{"id":26380,"date":"2023-03-06T12:27:09","date_gmt":"2023-03-06T09:27:09","guid":{"rendered":"https:\/\/www.klimikdergisi.org\/?p=26380"},"modified":"2023-03-21T14:13:59","modified_gmt":"2023-03-21T11:13:59","slug":"hacettepe-universitesi-saglik-ve-covid-19-kohortu","status":"publish","type":"post","link":"https:\/\/www.klimikdergisi.org\/tr\/2023\/03\/06\/hacettepe-universitesi-saglik-ve-covid-19-kohortu\/","title":{"rendered":"Hacettepe Sa\u011fl\u0131k Kohortu (HU-CoVaCS): \u00c7al\u0131\u015fma Tasar\u0131m\u0131, Ba\u015flang\u0131\u00e7 Viziti De\u011ferlendirmesi ve COVID-19 A\u015f\u0131l\u0131lar\u0131n \u0130lk \u00dc\u00e7 Ayl\u0131k Takip Verileri"},"content":{"rendered":"

G\u0130R\u0130\u015e<\/h2>\n

SARS-CoV-2 virusu kaynakl\u0131 COVID-19 pandemisi, t\u00fcm d\u00fcnyada oldu\u011fu gibi T\u00fcrkiye\u2019de de h\u0131zla yay\u0131lan bir halk sa\u011fl\u0131\u011f\u0131 sorunu olarak 11 Mart 2020 tarihinden itibaren sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131 do\u011frudan etkilemi\u015ftir. SARS-CoV-2 ile kars\u0327\u0131las\u0327ma riskinin y\u00fcksek olmas\u0131 ve\/veya y\u00fcksek viral y\u00fck al\u0131m\u0131 nedeniyle sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 pandemide y\u00fcksek riskli gruplar\u0131n ba\u015f\u0131nda gelmektedir (1,2).<\/p>\n

Sag\u0306l\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n pandemiden bireysel olarak etkilenmeleri hasta bak\u0131m\u0131na da dog\u0306rudan yans\u0131makta, sa\u011fl\u0131k bak\u0131m hizmetinin gecikmesine ve\/veya aksamas\u0131na neden olmaktad\u0131r. Bu nedenle, pandemi d\u00f6nemlerinde sag\u0306l\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n \u00f6ncelikli olarak korunmas\u0131 son derece o\u0308nemlidir (2). Birincil korunman\u0131n \u00fc\u00e7 temel kural\u0131 olan maske, fiziksel mesafe ve hijyen ile birlikte Ocak 2021\u2019den itibaren \u00fclkemizde COVID-19 a\u015f\u0131 uygulamas\u0131 ba\u015flat\u0131lm\u0131\u015f ve a\u015f\u0131lamada, sa\u011fl\u0131k hizmeti sunan \u00f6\u011frenciler de dahil olmak \u00fczere, sag\u0306l\u0131k \u00e7al\u0131\u015fanlar\u0131 \u00f6ncelikli grubuna dahil edilmi\u015ftir (3). Hacettepe U\u0308niversitesi\u2019nde de T\u0131p Fak\u00fcltesi\u2019nde eg\u0306itimlerine kliniklerde devam eden 4., 5. ve 6. d\u00f6nem \u00f6\u011frencileri ve Dis\u0327 Hekimlig\u0306i Fak\u00fcltesi\u2019nde e\u011fitim g\u00f6ren 4. ve 5. d\u00f6nem o\u0308g\u0306rencileri ulusal COVID-19 a\u015f\u0131lama program\u0131 kapsam\u0131nda 14 Ocak 2021 tarihinden itibaren 28 g\u00fcn ara ile iki doz inaktif CoronaVac (Sinovac Life Sciences, Pekin, \u00c7in) as\u0327\u0131 uygulamas\u0131na dahil edilmi\u015ftir.\u00a0<\/span><\/p>\n

Hacettepe Sa\u011fl\u0131k Kohortu (HU-CoVaCS) \u00e7al\u0131\u015fmas\u0131nda, prospektif kohort tipi bir ara\u015ft\u0131rma y\u00f6ntemiyle aktif hasta bak\u0131m\u0131nda \u00e7al\u0131\u015fan \u00f6\u011frenci grubunun pandemi d\u00f6neminde COVID-19 riski a\u00e7\u0131s\u0131ndan \u00f6ncellikli bir grup olmas\u0131ndan dolay\u0131 genel sa\u011fl\u0131k, COVID-19 ge\u00e7irme \u00f6yk\u00fcs\u00fc ve a\u015f\u0131lanma durumlar\u0131n\u0131n periyodik olarak takibi ve de\u011ferlendirilmesi ama\u00e7land\u0131.\u00a0<\/span><\/p>\n

Y\u00d6NTEMLER<\/h2>\n

Pandemi s\u00fcrecinde \u00e7ok say\u0131da \u00e7al\u0131\u015fmada, sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 COVID-19 ve ilgili a\u015f\u0131 uygulamalar\u0131 a\u00e7\u0131s\u0131ndan izleme al\u0131nm\u0131\u015ft\u0131r. Ara\u015ft\u0131rmam\u0131zda da \u00e7al\u0131\u015fma grubu olarak pandemi s\u00fcrecinde risklerden etkilenme olas\u0131l\u0131\u011f\u0131 en y\u00fcksek sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 aras\u0131nda yer alan ve e\u011fitimleri s\u0131ras\u0131nda aktif hasta bak\u0131m\u0131 ile ilgilenen \u00f6\u011frenciler se\u00e7ildi.<\/p>\n

\u00d6\u011frencilerin; hasta bak\u0131m\u0131nda daha deneyimsiz olmas\u0131, maske takma al\u0131\u015fkanl\u0131klar\u0131n\u0131n olmamas\u0131, farkl\u0131 birimlerde k\u0131sa s\u00fcrelerle \u00e7al\u0131\u015ft\u0131klar\u0131 i\u00e7in de\u011fi\u015fen kurallara uyum sorunlar\u0131n\u0131n olmas\u0131 bu grubu hastane i\u00e7inde COVID-19 infeksiyonu a\u00e7\u0131s\u0131ndan daha riskli bir duruma sokmaktad\u0131r; gen\u00e7 olmalar\u0131 nedeniyle morbidite ve fatalite risklerinin d\u00fc\u015f\u00fck alg\u0131lanmas\u0131 da risk alma tutumlar\u0131n\u0131 etkilemektedir. \u00d6\u011frencilerde asemptomatik COVID-19 infeksiyonunun yayg\u0131n olmas\u0131 s\u00f6z konusu grupta hastal\u0131\u011f\u0131n tan\u0131nmas\u0131n\u0131 da zorla\u015ft\u0131rmaktad\u0131r. Ayr\u0131ca \u00f6\u011frencilerin sosyal ortamlar\u0131nda ve toplu ta\u015f\u0131ma ara\u00e7lar\u0131nda infeksiyona maruz kalma olas\u0131l\u0131klar\u0131 da y\u00fcksektir. Yemekhane, k\u00fct\u00fcphane ve\/veya yurt gibi ortak mekanlarda \u00f6\u011frenciler hastal\u0131\u011f\u0131 kolay aktarabilir ve \u00e7al\u0131\u015fma birimleri aras\u0131nda g\u00f6rev de\u011fi\u015fiklikleriyle infeksiyonu farkl\u0131 birimlere ta\u015f\u0131yabilir.<\/p>\n

Hacettepe \u00dcniversitesi T\u0131p Fak\u00fcltesi ve Di\u015f Hekimli\u011fi Fak\u00fcltesi\u2019nde 4. s\u0131n\u0131ftan itibaren \u00f6\u011frenciler aktif hasta bak\u0131m\u0131na kat\u0131lmaktad\u0131r. Bu nedenle, 2020-2021 e\u011fitim d\u00f6neminde ilgili okullar\u0131n 4. s\u0131n\u0131f ve \u00fcst\u00fc s\u0131n\u0131flara devam eden t\u00fcm \u00f6\u011frencilerini bir \u201ckohort\u201d olarak kabul ederek \u00f6\u011frenciler \u00e7al\u0131\u015fmaya davet edildi. Bilgilendirilmi\u015f onam formu imzalayarak \u00e7al\u0131\u015fmaya kat\u0131lmay\u0131 kabul eden \u00f6\u011frencilerin mezuniyetlerine veya \u00f6\u011frencili\u011fi devam edenlerin May\u0131s 2023 sonuna kadar izlenmesi hedeflendi.\u00a0 <\/span>Bu s\u00fcre\u00e7te o\u0308g\u0306renciler sadece COVID-19 \u00f6yk\u00fcs\u00fc ve a\u015f\u0131 uygulamalar\u0131 ac\u0327\u0131s\u0131ndan deg\u0306il genel sag\u0306l\u0131k durumu ve yas\u0327am kalitesi ac\u0327\u0131s\u0131ndan da yak\u0131ndan takip edildi; \u00e7al\u0131\u015fma kapsam\u0131nda, gerekli g\u00f6r\u00fclmesi halinde, ileri de\u011ferlendirmeler i\u00e7in y\u00f6nlendirilerek pandemi s\u00fcrecinde sag\u0306l\u0131k a\u00e7\u0131s\u0131ndan ve sosyal ac\u0327\u0131dan desteklenmeleri de ama\u00e7land\u0131.\u00a0<\/span><\/p>\n

\u00dcniversite y\u00f6netimi ve akademisyenler bu \u00e7al\u0131\u015fmay\u0131 sosyal bir sorumluluk olarak kabul etti ve t\u00fcm \u00e7al\u0131\u015fma ekibi kendi uzmanl\u0131k alanlar\u0131nda g\u00f6n\u00fcll\u00fc olarak g\u00f6rev ald\u0131. Hacettepe U\u0308niversitesi Bilimsel Aras\u0327t\u0131rma Projeleri Koordinasyon Birimi taraf\u0131ndan 2021 y\u0131l\u0131 C\u0327ag\u0306r\u0131l\u0131 Aras\u0327t\u0131rma Projeleri kapsam\u0131nda da \u00e7al\u0131\u015fma desteklendi (T\u00c7P-2021-19467).\u00a0<\/span><\/p>\n

\u00c7al\u0131\u015fma, Sag\u0306l\u0131k Bakanl\u0131g\u0306\u0131 COVID-19 Bilimsel Ara\u015ft\u0131rma Deg\u0306erlendirme Komisyonu taraf\u0131ndan 14 S\u0327ubat 2021 tarihinde ve Hacettepe U\u0308niversitesi Klinik Aras\u0327t\u0131rmalar Etik Kurulu taraf\u0131ndan 23 \u015eubat 2021 tarih ve KA-21034 karar numaras\u0131yla onayland\u0131. T\u00fcrkiye I\u0307lac\u0327 ve T\u0131bbi Cihaz Kurumu (TI\u0307TCK) taraf\u0131ndan 07 May\u0131s 2021 tarih ve 21-AKD-34 karar numaras\u0131yla \u00e7al\u0131\u015fman\u0131n yap\u0131lmas\u0131na izin verildi. Kat\u0131l\u0131mc\u0131lardan bilgilendirilmi\u015f onam al\u0131nd\u0131. \u00c7al\u0131\u015fman\u0131n her basama\u011f\u0131 i\u00e7in ayr\u0131ca onam al\u0131narak \u00f6\u011frencilerin yaln\u0131zca kabul ettikleri basamaklara kat\u0131lmalar\u0131 sa\u011fland\u0131.\u00a0<\/span><\/p>\n

