{"id":30069,"date":"2025-03-21T10:24:11","date_gmt":"2025-03-21T07:24:11","guid":{"rendered":"https:\/\/www.klimikdergisi.org\/?p=30069"},"modified":"2025-03-21T16:39:55","modified_gmt":"2025-03-21T13:39:55","slug":"covid-19da-asilama-ve-prognoz-iliskisi","status":"publish","type":"post","link":"https:\/\/www.klimikdergisi.org\/tr\/2025\/03\/21\/covid-19da-asilama-ve-prognoz-iliskisi\/","title":{"rendered":"Hastane Yat\u0131\u015f\u0131 Gerektiren Ciddi COVID-19\u2019da A\u015f\u0131laman\u0131n ve Komorbid Hastal\u0131klar\u0131n Prognoz ile \u0130li\u015fkisi"},"content":{"rendered":"

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

\u015eiddetli akut solunum yolu sendromu virusu (SARS-CoV-2)\u2019nun neden oldu\u011fu koronavirus hastal\u0131\u011f\u0131 2019 (COVID-19) t\u00fcm d\u00fcnyada \u00f6nemli bir mortalite ve morbidite sebebi olmaya devam etmektedir. D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc (DS\u00d6)\u2019n\u00fcn raporlar\u0131 21 Temmuz 2024 itibar\u0131yla d\u00fcnya genelinde 7 milyondan fazla \u00f6l\u00fcm ve 775 milyondan fazla k\u00fcm\u00fclatif COVID-19 olgusu oldu\u011funu g\u00f6stermektedir (1). G\u00fcn\u00fcm\u00fczde hastal\u0131\u011f\u0131n k\u00fcresel d\u00fczeydel etkileri \u00f6nemini bir miktar kaybetmekle birlikte \u00f6zellikle riskli gruplarda COVID-19\u2019a ba\u011fl\u0131 ciddi hastal\u0131k, hastane yat\u0131\u015f\u0131 ve yo\u011fun bak\u0131m ihtiyac\u0131 g\u00f6r\u00fclmeye devam etmektedir.<\/p>\n

COVID-19 i\u00e7in geli\u015ftirilen a\u015f\u0131lar pandeminin kontrol alt\u0131na al\u0131nmas\u0131nda en \u00f6nemli unsurlardan biri olmu\u015ftur (2). Kapsaml\u0131 randomize kontroll\u00fc \u00e7al\u0131\u015fmalar ve ger\u00e7ek ya\u015fam verileri sayesinde a\u015f\u0131lar\u0131n SARS-CoV-2\u2019ye ba\u011fl\u0131 semptomatik hastal\u0131\u011f\u0131, hastane yat\u0131\u015f\u0131n\u0131 ve \u00f6l\u00fcmleri y\u00fcksek oranda \u00f6nledi\u011fi g\u00f6sterilmi\u015ftir (3-6). A\u015f\u0131lar\u0131n y\u00fcksek etkinli\u011fine ra\u011fmen k\u0131smi a\u015f\u0131lanm\u0131\u015f ve tam doz a\u015f\u0131l\u0131 bireylerde COVID-19\u2019a ba\u011fl\u0131 \u201cbreakthrough\u201d infeksiyon\u201d, ciddi hastal\u0131k, hastane yat\u0131\u015f\u0131 ve yo\u011fun bak\u0131m ihtiyac\u0131 geli\u015febildi\u011fi bilinmektedir.\u00a0 <\/span>Uygulanan a\u015f\u0131n\u0131n tipi, SARS-CoV-2 varyant\u0131, a\u015f\u0131 uygulamas\u0131n\u0131n \u00fczerinden ge\u00e7en s\u00fcre, ileri ya\u015f, \u00e7oklu komorbidite varl\u0131\u011f\u0131 ve imm\u00fcns\u00fcpresyon gibi durumlar\u0131n de\u011fi\u015fen imm\u00fcn yan\u0131tla birlikte koronavirus a\u015f\u0131lar\u0131n\u0131n etkinli\u011fini de\u011fi\u015ftirebilece\u011fi bildirilmi\u015ftir (7-9).<\/p>\n

