مقايسه ويژگي‌هاي باليني و اپيدميولوژيكي بيماران فوتي و بهبود يافته مبتلا به كوويد-19 مراجعه‌كننده به مركز آموزشي و درماني واسعي شهر سبزوار

Comparison of Clinical and Epidemiological Characteristics of Deceased and Recovered Patients with COVID-19 in Sabzevar, Iran

زﻣﯿﻨﻪ و ﻫﺪف:SARS-CoV-2 ﺧﻄﺮﻧﺎكﺗﺮﯾﻦ وﯾﺮوسﻫﺎي ﺧﺎﻧﻮاده ﮐﺮوﻧﺎوﯾﺮوس ﻣﺤﺴﻮب ﺷﺪه و ﻫﺸﺪار ﺟﺪي ﺑﺮاي ﺗﻤﺎم ﮐﺸﻮرﻫﺎي ﺟﻬﺎن اﺳﺖ. ﻋﻠﯽرﻏﻢ ﺗﻠﺎش ﻣﺤﻘﻘﺎن، اﺑﻬﺎﻣﺎت ﮔﺴﺘﺮدهاي در راﺑﻄﻪ ﺑﺎ آن وﺟﻮد دارد. ﻫﺪف ﭘﮋوﻫﺶ ﺣﺎﺿﺮ ﻣﻘﺎﯾﺴﻪ وﯾﮋﮔﯽﻫﺎي ﺑﺎﻟﯿﻨﯽ و اﭘﯿﺪﻣﯿﻮﻟﻮژﯾﮑﯽ ﺑﯿﻤﺎران ﻓﻮﺗﯽ و ﺑﻬﺒﻮدﯾﺎﻓﺘﻪ ﮐﻮوﯾﺪ- 19ﺑﻮد. روشﻫﺎ: اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺗﻮﺻﯿﻔﯽ- ﺗﺤﻠﯿﻠﯽ، در ﺑﯿﻤﺎران ﮐﻮوﯾﺪ-19 ﺑﯿﻤﺎرﺳﺘﺎن واﺳﻌﯽ ﺷﻬﺮ ﺳﺒﺰوار در اﺳﻔﻨﺪ و ﻓﺮوردﯾﻦ 99-1398 اﻧﺠﺎم ﺷﺪ. اﺑﺰار ﻣﻮرد اﺳﺘﻔﺎده ﭘﺮﺳﺸﻨﺎﻣﻪ ﻣﺤﻘﻖﺳﺎﺧﺘﻪ، ﻣﺼﺎﺣﺒﻪ و اﻃﻠﺎﻋﺎت ﭘﺮوﻧﺪه ﺑﻮد. ﯾﺎﻓﺘﻪﻫﺎ: از 178 ﺑﯿﻤﺎر، 52/8 % زن و ﻣﯿﺎﻧﮕﯿﻦ ﺳﻨﯽ 57/1±18 ﺳﺎل ﺑﻮد. 85/4 %، ﺑﻬﺒﻮدﯾﺎﻓﺘﻪ و 14% از ﺑﯿﻤﺎران ﻓﻮت ﻧﻤﻮدهاﻧﺪ. ﺗﻨﮕﯽ ﻧﻔﺲ )72/5 %( ﺷﺎﯾﻊﺗﺮﯾﻦ ﻋﻠﺎﻣﺖ و ﺳﭙﺲ ﺳﺮﻓﻪ )61/8 %( و ﺗﺐ )48/9 %( ﺑﻮد. 43/8 % ﮐﻞ ﺑﯿﻤﺎران و 71/9 % ﺑﯿﻤﺎران ﻓﻮﺗﯽ ﺣﺪاﻗﻞ ﯾﮏ ﺑﯿﻤﺎري زﻣﯿﻨﻪاي داﺷﺘﻨﺪ. ﺳﺮﻓﻪ در ﺑﻬﺒﻮدﯾﺎﻓﺘﻪﻫﺎ و ﮐﺎﻫﺶ ﺳﻄﺢ ﻫﻮﺷﯿﺎري در ﻓﻮﺗﯽﻫﺎ ﺑﻪﻃﻮر ﻣﻌﻨﯽداري ﺑﯿﺸﺘﺮ ﺑﻮد )0/05< P(. اﻓﺰاﯾﺶ ﺳﻄﺢ ﮔﻠﺒﻮل ﻫﺎي ﺳﻔﯿﺪ ﺧﻮن، ﮐﺎﻫﺶ ﻟﻨﻔﻮﺳﯿﺖ ﻫﺎ و اﻓﺰاﯾﺶ ﻧﻮﺗﺮوﻓﯿﻞ ﻫﺎ در ﺑﯿﻤﺎران ﻓﻮت ﺷﺪه ﺑﻪ ﻃﻮر ﻣﻌﻨﺎداري ﺑﯿﺸﺘﺮ ﺑﻮد )0/05< P(. ﻧﺘﯿﺠﻪﮔﯿﺮي: ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﺑﺎﻟﺎﺗﺮ ﺑﻮدن ﻣﯿﺰان اﺑﺘﻠﺎ و ﻓﻮت در اﻓﺮاد ﺑﺎ ﺳﻦ ﺑﺎﻟﺎﺗﺮ و داراي ﺑﯿﻤﺎريﻫﺎي زﻣﯿﻨﻪاي، اﻗﺪاﻣﺎت اﺣﺘﯿﺎﻃﯽ و ﭘﯿﺸﮕﯿﺮاﻧﻪ در اﯾﻦ ﻗﺸﺮ ﻟﺎزم ﻣﯽﺑﺎﺷﺪ. ﻫﻤﭽﻨﯿﻦ ﺗﻮﺟﻪ ﺑﻪ ﻋﻠﺎﺋﻢ ﺑﯿﻤﺎران در ﺑﺪو ورود در ﺷﻨﺎﺳﺎﯾﯽ ﭘﯿﺶآﮔﻬﯽ ﺑﯿﻤﺎران ﮐﻤﮏﮐﻨﻨﺪه اﺳﺖ. اﻓﺰاﯾﺶ ﮔﻠﺒﻮلﻫﺎي ﺳﻔﯿﺪ ﺧﻮن و ﻧﻮﺗﺮوﻓﯿﻞﻫﺎ و ﮐﺎﻫﺶ ﻟﻨﻔﻮﺳﯿﺖﻫﺎ، ﻧﺸﺎندﻫﻨﺪه درﮔﯿﺮي ﺳﯿﺴﺘﻢ اﯾﻤﻨﯽ اﯾﻦ ﺑﯿﻤﺎران اﺳﺖ. ﺑﺮاي ﺷﻨﺎﺳﺎﯾﯽ ﻋﻮاﻣﻞ ﭘﺎﺗﻮژﻧﺰ و زﻣﯿﻨﻪاي در اﯾﻦ ﺑﯿﻤﺎران ﺗﺤﻘﯿﻘﺎت ﺑﯿﺸﺘﺮ ﻣﻮرد ﻧﯿﺎز اﺳﺖ.