\u00c7al\u0131\u015fma Tasar\u0131m\u0131<\/h3>\n
\"\"<\/a>

\u015eekil 1.<\/strong> Kohort ve Yuvaland\u0131r\u0131lm\u0131\u015f Olgu Kontrol Tasar\u0131mlar\u0131<\/p><\/div>\n

Aras\u0327t\u0131rma prospektif kohort tipi bir go\u0308zlemsel aras\u0327t\u0131rma olarak planland\u0131; semptomatik COVID-19 ile ili\u015fkili risk fakt\u00f6rlerinin saptanmas\u0131 i\u00e7in kohort i\u00e7ine yuvaland\u0131r\u0131lm\u0131\u015f bir e\u015fle\u015ftirilmi\u015f olgu-kontrol \u00e7al\u0131\u015fmas\u0131 ile veri eldesi zenginle\u015ftirildi. Aras\u0327t\u0131rman\u0131n ba\u015flang\u0131\u00e7 verileri 21 Haziran-30 Temmuz 2021 aras\u0131nda topland\u0131. \u00c7al\u0131\u015fman\u0131n devam\u0131 kapsam\u0131nda 3., 9. ve 24. aylarda yap\u0131lacak vizitlerle sag\u0306l\u0131k durumundaki de\u011fi\u015fikliklerin ve a\u015f\u0131lar\u0131n etkililik, g\u00fcvenilirlik ve ba\u011f\u0131\u015f\u0131kl\u0131k yan\u0131t\u0131n\u0131n devaml\u0131l\u0131\u011f\u0131n\u0131n izlenmesi planland\u0131 (\u015eekil 1). Bu makalede, \u00e7al\u0131\u015fma tasar\u0131m\u0131n\u0131n detayl\u0131 olarak tan\u0131t\u0131lmas\u0131 ve kat\u0131l\u0131mc\u0131lar\u0131n bazal verilerinin analizinin sunulmas\u0131 ama\u00e7land\u0131.<\/p>\n

Aras\u0327t\u0131rman\u0131n evrenini, kay\u0131tl\u0131 \u00f6\u011frenci say\u0131lar\u0131 \u00fczerinden, Hacettepe U\u0308niversitesi T\u0131p Faku\u0308ltesi\u2019nde 4., 5. ve 6. s\u0131n\u0131fa devam eden 1441 o\u0308g\u0306renci ile Dis\u0327 Hekimlig\u0306i Faku\u0308ltesi 4. ve 5. s\u0131n\u0131fa devam eden 100 o\u0308g\u0306renci olus\u0327turdu. C\u0327al\u0131s\u0327ma vizitlerinden o\u0308nceki hafta dekanl\u0131klar\u0131n onay\u0131yla ilgili o\u0308g\u0306renci is\u0327leri birimleri taraf\u0131ndan kay\u0131tl\u0131 iletis\u0327im e-posta adreslerine toplu mesaj at\u0131larak \u00f6\u011frenciler c\u0327al\u0131s\u0327ma hakk\u0131nda bilgilendirildi ve kat\u0131lmak isteyenler muayene alan\u0131na yo\u0308nlendirildi. \u0130lgili s\u0131n\u0131flar\u0131n temsilcileri olarak belirlenen sekiz \u00f6\u011frenci \u00e7al\u0131\u015fman\u0131n planlama a\u015famalar\u0131ndan itibaren ekibe katk\u0131 sa\u011flad\u0131 ve \u00e7al\u0131\u015fma a\u015famalar\u0131nda verilerin anonim olarak toplanmas\u0131na destek oldu. Aras\u0327t\u0131rma kapsam\u0131nda bir o\u0308rneklem grubu sec\u0327ilmedi ve \u00e7al\u0131\u015fmaya kat\u0131lmay\u0131 kabul eden, muayene, \u00f6l\u00e7\u00fcm, anket ve testleri tamamlayan 778 \u00f6\u011frenci verisi analize dahil edildi; tamamlanma %50.5\u2019dir (n=1541).<\/p>\n

\u00d6l\u00e7\u00fcmler<\/h3>\n

Ki\u015fisel verilerin korunmas\u0131 amac\u0131yla ara\u015ft\u0131rma ekibinde olmayan iki akademisyen taraf\u0131ndan ilk muayenede kat\u0131l\u0131mc\u0131lara rastgele olacak \u015fekilde kod verildi. \u201cGoogle Docs Editors\u201d arac\u0131l\u0131\u011f\u0131yla haz\u0131rlanan \u00e7evrimi\u00e7i anket formunu her \u00f6\u011frenci internet ba\u011flant\u0131s\u0131 \u00fczerinden kendi bireysel kat\u0131l\u0131m kodunu kullanarak doldurdu. \u00d6\u011frenciler, kan testi sonu\u00e7lar\u0131na kodlar\u0131yla ili\u015fkilendirilmi\u015f \u00f6zel dosyaland\u0131rma sistemi arac\u0131l\u0131\u011f\u0131yla Hacettepe Hasta Bilgi Sistemi\u2019nden ula\u015ft\u0131. Veri taban\u0131nda, ki\u015fisel mahremiyeti ve veri g\u00fcvenli\u011fi bilgilerini azami d\u00fczeyde korumak amac\u0131yla kat\u0131l\u0131m kodlar\u0131 d\u0131\u015f\u0131nda bireysel tan\u0131mlay\u0131c\u0131 bilgilere yer verilmedi. \u00c7al\u0131\u015fman\u0131n kay\u0131t, antropometrik \u00f6l\u00e7\u00fcm, fizik muayene ve kan al\u0131mlar\u0131, anketlerin doldurulmas\u0131 ile e\u015f zamanl\u0131 olarak, Hacettepe \u00dcniversitesi S\u0131hhiye Kamp\u00fcs\u00fc Mediko Sosyal Merkezi i\u00e7inde \u00f6zel haz\u0131rlanm\u0131\u015f bir alanda COVID-19 \u00f6nlemlerine uyularak, ara\u015ft\u0131rma ekibi, akademisyenler ve g\u00f6revlendirilmi\u015f hem\u015fire taraf\u0131ndan ger\u00e7ekle\u015ftirildi. \u00d6\u011frencilerin tamam\u0131n\u0131n fizik muayeneleri yap\u0131ld\u0131, vital bulgular\u0131, boy ve v\u00fccut a\u011f\u0131rl\u0131klar\u0131 kay\u0131t alt\u0131na al\u0131nd\u0131. V\u00fccut kitle indeksi (VK\u0130) v\u00fccut a\u011f\u0131rl\u0131\u011f\u0131n\u0131n boy uzunlu\u011funun karesine b\u00f6l\u00fcnmesiyle (kg\/m\u00b2) hesapland\u0131 ve D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc (DS\u00d6) kriterlerine uygun olarak de\u011ferlendirildi.<\/p>\n

Anket arac\u0131l\u0131\u011f\u0131yla; demografik \u00f6zellikler, a\u015f\u0131lanma bilgisi, temel sa\u011fl\u0131kl\u0131 ya\u015fam al\u0131\u015fkanl\u0131klar\u0131 (uyku, beslenme, vb.), sigara ic\u0327me o\u0308yku\u0308su\u0308, maske-mesafe-hijyen kurallar\u0131na uyum, a\u015f\u0131 sonras\u0131 maske-mesafe-hijyen kurallar\u0131na uyumda de\u011fi\u015fim, eg\u0306itim su\u0308recinde yas\u0327am yeri, is\u0327 yerinde korunma ile ilgili (varsa) riskler konular\u0131nda beyana dayal\u0131 olarak bilgi edinildi.\u00a0<\/span><\/p>\n

Bas\u0327lang\u0131c\u0327 vizitlerinde tu\u0308m o\u0308g\u0306rencilere yap\u0131lan tam kan say\u0131m\u0131 ve biyokimya analizleri Hacettepe U\u0308niversitesi Hastaneleri Merkez Laboratuvar\u0131\u2019nda bulunan sistemler kullan\u0131larak gerc\u0327ekles\u0327tirildi.<\/p>\n

Klinik o\u0308rneklerden nu\u0308kleik asit izolasyonu Bio-Speedy viral nu\u0308kleik asit tamponu (vNAT\u00ae) (Bioeksen AR-GE Teknolojileri, Tu\u0308rkiye) kullan\u0131larak; anti-SARS-CoV-2 kantitatif IgG antikor \u00f6l\u00e7\u00fcm\u00fc ise anti-SARS-COV-2 spike \u201creceptor binding domain\u201d protein IgG kiti (Architect, Abbott Laboratories, ABD) kullan\u0131larak gerc\u0327ekles\u0327tirildi. Sonu\u00e7lar AU\/ml cinsinden 0 ile 40 000 aras\u0131nda bir de\u011fer olarak verildi; 50 ve \u00fczerindeki de\u011ferler pozitif olarak kabul edildi. \u00c7al\u0131\u015fmam\u0131zda Abbott SARS-CoV-2 IgG II Quant testi ile elde edilen AU\/ml de\u011feri 0.142 ile \u00e7arp\u0131larak DS\u00d6 standard\u0131na kar\u015f\u0131l\u0131k gelen BAU\/ml cinsinden verildi. Kullan\u0131lan teste ili\u015fkin \u00f6l\u00e7\u00fcm de\u011ferlerinin COVID-19 i\u00e7in koruyuculuk belirteci olarak kullan\u0131labilece\u011fine dair yay\u0131nlar bulunmaktad\u0131r (4).<\/p>\n

Yuvaland\u0131r\u0131lm\u0131\u015f olgu-kontrol alt \u00e7al\u0131\u015fmas\u0131; s\u00fcre\u00e7 i\u00e7inde COVID-19 tan\u0131s\u0131 alan ve almayanlar\u0131n kar\u015f\u0131la\u015ft\u0131r\u0131larak, ki\u015fisel \u00f6zellikler, maske-mesafe-hijyen uyumu ve anti-SARS CoV-2 antikorlar\u0131 ile hastal\u0131k ili\u015fkisinin detayl\u0131 incelenmesi i\u00e7in planland\u0131. Kohort i\u00e7inden izlem s\u00fcresi boyunca semptomatik\/temasl\u0131 olup test i\u00e7in Hacettepe C1 ve C2 birimlerinde PCR testi verenler listesinden pozitif olanlar\u0131n saptanmas\u0131 ile \u201colgu\u201dlar belirlendi. E\u015f zamanl\u0131 olarak \u00f6\u011frenci temsilcileri s\u0131n\u0131f listelerine yazarak, olgu ile ayn\u0131 okul, d\u00f6nem ve cinsiyetten iki ki\u015fiyi PCR ve kan antikor testi i\u00e7in davet etti: Bu ki\u015filer \u00e7al\u0131\u015fmada kontrol grubunu olu\u015fturdu.\u00a0<\/span><\/p>\n

