Objective: We aimed to evaluate the epidemiological and clinical characteristics, laboratory and imaging findings and outcome of patients with COVID-19 diagnosis who were hospitalized during the first wave of the COVID-19 pandemic.
Methods: A total of 124 cases followed with the diagnosis of COVID-19 were evaluated, retrospectively. Patients with SARS-CoV-2 RT-PCR test result positivity in respiratory specimen were accepted as the confirmed cases. Despite of a negative RT-PCR test result, patients having a combination of compatible symptoms and typical findings of viral pneumonia on thorax computed tomography (CT) were accepted as possible cases. Severe illness was defined as SpO2 ≤93% on room air and to need supplemental oxygen support or mechanical ventilation (MV) or extracorporeal membrane oxygenation. Patients achieving clinical improvement were defined by defervescence of fever for 48 hours, improvement of leukopenia and increase in lymphocyte and thrombocyte count, decrease in demand for oxygen support or weaning from MV.
Results: The median age of 124 cases was 54 (minimum-maximum 17-98) years and 59.7% of them were male. Among the overall population, 58% had comorbidities. Most frequent was hypertension (33.9%) followed by diabetes mellitus (16.1%) and cardiac disorders (13.7%). Most common clinical complaints were fever (73.4%), cough (70.2%), and shortness of breath (30.7%). SARS-CoV-2 RT-PCR tests of 81 (65.3%) patients were positive. Severe illness was present in 43 (34.6%) patients and 18 of them were followed in the intensive care unit. Patients with severe illness had higher mean ages, more accompanying comorbidities, and prolonged hospitalization compared to the patients with non-severe illness. Among the laboratory findings, leukocytosis was more frequent than leukopenia. In addition to presence of lymphopenia, thrombocytopenia and hypoalbuminemia, increases in levels of creatinine, D-dimer, and acute phase reactants were more prominent in patients with severe illness. Main thorax CT findings were ground glass opacities (93.3%), often bilateral (73%), involving the lower and lower-middle lobes (48.7%) and showing a peripheral distribution (49.6%). No serious side effects developed during the treatment given according to the recommendations of Ministry of Health Guidelines. Overall mortality rate was 3.2%, and 2 (2.2%) patients died were confirmed cases.
Conclusions: The sensitivity of available RT-PCR tests is not sufficient for diagnosis and management of COVID-19. Therefore, combining the imaging methods and serum antibody testing are also needed for management of the disease process.
Klimik Dergisi 2020; 33(3): 223-9.
Cite this article as: Karakoç ZÇ, Pınarbaşı-Şimşek B, Asil R, et al. [First wave in COVID-19 pandemic: A single center experience]. Klimik Derg. 2020; 33(3): 223-9. Turkish.