Medipol Mega Üniversite Hastanesi Organ Nakli Bölümünden Prof. Dr. Onur Yaprak, Kovid-19'un akciğerler dışında birçok organı etkilediğini belirterek, önemli açıklamalarda bulundu.
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Medipol Mega Üniversite Hastanesi Organ Nakli Bölümünden Prof. Dr. Onur Yaprak, Kovid-19'un akciğerler dışında birçok organı etkilediğini belirterek, önemli açıklamalarda bulundu.
Prof. Dr. Yaprak, pandemi sürecinin yaklaşık 1.5 yıldır sürdüğüne değinerek, "11 Mart 2020 tarihinde Dünya Sağlık Örgütü tarafından pandemi ilanı yapılan Kovid-19 enfeksiyonu ile ilgili salgının ilk başında bildiklerimizden artık çok daha fazla bilgiye sahibiz. Her gün yeni bir şeyler öğrenerek salgında 1.5 yıla yakın bir süreyi geride bıraktık ve bu süre zarfında da hastalık hakkında binlerce bilimsel makale yayınlandı" diye konuştu.
KORONAVİRÜS SİSTEMİK BİR HASTALIK
Geçen süre zarfında hastalık geçiren kişilerin en az 6 ay izlenmesiyle ortaya çıkan yayınların sonuçlarına dikkati çeken Prof. Dr. Yaprak, şu ifadeleri kullandı:
"İlk olarak Sars-Cov-2 virüsü başlangıçta damlacık enfeksiyonu ile bulaşan ama sonra vücutta tüm organları etkileyen sistemik bir hastalığa yol açar. Bunun altında yatan neden virüsün vücuda girdiği ACE reseptörlerinin 20'ye yakın organ ve dokuda bulunması, virüsün damarları yoğunca tutması, tüm organların damar içermesidir.
İkinci olarak da uzamış Kovid ismi verilen ve hastalığı atlatanların bir kısmında tutulan organlara ait sekellerin aylarca süren şikayetlere yol açması. Hastalık sonrası 3-4 haftadan daha uzun süren birtakım şikayetlerin devam etmesine uzamış covid demekteyiz. Bu durumun 3 aydan fazla sürmesi ise kronik Kovid olarak adlandırılmakta olup hastalığı ağır geçiren ve iyileşenlerde daha çok rastlanılır."
AKCİĞERDEN SONRA EN ÇOK SİNDİRİM SİSTEMİ ETKİLENİYOR
Prof. Dr. Yaprak, virüsün sadece akciğerlere zarar vermediğini belirterek, "Karaciğer, kalp, böbrek, bağırsak, beyin, sinir sistemi hatta cildimiz bile koronavirüsten değişen oranlarda etkilenebilir.
Karaciğer ve bağırsaklarda ACE reseptörleri oldukça yoğun olduğu için akciğerden sonra en çok etkilenen organ sindirim sistemidir. Hastaların yüzde 20 ila 30'unda karaciğer enzimlerinde 2 ila 5 kat arası yükselme, bulantı, kusma, karın ağrısı gibi bulgular gelişiyor. Karaciğerin etkilenmesinin altında yatan olası mekanizmalar, virüsün organların içindeki kılcal damarlarda pıhtılaşmaya yol açması, organların kanlanmasının bozulması, bağışıklık sisteminin aşırı tepkisi, yoğun bakımda solunum cihazına bağlanmaya bağlı karın içi basınç değişiklikleri, ilaç yan etkileri, bağırsağın geçirgenliğinin bozulması nedeniyle toksinlerin sistemik dolaşımla karaciğere gelmesi, safra yapımı ve salgılanmasında duraklama, altta yatan karaciğer hastalığının alevlenmesi gibi nedenlerdir" ifadelerini kullandı.
HASTALIĞI DAHA ŞİDDETLİ GEÇİRİYORLAR
Prof. Dr. Onur Yaprak "Kovid yüzünden ölen hastalarda yapılan otopsi çalışmalarında karaciğerde elekton mikroskopta virüse ait parçalar, karaciğer dokusunda PCR pozitifliği, iltihap ve yağlanma saptandı. Karaciğer tutulumu olan hastalar, hastalığı daha şiddetli geçirmekte ve ölüm oranlarında 3 kat artış oluyor. İyileşen hastalarda karaciğer enzimleri altta yatan bir karaciğer hastalığı yoksa genellikle normale dönmekte ancak altta karaciğer hastalığı olanlarda hastalığın ilerlemesine sebep oluyor. Bazı hastalarda ise haftalarca bulantı, karın ağrısı gibi şikayetler devam edebilir. Hastalığı ağır geçirenlerin ortalama yarısında halsizlik, güçsüzlük, çabuk yorulma şikayetleri haftalar bazen aylarca sürer. Akciğerlerde kalan sekele bağlı yine hafif-orta geçirmiş hastaların 1/3'ünde akciğerde fibrozis dediğimiz elastikiyet kaybı ve kanın oksijenlenmesindeki bozulmaya bağlı olarak nefes darlığı aylarca sürüyor. Hastalığı daha şiddetli geçirenlerde bu tablo daha da ağır olur. İyileşen hastaların yüzde 2.5 oranında taburculuktan 1 ay sonra damar içi pıhtılaşma sorunları geliştiği bildirildi" dedi.
SİNİR SİSTEMİNİ DE OLUMSUZ ETKİLER
Koronavirüsün kalp ve sinir sistemine etkisine de değinen Prof. Dr. Yaprak, şu şekilde devam etti:
"Kalp açısından virüs kalp kasında iltihaba yol açar. Zamanla kalp kasında yağlanma ve fibrozis gelişmesi kişide kalp yetmezliği, ritim bozuklukları gibi, göğüs ağrısı gibi sorunlara yol açabilir. 6 aylık takipte hastaların yüzde 9'unda çarpıntı, yüzde 5'inde göğüs ağrısının sürdüğü bildirildi. Salgında hayatını kaybeden hastalarda yapılan otopsi çalışmalarında da yüzde 62.5 oranındaki hastanın kalp dokusunda elektron mikroskopide virüse rastlandı.
Sinir sistemi açısından hastalık sürecinde görülen yüzde 10 ila 30 hastada depresyon, baş ağrısı, kas ağrısı, tat koku alma kaybı gibi yakınmalar gelişir ve bu yakınmaların bir kısmı haftalar ya da aylarca sürer. Böbrekler açısından ise tüm hastaneye yatırılan hastaların yüzde 5'inde ve yoğun bakıma yatırılan hastaların yüzde 30'unda akut böbrek hasarı gelişmekte iyileşen hastaların 6 ay sonunda yüzde 13'ünde böbrek fonksiyonlarının azaldığı saptandı. Hastalık deride bile bazı sorunlara yol açabilmekte yüzde 15 ila 20 hastada saç dökülmesi gözlendi."