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Multidisipliner COVID-19 Editör: Dr BURSA TAB‹P ODASI SÜREKL‹ TIP E⁄‹T‹M‹ PANDEM‹ K‹TABI TEMMUZ, 2020 Multidisipliner COVID-19 Editör: Dr. Cem Heper Nilüfer Aylin ACET ÖZTÜRK Berna AKOVA Kiper ASLAN Ali AYDINLAR Kenan AYDO⁄AN Gizem AYTO⁄U Naile BOLCA TOPAL Levent BÜYÜKUYSAL Belk›s Nihan COfiKUN Nil Kader ÇA⁄AÇ Ediz DALKILIÇ Gülay DURMUfi ALTUN Baflak ERDEML‹ GÜRSEL Alparslan ERSOY Canan ERSOY Gökhan GÖKALP Asl› GÖREK D‹LEKTAfiLI Özge GÜÇLÜ AYDIN Zülfiye GÜL Rümeysa Ayfle GÜLLÜLÜ Mustafa K. HACIMUSTAFAO⁄LU Yasemin HEPER Hakk› Caner ‹NAN Ferda fi. KAHVEC‹ Cansu KARA TURAN Fikret KASAPO⁄LU Esra KAZAK Sertaç Argun KIVANÇ Ülkü KORKMAZ Selim Giray NAK Ömer Fatih NAS Osman Okan OLCAYSÜ Barbaros ORAL Banu OTLAR CAN Gökhan ÖNGEN Cüneyt ÖZAKIN Alis ÖZÇAKIR Büflra ÖZDEM‹R Vildan ÖZKOCAMAN Rifat ÖZPAR Mine ÖZfiEN Kay›han PALA ‹mran SA⁄LIK Yusuf S‹VR‹O⁄LU P›nar TAfiAR Özlem TAfiKAPILIO⁄LU Alpaslan TÜRKKAN Gürkan UNCU Yeflim UNCU P›nar VURAL Kadir YEfi‹LBA⁄ Emel YILMAZ Aysun YILMAZLAR Pandemide hayatlarını kaybeden meslektaşlarımıza… Bu kitap onlara adanmıştır. KALPLERİMİZDELER… Bursa Tabip Odası Sürekli Tıp Eğitimi PANDEMİ KİTABI Temmuz, 2020 Multidisipliner COVID-19 Editör: Dr. Cem Heper Grafik: Naci Demiray ISBN: 978-605-9665-56-8 Bursa Tabip Odası Yayınları www.bto.org.tr e-mail: [email protected] UYARI ve NOTLAR: Bu kitaptaki bilgiler tıbbın her alanında olduğu gibi sürekli olarak yenilenmekte ve değişmektedir. Kitabın kapsamı nedeniyle aktarılan bilgiler oldukça sınırlı ölçülerdedir. İnsanların her biri, diğerlerine göre farklı özelliklere ve duyarlılıklara sahiptir. Bu nedenle buradaki bilgilerin uygulanmasından ve yeterliliğinden doğacak tıbbi ve hukuki sorumluluklar uygulamayı yapan hekim ve kişilere aittir. Kitabımızı ve odamızın bütün yayınlarını www.bto.org>yayınlarımız adresinden ücretsiz olarak indirebilir veya online olarak okuyabilirsiniz. Hekimlerin ve tıp eğitimi ile ilgilenen herkesin bedelsiz olarak temin edebildiği bu kitaptan yapılacak alıntılar veya kullanılacak bilgiler kaynak gösterilerek yapılırsa mutluluk duyarız. Atıflarınız veya referanslarınızın içinde, yazarlarımız ve kitabımız yer aldıkça teşvik edilmiş olacağız. Çalışmalarımızın değerini artırmış olacaksınız. Atıflarınızı lütfen aşağıdaki örneğe uygun olarak yapınız: Yazar adı. Bölüm adı. Multidisipliner COVID-19 Bursa Tabip Odası Sürekli Tıp Eğitimi Pandemi Kitabı. Ed. Heper Cem.Bursa Tabip Odası Yayınları. Temmuz 2020, Bursa. Sayfa: x-x Yapım: Rota Ofset, Rota Barışçı Matbaacılık ve Tanıtım Hizmetleri A.