Koroner arter hastalığı tanısı alan COVID-19 hastalarında hastane içi mortalite ile inflamasyon belirteçleri arasındaki ilişki

Abstract

Giriş: Enflamasyon, koroner arter hastalıklarının temelinde ve olumsuz sonlanımlarında önemli rol oynar. Nötrofil-lenfosit oranı (NLR), sistemik immün inflamasyon indeksi (SII) ve CRP ise inflamatuar durumu yansıtan basit ve kullanışlı belirteçlerdir. Çalışmamızın amacı bu belirteçlerin koroner arter hastalığı tanılı COVID-19 hastalarında hastane içi mortaliteyi öngörmede kullanılabilirliğini değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışmamız 111 (48 erkek, 63 kadın) yeni tanı COVID-19 hastasından oluşuyordu. Nötrofil (N), lenfosit (L) değerleri kullanılarak NLR (N/L) ve N,L ve trombosit (P) değerleri kullanılarak sistemik immün inflamasyon indeksi SII (NxP / L) elde edildi. NLR, SII ve CRP değerlerinin hastane içi mortaliteyle olan ilişkileri incelendi. Bulgular: Tedavi sürecinde 16 hastada ölüm izlendi. N, L ve P değerleri hayatını kaybenler ve şifa ile taburcu olan grup arasında kıyaslandığında istatiksel farklılıklar izlenmedi ( p= 0.971, p=0.256, p=0.759 sırasıyla). Bunların kombinasyonu ile elde edilen SII ve NLR değerleri içinde gruplar arasında istatiksel farklılıklar izlenmezken (p=0.872, p=0.979 sırasıyla), CRP değerlerinde ise hastane içi ölüm izlenen grupta istatiksel anlamlıydı (p<0.001). Logistik regresyon analizinde, CRP’nin (odds oranı [OO]= 1.078 ,%95 güven aralığı [GA]: 1.0225-1.133, p= 0.003) hastane içi mortaliteyle ilşkili olduğu gösterildi. ROC analizinde hastane içi mortaliteyi tahmin etmede CRP için 3.1 mg/dL kestirim değerleri %87 hassasiyet ve %58 özgüllük ile anlamlı bulundu (p<0.001). Sonuç: Koroner girişim öyküsü olan koroner arter hastalığı tanılı COVID-19 hastalarında CRP seviyeleri hastane içi ölümle ilişkilidir.

Keywords

• COVID-19
• ölüm
• koroner arter hastalığı

Relationship between in-hospital mortality and inflammation markers in COVID-19 patients with the diagnosis of coronary artery disease

Abstract

Introduction: Inflammation plays an important role in the basis of coronary artery diseases and their adverse outcomes. Neutrophil-lymphocyte ratio (NLR), Systemic Immune Inflammation Index (SII) and C-reactive protein (CRP) are simple and useful markers that reflect the inflammatory state. Our study evaluated the usability of these markers in predicting in-hospital mortality in patients with COVID-19 with the diagnosis of coronary artery disease. Material and Method: Our study population consisted of 111 (48 male, 63 female) newly diagnosed patients with COVID-19. Neutrophil-lymphocyte ratio (NLR) was estimated using neutrophil (N), and lymphocyte (L) counts and the systemic immune inflammation index SII (NxP / L) was calculated using N, L and platelet (P) values. The relationship of NLR, SII and CRP values with in-hospital mortality was investigated. Results: During the treatment process, 16 patients exited. Any statistically significant intergroup difference was not observed as for SII and NLR values obtained by their use in combination (p = 0.872, p = 0.979, respectively), CRP values were statistically significant in the group with in-hospital mortality (p <0.001). In logistic regression analysis, CRP (odds ratio [OR] = 1.078, 95% confidence interval [CI]: 1.0225-1.133, p = 0.003) was associated with in-hospital mortality. In ROC analysis, the cut-off values of 3.1 mg / dL, for CRP were significant with 87% sensitivity and 58% specificity in predicting in-hospital mortality (p <0.001). Conclusions: CRP levels are associated with in-hospital mortality in patients with COVID-19 who had also received coronary artery disease with a history of coronary intervention.

Keywords

• COVID-19
• mortality
• coronary artery disease

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