Background and Aim: SARS-CoV-2 is the most dangerous virus in the coronavirus family and is a serious warning to all countries in the world. Despite the efforts of researchers, there are widespread ambiguities about it. The aim of this study was to compare the clinical and epidemiological characteristics of deceased and recovered patients with COVID-19. Methods: This descriptive-analytical study was performed in patients with COVID-19 in Vasei Hospital in Sabzevar, Iran in March and April 2020. The tools used were the researcher-made questionnaire, interview and medical files. Results: From the 178 patients, 52.8% were women and the mean age was 57.1±18 years. 85.4% have recovered and 14% have died. Shortness of breath (72.5%) was the most common symptom, followed by cough (61.8%) and fever (48.9%). 43.8% of all patients and 71.9% of deceased patients had at least one underlying disease. There were significant differences in terms of cough in recovered cases and decreased level of consciousness in deceased patients (P <0.05). Increased white blood cell counts, decreased lymphocytes, and increased neutrophils were significantly higher in deceased patients (P <0.05) Conclusion: Due to the high rate of infection and death in older people with underlying diseases, precautionary measures should be taken in this group. It is also helpful to pay attention to patientschr('39') symptoms in admission to identify the patientchr('39')s prognosis. An increase in white blood cells and neutrophils and a decrease in lymphocytes indicate that the immune system is involved in these patients. More research is needed to identify the pathogenesis and underlying factors in these patients.