T.C. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 kararlar\u0131 do\u011frultusunda 13 Ocak 2021 tarihinde 28 g\u00fcn ara ile iki doz inaktif CoronaVac a\u015f\u0131 (Sinovac Life Sciences, Pekin, \u00c7in) uygulamas\u0131 ilk olarak sa\u011fl\u0131k personeline ve 65 ya\u015f ve \u00fczeri bireylere e\u015f zamanl\u0131 olarak ba\u015flat\u0131lm\u0131\u015ft\u0131r; 2 Nisan 2021 tarihinde a\u015f\u0131 uygulamalar\u0131nda Pfizer-BioNTech <\/span>mRNA a\u015f\u0131s\u0131n\u0131n (Comirnaty\u00ae<\/sup><\/span>) se\u00e7imine imkan tan\u0131nm\u0131\u015f ve 30 Haziran 2021\u2019den itibaren sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131na \u00fc\u00e7\u00fcnc\u00fc doz, tercih edilen her hangi bir a\u015f\u0131 ile uygulanm\u0131\u015ft\u0131r (5). \u00c7al\u0131\u015fma grubumuzda kat\u0131l\u0131mc\u0131lar ulusal a\u015f\u0131lama program\u0131 dahilinde, kendi se\u00e7imlerine uygun olarak a\u015f\u0131lanm\u0131\u015f olup beyana dayal\u0131 olarak a\u015f\u0131 say\u0131 ve t\u00fcrlerini bildirdi. \u00c7al\u0131\u015fma ekibimiz, a\u015f\u0131 tarihlerinin do\u011fru belirtildi\u011finden emin olmak i\u00e7in \u00f6\u011frencilerden, COVID-19 a\u015f\u0131 t\u00fcr ve tarihlerini T.C. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 e-Nab\u0131z Ki\u015fisel Sa\u011fl\u0131k Sistemi kay\u0131tlar\u0131na uygun olarak bildirmelerini istedi.<\/p>\n

\u0130statistiksel Analizler<\/h3>\n

Tan\u0131mlay\u0131c\u0131 istatistikler, niteliksel verilerde say\u0131 (n) ve y\u00fczde (%) ile g\u00f6sterildi; s\u00fcrekli niceliksel verilerde, normal da\u011f\u0131lan veriler i\u00e7in ortalama ve standart sapma, normal da\u011f\u0131lmayan veriler i\u00e7inse ortanca ve minimum-maksimum de\u011ferlerle verildi. Gruplar aras\u0131 kars\u0327\u0131las\u0327t\u0131rmalarda, deg\u0306is\u0327ken tu\u0308ru\u0308 ve say\u0131ya uygun olarak; \u03c7\u00b2, Fisher kesin olas\u0131l\u0131k testi, ANOVA testi veya nonparametrik testler kullan\u0131ld\u0131. \u0130nsidans h\u0131z\u0131 ve k\u00fcm\u00fclatif insidans hesapland\u0131. I\u0307statistiksel anlaml\u0131l\u0131k du\u0308zeyi (alfa) 0.05 olarak kabul edildi. Analizler, fak\u00fclte ve s\u0131n\u0131flara g\u00f6re tabakal\u0131 olarak yap\u0131lmakla birlikte gruplar aras\u0131nda fark olmad\u0131\u011f\u0131 durumlarda sonu\u00e7lar genel toplamlar \u00fczerinden verildi.<\/p>\n

BULGULAR<\/h2>\n
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\u015eekil 2.<\/strong> Ak\u0131\u015f \u015eemas\u0131<\/p><\/div>\n

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Tablo 1.<\/strong> Kat\u0131l\u0131mc\u0131lar\u0131n Demografik Bulgular\u0131<\/p><\/div>\n

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Tablo 2. <\/strong>Kat\u0131l\u0131mc\u0131lar\u0131n Sa\u011fl\u0131k Durumlar\u0131<\/p><\/div>\n

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Tablo 3.<\/strong> Pandemi D\u00f6neminde \u0130nfeksiyondan Korunma \u00d6nlemlerine Uyum ve Risk<\/p><\/div>\n

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Tablo 4.<\/strong> Kat\u0131l\u0131mc\u0131lar\u0131n A\u015f\u0131 Olma Durumlar\u0131 ve A\u015f\u0131 Sonras\u0131 Yan Etkilerin Da\u011f\u0131l\u0131m\u0131<\/p><\/div>\n

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\u015eekil 3.<\/strong> Erkek Kat\u0131l\u0131mc\u0131lar\u0131n A\u015f\u0131lanma Durumlar\u0131na G\u00f6re BAU\/ml Cinsinden Anti-SARS CoV-2 IgG Antikor D\u00fczeylerinin Log Da\u011f\u0131l\u0131m\u0131<\/p><\/div>\n

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\u015eekil 4.<\/strong> Kad\u0131n Kat\u0131l\u0131mc\u0131lar\u0131n A\u015f\u0131lanma Durumlar\u0131na G\u00f6re BAU\/ml Cinsinden Anti-SARS CoV-2 IgG Antikor D\u00fczeylerinin Log Da\u011f\u0131l\u0131m\u0131<\/p><\/div>\n

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Tablo 5.<\/strong> Kat\u0131l\u0131mc\u0131lar\u0131n SARS-CoV-2 \u201cSpike\u201d (S) Proteinine Kar\u015f\u0131 Olu\u015fan IgM Kantitatif Antikor D\u00fczeylerinin A\u015f\u0131lanma Durumlar\u0131na G\u00f6re Da\u011f\u0131l\u0131m ve Yay\u0131l\u0131m \u0130statistikleri<\/p><\/div>\n

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Tablo 6.<\/strong> 21 Haziran 2021 \u2013 01 Ekim 2021 Tarihleri Aras\u0131nda COVID-19 Hastal\u0131\u011f\u0131 Tan\u0131s\u0131 Alan \u00d6\u011frenciler ve Kontrol Gruplar\u0131n\u0131n A\u015f\u0131 ve Antikor \u00d6zellikleri<\/p><\/div>\n

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Tablo 7.<\/strong> Kat\u0131l\u0131mc\u0131lar\u0131n Laboratuvar Bulgular\u0131<\/p><\/div>\n

Bas\u0327lang\u0131c\u0327 vizitlerinin yap\u0131ld\u0131\u011f\u0131 ilk be\u015f haftal\u0131k do\u0308nemde \u00e7al\u0131\u015fmaya kat\u0131lmay\u0131 kabul edenlerin say\u0131s\u0131 783\u2019t\u00fcr; \u00e7al\u0131\u015fman\u0131n t\u00fcm basamaklar\u0131n\u0131 tamamlayanlar\u0131n y\u00fczdesi ise 92.4\u2019t\u00fcr. Hematolojik ve biyokimyasal analizler, periyodik izlem ve muayeneler s\u00fcrd\u00fcr\u00fclemeyece\u011fi i\u00e7in son s\u0131n\u0131f \u00f6\u011frencilerine yap\u0131lmad\u0131. Biyokimya testleri ic\u0327in 545, tam kan say\u0131m\u0131 ve 25-OH vitamin D ic\u0327in 537, HbA1c ic\u0327in 538 kat\u0131l\u0131mc\u0131n\u0131n kan o\u0308rneg\u0306i deg\u0306erlendirildi (\u015eekil 2).\u00a0<\/span><\/p>\n

Kat\u0131l\u0131mc\u0131lar\u0131n %53.6\u2019s\u0131 kad\u0131nd\u0131; ortanca ya\u015f 23 (21-36) olarak tespit edildi.\u00a0 <\/span>Cevap verenlerin %38.6\u2019s\u0131 ailelerinin sosyoekonomik durumunu \u201ciyi\u201d, %51.9\u2019u \u201corta\u201d olarak belirtti. Kat\u0131l\u0131mc\u0131lar\u0131n yakla\u015f\u0131k %60\u2019\u0131 evde veya yurtta ya\u015fad\u0131\u011f\u0131 ortam\u0131 bir veya daha fazla ki\u015fi ile payla\u015fmaktayd\u0131 (Tablo 1).<\/p>\n

Kat\u0131l\u0131mc\u0131lar\u0131n %81\u2019i kendini iyi hissetti\u011fini ifade ederken, yakla\u015f\u0131k \u00fc\u00e7te biri tan\u0131 koyulmu\u015f en az bir hastal\u0131\u011f\u0131 oldu\u011funu belirtti. Her \u00fc\u00e7 kat\u0131l\u0131mc\u0131dan biri yeterli ve dengeli beslendi\u011fini ifade ederken, %6.4\u2019\u00fc obez kategorisindeydi. Kat\u0131l\u0131mc\u0131lar\u0131n beyanlar\u0131na g\u00f6re g\u00fcnl\u00fck uyku s\u00fcreleri yeterliydi. \u00c7al\u0131\u015fman\u0131n y\u00fcr\u00fct\u00fcld\u00fc\u011f\u00fc d\u00f6nemde kat\u0131l\u0131mc\u0131lar\u0131n be\u015fte biri sigara i\u00e7ti\u011fini bildirdi; fak\u00fclte ve d\u00f6neme g\u00f6re de\u011ferlendirildi\u011finde, sigara i\u00e7me yayg\u0131nl\u0131\u011f\u0131 s\u0131n\u0131f ile artmaktayd\u0131. Di\u015f Hekimli\u011fi Fak\u00fcltesi\u2019nde 4. s\u0131n\u0131fta sigara i\u00e7me y\u00fczdesi 28.4 iken 5. s\u0131n\u0131fta bu %38. 7 olarak tespit edildi; T\u0131p Fak\u00fcltesi\u2019nde ise y\u00fczdeler 4. s\u0131n\u0131fta %13.2, 5. s\u0131n\u0131fta %21.1 ve 6. s\u0131n\u0131fta %29.9\u2019du.\u00a0<\/span><\/p>\n

\u00d6\u011frencilerin, PCR ile teyit edilmi\u015f COVID-19 tan\u0131s\u0131 alma durumlar\u0131 sorguland\u0131\u011f\u0131nda; %13.2\u2019si tan\u0131 alm\u0131\u015f olup be\u015fte birinin COVID-19 temas \u00f6yk\u00fcs\u00fc bulunmaktayd\u0131. Temmuz 2021 sonu itibar\u0131 ile grup i\u00e7inde en az bir doz COVID-19 a\u015f\u0131s\u0131 yap\u0131lan (%99.1) her be\u015f \u00f6\u011frenciden biri en az bir a\u015f\u0131 nedenli istenmeyen etki ya\u015fad\u0131\u011f\u0131n\u0131 belirtti (Tablo 2).<\/p>\n

COVID-19 i\u00e7in olas\u0131 risk fakt\u00f6r\u00fc olan \u201caerosol olu\u015fturan i\u015flem<\/i>\u201d yayg\u0131nl\u0131\u011f\u0131 %2.2 olarak bildirildi.\u00a0 <\/span>Kat\u0131l\u0131mc\u0131lar\u0131n gerek hastane ic\u0327inde (poliklinik, servis, ameliyathane, vb.) gerekse sosyal alanlarda (yemekhane, dinlenme salonlar\u0131, vb.) maske-mesafe-hijyen kurallar\u0131na uyumlar\u0131 beyanlar\u0131na g\u00f6re %70\u2019in \u00fczerindedir. Kat\u0131l\u0131mc\u0131lar\u0131n %37.2\u2019si ise pandemi nedeni ile kalabal\u0131k ortamda hi\u00e7 bulunmad\u0131g\u0306\u0131n\u0131 ifade etti. A\u015f\u0131 sonras\u0131 maske kullan\u0131m\u0131 azal\u0131rken (%7.2), kalabal\u0131k ortamda bulunma durumunun artt\u0131\u011f\u0131 (%37.0) ifade edildi (Tablo 3).<\/p>\n