T\u00fcm d\u00fcnyada farkl\u0131 tiplerde (inaktif virus, mRNA, viral vektor ve protein alt \u00fcnitesi, vb.) COVID-19 a\u015f\u0131lar\u0131 onaylanm\u0131\u015ft\u0131r. A\u015f\u0131lama politikalar\u0131n\u0131n bir sonucu olarak, d\u00fcnyan\u0131n farkl\u0131 b\u00f6lgelerinde de\u011fi\u015fen homolog ve heterolog \u015femalar do\u011frultusunda farkl\u0131 primer ve \u201cbooster\u201d dozlar uygulanmaktad\u0131r. \u201cBreakthrough\u201d SARS-CoV-2 infeksiyonlar\u0131n\u0131n de\u011ferlendirildi\u011fi \u00e7al\u0131\u015fmalar \u00e7o\u011funlukla mRNA a\u015f\u0131lar\u0131 veya viral vekt\u00f6r a\u015f\u0131lar\u0131n\u0131n incelendi\u011fi \u00e7al\u0131\u015fmalard\u0131r (10-12). \u00dclkemiz gibi, inaktive virus a\u015f\u0131s\u0131 ve mRNA a\u015f\u0131s\u0131n\u0131n birlikte uyguland\u0131\u011f\u0131 \u00fclkelerin say\u0131s\u0131n\u0131n g\u00f6rece az olmas\u0131 nedeniyle, \u201cbreakthrough\u201d infeksiyonlarda heterolog a\u015f\u0131lama ile ilgili \u00e7al\u0131\u015fmalar s\u0131n\u0131rl\u0131d\u0131r. \u00c7al\u0131\u015fmam\u0131zda, ciddi COVID-19 nedeniyle hastaya yat\u0131r\u0131larak izlenen hastalarda a\u015f\u0131lanma durumu ile k\u00f6t\u00fc prognoz geli\u015fimi aras\u0131ndaki ili\u015fkinin ara\u015ft\u0131r\u0131lmas\u0131 ama\u00e7land\u0131.<\/p>\n

Y\u00d6NTEMLER<\/h2>\n

Tek merkezli, g\u00f6zlemsel ve retrospektif olarak yap\u0131lan bu \u00e7al\u0131\u015fmaya,\u00a0 <\/span>01 Mart – 30 Kas\u0131m 2021 tarihleri aras\u0131nda polimeraz zincir reaksiyonu (PCR) testi ile do\u011frulanm\u0131\u015f COVID-19 tan\u0131s\u0131 alarak ciddi pn\u00f6moni nedeni ile hastaneye yat\u0131r\u0131lan ve takip edilen 18 ya\u015f ve \u00fczeri hastalar d\u00e2hil edildi. 18 ya\u015f\u0131n alt\u0131nda olanlar, a\u015f\u0131lanma durumlar\u0131na ve t\u0131bbi bilgilerine ula\u015f\u0131lamayanlar, gebe olanlar ve SARS-CoV-2 PCR test sonucu negatif olup yaln\u0131zca toraks tomografi bulgular\u0131 ile COVID-19 tan\u0131s\u0131 alanlar \u00e7al\u0131\u015fmaya al\u0131nmad\u0131. \u00c7al\u0131\u015fmaya d\u00e2hil edilen hastalar\u0131n demografik \u00f6zelliklerine, klinik bilgilerine, laboratuvar sonu\u00e7lar\u0131na ve a\u015f\u0131lanma durumlar\u0131na, hastane veritaban\u0131, T.C. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 e-Nab\u0131z Ki\u015fisel Sa\u011fl\u0131k Sistemi, Halk Sa\u011fl\u0131\u011f\u0131 Y\u00f6netim Sistemi ve T.C. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 A\u015eILA Mobil Uygulamas\u0131 ile ula\u015f\u0131ld\u0131.<\/p>\n

\u00c7al\u0131\u015fma Y\u0131ld\u0131r\u0131m Beyaz\u0131t \u00dcniversitesi Yenimahalle E\u011fitim ve Ara\u015ft\u0131rma Hastanesi Etik Kurulu taraf\u0131ndan 5 Ocak 2022 tarih ve E2021-72 karar numaras\u0131yla onayland\u0131.<\/p>\n

