Kanser Hastalarında COVID-19 Bilgisayarlı Tomografi, Klinik ve Laboratuvar Bulgularının Değerlendirilmesi

Year 2020, Volume: 22 Issue: Special Issue, 56 - 60, 30.11.2020

Tolga Köşeci , Ömer Kaya , Okan Dilek , İrfan Alişan Veysel Haksöyler Berna Bozkurt Duman , Timuçin Çil

https://doi.org/10.18678/dtfd.795333

Abstract

Amaç: Bu çalışmanın amacı kanser hastalarında koronavirus hastalığı 2019 (coronavirus disease 2019, COVID-19) bilgisayarlı tomografi (BT), klinik ve laboratuvar bulgularının değerlendirilmesi ve polimeraz zincir reaksiyonu (polymerase chain reaction, PCR) pozitif ve negatif hastaların bulgularının karşılaştırılmasıdır.
Gereç ve Yöntemler: Çalışmaya PCR testi pozitif olan 23, klinik ve radyolojik bulgularla COVID-19 tanısı almış 22 kanser hastası alındı. Hastaların BT görüntüleri iki radyolog tarafından eşzamanlı değerlendirildi. Komorbid hastalık varlığı, semptomlar ve laboratuvar değerleri değerlendirildi.
Bulgular: En sık BT tutulum paterni %88,9 (n=40) ile periferaldi. Bilateral akciğer tutulumu oranı %57,8 (n=26) idi. En sık saptanan bulgu buzlu cam dansiteleri idi (n=38, %84,5). Bunların %35,5 (n=16)’ine konsolidasyon da eşlik etmekteydi. Vakaların %62,2 (n=28)’sinde multifokal tutulum mevcuttu. En sık tutulan loblar alt loblar idi. Diğer nispeten sık bulgular septal kalınlaşma, subplevral çizgilenme ve hava bronkogramı idi. Hastaların ortanca nötrofil, lenfosit, D-dimer, prokalsitonin, C-reaktif protein ve laktat dehidrogenaz değerleri sırasıyla 2000 mm3, 1200 mm3, 1990 ng/mL, 30.7 µg/L 15.8 mg/dl, 161 IU/L idi.
Sonuç: Multifokal ve bilateral tutulum ile buzlucam dansiteleri en sık bulgulardı. Ancak genelde daha az saptanan septal kalınlaşmanın yüksek saptanması kanser hastalarında bulguların daha ciddi olabileceğini düşündürmektedir. PCR negatif vakalarda inflamatuvar markerların birçoğu daha yüksekti. Çok merkezde daha fazla hasta ile yapılacak çalışmalar kanser hastalarındaki bulguları genel popülasyonla daha iyi karşılaştırmayı sağlayacaktır.

Keywords

COVID-19, kanser, bilgisayarlı tomografi, laboratuvar, PCR

Evaluation of Computed Tomography, Clinical and Laboratory Findings of COVID-19 in Cancer Patients

Abstract

Aim: The aim of this study was to evaluate the computed tomography (CT), clinical and laboratory findings of coronavirus disease 2019 (COVID-19) in cancer patients and to compare the findings between polymerase chain reaction (PCR) positive and negative patients.
Material and Methods: Twenty-three cancer patients with positive PCR tests and 22 diagnosed as COVID-19 with clinical and radiological findings were included in the study. CT images of the patients were evaluated simultaneously by two radiologists. Presence of comorbid diseases, symptoms and laboratory values were evaluated.
Results: The most common CT involvement pattern was peripheral with 88.9% (n=40). Bilateral lung involvement rate was 57.8% (n=26). The most common finding was ground glass opacities (n=38, 84.5%). 35.6% (n=16) of these were accompanied by consolidation. Multifocal involvement was present in 62.2% (n=28) of the cases. The most frequently involved lobes were lower lobes. Other relatively common findings were septal thickening, subpleural streaking, and air bronchogram. The median neutrophil, lymphocyte, D-dimer, procalcitonin, C-reactive protein and lactate dehydrogenase values of the patients were 2000 mm3, 1200 mm3, 1990 ng/mL, 30.7 mcg/L 15.8 mg/dl, 161 IU/L, respectively.
Conclusion: Multifocal and bilateral involvement, and ground glass opacities were the most common findings. However, higher rates of septal thickening, which is generally less common, suggest that the findings may be more severe in cancer patients. Most of the inflammatory markers were higher in PCR negative cases. Studies with more patients in multiple centers will provide better comparison of the findings in cancer patients with the general population.

Keywords

COVID-19, cancer, computed tomography, laboratory, PCR

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