COVID-19 enfeksiyonunda yoğun bakımda BNP'nin prognostik bir biyobelirteç olarak yeniden tanımlanması

Year 2022, , 116 - 127, 31.08.2022

Özge Turgay Yıldırım , Ayşe Ayyıldız , Selim Yıldırım

https://doi.org/10.36516/jocass.1123404

Abstract

Amaç
Coronavirus hastalığı 2019 (COVID-19), küresel bir pandemiye neden olmuş ve artan ölüm oranları, araştırmacıları daha yüksek ölüm riski altındaki hastaları belirlemek için prognostik faktörleri araştırmaya zorlamıştır.Biz bu çalışmada, yoğun bakım ünitesinde yatan kritik hastalarda, beyin natriüretik peptidinin (BNP) mortalitenin bir belirleyicisi olarak kullanılabilirliğini araştırmayı amaçladık.
Materyal ve Metod
Bu retrospektif çalışmaya COVID-19 tanısı konan ve yoğun bakım ünitesinde takip edilen 50 hasta dahil edilmiştir. Bilinen kalp yetmezliği olan ve takiplerinde ekokardiyografide kalp yetmezliği saptanan hastalar çalışma dışı bırakılmıştır.
Bulgular
Hastalar yoğun bakım ünitesinde yatışları sırasındaki mortalite durumlarına göre iki gruba ayrıldı. Bu gruplar kronik hastalık, cinsiyet ve yaş açısından istatistiksel olarak benzerdi (p>0.05). Mortalite ile seyreden grup, hayatta kalan grupla karşılaştırıldığında yoğun bakım ünitesine kabulde daha yüksek BNP seviyelerine sahipti (mortalite ile seyreden grup 93,2 pg/mL (43,5-357,3) ve hayatta kalan grup 62,9 (25,0-147,1), p=0.004). Regresyon analizi, daha yüksek BNP düzeylerinin ve daha düşük lenfosit sayılarının bu hastalarda mortalitenin bir göstergesi olarak kullanılabileceğini ortaya koydu. ROC eğrisi analizi, BNP için hastane içi ölümü öngörmede en iyi eşik değerinin %73,1 duyarlılık ve %70,8 özgüllük ile 85,6 pg/mL olduğunu gösterdi.
Sonuç
Yoğun bakım ünitesinde takip edilen COVID-19 hastalarında yoğun bakıma kabuldeki yüksek BNP seviyeleri hastane içi mortalite göstergesi olarak kullanılabilir.

Keywords

Beyin natriüretik peptidi, COVID-19, prognoz, mortalite, yoğun bakım

Redefinition of BNP as a prognostic biomarker in intensive care at COVID-19 infection

Abstract

Aim
Coronavirus disease 2019 (COVID-19) has caused a global pandemic and increased mortality has forced researchers to identify prognostic factors to identify patients at higher risk of mortality. In this study, we aimed to investigate the usability of Brain natriuretic peptide (BNP) as a predictor of mortality in critically ill patients hospitalized in the intensive care unit.
Material and Method
This retrospective study included 50 patients diagnosed with COVID-19 and followed in the intensive care unit. Patients with known heart failure who were found to have heart failure on echocardiography during follow-up were excluded from the study.
Results
The patients were divided into two groups based on their mortality status during hospitalization in the intensive care unit. These groups were found to be statistically similar in terms of chronic disease, gender and age (p>0.05). Non-survivor group had higher levels of BNP at the admission to intensive care unit when compared to survivor group (93.2 pg/mL (43.5-357.3) vs. 62.9 (25.0-147.1), p=0.004, respectively). Regression analysis revealed that higher BNP levels and lower lymphocyte counts can be used as a predictor of mortality for these patients. ROC curve analysis indicated that best cut-off value for predicting in-hospital death for BNP was 85.6 pg/mL with a sensitivity of 73.1% and a specificity of 70.8%.
Conclusions
High BNP levels at admission to the intensive care unit can be used as an in-hospital mortality indicator in COVID-19 patients followed up in the intensive care unit.

Keywords

Brain natriuretic peptide, COVID-19, prognosis, mortality, intensive care

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