Analiza post-covidnih zapletov pri bolnikih, hospitaliziranih na Nevrološkem oddelku ter Oddelku za bolezni ledvic in dializo Splošne bolnišnice Celje

Golčer, Zala (author), Kerec Kos, Mojca (mentor), Hriberšek, Danila (co-mentor)

Koronavirusno bolezen 2019 (COVID-19) povzroča koronavirus 2 hudega akutnega respiratornega sindroma (SARS-CoV-2), ki je povzročil eno izmed največjih pandemij v zgodovini človeštva. Večina bolnikov po preboleli okužbi popolnoma okreva, pri določenem deležu okuženih pa simptomi vztrajajo dlje časa po bolezni. V retrospektivni raziskavi smo analizirali demografske in klinične značilnosti, vrsto post-covidnih zapletov in izide zdravljenja bolnikov, ki so se med 1.10.2020 in 31.1.2022 zaradi omenjenih zapletov zdravili na Nevrološkem oddelku in Oddelku za bolezni ledvic in dializo Splošne bolnišnice Celje. Podatke za raziskavo smo pridobili iz bolnišničnega informacijskega e-sistema Birpis in odpustnih pisem. V raziskavo smo vključili 78 bolnikov (51 moških; 65,4 %). Mediana starosti vseh bolnikov je bila 75 let. Na Nevrološkem oddelku so bili najpogostejši oz. glavni post-covidni zapleti možganska kap (53,3 %; 16/30), miopatija kritično bolnega in epileptični napad (oba s po 13,3 %; 4/30), pri bolnikih na Oddelku za bolezni ledvic in dializo pa poslabšanje kronične ledvične bolezni (25,0 %; 12/48), okužba sečil (18,8 %; 9/48), bakterijska pljučnica (16,7 %; 8/48) in akutna ledvična odpoved (12,5 %; 6/48). Bolniki na Oddelku za bolezni ledvic in dializo so bili statistično značilno starejši, imeli so značilno več pridruženih bolezni in so prejemali večje število zdravilnih učinkovin v kronični terapiji kot tisti na Nevrološkem oddelku, dolžina hospitalizacije pa je bila pri njih značilno krajša. Med bolniki s hudo in blago obliko COVID-19 znotraj posameznega oddelka ni bilo značilnih razlik v spolu, starosti, številu pridruženih bolezni, številu zdravilnih učinkovin v kronični terapiji in trajanju hospitalizacije. Med hospitalizacijo je umrlo 12 bolnikov, in sicer značilno več moških (91,7 %). Med umrlimi in odpuščenimi bolniki ni bilo statistično značilnih razlik v starosti, številu pridruženih bolezni, številu predpisanih zdravilnih učinkovin v kronični terapiji ter težavnosti COVID-19. Najpogostejši oz. glavni post-covidni zaplet, ki je privedel do smrtnega izida, je bila bakterijska pljučnica. Bolniki so imeli po prebolelem COVID-19 številne zaplete s področja različnih organskih sistemov, ki so zahtevali kompleksno obravnavo in rehabilitacijo, vendar pa ne moremo absolutno trditi, da so bili vsi posledica COVID-19. V prihodnosti potrebujemo večje število raziskav in predvsem daljša spremljanja post-covidnih zapletov, da bi lahko razumeli celoten spekter posledic, ki jih lahko povzroči COVID-19.

• Language: Slovenian
• Keywords: COVID-19, SARS-CoV-2, post-covidni zapleti, bolezni ledvic, nevrološki zapleti
• Work type: Master's thesis/paper
• Organization: FFA - Faculty of Pharmacy
• Year: 2023
• PID: 20.500.12556/RUL-151757
• Publication date in RUL: 19.10.2023

Secondary language

• Language: English
• Title: Analysis of postcovid complications in patients hospitalised at the Department of Neurology and the Department of Kidney Diseases and Dialysis of the General Hospital Celje

Abstract

The Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which caused one of the largest pandemics in human history. Most patients make a full recovery after overcoming the infection, however, a certain proportion of the infected have symptoms that persist for a long time after the illness. In this retrospective study, we analysed the demographic and clinical characteristics, the type of post-covid complications and the treatment outcomes of patients treated for these complications at the Department of Neurology and the Department of Kidney Diseases and Dialysis of General Hospital Celje between 1 October 2020 and 31 January 2022. The data for the study were obtained from the hospital's e-information system Birpis and discharge letters. We included 78 patients in the study (51 males; 65.4%). Median age of all patients was 75 years. At the Department of Neurology, the most frequent or the main post-covid complications were cerebral infarction (53.3%; 16/30), critical illness myopathy and epileptic seizure (both 13.3%; 4/30), in patients admitted to the Department of Kidney Diseases and Dialysis, exacerbation of chronic kidney disease (25.0%; 12/48), urinary tract infection (18.8%; 9/48), bacterial pneumonia (16.7%; 8/48) and acute renal failure (12.5%; 6/48). Patients at the Department of Kidney Diseases and Dialysis were statistically significantly older, had significantly more comorbidities and received a higher number of drugs in chronic therapy than those at the Department of Neurology and their length of hospital stay was significantly shorter. There were no significant differences between patients with severe and mild COVID-19 within each ward in sex, age, number of comorbidities, number of drugs in their chronic therapy, as well as the length of hospitalisation. During hospitalisation, 12 patients died, significantly more males (91.7%). There were no statistically significant differences in age, number of comorbidities, number of of drugs prescribed in their chronic therapy and severity of COVID-19 between patients who died and those who were discharged. Patients had multiple complications in different organ systems, requiring complex management and rehabilitation, however, we cannot say absolutely that all complications were due to COVID-19. In the future, we need more research and longer follow-up of post-covid complications to understand the full spectrum of consequences that can be caused by COVID-19.

• Keywords: COVID-19, SARS-CoV-2, post-covid complications, renal diseases, neurological complications