Ş. [email protected] / www.rotaofset.com.tr Barışçı İş Merkezi, Fethiye Mah. Sanayi Cad. No: 317 16140 Nilüfer, Bursa Tel: 0224 242 72 00 BURSA TAB‹P ODASI SÜREKL‹ TIP E⁄‹T‹M‹ PANDEM‹ K‹TABI, TEMMUZ, 2020 Multidisipliner COVID-19 Editör: Dr. Cem Heper İÇİNDEKİLER SUNUŞ 9 EDİTÖRÜN ÖNSÖZÜ 10 BÖLÜM 01 COVID-19’un Epidemiyolojik Özellikleri 13 Prof. Dr. Kayıhan PALA BÖLÜM 02 SARS-CoV-2 Özellikleri ve Laboratuvar Tanısı 29 Doç. Dr. İmran SAĞLIK BÖLÜM 03 COVID-19 Pandemisinde Dezenfeksiyon ve Sterilizasyon 63 Açısından Bilinmesi Gerekenler Prof. Dr. Cüneyt ÖZAKIN BÖLÜM 04 COVID-19 Genel Bakış 67 Doç. Dr. Yasemin HEPER BÖLÜM 05 Çocuklarda Coronavirus Hastalığı 2019 (COVID-19): 81 Çocuklarda Farklılıklar ve Yaklaşım Uz. Dr. Cansu KARA TURAN Prof. Dr. Mustafa K. HACIMUSTAFAOĞLU BÖLÜM 06 Enfeksiyon Hastalıkları Uzmanı Gözünden COVID-19 SSS ve Nörolojik Tutulum 107 Prof. Dr. Emel YILMAZ BÖLÜM 07 Enfeksiyon Hastalıkları Uzmanı Gözünden COVID -19 Hastalığında Böbrek 119 Doç. Dr. Esra KAZAK BÖLÜM 08 Enfeksiyon Hastalıkları Uzmanı Gözünden COVID-19 Hastalığı ve Karaciğer 129 Doç. Dr. Esra KAZAK BÖLÜM 09 Enfeksiyon Hastalıkları Uzmanı Gözünden COVID-19 ve Kalp 141 Doç. Dr. Yasemin HEPER BÖLÜM 10 COVID-19 ve Akciğerler 157 Uz. Dr. Nilüfer Aylin ACET ÖZTÜRK Uz. Dr. Özge AYDIN GÜÇLÜ Doç. Dr. Aslı GÖREK DİLEKTAŞLI BÖLÜM 11 COVID-19 Kritik Hasta:Yoğun Bakımda Tedavi ve Yönetim 183 Prof. Dr. Ferda Ş. KAHVECİ BÖLÜM 12 COVID-19 Tedavi Stratejileri 199 Dr. Öğr. Üyesi Zülfiye GÜL Prof. Dr. R. Levent BÜYÜKUYSAL BÖLÜM 13 İmmün (Konvelesan) Plazma Tedavisi 227 Doç. Dr. Yasemin HEPER BÖLÜM 14 COVID-19 Aşı Platformları ve Güncel Aşı Geliştirme Çalışmaları 239 Prof. Dr. Kadir YEŞİLBAĞ Dr. Gizem AYTOĞU BÖLÜM 15 COVID-19 Pnömonisinde Akciğer Görüntüleme 261 Dr. Öğr. Gör. Gökhan ÖNGEN Doç. Dr. Gökhan GÖKALP BÖLÜM 16 Ultrasonografide COVID-19 279 Dr. Öğr. Gör. Başak ERDEMLİ GÜRSEL Prof. Dr. Naile BOLCA TOPAL BÖLÜM 17 Girişimsel Radyoloji Ünitelerinde Yeni Tip Koronavirüs 291 (COVID-19) Hastalarının Yönetimi Doç. Dr. Ömer Fatih NAS BÖLÜM 18 COVID-19 Pandemisinde Nöroradyoloji 299 Dr. Öğr. Gör. Rifat ÖZPAR BÖLÜM 19 COVID-19 Enfeksiyonunda Patogenez ve Histopatolojik 311 Bulgular Uz. Dr. Mine ÖZŞEN BÖLÜM 20 COVID-19'da Bağışıklık Yanıtları ve Yangısal Olaylar 319 Prof. Dr. H. Barbaros ORAL BÖLÜM 21 