Kat\u0131l\u0131mc\u0131lara a\u015f\u0131 sonras\u0131 deneyimlenen advers etkiler doz \u00f6zelinde soruldu. A\u015f\u0131 sonras\u0131 en yayg\u0131n belirtilen lokal yan etkiler (a\u015f\u0131 yerinde ve kolda a\u011fr\u0131, lokal \u0131s\u0131 art\u0131\u015f\u0131 ve k\u0131zar\u0131kl\u0131k) ve takiben halsizlik, miyaljidir. Doz say\u0131s\u0131 ile advers etki aras\u0131nda pozitif ili\u015fki saptand\u0131 (Tablo 4).<\/p>\n

Kat\u0131lan o\u0308g\u0306rencilerin tamam\u0131n\u0131n fizik muayeneleri yap\u0131ld\u0131 ve vital bulgular\u0131, boy ve v\u00fccut a\u011f\u0131rl\u0131klar\u0131 kay\u0131t alt\u0131na al\u0131nd\u0131. V\u00fccut s\u0131cakl\u0131g\u0306\u0131 en yu\u0308ksek 37.9\u00b0C o\u0308lc\u0327u\u0308ld\u00fc. Sistolik kan bas\u0131nc\u0327lar\u0131 hipertansiyon s\u0131n\u0131r\u0131n\u0131n u\u0308zerinde olanlar yaklas\u0327\u0131k %5 iken, yu\u0308ksek normal grup dahil edildig\u0306inde\u00a0 <\/span>%15\u2019i bulmaktayd\u0131. Y\u00fcksek diyastolik kan bas\u0131nc\u0131 kat\u0131l\u0131mc\u0131lar\u0131n yakla\u015f\u0131k %5\u2019inde saptand\u0131. Fizik muayeneden k\u0131sa su\u0308re o\u0308nce as\u0327\u0131 olan \u00fc\u00e7 (%0.4) kat\u0131l\u0131mc\u0131n\u0131n enjeksiyon bo\u0308lgesinde k\u0131zar\u0131kl\u0131k ve s\u0131cakl\u0131k art\u0131s\u0327\u0131 saptand\u0131. Solunum muayenesi s\u0131ras\u0131nda iki (%0.3) kat\u0131l\u0131mc\u0131da anormal dinleme bulgusu (ral-ronku\u0308s) tespit edildi. Toplam 177 (%22.8) kat\u0131l\u0131mc\u0131n\u0131n servikal lenf bezlerinde bu\u0308yu\u0308me tespit edildi. Bu ki\u015filerin a\u015f\u0131lanma durumlar\u0131 incelendi\u011finde; 117(%66.1)\u2019sinin iki doz inaktif CoronaVac a\u015f\u0131s\u0131 (Sinovac Life Sciences, Pekin, \u00c7in) ve bir doz Pfizer-BioNTech <\/span>mRNA a\u015f\u0131s\u0131 (Comirnaty\u00ae<\/sup>); <\/span>49 (%27.9)\u2019unun iki doz CoronaVac, iki doz Comirnaty\u00ae<\/sup><\/span>; 9 (%5.1)\u2019unun iki doz CoronaVac; birinin (%0.6)\u2019de iki doz Comirnaty\u00ae<\/sup><\/span> yapt\u0131rd\u0131\u011f\u0131 tespit edildi.<\/p>\n

Kat\u0131l\u0131mc\u0131lar\u0131n en az bir doz COVID-19 a\u015f\u0131s\u0131 olma durumu\u00a0 <\/span>%99.1 olup en az iki doz a\u015f\u0131 olma durumu ise %98\u2019dir. Yurt d\u0131\u015f\u0131 ziyareti s\u0131ras\u0131nda a\u015f\u0131lanma veya Ulusal A\u015f\u0131lama Program\u0131\u2019na eklenen 3. doz nedeniyle, grubun %11.7\u2019sinde \u00fc\u00e7 veya d\u00f6rt doz a\u015f\u0131lanma tespit edildi. I\u0307ki doz CoronaVac as\u0327\u0131s\u0131 olanlar\u0131n 2. doz as\u0327\u0131s\u0131n\u0131n u\u0308zerinden ortanca 134 (34-166) gu\u0308n gec\u0327mis\u0327ti. I\u0307ki doz CoronaVac u\u0308zerine 3. doz olarak Comirnaty\u00ae<\/sup><\/span> as\u0327\u0131s\u0131 olanlar\u0131n 2. doz as\u0327\u0131s\u0131 u\u0308zerinden ortanca 164 (151-202) gu\u0308n ve 3. (son) doz as\u0327\u0131s\u0131 u\u0308zerinden ortanca 25 (14-56) gu\u0308n gec\u0327mis\u0327ti.<\/p>\n

T\u00fcm kat\u0131l\u0131mc\u0131lar i\u00e7in ortanca antikor d\u00fczeyi 53.55 BAU\/ml (0-5680) olarak tespit edildi. I\u0307lk vizitte iki doz CoronaVac as\u0327\u0131s\u0131 olanlarda ortanca antikor d\u00fczeyi 47.19 BAU\/ml<\/span> iken iki doz CoronaVac u\u0308zerine 3. dozu Comirnaty\u00ae<\/sup><\/span> olanlarda bunun 100 kat\u0131n\u0131n u\u0308zerindedir (4943.64 BAU\/ml) (Tablo 5) (\u015eekil 3-4).\u00a0<\/span><\/p>\n

Antikor du\u0308zeyinin tespiti ic\u0327in kan analizi yap\u0131lan 766 kis\u0327inin 16 (%2.1)\u2019s\u0131n\u0131n anti-SARS-CoV-2 IgG antikor du\u0308zeyi testin kesim noktas\u0131 deg\u0306eri olan 50 AU\/ml (yakla\u015f\u0131k 7.1 BAU\/ml)\u2019nin alt\u0131nda saptand\u0131. S\u00f6z konusu 16 \u00f6\u011frencinin 10\u2019u erkek, alt\u0131s\u0131 kad\u0131nd\u0131r; hepsi T\u0131p Fak\u00fcltesi \u00f6\u011frencisi olup alt\u0131s\u0131 4. s\u0131n\u0131f, \u00fc\u00e7\u00fc 5. s\u0131n\u0131f ve yedisi 6. s\u0131n\u0131f o\u0308g\u0306rencisidir. Laboratuvara kan verme gu\u0308nu\u0308nu\u0308n 14 gu\u0308n o\u0308ncesi i\u00e7in as\u0327\u0131lanma durumu baz al\u0131nd\u0131g\u0306\u0131nda; antikor du\u0308zeyi s\u0131f\u0131r olan \u00fc\u00e7 kis\u0327i hic\u0327 as\u0327\u0131 olmam\u0131s\u0327, antikor du\u0308zeyi negatif olan13 kis\u0327i ise ortanca 133 (122-146) g\u00fcn \u00f6nce iki doz CoronaVac as\u0327\u0131s\u0131 olmus\u0327tu. S\u00f6z konusu 16 kis\u0327inin hic\u0327birine daha o\u0308nce SARS-CoV-2 tan\u0131s\u0131 koyulmam\u0131\u015f olup d\u00f6rd\u00fc SARS-CoV-2 temasl\u0131s\u0131 oldug\u0306unu belirtti.\u00a0<\/span><\/p>\n

\u00c7al\u0131\u015fman\u0131n ba\u015flang\u0131c\u0131nda ilk vizite kat\u0131lan ve ikinci izlemin ba\u015flang\u0131c\u0131 olan 01 Ekim 2021 tarihine kadar mezun olan \u00f6\u011frenciler d\u0131\u015f\u0131nda kalan ve izlemi devam eden toplam 522 \u00f6\u011frencinin alt\u0131s\u0131 ilk kez COVID-19 tan\u0131s\u0131 alm\u0131\u015ft\u0131. Kat\u0131l\u0131mc\u0131lar\u0131n hi\u00e7birinde hastanede yatmay\u0131 gerektirecek a\u011f\u0131r hastal\u0131k geli\u015fmemi\u015fti; izolasyon s\u00fcreleri dolduktan sonra normal ya\u015famlar\u0131na komplikasyonsuz olarak devam ettikleri saptand\u0131.<\/span> Her olgu i\u00e7in ya\u015f, cinsiyet, okul ve s\u0131n\u0131f \u00f6zelinde e\u015fle\u015ftirilmi\u015f iki\u015fer kontrol aday\u0131 davet edilmi\u015f olmakla birlikte \u00f6\u011frenci kat\u0131l\u0131m\u0131n\u0131n s\u0131n\u0131rl\u0131 olmas\u0131 nedeni ile kontrol grubu say\u0131s\u0131 hedeflenenin alt\u0131nda kald\u0131. Test negatif olgu-kontrol tasar\u0131m\u0131na uygun olarak olgunun tan\u0131 ald\u0131\u011f\u0131 24 saat i\u00e7inde RT-PCR testi negatif olanlar kontrol grubu olarak se\u00e7ildi. \u0130zlemdeki 522 ki\u015fi i\u00e7inde<\/span> COVID-19 hastal\u0131g\u0306\u0131na yakalanma insidans\u0131 4\/1000 kis\u0327i-ay olarak hesapland\u0131 (k\u00fcm\u00fclatif insidans %1). Kat\u0131l\u0131mc\u0131lar\u0131n COVID-19 PCR testini <\/span>Hacettepe<\/span> \u00dcniversitesi T\u0131p Fak\u00fcltesi Hastaneleri d\u0131\u015f\u0131nda yapt\u0131rm\u0131\u015f olabilecekleri d\u00fc\u015f\u00fcn\u00fclerek Ekim 2021\u2019de ger\u00e7ekle\u015ftirilen ikinci vizit s\u00fcrecinde COVID-19 \u00f6yk\u00fcleri sorguland\u0131 ve bireysel beyan esas al\u0131nd\u0131\u011f\u0131nda iki izlem aras\u0131nda\u00a0 <\/span>\u00fc\u00e7 ki\u015finin daha COVID-19 hastal\u0131g\u0306\u0131na yakaland\u0131\u011f\u0131 saptand\u0131: beyana dayal\u0131\u00a0 <\/span>insidans 7\/1000 ki\u015fi-ay olarak hesapland\u0131 (k\u00fcm\u00fclatif insidans %1.4). Tan\u0131 alan \u00f6\u011frencilere ait durumsal antikor testi yap\u0131lamad\u0131\u011f\u0131 i\u00e7in olgular\u0131n ve kontrol grubunun antikor de\u011ferlerinin kar\u015f\u0131la\u015ft\u0131r\u0131lmas\u0131 \u00e7al\u0131\u015fma ba\u015flang\u0131\u00e7 viziti antikor d\u00fczeyleri \u00fczerinden yap\u0131ld\u0131 (Tablo 6).<\/span><\/p>\n