Olgu Tan\u0131mlar\u0131<\/h3>\n

T.C. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 COVID-19 Rehberi\u2019ne uygun olarak, PCR testi ile do\u011frulanm\u0131\u015f ve yatarak tedavi gerektiren ciddi pn\u00f6moni tan\u0131s\u0131 alan hastalar (oda havas\u0131nda SpO2<\/sub><\/span> d\u00fczeyi \u226494, solunum say\u0131s\u0131 \u226530\/dk veya radyolojik g\u00f6r\u00fcnt\u00fclemede akci\u011fer infiltrasyonu \u2265%50) ciddi COVID-19 hastas\u0131 olarak tan\u0131mland\u0131 ve \u00e7al\u0131\u015fmaya dahil edildi.<\/p>\n

Hastalar a\u015f\u0131lanma durumlar\u0131na g\u00f6re \u2018a\u015f\u0131s\u0131z\u2019 ve \u2018a\u015f\u0131l\u0131\u2019 olmak \u00fczere iki grupta incelendi. Daha \u00f6nce hi\u00e7 a\u015f\u0131lama yap\u0131lmayan, tek doz CoronaVac a\u015f\u0131s\u0131 (Sinovac Life Sciences, Pekin, \u00c7in) ya da tek doz BNT162b2
\n(Pfizer-BioNTech) a\u015f\u0131s\u0131 olan ve iki doz a\u015f\u0131l\u0131 olup son doz a\u015f\u0131lama \u00fczerinden en az 14 g\u00fcn ge\u00e7memi\u015f olan hastalar a\u015f\u0131s\u0131z grup olarak tan\u0131mland\u0131. En az iki doz a\u015f\u0131l\u0131 olup (iki doz CoronaVac, \u00fc\u00e7 doz CoronaVac, iki doz CoronaVac ve bir doz BNT162b2, iki doz BNT162b2) a\u015f\u0131lama \u00fczerinden en az 14 g\u00fcn ge\u00e7mi\u015f olan hastalar a\u015f\u0131l\u0131 grup olarak tan\u0131mland\u0131. A\u015f\u0131s\u0131z ve a\u015f\u0131l\u0131 gruplar ya\u015f, cinsiyet, komorbid hastal\u0131klar, hastane yat\u0131\u015f s\u00fcreleri, yo\u011fun bak\u0131m ihtiyac\u0131, mortalite durumlar\u0131 ve laboratuvar de\u011ferleri a\u00e7\u0131s\u0131ndan kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131.<\/p>\n

\u0130statistiksel Analizler<\/h3>\n

S\u00fcrekli verilere ili\u015fkin tan\u0131mlay\u0131c\u0131 istatistikler ortanca ve 25.-75. y\u00fczdelik dilimler (interquartile range – IQR) olarak, kesikli veriler ise say\u0131 (n) ve y\u00fczde (%) olarak sunuldu. Verilerin normal da\u011f\u0131l\u0131ma uygunlu\u011funun incelenmesinde Kolmogorov-Smirnov testinden yararlan\u0131ld\u0131. Nominal de\u011fi\u015fkenlerin grup kar\u015f\u0131la\u015ft\u0131rmalar\u0131nda (\u00e7apraz tablolarda) \u03c72\u00a0ve Fisher kesin testi; s\u00fcrekli verilerin kar\u015f\u0131la\u015ft\u0131rmalar\u0131nda normal da\u011f\u0131l\u0131ma uyan verilerde ba\u011f\u0131ms\u0131z \u00f6rneklem t testi, normal da\u011f\u0131l\u0131m g\u00f6stermeyen verilerde Mann-Whitney U testi kullan\u0131ld\u0131. Verilerin analizi, SPSS (Statistical Package for the Social Sciences) versiyon 20.0 program\u0131 (IBM Corp., Armonk, NY, ABD) ile yap\u0131ld\u0131 ve istatistiksel anlaml\u0131l\u0131k d\u00fczeyi p<\/i><0.05 kabul edildi.<\/span><\/p>\n

BULGULAR<\/h2>\n
\"\"<\/a>

Tablo 1.<\/strong> Hastalar\u0131n Demografik ve Klinik \u00d6zellikleri (N=775)<\/p><\/div>\n

