Öz

Amaç

Retrospektif ve kesitsel olarak planlanan bu çalışmada yoğun bakım ünitesinde (YBÜ) yatan ve sitokin fırtınası gelişen kritik koronavirüs hastalığı-2019 (COVID-19) hastalarında uygulanan tocilizumab (TCZ) tedavisinin etkinliğini değerlendirmeye çalıştık.

Gereç ve Yöntem

Çalışmaya, YBÜ’de takip edilen ve TCZ tedavisi uygulanmış olan 219 kritik COVID-19 hastası dahil edildi. Tüm hastalara, YBÜ’de yattığı süre içinde 400 mg/gün 2 doz TCZ tedavisi verildi. TCZ tedavisinden önceki ve sonraki klinik durumları, laboratuvar verileri, inotrop ihtiyacı ve akciğer grafileri karşılaştırıldı. Hastalara ait 7. gün, 28. gün ve total mortalite oranları kaydedildi.

Bulgular

TCZ tedavisinden sonra zamanla C-reaktif protein (CRP) değerlerinde anlamlı azalma olduğu görüldü. Lökosit, lenfosit, laktat, üre, kreatin, aspartat transferaz, D-dimer, laktat dehidrogenaz ve prokalsitonin değerlerinde ise anlamlı artış olduğu saptandı. Hastalara ait 7. günlük mortalite %21, 28 günlük mortalite %64,8 ve total mortalite oranı %65,3 olarak saptandı.

Sonuç

TCZ tedavisi sonrası hastalarda inflamatuar parametrelerden sadece CRP düzeylerinde anlamlı azalma olduğu, hastaların böbrek ve karaciğer fonksiyon testlerinde artış ile birlikte mortalite oranlarının hala yüksek seyrettiği saptanmıştır.

Anahtar Kelimeler: Koronavirüs hastalığı-2019, yoğun bakım ünitesi, mortalite oranı, tocilizumab

Referanslar

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Nasıl atıf yapılır?

1.
Saruhan R, Uzundere O. Yoğun Bakım Ünitesinde Takip Edilen Kritik COVID-19 Hastalarında Tocilizumab Tedavisinin Etkinliği. Turk J Intensive Care. 2024;22(3):197-206. https://doi.org/10.4274/tybd.galenos.2023.28199