Tam kan say\u0131m\u0131 ve biyokimya analiz sonu\u00e7lar\u0131 de\u011ferlendirildi\u011finde; kat\u0131l\u0131mc\u0131lar\u0131n %3.1\u2019inde l\u00f6kopeni tespit edildi, erkek kat\u0131l\u0131mc\u0131lardaki anemi d\u00fczeyi %28\u2019di ve %10\u2019a yakla\u015fan kreatinin y\u00fcksekli\u011fi dikkat \u00e7ekti. Kat\u0131l\u0131mc\u0131lar\u0131n %8\u2019inin 25-OH vitamin D d\u00fczeyleri ciddi oranda d\u00fc\u015f\u00fckt\u00fc ve yakla\u015f\u0131k %11\u2019inde HbA1c y\u00fcksekli\u011fi tespit edildi (Tablo 7).<\/p>\n

\u0130RDELEME<\/h2>\n

HU-CoVaCS \u00e7al\u0131\u015fmas\u0131, \u00f6\u011frencilerin sadece COVID-19 hastal\u0131k durumlar\u0131n\u0131 de\u011fil genel sa\u011fl\u0131k durumlar\u0131 a\u00e7\u0131s\u0131ndan pandemi s\u00fcrecini ne kadar iyi ge\u00e7irdiklerinin incelenmesini ve gerekli m\u00fcdahalenin zaman\u0131nda yap\u0131labilmesini hedefledi.\u00a0<\/span><\/p>\n

Genel Sa\u011fl\u0131k Durumu<\/h3>\n

Pandemi do\u0308neminde kis\u0327ilerin uyku, fiziksel aktivite, beslenme gibi sag\u0306l\u0131kl\u0131 yas\u0327am davran\u0131s\u0327lar\u0131nda negatif yo\u0308nde deg\u0306is\u0327imler oldug\u0306unu go\u0308steren \u00e7ok say\u0131da \u00e7al\u0131\u015fma yay\u0131mlanm\u0131\u015ft\u0131r. T\u0131p Faku\u0308ltesi o\u0308g\u0306rencilerinin sag\u0306l\u0131k durumlar\u0131 u\u0308zerine Almanya ve Macaristan\u2019da 2016 y\u0131l\u0131nda yap\u0131lan c\u0327ok merkezli bir c\u0327al\u0131s\u0327mada, kat\u0131l\u0131mc\u0131lar\u0131n c\u0327og\u0306unlug\u0306u sag\u0306l\u0131k durumlar\u0131n\u0131 \u201ciyi<\/i>\u201d (%28.3), \u201cc\u0327ok iyi<\/i>\u201d (%43.5) ve \u201cmu\u0308kemmel<\/i>\u201d (%23.6) olarak tan\u0131mlam\u0131s\u0327t\u0131r (6). \u00c7al\u0131\u015fmam\u0131zda ise pandemi s\u00fcrecinde kendi sa\u011fl\u0131\u011f\u0131n\u0131 \u201c\u00e7ok iyi<\/i>\u201d olarak tan\u0131mlayanlar <\/span>%19.1 ve \u201ciyi<\/i>\u201d olarak tan\u0131mlayanlar ise %61,9\u2019du; kat\u0131l\u0131mc\u0131lar\u0131n kendini k\u00f6t\u00fc hissetme durumlar\u0131 %2 ile pandemi \u00f6ncesine ait olan %0.8 ile k\u0131yasland\u0131\u011f\u0131nda y\u00fcksek olmakla birlikte olumsuz etkilenimi i\u015faret edecek boyutta bulunmad\u0131.<\/p>\n

Yeterli ve dengeli beslenme, sag\u0306l\u0131kl\u0131 beslenme olarak da ifade edilebilir. Samsun Ondokuz May\u0131s U\u0308niversitesi o\u0308g\u0306rencileri aras\u0131nda 2015 y\u0131l\u0131nda yap\u0131lan bir c\u0327al\u0131s\u0327mada, o\u0308g\u0306rencilerin %66.4\u2019u\u0308n\u00fcn sag\u0306l\u0131kl\u0131 beslendig\u0306ine inand\u0131g\u0306\u0131 belirlenmis\u0327tir (7)<\/span>. <\/span>COVID-19 \u00f6ncesi d\u00f6nemde Hacettepe \u00dcniversitesi T\u0131p Fak\u00fcltesi \u00f6\u011frencileri aras\u0131nda yap\u0131lan bir di\u011fer \u00e7al\u0131\u015fmada \u00f6\u011frencilerin %40.2\u2019si sa\u011fl\u0131kl\u0131 beslendiklerini belirtmi\u015ftir (8). \u00c7al\u0131\u015fmam\u0131zda kat\u0131l\u0131mc\u0131lar\u0131n %31.9\u2019u yeterli ve dengeli beslendig\u0306ini bildirdi. S\u00f6z konusu bu farkl\u0131l\u0131k o\u0308g\u0306renci profili ile ilgili olabilece\u011fi gibi pandemi kos\u0327ullar\u0131na ba\u011fl\u0131 bir azalma olabilece\u011fi de dikkate al\u0131nmal\u0131d\u0131r. Nitekim <\/span>kat\u0131l\u0131mc\u0131lar\u0131n %6.4\u2019\u00fc \u015fi\u015fman olup fazla kilolu grubu da dahil etti\u011fimizde her 3 \u00f6\u011frenciden birinin normalin u\u0308zerinde bir vu\u0308cut ag\u0306\u0131rl\u0131g\u0306\u0131na sahip olmas\u0131 dikkat \u00e7ekicidir. Bu de\u011fer, 2013 y\u0131l\u0131nda ger\u00e7ekle\u015ftirilen T\u00fcrkiye Kronik Hastal\u0131klar ve Risk Fakt\u00f6rleri S\u0131kl\u0131\u011f\u0131 \u00c7al\u0131\u015fmas\u0131\u2019nda 15-24 ya\u015f grubunda erkeklerde %4.4 ve kad\u0131nlarda %5.6 olarak belirlenen obezite de\u011ferlerinin \u00fczerindedir (9). Bu nedenle, kamp\u00fcs i\u00e7inde sa\u011fl\u0131kl\u0131 beslenme olanaklar\u0131n\u0131n ve eri\u015filebilirli\u011finin art\u0131r\u0131lmas\u0131, meyve\/sebze sat\u0131\u015f alanlar\u0131n\u0131n olu\u015fturulmas\u0131, spor olanaklar\u0131n\u0131n yayg\u0131nla\u015ft\u0131r\u0131lmas\u0131 ve \u00f6\u011frencilerin hareketli ya\u015fam konusunda motive edilmesi yararl\u0131 olacakt\u0131r. Her ne kadar tip-2 hata d\u0131\u015flanamasa da \u00e7al\u0131\u015fmada, COVID-19 ge\u00e7irme ile \u00f6\u011frencilerin VK\u0130 de\u011ferleri, <\/span>25-OH vitamin D ve HbA1c d\u00fczeyleri aras\u0131nda istatistiksel olarak ili\u015fki saptanmad\u0131.<\/span><\/p>\n

\u00d6\u011frencilerin %87.9\u2019u son 3 ayda gu\u0308nlu\u0308k uyku su\u0308relerinin 6-8 saat aras\u0131nda oldug\u0306unu bildirdi. Kurumumuzda bu konuda kar\u015f\u0131la\u015ft\u0131r\u0131labilir bir veri bulunmasa da uluslarara<\/span>s\u0131 \u00e7al\u0131\u015fmalara k\u0131yasla uyku s\u00fcresi olduk\u00e7a y\u00fcksektir (10<\/span>). C\u0327al\u0131s\u0327mam\u0131zda, uyku esas olarak su\u0308re ile deg\u0306erlendirildi\u011fi ic\u0327in uyku kalitesi konusunda yorum yap\u0131labilmesi ve pandemi \u00f6ncesi ile k\u0131yaslanabilmesi ic\u0327in yeterli veri yoktur.<\/p>\n

HU-CoVaCS \u00e7al\u0131\u015fmas\u0131n\u0131n tespit edilen sigara i\u00e7me y\u00fczdeleri t\u0131p faku\u0308ltesi o\u0308g\u0306rencileri aras\u0131nda yap\u0131lan farkl\u0131 \u00e7al\u0131\u015fmalar ile <\/span>benzerdir (11,12) ve s\u0131n\u0131flar ilerledik\u00e7e sigara i\u00e7me y\u00fczdelerinin artmas\u0131 dikkat \u00e7ekicidir. Bu durum, ya\u015fla ili\u015fkili olabilece\u011fi gibi e\u011fitimde pratik y\u00fck\u00fcn artmas\u0131, hasta sorumlulu\u011fu alma ile stresin artmas\u0131 ve akran etkisi kaynakl\u0131 da olabilir.<\/p>\n

\u00c7al\u0131\u015fman\u0131n sa\u011fl\u0131kl\u0131 ya\u015fam al\u0131\u015fkanl\u0131klar\u0131 ve ili\u015fkili laboratuvar de\u011ferlerinin kar\u015f\u0131la\u015ft\u0131rmal\u0131 incelenmesine ait en dikkat \u00e7ekici bulgulardan biri erkeklerde daha belirgin olarak tespit edilen anemi yayg\u0131nl\u0131\u011f\u0131d\u0131r. <\/span>Normal hemoglobin alt s\u0131n\u0131r deg\u0306erinin erkeklerde daha yu\u0308ksek al\u0131nmas\u0131 go\u0308z o\u0308nu\u0308nde tutulsa da kat\u0131lan her \u00fc\u00e7 erkekten birinde anemi saptanmas\u0131 \u00f6nemli bir bulgudur ve beslenme \u00f6zellikleri ile birlikte detayl\u0131 olarak incelenmesi yararl\u0131 olacakt\u0131r. Hindistan\u2019da bir sag\u0306l\u0131k enstitu\u0308su\u0308nde kad\u0131n o\u0308g\u0306renciler aras\u0131nda yap\u0131lan bir aras\u0327t\u0131rmada anemi prevalans\u0131 %28.6 olarak saptanm\u0131s\u0327t\u0131r (<\/span>13)<\/span>. \u00c7al\u0131\u015fmam\u0131zda, erkeklerin aksine, kad\u0131nlarda anemi %2.5 bulunmu\u015f olup g\u00f6receli olarak daha az tespit edildi ancak takviye g\u0131da (\u201csupplement\u201d) al\u0131m\u0131 ile birle\u015ftirildi\u011finde %6.5\u2019e \u00e7\u0131kmaktad\u0131r. \u00c7al\u0131\u015fma protokol\u00fcnde yer almad\u0131\u011f\u0131 i\u00e7in daha detayl\u0131 inceleme yap\u0131lamam\u0131\u015f olup anemi saptanan \u00f6\u011frenciler vitamin B12, folat, demir du\u0308zeylerinin belirlenmesi ve ileri incelemeler i\u00e7in dahiliye poliklini\u011fine y\u00f6nlendirildi. \u0130leri d\u00f6nemlerde \u00f6\u011frencilerin anemi ve beslenme ili\u015fkisi a\u00e7\u0131s\u0131ndan incelenmesi ve gerekti\u011fi durumlarda tedavisi de\u011ferli olacakt\u0131r.\u00a0<\/span><\/p>\n