\u00c7al\u0131\u015fmaya 775 hasta dahil edildi; ya\u015f ortalamas\u0131 58.80\u00b115.22 y\u0131l olup %54.6\u2019s\u0131 kad\u0131nd\u0131. Hastalar\u0131n 505 (%65.2)\u2019inde en az bir komorbid hastal\u0131k saptand\u0131. En s\u0131k saptanan komorbidite hipertansiyon (%43) idi. Hastalar\u0131n %33\u2019\u00fc a\u015f\u0131l\u0131yd\u0131 ve en s\u0131k olarak iki doz CoronaVac a\u015f\u0131s\u0131 (%66.4) olundu\u011fu saptand\u0131. Yo\u011fun bak\u0131m ihtiyac\u0131 hastalar\u0131n %20.1\u2019inde ortaya \u00e7\u0131km\u0131\u015ft\u0131 ve %7.4\u2019\u00fcnde mortalite geli\u015fmi\u015fti (Tablo 1).<\/p>\n

\"\"<\/a>

Tablo 2.<\/strong> A\u015f\u0131l\u0131 ve A\u015f\u0131lanmam\u0131\u015f Hastalar\u0131n Kar\u015f\u0131la\u015ft\u0131r\u0131lmas\u0131<\/p><\/div>\n

A\u015f\u0131l\u0131 grupta; ya\u015f, en az bir komorbid hastal\u0131k varl\u0131\u011f\u0131, hipertansiyon, diabetes mellitus, kronik obstr\u00fcktif akci\u011fer hastal\u0131\u011f\u0131 (KOAH), imm\u00fcns\u00fcpresyon, akut b\u00f6brek yetmezli\u011fi, kronik b\u00f6brek yetmezli\u011fi ve konjestif kalp yetmezli\u011fi a\u015f\u0131s\u0131z gruba g\u00f6re daha y\u00fcksekti. \u0130ki grup aras\u0131nda yo\u011fun bak\u0131m ihtiyac\u0131 ve mortalite a\u00e7\u0131s\u0131ndan anlaml\u0131 d\u00fczeyde fark saptanmad\u0131 (Tablo 2).<\/p>\n

\u0130RDELEME<\/h2>\n

\u00c7al\u0131\u015fmam\u0131zda, a\u015f\u0131lama sonras\u0131 \u201cbreakthrough\u201d infeksiyon ge\u00e7iren ciddi COVID-19 hastalar\u0131n\u0131n, a\u015f\u0131s\u0131zlara g\u00f6re daha ya\u015fl\u0131 ve daha \u00e7ok komorbiditeye sahip olduklar\u0131 saptand\u0131. Ek olarak, a\u015f\u0131l\u0131 grupta hipertansiyon, diabetes mellitus, hiperlipidemi, KOAH, kronik b\u00f6brek hastal\u0131\u011f\u0131 ve konjestif kalp yetmezli\u011fi anlaml\u0131 d\u00fczeyde daha fazla idi. A\u015f\u0131l\u0131 ve a\u015f\u0131s\u0131z grupta yo\u011fun bak\u0131m ihtiyac\u0131 ve mortalite a\u00e7\u0131s\u0131ndan anlaml\u0131 d\u00fczeyde fark saptanmad\u0131.<\/p>\n

Pandeminin ba\u015flang\u0131c\u0131ndan bu yana hem a\u015f\u0131lama \u00f6ncesi hem de a\u015f\u0131lama sonras\u0131 d\u00f6nemde hastal\u0131k prognozu ile ili\u015fkili en \u00f6nemli risk fakt\u00f6rlerinden biri ya\u015f olarak bildirilmi\u015ftir (13-14). Artan ya\u015fla birlikte n\u00f6tralizan antikor aktivitesi ve titresinde azalma, T h\u00fccre ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131n\u0131n zay\u0131flamas\u0131 gibi fakt\u00f6rler nedeniyle \u201cbreakthrough\u201d infeksiyon riskinin beklenen bir durum oldu\u011fu bildirilmi\u015ftir (15). Benzer mekanizmalar sonucu altta yatan komorbid hastal\u0131klar da ciddi COVID-19\u2019a ba\u011fl\u0131 morbidite ve mortalitenin \u00f6nemli nedenlerindendir (15). De\u011ferlendirilen hasta say\u0131s\u0131n\u0131n
\n1\u00a0218 630 oldu\u011fu bir kohort \u00e7al\u0131\u015fmas\u0131nda, \u00e7al\u0131\u015fmam\u0131za benzer \u015fekilde diabetes mellitus, KOAH ve kronik b\u00f6brek hastal\u0131\u011f\u0131 olanlarda \u201cbreakthrough\u201d infeksiyonun g\u00f6r\u00fclme olas\u0131l\u0131\u011f\u0131 iki kat fazla olarak bildirilmi\u015ftir (16). Bu nedenle d\u00fcnyada ve \u00fclkemizde yap\u0131lan COVID-19 a\u015f\u0131 kampanyalar\u0131nda ileri ya\u015f ve komorbiditesi olan hastalar \u00f6nceliklendirilmi\u015ftir. \u00c7al\u0131\u015fmam\u0131z da yap\u0131lan di\u011fer \u00e7al\u0131\u015fmalarla benzer \u015fekilde \u201cbreakthrough\u201d infeksiyon ge\u00e7iren grupta, ya\u015f ve komorbidite hastal\u0131k varl\u0131\u011f\u0131n\u0131n daha y\u00fcksek oldu\u011funu g\u00f6sterdi (12,17,18).<\/p>\n

