Şiddetli COVID-19 Enfeksiyonlarının İzlenmesinde Laboratuvar Testlerinin Etkinliği

Year 2024, Volume: 9 Issue: 3, 89 - 96

Erdoğan Yayla , Şeniz Korkmaz , Samican Özmen

https://doi.org/10.58854/jicm.1510319

Abstract

Amaç: Şiddetli akut solunum yolu sendromu koronavirüs-2 (SARS-CoV-2), COVID-19’a (Koronavirüs Hastalığı 2019) neden olan bir virüstür ve sağlık sistemleri ve küresel halk sağlığı açısından ciddi zorluklar oluşturmaktadır. COVID-19 ile ilgili çok sayıda yayın olması nedeniyle, klinisyenlerin COVID-19’lu hastalarla ilgilenirken rehberlik sağlamak için bir kanıt sentezine ihtiyaçları vardır. Ortaya çıkan çalışmalar, klinisyenlerin COVID-19’un şiddetini ve mortalitesini tahmin etmelerinde yararlı olabilecek çok sayıda demografik, klinik, immünolojik, biyokimyasal ve radyografik verinin varlığını ortaya koymaktadır. Bu çalışmanın amacı; yalnızca SARS-CoV 2 PCR test pozitifliği tanısı almış hastalarda ve seçilmiş hastaların klinik durumlarından bağımsız olarak ve laboratuvar bulgularına dayanarak COVID-19 hastalığının seyrini ve şiddetini tahmin edebilen laboratuvar parametrelerini belirlemektir.
Yöntem: Bu çalışma Ocak-Nisan 2022 tarihleri arasında Karacabey Devlet Hastanesi’nde yürütülen retrospektif kesitsel bir çalışmadır. COVID-19 polikliniğine başvuran hastalar arasından 18 yaş üstü, SARS-CoV-2 RT-PCR pozitif 469 hasta (261 kadın, 208 erkek) çalışmaya dahil edildi. Hastalar ayaktan, yatan ve yoğun bakıma (yoğun bakım ünitesi, yoğun bakım) ihtiyaç duyan hastalar olarak gruplara ayrıldı. Hastaların demografik verileri (yaş, cinsiyet), COVID-19 RT-PCR sonuçları ve eş zamanlı laboratuvar parametreleri retrospektif olarak tarandı.
Bulgular: CRP, üre, ferritin, LEU, NEU, MONO, RBC, HGB, HCT, MCV, NLR, PLR, CRP-NR ve SII indeks değerlerine bakıldığında gruplar arasında istatistiksel olarak anlamlı fark bulundu. Kreatinin, ALT, AST, LDH, troponin I, kütle CK-MB, D dimer, LYM, EOS, PLT, ELR ve PNR değerleri gruplar arasında anlamlı farklılık göstermedi.
Sonuç: Bu çalışmanın avantajları; tek bir pozitif PCR test sonucuna göre hastanın diğer laboratuvar bulgularındaki değişimleri karşılaştırmak ve ciddi covid riski açısından anlamlı oranlar bulmaktır. Bu çalışmanın dezavantajı ise hastanın kliniğinden ve hastalık evresinden bağımsız bir çalışma olmasıdır. CRP, üre, ferritin ve NLR, PLR, CRP-NR ve SII indeks değerleri gibi indeksler hastalığın şiddetini tahmin etmede kullanılabilir.

Keywords

SARS-CoV-2, NLR, CRP-NR, SII index

Effectiveness of Laboratory Tests in Tracking Severely COVID-19 Infections

Abstract

Aim: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a virus that causes COVID-19 (Coronavirus Disease 2019), and poses serious difficulties in terms of healthcare systems and global public health. With the large number of publications on COVID-19, clinicians need a synthesis of evidence to provide guidance when dealing with patients with COVID-19. Emerging studies reveal the existence of numerous demographic, clinical, immunological, biochemical and radiographic data that may be useful for clinicians to predict the severity and mortality of COVID-19. The aim of this study; to determine laboratory parameters that can predict the course and severity of COVID-19 disease in patients, independently of the clinic status of selected patients and based on laboratory findings.
Methods: This study is a retrospective cross-sectional study conducted at Karacabey State Hospital between January and April 2022. Among the patients who applied to the COVID-19 outpatient clinic, 469 patients (261 females, 208 males) over the age of 18 and positive for SARS-CoV-2 RT-PCR were included in the study. The patients were divided into groups as outpatients, inpatients and patients in need of intensive care (intensive care unit, ICU). Demographic data (age, gender), COVID-19 RT-PCR results, and simultaneous laboratory parameters of the patients were scanned retrospectively.
Results: When CRP, urea, ferritin, LEU, NEU, MONO, RBC, HGB, HCT, MCV, NLR, PLR, CRP-NR, and SII index values were taken into consideration, a statistically significant difference was found between the groups. Creatinine, ALT, AST, LDH, troponin I, mass CK-MB, D dimer, LYM, EOS, PLT, ELR, and PNR values were not significantly different between the groups.
Conclusion: Advantages of this study; Comparing the changes in the patient’s other laboratory findings based on a single positive PCR test result and finding meaningful rates in terms of serious covid risk. The disadvantage of this study is that it is a study independent of the patient’s clinic and disease stage. In this study, we found that particularly increased SII was associated with more severe disease progression in patients diagnosed with COVID-19 along with laboratory findings. CRP, urea, ferritin, and indexes such as NLR, PLR, CRP-NR, and SII index values can be used to predict the severity of the disease.

Keywords

SARS-CoV-2, NLR, CRP-NR, SII index

Ethical Statement

BURSA ŞEHİR HASTANESİNDEN 2022 YILINDA ALINAN ETİK KURUL ONAYI KARARI (2022-6/3-20.04.2022) EKTE SUNULMUŞTUR.

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