COVID-19 Seyrinde NLR, LMR, PLR, d-NLR, LeCR, LCR, NMR Biyoparametrelerinin Etkinliğinin Değerlendirilmesi

Year 2023, Volume: 12 Issue: 3, 171 - 181, 29.12.2023

Didem Çelik Özge İnceer

https://doi.org/10.47493/abantmedj.1271653

Abstract

Amaç: Bağışıklık sisteminin şiddetli inflamatuar yanıtı, 2019 Coronavirüs hastalığının (COVID-19) ilerlemesinde ciddi bir role sahiptir. COVID-19'un immün aktivasyonunun erken teşhisinin klinik faydaları, bugüne kadar yapılan çalışmalarda vurgulanmıştır. Bu çalışmada nötrofil-lenfosit oranı (NLR), lenfosit-monosit oranı (LMR), trombosit-lenfosit oranı (PLR), türetilmiş nötrofil-lenfosit oranı (d-NLR), lenfosit-to-lenfosit oranı -C reaktif protein oranı (LCR), lökosit-C reaktif protein oranı (LeCR), nötrofil-monosit oranı (NMR) biyoendeksleri, COVID-19'un klinik seyrini tahmin etmek için değerlendirildi.
Gereç ve Yöntemler: Bu retrospektif kohort çalışmasına, Nisan ve Kasım 2020 tarihleri arasında üçüncü basamak bir hastanede yatarak tedavi görmüş, laboratuvarca doğrulanmış 383 COVID-19 vakası dahil edildi. 279 hafif ve 104 ciddi vaka dahil olmak üzere hastalar sırayla seçildi. Başvuru sırasında yapılan kan testleri incelendi. Veriler SPSS 22.0 programı kullanılarak analiz edildi ve ROC analizi yapıldı.
Bulgular: Çalışmaya alınan hastaların %44,3'ü kadındı, hastaların %99,2'sinde viral pnömoni vardı, %27,2'si ciddi hastalık klinik kriterlerini taşıyordu ve medyan yaş 58 idi. Klinik olarak ciddi hastalığı olan grupta yaş, hastanede yatış süresi, lökosit sayısı, nötrofil sayısı, ferritin, CRP, prokalsitonin, D-dimer, troponin düzeyleri daha yüksek, lenfosit, monosit sayıları daha düşüktü. LCR, CRP, d-NLR, NLR, LeCR'nin sırasıyla 15, 74,65, 2,55, 4, 133'lük eşik değerleri ile klinik şiddeti öngörmek için tanısal duyarlılıkları yüksek (AUC> 0.8) bulundu.
Sonuç: Yüksek CRP, d-NLR, NLR ve düşük LCR, LeCR klinik ciddiyetin erken belirteçleridir, bu hastalar yakın izlem ve erken müdahale için hastanede takip edilmelidir.

Keywords

COVID-19, d-NLR, LCR, LeCR, NLR

Evaluation Of the Effectiveness Of NLR, LMR, PLR, d-NLR, LeCR, LCR, NMR Bioparameters In the Course Of COVID-19

Abstract

Objective: Severe inflammatory response of the immune system has a serious role in the progression of Coronavirus disease 2019 (COVID-19). The clinical benefits of early diagnosis of immune activation of COVID-19 have been emphasized repeatedly in the trials to this date. In this study, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), derived neutrophil-to-lymphocyte ratio (d-NLR), lymphocyte-to-C reactive protein ratio (LCR), leukocyte-to-C reactive protein ratio (LeCR), neutrophil-to-monocyte ratio (NMR) biomarkers were evaluated for predicting clinical course of COVID-19.
Materials and Methods: In this retrospective cohort study, 383 laboratory-confirmed COVID-19 cases, who had been hospitalized in a tertiary care hospital between April and November 2020, were included. Patients, including 279 mild and 104 severe cases, were sequentially selected. Blood tests, conducted at the time of admission, were examined. Data was analyzed and ROC analysis was performed by using SPSS 22.0 program.
Results: 44.3% of the patients included in the study were female, 99.2% of the patients had viral pneumonia, 27.2% met clinical criteria for severe disease and median age was 58 years. Age, duration of hospitalization, white blood cell count, neutrophil count, ferritin, CRP, procalcitonin, D-dimer, troponin levels were higher and lymphocyte, monocyte counts were lower in the group with clinically severe disease. The diagnostic sensitivities of LCR, CRP, d-NLR, NLR, LeCR were found to be high (AUC> 0.8) for the prediction of clinical severity with cut-off values of 15, 74.65, 2.55, 4, 133 respectively.
Conclusion: High CRP, d-NLR, NLR and low LCR, LeCR are early predictors of the clinical severity, these patients should be under hospital follow-up for close monitoring and early intervention.

Keywords

COVID-19, d-NLR, LCR, LeCR, NLR

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