ve çocuk yoğun bakım ünitesi olarak üç ayrı gruba ayrılmışlardır.
Bulgular:
Kardiyak tutulum 214 hastanın %7,9’unda gözlenmiş olup bunların %88.2’sinde troponin I yüksekliği, %70,5’inde anormal elektrokardiyografi bulguları ve yine %70,5’inde anormal elektrokardiyografi bulguları saptadık. Troponin I yüksekliği saptanan hastaların %82.3’ünde beraberinde anormal elektrokardiyografi bulguları saptanırken, yine bu hastaların %76.4’ünde anormal ekokardiyografi bulguları saptadık. Yedi hasta çoklu sistem inflamatuar sendromu olarak değerlendirildi.
Sonuç:
SARS-CoV-2 enfeksiyonu tedavisi alan hastalarımızın büyük bir kısmında kardiyak tutulum tespit etmedik. Tutulum saptadığımız hastalarda ise tutulum şekli oldukça değişkenlik göstermekte idi. Lakin bu yelpazenin bir ucunda sadece troponin I yüksekliği olan hastalarımız var iken diğer ucunda ekstrakorporeal membran oksijenizasyonu tedavisine ihtiyaç duyan sol ventrikül sistolik fonksiyon bozukluğu olan hastalarımız mevcuttu.
Anahtar Kelimeler: Kardiyak tutulum, COVID-19, yenidoğan, çocuklar
Kaynakça
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