Kat\u0131l\u0131mc\u0131lar\u0131n fizik muayenelerinde sistolik hipertansiyon yayg\u0131nl\u0131\u011f\u0131 %4.6, diyastolik hipertansiyon %4.1 olarak saptand\u0131; bu de\u011ferler ilgili ya\u015f gruplar\u0131na ait ulusal de\u011ferler ile uyumlu olsa da (9<\/span>), yu\u0308ksek normal grup da dahil edildig\u0306inde, sistolik kan bas\u0131nc\u0131 ac\u0327\u0131s\u0131ndan yu\u0308ksek kan bas\u0131nc\u0131na sahip \u00f6\u011frencilerin %15\u2019lere varmas\u0131 dikkat \u00e7ekici ve erken tan\u0131\/m\u00fcdahale gere\u011fi a\u00e7\u0131s\u0131ndan uyar\u0131c\u0131d\u0131r.\u00a0 <\/span>Gen\u00e7 sa\u011fl\u0131k personeli aras\u0131nda kan bas\u0131nc\u0131 fark\u0131ndal\u0131g\u0306\u0131n\u0131n artmas\u0131 ve ilgili morbidite yu\u0308ku\u0308nu\u0308 azaltma konusunda \u00e7al\u0131\u015fmam\u0131zda oldug\u0306u gibi belirli aral\u0131klarla o\u0308g\u0306rencilerin kan bas\u0131nc\u0131 deg\u0306erlerinin izlenmesi, bas\u0327ta yerles\u0327ke ic\u0327inde olmak u\u0308zere tu<\/span>z tu\u0308ketiminin azalt\u0131lmas\u0131yla ilgili giris\u0327imlerde bulunulmas\u0131, genel sag\u0306l\u0131kl\u0131 yas\u0327am o\u0308nerileri (o\u0308g\u0306rencilerin fizik aktivitesinin art\u0131r\u0131lmas\u0131, sag\u0306l\u0131kl\u0131 beslenme, obezitenin azalt\u0131lmas\u0131, vb.) ic\u0327in kampu\u0308s ic\u0327inde ad\u0131mlar at\u0131lmas\u0131, kan bas\u0131nc\u0131 du\u0308zeyi yu\u0308ksek olarak seyreden o\u0308g\u0306rencilerin uygun s\u0327ekilde tedavisinin sag\u0306lanmas\u0131 de\u011ferli olacakt\u0131r.<\/p>\n

HU-CoVaCS \u00e7al\u0131\u015fmas\u0131nda uygulanan anketlerde sa\u011fl\u0131kla ili\u015fkili davran\u0131\u015flar kesitsel olarak irdelenmi\u015f olup pandemi ile ili\u015fkili olas\u0131 de\u011fi\u015fiklikler \u00f6zel olarak sorulmad\u0131\u011f\u0131 i\u00e7in pandeminin sa\u011fl\u0131k davran\u0131\u015flar\u0131 ile ili\u015fkisi ilk vizit verileri ile do\u011frudan incelenemedi. Bu ancak periyodik vizitlerde \u00f6\u011frencilerin (varsa) davran\u0131\u015f de\u011fi\u015fiklikleri ve bunlar\u0131n genel sa\u011fl\u0131k\/COVID-19 ile ili\u015fkisinin irdelenmesiyle m\u00fcmk\u00fcn olabilecektir. \u00d6te yandan, \u00f6\u011frencilere sa\u011fl\u0131k ile ilgili detayl\u0131 sorular\u0131n sorulmas\u0131yla fark\u0131ndal\u0131klar\u0131n\u0131n art\u0131r\u0131ld\u0131\u011f\u0131 d\u00fc\u015f\u00fcn\u00fclmektedir. Ayr\u0131ca, yeni tan\u0131 alan obezite, hipertansiyon, hiperlipidemi, anemi, pre-diyabet ve talasemi olgular\u0131n\u0131n ilgili kliniklere y\u00f6nlendirilmesiyle \u00f6\u011frenci sa\u011fl\u0131\u011f\u0131n\u0131n iyile\u015ftirilmesi y\u00f6n\u00fcnde katk\u0131 sa\u011flanmaya \u00e7al\u0131\u015f\u0131ld\u0131.<\/p>\n

COVID-19 ve \u0130li\u015fkili Fakt\u00f6rler<\/h3>\n

\u00c7al\u0131\u015fmam\u0131zda, pandemi s\u00fcrecinde COVID-19\u2019dan korunmada farmakolojik olmayan \u00f6nlemlere uyum de\u011ferlendirmesinde kat\u0131l\u0131mc\u0131lar\u0131n hastane ic\u0327inde ve sosyal alanlarda maske-mesafe-hijyen kurallar\u0131na uyumlar\u0131n\u0131n yu\u0308ksek du\u0308zeyde oldug\u0306u saptand\u0131; uyumun hastane ortam\u0131nda %90\u2019lara ula\u015ft\u0131\u011f\u0131 belirlendi. Gordon ve arkada\u015flar\u0131n\u0131n (14) c\u0327al\u0131s\u0327t\u0131klar\u0131 hastanede sag\u0306l\u0131k personeli aras\u0131nda COVID-19 hastal\u0131g\u0306\u0131n\u0131n artmas\u0131 u\u0308zerine yapt\u0131klar\u0131 c\u0327al\u0131s\u0327mada, bulas\u0327ma kaynag\u0306\u0131 olarak personelin c\u0327ay salonu tespit edilmi\u015ftir; burada al\u0131nan o\u0308nlemlerin ard\u0131ndan hasta say\u0131s\u0131n\u0131n azald\u0131g\u0306\u0131 go\u0308sterilmi\u015ftir. \u00c7elebi ve arkada\u015flar\u0131 (15) benzer \u015fekilde sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 aras\u0131nda bula\u015fmaya neden olan risk fakt\u00f6rlerini inceledikleri \u00e7al\u0131\u015fmada ayn\u0131 dinlenme odas\u0131nda maskesiz 15 dakikadan fazla kalman\u0131n ve bir metreden az mesafede yiyecek t\u00fcketmenin bula\u015fma i\u00e7in risk fakt\u00f6r\u00fc oldu\u011funu tespit etmi\u015ftir. Bu nedenle, hastane ic\u0327inde ve sosyal ortamlarda korunma kurallar\u0131na \u201ctam\u201d uyum konusunda o\u0308g\u0306rencilerin fark\u0131ndal\u0131\u011f\u0131n\u0131n art\u0131r\u0131lmas\u0131 son derece \u00f6nemlidir. COVID-19 infeksiyonunda, %20-85\u00a0 <\/span>aras\u0131nda deg\u0306is\u0327en asemptomatik s\u00fcrece ek olarak presemptomatik do\u0308nemde de bulas\u0327ma riski olmas\u0131 sosyal alanlar\u0131n da riskli bo\u0308lgeler oldu\u011funu g\u00f6sterir.\u00a0 <\/span>\u00d6zellikle as\u0327\u0131l\u0131 bireylerin asemptomatik s\u00fcrecinin daha uzun olabilmesi nedeniyle sosyal ortamlarda da korunmaya maksimum o\u0308nem go\u0308sterilmesi konusunda \u00f6\u011frenciler bilgilendirilmeli ve motive edilmelidir.\u00a0<\/span><\/p>\n

\u00c7al\u0131\u015fmam\u0131za kat\u0131lan \u00f6\u011frenciler a\u015f\u0131laman\u0131n maske kullanma s\u0131kl\u0131klar\u0131n\u0131 etkilemedi\u011fini beyan etmekle birlikte kalabal\u0131k ortamlara girme yayg\u0131nl\u0131g\u0306\u0131 ve kalabal\u0131k ortamlarda gec\u0327irilen su\u0308renin a\u015f\u0131lanma sonras\u0131nda belirgin bir \u015fekilde artm\u0131\u015f oldu\u011fu saptand\u0131<\/span>. Bu durum, kitlesel a\u015f\u0131lama sonras\u0131nda restoranlar\u0131n, al\u0131\u015fveri\u015f merkezlerinin ac\u0327\u0131lmas\u0131, du\u0308g\u0306u\u0308n ve kutlamalar\u0131n tekrar bas\u0327lamas\u0131 gibi bir araya gelme etkinliklerinin toplumdaki art\u0131\u015f\u0131na paralel bir yans\u0131ma olarak deg\u0306erlendirilebilir. A\u015f\u0131laman\u0131n temel korunma \u00f6nlemlerine alternatif olmad\u0131\u011f\u0131 vurgulanmal\u0131d\u0131r. \u00d6zellikle havalar\u0131n so\u011fudu\u011fu ve y\u00fcz y\u00fcze e\u011fitimin yayg\u0131nla\u015ft\u0131\u011f\u0131 d\u00f6nemde, bula\u015fma riski a\u00e7\u0131s\u0131ndan, \u00f6\u011frencilerin temel korunma y\u00f6ntemlerine uyumlar\u0131n\u0131n desteklenmesi \u00f6nemlidir.\u00a0<\/span><\/p>\n

\u00c7al\u0131\u015fmaya kat\u0131lan \u00f6\u011frencilerin staj yerlerine ba\u011fl\u0131 olarak hastalar ile olan ili\u015fkileri ve hastaneye ili\u015fkin COVID-19 bula\u015fma riskleri farkl\u0131l\u0131k g\u00f6sterebilmektedir; kimi durumlarda (aerosol olu\u015fturan is\u0327lem vb.) risk d\u00fczeyleri daha da artmaktad\u0131r. \u00d6\u011frencilerin bu riskler konusundaki fark\u0131ndal\u0131klar\u0131 yeterince \u00e7al\u0131\u015f\u0131lmam\u0131\u015ft\u0131r (16<\/span>). Eg\u0306itim su\u0308recinde COVID-19 tan\u0131s\u0131 alm\u0131s\u0327 <\/span>hastalara o\u0308g\u0306rencilerin dog\u0306rudan bak\u0131m vermesi gerekiyorsa o\u0308zellikle aerosol olus\u0327turan is\u0327lemler ile ilgili olarak korunma konusunda uzman ve k\u0131demli \u00e7al\u0131\u015fanlar\u0131n hat\u0131rlatma ve denetim yapmalar\u0131 son derece \u00f6nemlidir.\u00a0<\/span><\/p>\n

COVID-19 A\u015f\u0131lamas\u0131 ve Antikor D\u00fczeyleri<\/h3>\n

Dokuz Eyl\u00fcl U\u0308niversitesi\u2019nde yap\u0131lan c\u0327al\u0131s\u0327mada\u00a0 <\/span>560\u00a0 <\/span>sag\u0306l\u0131k c\u0327al\u0131s\u0327an\u0131n\u0131n 25 (%4.4)\u2019i\u00a0 <\/span>6 ayl\u0131k izlem s\u00fcresi boyunca COVID-19 hastal\u0131g\u0306\u0131na yakalanm\u0131s\u0327t\u0131r (17). \u00c7al\u0131\u015fmam\u0131zda, ba\u015flang\u0131\u00e7tan itibaren 3 ay izlenmis\u0327 olan 527 o\u0308g\u0306renciden alt\u0131s\u0131 COVID-19 hastal\u0131g\u0306\u0131na yakalanm\u0131s\u0327t\u0131r; \u00fc\u00e7 ayl\u0131k k\u00fcm\u00fclatif insidans %1 olup \u00fclkemiz i\u00e7in rapor edilen de\u011ferin \u00fczerindedir. Bu y\u00fckseklik COVID-19 bula\u015fma riskine ait ger\u00e7ek bir risk ile a\u00e7\u0131klanabilse de \u00f6\u011frencilerin semptomlar konusundaki fark\u0131ndal\u0131k ve\/veya PCR testine olan eri\u015fiminin y\u00fcksek olmas\u0131 ile de ili\u015fkilendirilebilir.\u00a0<\/span><\/p>\n