COVID-19 ve Oftalmoloji 329 Op. Dr. Osman Okan OLCAYSÜ Doç. Dr. Berna AKOVA Doç. Dr. Sertaç Argun KIVANÇ BÖLÜM 22 COVID-19 Pandemisinde Nörolojik Hastalıklar 345 Doç. Dr. Özlem TAŞKAPILIOĞLU BÖLÜM 23 COVID-19 Dermatolojik Bulguları 365 Prof. Dr. Kenan AYDOĞAN BÖLÜM 24 COVID-19 ve Endokrin Sistem Hastalıkları 407 Prof. Dr. Canan ÖZYARDIMCI ERSOY BÖLÜM 25 Romatoloji ve COVID-19 429 Doç. Dr. Ediz DALKILIÇ Uz. Dr. Belkıs Nihan COŞKUN BÖLÜM 26 Gastrointestinal Traktus ve COVID-19 437 Prof. Dr. Selim Giray NAK BÖLÜM 27 COVID-19 ve Böbrek Hastalıkları 453 Prof. Dr. Alparslan ERSOY BÖLÜM 28 COVID-19 Gebelik &Laktasyon 497 Dr. Öğr. Gör. Kiper ASLAN Prof. Dr. Gürkan UNCU BÖLÜM 29 COVID-19 ve Hematoloji 507 Doç. Dr. Vildan ÖZKOCAMAN BÖLÜM 30 COVID-19 Pandemisi ve Kalp-Damar Sistemi 517 Prof. Dr. Ali AYDINLAR BÖLÜM 31 Kulak Burun Boğaz Hastalıkları ve COVID-19 581 Dr. Öğr. Gör. Hakkı Caner İNAN Prof. Dr. Fikret KASAPOĞLU BÖLÜM 32 COVID- 19 Pandemisinde Cerrahi 593 Doç. Dr. Pınar TAŞAR BÖLÜM 33 COVID-19 Hastalarında Anestezi 601 Uz. Dr. Banu OTLAR CAN BÖLÜM 34 COVID-19 Salgın Sürecinde Çocuk ve Ergen Ruh Sağlığı 611 Doç. Dr. Pınar VURAL BÖLÜM 35 Psikiyatri Açısından COVID-19 619 Dr. Rümeysa Ayşe GÜLLÜLÜ Doç. Dr. E. Yusuf SİVRİOĞLU BÖLÜM 36 COVID-19 Salgınının Nükleer Tıp Bölümlerine Etkisi 641 Prof. Dr. Gülay DURMUŞ ALTUN Uz. Dr. Ülkü KORKMAZ Arş. Gör. Dr. Büşra ÖZDEMİR BÖLÜM 37 COVID-19 Pandemisinde İşçi Sağlığı ve İş Güvenliği 649 Doç. Dr. Alpaslan TÜRKKAN BÖLÜM 38 COVID-19 ve Dijital Sağlık 659 Arş. Gör. Dr. Nil Kader ÇAĞAÇ BÖLÜM 39 COVID-19 Pandemisinde Hastane Yönetimi 679 Prof. Dr. Aysun YILMAZLAR BÖLÜM 40 COVID-19 ve Aile Hekimliği 687 Prof. Dr. Alis ÖZÇAKIR Prof. Dr. Yeşim UNCU SUNUŞ Virüslerin tarihte bütün dünyayı etkisine alan salgınlar yaptığı bilinmek- tedir. Bilinen ölüme en fazla yol açan virüs salgını, yaklaşık yüz yıl önce ortaya çıkan İspanyol Gribi salgınıdır. Bu salgında 50 milyona yakın insa- nın hayatını kaybetmiş olabileceğine ilişkin tahminler yapılmaktadır. Koronavirüsler ilki 2003’de olmak üzere bugüne kadar üç kez (SARS, MERS ve COVID-19) salgına yol açmıştır. Yeni koronavirus hastalığı (2019-nCoV) ilk olarak 31 Aralık 2019’da, Çin’in Hubei eyaletinin Vuhan kentinde etiyolojisi bilinmeyen pnömoni vakası kümesi bildirmesiyle ortaya çıktı. Ardından 30 Ocak 2020’de Dünya Sağlık Örgütü Acil Durum Komitesi yeni koronavirüs hastalığını, ‘Uluslar- arası Endişe verici Halk Sağlığı Acil Durumu’ (Public Health Emergency of International Concern) olarak ilan etti. 11 Şubat 2020 tarihinde 2019-n- CoV hastalığının adı Dünya Sağlık Örgütü tarafından COVID-19 olarak kabul edildi. Hastalığın kıtalar arasında yayılmasının ardından Dünya Sağlık Örgütü bu kez uyarı düzeyini en yüksek seviyeye çıkartarak, COV- ID-19’u 11 Mart 2020 tarihinde ‘Pandemi’ olarak ilan etti. Elinizdeki bu kitap, yalnızca doğrulanmış olgular söz konusu olduğunda bile Temmuz ayının ikinci yarısı itibarıyla dünya çapında 15 milyondan fazla kişinin hastalanmasına ve 600 binden fazla kişinin yaşamını yitirme- sine yol açan COVID-19 hastalığı ile ilgili tıbbi bilgileri meslektaşlarımızla buluşturmayı amaçlamaktadır. Kısa zaman içerisinde büyük bir özveri ile kitabın hazırlanmasına kat- kıda bulunan başta kitabımızın editörü Dr. Cem Heper olmak üzere, bütün yazarlara teşekkür ediyoruz. Ülkemizin bu salgından en az hasarla çıkabilmesi için bütün meslektaşla- rımız ve sağlık çalışanlarıyla birlikte uğraş vermeye devam edeceğiz. Bursa Tabip Odası Yönetim Kurulu EDİTÖRÜN ÖNSÖZÜ Bir ülkenin veya bir toplumun gelişmişliği, her türlü alanda yazılan kitaplar, makaleler veya bilgi üretkenliğinin sürekliliği ile belirlenir. Bilim, sorunların ortadan kaldırılması veya zararsız hale getirilmesi için elimizde olan bütün bilgilerden yararlanır. Bunların arasından önceliği olanların belirlenip, değerlendiril- mesini ve zaman içinde daha iyi çözümler getiren yeni bilgilerin üretilmesini sağlar. Bildiğiniz gibi, sağlık alanındaki eski ve kadim kitaplar, Hipokrat’ın Hipokrat olmasını, İbn-i Sina’nın da İbn-i Sina olmasını sağlamışlardır. Bunun bir nedeni, eserlerinin yüzyıllar boyunca hekimlik uygulamalarında kaynak olmasıdır. Diğer nedeni de, ele aldıkları sorun- ların bu yüzyıllar içinde daha iyi ve daha doğru yöntemlerle çözülememiş olmasıdır. Bugün dünyanın en önemli sağlık sorunu, COVID-19 hastalığı ve pandemisidir. COVID-19 hastalığı ilk kez 2019 yılında Çin’in Wuhan bölgesinde fark edilmiştir. Dr. Ai Fen bu hastalığı ilk fark edenlerden ve bu hastalık nedeniyle hayatını kaybeden meslektaşlarımızdan biridir. Dr. Ai Fen ve arkadaşlarının uyarılarına zamanında kulak verilmemesi ve maruz bırakıldıkları şartlar; bulaşıcı hastalıklarla mücadelenin gerektirdiği çalışma koşulları, mesleki sorumluluklar, özgürlükler ve güvenceler için, alınması gereken bazı önemli dersler içermektedir. Dr.
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