GKD Anest Yoð Bak Dern Derg. 2022; 28(1): 36-41 | DOI: 10.14744/GKDAD.2022.39259

COVID-19, Yoðun Bakým Ünitesindeki Octogenarian ve Nonagenerian Popülasyonda Daha Þiddetli ve Ölümcül Olabilir

Behiye Deniz Kosovali¹, Büþra Tezcan¹, Nevzat Mehmet Mutlu¹, Seval Ýzdeþ^2
1Ankara Þehir Hastanesi, Yoðun Bakým Kliniði, Ankara, Türkiye
²Ankara Yýldýrým Beyazýt Üniversitesi Týp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalý, Ankara, Türkiye

Amaç: Bu çalýþmada, “Coronavirus Disease-2019 (COVID-19)”a yakala-nan yoðun bakým hastalarýný octogenarian ve nonagenarian grup ve 80 yaþýndan genç hastalar olarak gruplandýrarak demografik ve klinik özel-liklerinin, yoðun bakýmdaki destek tedavilerinin, mortalite oranlarýnýn ve mortaliteye etkili faktörlerin belirlenmesi hedeflendi.
Yöntem: Retrospektif gözlemsel bu çalýþmaya, 19 Mart 2020-31 Mart 2021 tarihleri arasýnda COVID-19 yoðun bakým ünitelerinde yatan po-limeraz zincir reaksiyonu pozitifliði ile COVID-19 tanýsý alan ≥18 yaþ has-talar dahil edildi.
Bulgular: Polimeraz zincir reaksiyonu pozitif 1004 hastanýn %58,7’si er-kek, en genç hasta 20, en yaþlý hasta 100 yaþýndaydý. Grup 1’de (20-79 yaþ) 738, grup 2’de (≥80 yaþ) 266 hasta vardý. Cinsiyet, akut fizyoloji ve kronik saðlýk deðerlendirmesi II (APACHE II) skoru, entübasyon ihtiyacý, vazop-resör/inotrop ihtiyacý ve bakým ihtiyacý olan hastalar grup 2’de daha faz-laydý (hepsi için p<0,001). Sadece grup 1’deki hastalara ekstrakorporeal membran oksijenasyonu uygulandý. Hipertansiyon, kardiyovasküler sis-tem, solunum sistemi ve nörolojik hastalýklar, komorbidite sayýsý ve mor-talite oraný grup 2'de anlamlý olarak yüksekti (sýrasýyla; p<0,001, p=0,001, p=0,006, p<0,001, p<0,001, p<0,001). Yaþ, erkek cinsiyet, hipertansiyon, entübasyon ve vazopresör/inotrop ihtiyacý mortalite prediktörleri olarak belirlendi.
Sonuç: COVID-19, yoðun bakým ünitesindeki octogenarian ve nonage-narian popülasyonda daha þiddetli ve ölümcül olabilir.

Anahtar Kelimeler: COVID-19, mortalite oraný, nonagenarian, octoge-narian, yoðun bakým ünitesi

---

COVID-19 Could Be More Severe and Fatal in the Octogenarian and Nonagenarian Population in Intensive Care Unit

Behiye Deniz Kosovali¹, Büþra Tezcan¹, Nevzat Mehmet Mutlu¹, Seval Ýzdeþ^2
1Department of Critical Care, Ankara City Hospital, Ankara, Turkey
²Department of Anesthesiology and Reanimation, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey

Objectives: In this study, it was aimed to determine demographic and clinical characteristics, supportive treatments in intensive care unit (ICU), mortality rates and factors affecting mortality by grouping COVID-19 in-tensive care patients as octogenarian and nonagenarian groups, and patients younger than 80-years-old.
Methods: The patients aged ≥18 years diagnosed with COVID-19 with PCR positivity in ICUs between March 19, 2020 and March 31, 2021 were included in this retrospective observational study.
Results: Of the 1004 PCR positive patients, 58.7% were male. The youngest patient was 20, the oldest patient was 100-years-old. There were 738 patients in Group 1 (20-79 years) and 266 patients in Group 2 (≥80 years). Between the two groups, gender, APACHE II score, need for intubation, need for vasopressor/inotrope, and patients in need of care were higher in Group 2 (p<0.001 for all). Only the patients in Group 1 were established ECMO. Hypertension (HT), cardiovascular, respira-tory and neurological diseases, number of comorbidity, and mortality rate were higher significantly in Group 2 (p<0.001, p=0.001, p=0.006, p<0.001, p<0.001, and p<0.001; respectively). Age, male gender, HT, in-tubation, and vasopressor/inotrope requirement were found to be pre-dictors of mortality.
Conclusion: COVID-19 may have a more severe and fatal course in the octogenerian and nonagenerian age group with high comorbidity in the ICU.

Keywords: COVID-19, intensive care unit, mortality rate, nonagenarian, octogenarian

---

ATIF KOPYALA