CoronaVac a\u015f\u0131s\u0131na k\u0131yasla Comirnaty\u00ae a\u015f\u0131s\u0131nda elde edilen antikor yan\u0131t\u0131n\u0131n \u00e7ok y\u00fcksek oldu\u011fu tespit edildi; iki doz CoronaVac a\u015f\u0131s\u0131 olanlara k\u0131yasla \u00fc\u00e7\u00fcnc\u00fc doz olarak Comirnaty\u00ae a\u015f\u0131s\u0131 olan gruplara ait ortanca antikor de\u011ferlerinde ise 100 kat\u0131 ve \u00fczerinde fark g\u00f6zlendi. \u0130kinci ve \u00fc\u00e7\u00fcnc\u00fc dozlar aras\u0131nda tespit edilen antikor yan\u0131t\u0131ndaki anlaml\u0131 fark, ikinci doz as\u0327\u0131dan sonra gec\u0327en su\u0308rede bag\u0306\u0131s\u0327\u0131kl\u0131k yan\u0131t\u0131 olarak antikor du\u0308zeylerinde du\u0308s\u0327me olmas\u0131 ile ac\u0327\u0131klanabileceg\u0306i gibi, ilk iki doz herkes i\u00e7in CoronaVac a\u015f\u0131s\u0131 ile yap\u0131lm\u0131\u015f iken esas olarak \u00fc\u00e7\u00fcnc\u00fc doz olarak Comirnaty\u00ae<\/sup><\/span> as\u0327\u0131s\u0131 yap\u0131lmas\u0131na bag\u0306l\u0131 olarak antikor yan\u0131t\u0131ndaki anlaml\u0131 art\u0131\u015f ile ili\u015fkilendirilebilir. Bu bulgular daha \u00f6nce \u00fclkemizde yap\u0131lan benzer \u00e7al\u0131\u015fmalar ile uyumludur (17). \u00d6te yandan, iki dozun ard\u0131ndan yap\u0131lan \u00fc\u00e7\u00fcnc\u00fc doz dikkate al\u0131n\u0131rsa antikor yan\u0131t\u0131ndaki fark\u0131n \u00f6nemli bir k\u0131sm\u0131n\u0131n a\u015f\u0131ya ba\u011fl\u0131 ba\u011f\u0131\u015f\u0131kl\u0131k yan\u0131t\u0131n\u0131n zaman i\u00e7inde azalmas\u0131 ile ili\u015fkili olmas\u0131 yads\u0131namaz. Benzer \u015fekilde, tek doz a\u015f\u0131l\u0131larda antikor de\u011ferinin ayn\u0131 a\u015f\u0131 ile iki doz a\u015f\u0131lanm\u0131\u015f gruplara k\u0131yasla daha y\u00fcksek bulunmas\u0131 beklenmeyen bir sonu\u00e7 olsa da tek doz a\u015f\u0131l\u0131lar\u0131n a\u015f\u0131lanmay\u0131 yak\u0131n zamana kadar ertelemeleri nedeniyle antikor cevaplar\u0131n\u0131n hen\u00fcz d\u00fc\u015f\u00fc\u015fe ge\u00e7memi\u015f olmas\u0131 ve\/veya bunlar\u0131n bir k\u0131sm\u0131n\u0131n COVID-19 hastal\u0131\u011f\u0131 ge\u00e7irdikleri i\u00e7in a\u015f\u0131y\u0131 geciktirmeleri (dolay\u0131s\u0131yla, do\u011fal ba\u011f\u0131\u015f\u0131kl\u0131k da geli\u015ftirmi\u015f olmalar\u0131) bu durumu a\u00e7\u0131klayabilir. \u0130leri analizler kapsam\u0131nda yap\u0131lacak olan sa\u011fkal\u0131m analizlerinde a\u015f\u0131dan itibaren ge\u00e7en s\u00fcrenin analizlere dahil edilmesi ve COVID-19 ge\u00e7irme \u00f6yk\u00fcs\u00fc benzeri di\u011fer fakt\u00f6rler i\u00e7in kontrol sa\u011flanmas\u0131 daha ge\u00e7erli kan\u0131tlar elde edilmesini sa\u011flayacakt\u0131r.<\/p>\n

Manisa Celal Bayar U\u0308niversitesi\u2019nde yap\u0131lan c\u0327al\u0131s\u0327mada, iki doz CoronaVac as\u0327\u0131s\u0131n\u0131 izleyen u\u0308c\u0327u\u0308ncu\u0308 ay sonunda sag\u0306l\u0131k c\u0327al\u0131s\u0327anlar\u0131n\u0131n %77\u2019sinde SARS-CoV-2 antikorlar\u0131 tespit edilmis\u0327tir.\u00a0 <\/span>S\u00f6z konusu c\u0327al\u0131s\u0327man\u0131n takip izleminde ise iki doz CoronaVac ve \u00fc\u00e7\u00fcnc\u00fc doz Comirnaty\u00ae as\u0327\u0131s\u0131 olanlar\u0131n %99.4\u2019u\u0308n\u00fcn 80-120 gu\u0308n takiplerinde SARS-CoV-2 antikorlar\u0131 tespit edilmis\u0327tir (18). \u00c7al\u0131\u015fmam\u0131zda iki doz CoronaVac as\u0327\u0131s\u0131ndan 4.5 ay sonra 660 kis\u0327inin 647 (%98)\u2019sinde anti-SARS-CoV-2 IgG antikor du\u0308zeyleri pozitif bulundu. Aradaki fark; c\u0327al\u0131s\u0327malar\u0131n yu\u0308ru\u0308tu\u0308ldu\u0308g\u0306u\u0308 popu\u0308lasyonlar\u0131n (sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131, T\u0131p Fak\u00fcltesi \u00f6\u011frencileri ve Di\u015f Hekimli\u011fi Fak\u00fcltesi \u00f6\u011frencileri) demografik \u00f6zelliklerinin ve sa\u011fl\u0131k durumlar\u0131na ili\u015fkin farkl\u0131l\u0131klar\u0131n\u0131n yan\u0131 s\u0131ra kullan\u0131lan test kitlerinin duyarl\u0131l\u0131k farkl\u0131l\u0131klar\u0131ndan kaynaklan\u0131yor olabilir.\u00a0 <\/span>Her ne kadar takip su\u0308releri Manisa Celal Bayar U\u0308niversitesi\u2019nde ger\u00e7ekle\u015ftirilen \u00e7al\u0131\u015fmayla benzer olmamakla birlikte \u00fc\u00e7\u00fcnc\u00fc doz Comirnaty\u00ae as\u0327\u0131s\u0131n\u0131n yu\u0308ksek antikor pozitiflig\u0306i iki c\u0327al\u0131s\u0327mada da benzerdir.<\/p>\n

COVID-19 as\u0327\u0131s\u0131n\u0131n DS\u00d6 raporlar\u0131nda bildirilen yan etkileri c\u0327og\u0306unlukla hafif ila orta du\u0308zeyde olup birkac\u0327 gu\u0308nden fazla su\u0308rmemektedir. Tipik yan etkiler enjeksiyon yerinde ag\u0306r\u0131, ates\u0327, yorgunluk, bas\u0327 ag\u0306r\u0131s\u0131, kas ag\u0306r\u0131s\u0131, titreme ve ishaldir (19). U\u0308lkemizde yap\u0131lan CoronaVac as\u0327\u0131s\u0131 Faz 3 Ara Sonuc\u0327 Raporu\u2019na go\u0308re de en c\u0327ok go\u0308ru\u0308len yan etki enjeksiyon bo\u0308lgesinde ag\u0306r\u0131d\u0131r (20). C\u0327al\u0131s\u0327ma grubumuzda da benzer s\u0327ekilde en c\u0327ok go\u0308ru\u0308len yan etkiler, as\u0327\u0131 tu\u0308ru\u0308nden bag\u0306\u0131ms\u0131z olarak, as\u0327\u0131 yerinde ag\u0306r\u0131, halsizlik ve yorgunluk olarak bildirildi.\u00a0<\/span><\/p>\n

\u00c7al\u0131\u015fma Ocak 2021\u2019de planlanarak gerekli onaylar al\u0131nmas\u0131na ra\u011fmen TI\u0307TCK\u2019den izin alma su\u0308recinde ya\u015fanan gecikme nedeniyle planlanan primer hedeflerden biri olan tam as\u0327\u0131l\u0131lar\u0131n ikinci as\u0327\u0131dan sonra 28. gu\u0308nden itibaren bas\u0327layacak takiplerinin (Mart ay\u0131 son haftas\u0131ndan itibaren) yap\u0131labilmesi mu\u0308mku\u0308n olmad\u0131. Ulusal COVID-19 as\u0327\u0131lama program\u0131nda ani bir deg\u0306is\u0327iklik ile sag\u0306l\u0131k c\u0327al\u0131s\u0327anlar\u0131na Temmuz ay\u0131nda \u00fc\u00e7\u00fcnc\u00fc doz SARS-CoV-2 as\u0327\u0131s\u0131 olana\u011f\u0131\/o\u0308nerisi getirilmesi ile de o\u0308g\u0306rencilerin bir k\u0131sm\u0131 c\u0327al\u0131s\u0327man\u0131n veri toplama as\u0327amas\u0131nda \u00fc\u00e7\u00fcnc\u00fc doz as\u0327\u0131lar\u0131n\u0131 yapt\u0131rd\u0131; bu durum ikinci doz as\u0327\u0131 sonras\u0131 yap\u0131lmas\u0131 planlanan antikor o\u0308lc\u0327u\u0308m say\u0131s\u0131nda azalmaya neden oldu. Di\u015f Hekimli\u011fi Fak\u00fcltesi \u00f6\u011frencilerine ait SARS-CoV-2 S proteinine kar\u015f\u0131 olu\u015fan IgM antikor d\u00fczeyinin y\u00fcksek bulunmas\u0131, grup i\u00e7i a\u015f\u0131lama say\u0131 ve t\u00fcrlerine ba\u011fl\u0131 olarak Ulusal A\u015f\u0131lama Program\u0131\u2019ndaki ani de\u011fi\u015fikli\u011fin bir yans\u0131mas\u0131d\u0131r. Veri toplama a\u015famas\u0131na ge\u00e7 (Temmuz ay\u0131nda) kat\u0131lan \u00f6\u011frencilerin a\u011f\u0131rl\u0131kl\u0131 olarak yaz tatili sonras\u0131 okula geri d\u00f6nen Di\u015f Hekimli\u011fi Fak\u00fcltesi \u00f6\u011frencileri olmas\u0131 ve bu ki\u015filerin Haziran ay\u0131 ortas\u0131nda Ulusal A\u015f\u0131lama Program\u0131 kapsam\u0131nda a\u00e7\u0131lan \u00fc\u00e7\u00fcnc\u00fc doz a\u015f\u0131lamada \u00e7o\u011funlukla Comirnaty\u00ae a\u015f\u0131s\u0131 ile a\u015f\u0131lanm\u0131\u015f olmalar\u0131 antikor yan\u0131tlar\u0131n\u0131n y\u00fcksek d\u00fczeyini a\u00e7\u0131klamaktad\u0131r. SARS-CoV-2 IgG antikor d\u00fczeyi \u00f6l\u00e7\u00fcm\u00fcnde kullan\u0131lan kitin \u00f6zelli\u011fi nedeniyle 40 000 AU\/ml (\u00fczeri de\u011ferlerin >40 000 olarak [budanm\u0131\u015f olarak (\u201ctruncated\u201d)] verilmesi sonucu Di\u015f Hekimli\u011fi Fak\u00fcltesi \u00f6\u011frencileri analizlere 40 000 AU\/ml (5680 BAU\/ml )olarak dahil edildi; tablolarda hesaplanan ortanca ve maksimum de\u011ferler ger\u00e7ek de\u011ferleri oldu\u011fundan antikor d\u00fczeyini d\u00fc\u015f\u00fck g\u00f6sterme e\u011filimindedir.<\/p>\n