\u00dclkemizde yo\u011fun bak\u0131m gereksinimi olan COVID-19\u2019lu hastalar\u0131n de\u011ferlendirildi\u011fi \u00e7ok merkezli bir \u00e7al\u0131\u015fmada, bulgular\u0131m\u0131zla benzer \u015fekilde CoronaVac a\u015f\u0131s\u0131 olan ve olmayan grup aras\u0131nda mortalite a\u00e7\u0131s\u0131ndan anlaml\u0131 d\u00fczeyde bir fark bildirilmemi\u015ftir (19). Bununla birlikte, a\u015f\u0131l\u0131 grupta ya\u015f ve komorbiditenin daha y\u00fcksek oldu\u011fu ve mortalitenin ba\u011f\u0131ms\u0131z bir risk fakt\u00f6r\u00fc olarak de\u011ferlendirildi\u011fi bildirilmi\u015ftir. Yavuz ve arkada\u015flar\u0131n\u0131n (18) yapt\u0131\u011f\u0131 \u00e7al\u0131\u015fmada, CoronaVac ile a\u015f\u0131lanan grupta mortalite oran\u0131 y\u00fcksek bildirilmi\u015ftir; s\u00f6z konusu \u00e7al\u0131\u015fman\u0131n alt grup analizinde, a\u015f\u0131l\u0131 grup i\u00e7in ya\u015f, kronik b\u00f6brek hastal\u0131\u011f\u0131 ve akut b\u00f6brek hasar\u0131 mortalite i\u00e7in risk fakt\u00f6rleridir. \u0130naktif koronavirus a\u015f\u0131s\u0131 d\u0131\u015f\u0131nda kullan\u0131lan a\u015f\u0131lar sonras\u0131nda ortaya \u00e7\u0131kan \u201cbreakthrough\u201d infeksiyonlarda da benzer bulgular rapor edilmi\u015ftir (20). A\u015f\u0131lar\u0131n COVID-19\u2019dan korunma ve k\u00f6t\u00fc sonu\u00e7lanma riskini azaltmada etkili oldu\u011fu g\u00f6sterilmi\u015f olmakla birlikte, \u00e7al\u0131\u015fmam\u0131zda mortalite ve yo\u011fun bak\u0131m ihtiyac\u0131 a\u00e7\u0131s\u0131ndan iki grup aras\u0131nda anlaml\u0131 d\u00fczeyde fark saptanmad\u0131. Bu durumun, \u201cbreakthrough\u201d infeksiyon grubunun daha ileri ya\u015fta ve \u00e7oklu komorbiditelere sahip bulunmas\u0131 ile ili\u015fkili oldu\u011funu d\u00fc\u015f\u00fcn\u00fcyoruz. \u0130leri ya\u015f ve komorbiditenin COVID-19\u2019un sonu\u00e7lar\u0131 \u00fczerinde ba\u011f\u0131ms\u0131z risk fakt\u00f6rleri oldu\u011funu g\u00f6steren di\u011fer \u00e7al\u0131\u015fmalar, bu bulgumuzu desteklemektedir (21,22).<\/p>\n

\u00c7al\u0131\u015fmam\u0131z\u0131n en \u00f6nemli k\u0131s\u0131tl\u0131l\u0131\u011f\u0131; inaktif a\u015f\u0131, mRNA a\u015f\u0131s\u0131 ve bu iki a\u015f\u0131n\u0131n birlikte uyguland\u0131\u011f\u0131 hastalar\u0131n a\u015f\u0131l\u0131 grup ad\u0131 alt\u0131nda tek bir grupta incelenmesidir. Ayr\u0131ca, \u00f6rneklem say\u0131s\u0131n\u0131n yetersizli\u011fi nedeniyle farkl\u0131 a\u015f\u0131 gruplar\u0131n\u0131n tek tek prognoza etkisini de de\u011ferlendiremedik. Di\u011fer yanda, retrospektif olarak ger\u00e7ekle\u015ftirilen \u00e7al\u0131\u015fmam\u0131zda SARS-CoV-2 varyant analizine eri\u015femedik ve hastalarda n\u00f6tralizan antikor d\u00fczey \u00f6l\u00e7\u00fcm\u00fc yap\u0131lamad\u0131\u011f\u0131 i\u00e7in a\u015f\u0131 etkinli\u011fini de\u011ferlendirecek niceliksel verilerden de yoksunduk.<\/p>\n

Sonu\u00e7 olarak; a\u015f\u0131lama sonras\u0131 \u201cbreakthrough\u201d infeksiyon ge\u00e7iren ciddi COVID-19 hastalar\u0131n\u0131n, a\u015f\u0131s\u0131zlara g\u00f6re daha ileri ya\u015fta ve daha \u00e7ok komorbiditeye sahip ki\u015filer oldu\u011funu saptad\u0131k; a\u015f\u0131l\u0131 ve a\u015f\u0131s\u0131z grupta yo\u011fun bak\u0131m ihtiyac\u0131 ve mortalite a\u00e7\u0131s\u0131ndan ise anlaml\u0131 d\u00fczeyde bir fark tespit etmedik. A\u015f\u0131laman\u0131n t\u00fcm hasta gruplar\u0131nda yayg\u0131n koruma sa\u011flad\u0131\u011f\u0131 bilinmekle birlikte \u00e7al\u0131\u015fmam\u0131z\u0131n bulgular\u0131n\u0131n ileri ya\u015fta olup komorbid hastal\u0131\u011f\u0131 olan ki\u015filerin \u201cbreakthrough\u201d infeksiyon i\u00e7in risk alt\u0131nda oldu\u011funu ve COVID-19\u2019dan korunmada a\u015f\u0131 d\u0131\u015f\u0131nda ek tedbirlerin al\u0131nmas\u0131 gerekti\u011fini g\u00f6sterdi\u011fini d\u00fc\u015f\u00fcn\u00fcyoruz.<\/p>\n","protected":false},"excerpt":{"rendered":"

G\u0130R\u0130\u015e \u015eiddetli akut solunum yolu sendromu virusu (SARS-CoV-2)\u2019nun neden oldu\u011fu koronavirus hastal\u0131\u011f\u0131 2019 (COVID-19) t\u00fcm d\u00fcnyada \u00f6nemli bir mortalite ve morbidite sebebi olmaya devam etmektedir. D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc (DS\u00d6)\u2019n\u00fcn raporlar\u0131 21 Temmuz 2024 itibar\u0131yla d\u00fcnya genelinde 7 milyondan fazla \u00f6l\u00fcm ve 775 milyondan fazla k\u00fcm\u00fclatif COVID-19 olgusu oldu\u011funu g\u00f6stermektedir (1). G\u00fcn\u00fcm\u00fczde hastal\u0131\u011f\u0131n k\u00fcresel d\u00fczeydel etkileri […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5129],"tags":[5758,5174,3372],"class_list":["post-30069","post","type-post","status-publish","format-standard","hentry","category-ozgun-arastirma","tag-asilama","tag-covid-19","tag-prognoz"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/30069","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=30069"}],"version-history":[{"count":3,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/30069\/revisions"}],"predecessor-version":[{"id":30290,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/30069\/revisions\/30290"}],"wp:attachment":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media?parent=30069"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/categories?post=30069"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/tags?post=30069"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}