\u00c7al\u0131\u015fma kohortunda ilk vizit sonras\u0131 \u00fc\u00e7 ayl\u0131k s\u00fcre\u00e7te alt\u0131 kat\u0131l\u0131mc\u0131 test pozitif, semptomatik COVID-19 tan\u0131s\u0131 ald\u0131. COVID-19 RT-PCR testi pozitif olarak sonu\u00e7lad\u0131\u011f\u0131nda kat\u0131l\u0131mc\u0131lar\u0131n izolasyon s\u00fcresi ba\u015flad\u0131\u011f\u0131 i\u00e7in, tan\u0131 tarihli antikor testi sadece RT-PCR-negatif kontroller i\u00e7in yap\u0131l\u0131p olgular i\u00e7in yap\u0131lamad\u0131. Dolay\u0131s\u0131yla, \u00e7al\u0131\u015fma hastal\u0131k-antikor d\u00fczeyi ili\u015fkisini planlanan ge\u00e7erlilikte \u00f6l\u00e7emedi. Haziran 2021\u2019de ger\u00e7ekle\u015ftirilen ilk vizitteki antikor d\u00fczeyi \u00fczerinden kar\u015f\u0131la\u015ft\u0131rmalar yap\u0131lm\u0131\u015f ise de\u00a0 <\/span>arada a\u015f\u0131 tekrar\u0131 olabilmesi nedeniyle bu kar\u015f\u0131la\u015ft\u0131rman\u0131n ge\u00e7erlili\u011finin d\u00fc\u015f\u00fck olmas\u0131 beklenir. Sadece kontrollerde iki kez antikor \u00f6l\u00e7\u00fcm\u00fc yap\u0131lmas\u0131 istenen hedefi sa\u011flamamakla birlikte bireysel d\u00fczeyde zaman i\u00e7inde antikor d\u00fczeylerinde d\u00fc\u015fmeyi g\u00f6stermesi a\u00e7\u0131s\u0131ndan \u00f6nemlidir.<\/p>\n

HU-CoVaCS, pandemi d\u00f6neminde \u00f6\u011frenciler i\u00e7in \u00f6zel olarak tasarlanm\u0131\u015f ilk ulusal sa\u011fl\u0131k ve COVID-19 takip \u00e7al\u0131\u015fmas\u0131 olup bilimsel \u00e7\u0131kt\u0131lar\u0131 kadar sosyal sorumluluk a\u00e7\u0131s\u0131ndan da de\u011ferlidir.\u00a0 <\/span>\u00d6\u011frenciler sa\u011fl\u0131k alan\u0131nda aktif olarak \u00e7al\u0131\u015ft\u0131klar\u0131 i\u00e7in pandemi s\u00fcrecinde risk alt\u0131nda olan gruptayd\u0131lar ancak ara\u015ft\u0131rma onlar i\u00e7in erken tan\u0131 ve m\u00fcdahale olana\u011f\u0131 sa\u011flad\u0131. \u00c7al\u0131\u015fma, \u00fcniversite hastanesinin kendi alanlar\u0131nda yetkin ve ulusal kararlarda da s\u00f6z sahibi uzmanlar taraf\u0131ndan g\u00f6n\u00fcll\u00fc olarak, en g\u00fcncel bilgi, donan\u0131m ve ekipmanlarla ger\u00e7ekle\u015ftirildi. \u00d6\u011frenci temsilcileri ile s\u00fcrd\u00fcr\u00fclen i\u015f birli\u011fi ve kesintisiz ileti\u015fim sayesinde elde edilen verilerin nicelik ve niteli\u011fi desteklendi.<\/span><\/p>\n

\u00d6\u011frencilerin kat\u0131l\u0131m\u0131n\u0131n g\u00f6n\u00fcll\u00fcl\u00fck esas\u0131na dayal\u0131 olmas\u0131 nedeniyle t\u00fcm \u00e7al\u0131\u015fma evrenine ula\u015f\u0131lamay\u0131p, %50.5\u2019ine ula\u015f\u0131lm\u0131\u015ft\u0131r. \u00c7al\u0131\u015fmaya kat\u0131lma durumu, a\u015f\u0131lanma durumu ve\/veya zaman i\u00e7inde korunma kurallar\u0131na uyumdan do\u011frudan etkilenmedi\u011fi i\u00e7in, gruplar aras\u0131 kar\u015f\u0131la\u015ft\u0131rmalarda (varsa) hatay\u0131 yokluk y\u00f6n\u00fcnde (\u201ctowards the null\u201d) etkileme e\u011filiminde olacakt\u0131r.<\/span><\/p>\n

Ara\u015ft\u0131rman\u0131n iki y\u0131ll\u0131k prospektif bir izlem olmas\u0131; pandemi s\u00fcrecinde dola\u015f\u0131mda olan varyantlar, farkl\u0131 a\u015f\u0131 uygulamalar\u0131, heterolog\/homolog a\u015f\u0131 uygulamalar\u0131n\u0131n r\u00f6latif etkileri, a\u015f\u0131ya ba\u011fl\u0131 ba\u011f\u0131\u015f\u0131kl\u0131k yan\u0131t\u0131ndaki d\u00fc\u015fmeler, (varsa) uzun d\u00f6nemli advers etkilerin belirlenmesi benzeri durumlar\u0131n de\u011ferlendirilmesine olanak sa\u011flayacak olmas\u0131 a\u00e7\u0131s\u0131ndan de\u011ferlidir. \u00c7al\u0131\u015fmada, pandemi s\u00fcrecinde farkl\u0131 tasar\u0131mlar\u0131n birlikte kullan\u0131lmas\u0131 ile epidemiyolojik kan\u0131t kalitesi ve verimlili\u011fin art\u0131r\u0131lmas\u0131 konusunda ileride yap\u0131lacak \u00e7al\u0131\u015fmalara \u00f6rnek te\u015fkil etmek hedeflendi. Ayr\u0131ca pandemi s\u00fcrecinde kamp\u00fcste \u201cya\u015fayan\u201d bir ara\u015ft\u0131rma sahas\u0131 yarat\u0131larak hem planlama hem de uygulama a\u015famas\u0131nda \u00e7ok disiplinli bir akademisyen i\u015f birli\u011finin ortaya \u00e7\u0131kmas\u0131 sa\u011fland\u0131; b\u00f6ylesi bir ortamda \u00f6\u011frenciler ve \u00fcniversite \u00e7al\u0131\u015fanlar\u0131 e\u015f zamanl\u0131 olarak kat\u0131l\u0131mc\u0131, g\u00f6zlemci ve uygulay\u0131c\u0131 olma deneyimi kazand\u0131.\u00a0<\/span><\/span><\/p>\n

Sonu\u00e7 olarak; COVID-19 pandemisi hem k\u00fcresel hem de ulusal \u00f6l\u00e7ekte \u00f6nemli bir halk sa\u011fl\u0131\u011f\u0131 problemi olarak tart\u0131\u015f\u0131lmakla birlikte toplum d\u00fczeyinde sa\u011fl\u0131\u011f\u0131 koruyucu (farmakolojik olmayan) \u00f6nlemler istenildi\u011fi kadar hayata ge\u00e7irilememi\u015ftir. COVID-19 i\u00e7in ger\u00e7ekle\u015ftirilen a\u015f\u0131 geli\u015ftirme ve \u00fcretimi s\u00fcre\u00e7leri \u201ciyimser bir rahatlama\u201d sa\u011flam\u0131\u015f ise de toplumun geli\u015ftirilen a\u015f\u0131larla ne kadar s\u00fcre korunabilece\u011fi ve bunun s\u00fcrd\u00fcrebilirli\u011fi, a\u015f\u0131ya ve tedaviye eri\u015fimde toplumlar aras\u0131ndaki e\u015fitsizliklerin giderilmesi, a\u015f\u0131 se\u00e7im ve programlar\u0131n\u0131n uygunlu\u011fu ve pandeminin ne kadar s\u00fcrece\u011finin \u00f6ng\u00f6r\u00fclmesi konular\u0131nda yerel \u00e7al\u0131\u015fmalara ihtiya\u00e7 duyulmaktad\u0131r. Objektif, tekrarlayan, \u00f6l\u00e7\u00fcme dayal\u0131, prospektif izlem \u00e7al\u0131\u015fmalar\u0131 bu nedenle son derece de\u011ferlidir ve desteklenmelidir. HU-CoVaCS ve benzeri i\u00e7 ge\u00e7erlili\u011fi y\u00fcksek \u00e7al\u0131\u015fmalar farkl\u0131 topluluklar ve zaman i\u00e7inde tekrarland\u0131k\u00e7a d\u0131\u015f ge\u00e7erlilik de artacak, ulusal pandemi m\u00fccadelesi i\u00e7in gerekli olan veri setleri ve kan\u0131t havuzlar\u0131 g\u00fc\u00e7lenecektir.<\/p>\n","protected":false},"excerpt":{"rendered":"

G\u0130R\u0130\u015e SARS-CoV-2 virusu kaynakl\u0131 COVID-19 pandemisi, t\u00fcm d\u00fcnyada oldu\u011fu gibi T\u00fcrkiye\u2019de de h\u0131zla yay\u0131lan bir halk sa\u011fl\u0131\u011f\u0131 sorunu olarak 11 Mart 2020 tarihinden itibaren sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131 do\u011frudan etkilemi\u015ftir. SARS-CoV-2 ile kars\u0327\u0131las\u0327ma riskinin y\u00fcksek olmas\u0131 ve\/veya y\u00fcksek viral y\u00fck al\u0131m\u0131 nedeniyle sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 pandemide y\u00fcksek riskli gruplar\u0131n ba\u015f\u0131nda gelmektedir (1,2). Sag\u0306l\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n pandemiden bireysel olarak etkilenmeleri […]<\/p>\n","protected":false},"author":4,"featured_media":26854,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5129],"tags":[5174,5625,5379],"class_list":["post-26380","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ozgun-arastirma","tag-covid-19","tag-covid-19-antikor-testi","tag-covid-19-asisi"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/26380","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/comments?post=26380"}],"version-history":[{"count":4,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/26380\/revisions"}],"predecessor-version":[{"id":26842,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/26380\/revisions\/26842"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media\/26854"}],"wp:attachment":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media?parent=26380"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/categories?post=26380"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/tags?post=26380"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}