COVID-19 hastalarında yoğun bakım takibinde inflamatuvar biyobelirteçlerin önemi ve karşılaştırılması

Abstract

Amaç: Bu çalışmanın amacı, bir devlet hastanesinde COVID-19 ile YBÜ'ye kabul edilen hastaların prognozunu öngörmede laboratuvar parametrelerinin ve biyobelirteçlerin gücünü belirlemektir. Gereç ve Yöntemler: Bu retrospektif çalışmada, Mart 2020 ile Aralık 2021 tarihleri arasında Bolu İzzet Baysal Devlet Hastanesi YBÜ'lerine COVID-19 nedeniyle kabul edilen tüm hastaların hastane otomasyon sistemine kayıtları yapıldı ve incelendi. Demografik veriler, kan testleri, APACHE II skoru ve enflamatuar biyobelirteçler de kaydedildi. Hayatta kalan ve kalamayan hastaların sonuçları karşılaştırıldı. Sonuçlar: Çalışmaya 452 hasta dahil edildi ve mortalite %72,6 idi. Exitus hastaların APACHE II skorları ve yaşları daha yüksekti. Nörolojik bozukluğu olan hastalarda mortalite oranı anlamlı derecede yüksekti. Hayatta kalamayan hastalarda kan lökosit, prokalsitonin, LDH ve kreatinin düzeyleri daha yüksek, kan lenfosit ve trombosit düzeyleri ise daha düşüktü. ROC analizlerine göre, lenfosit sayısı AUC 0,624, APACHE II skoru AUC 0,618, serum prokalsitonin düzeyi AUC 0,584 ve trombosit sayısı 0,560 olarak bulunmuştur. Tek değişkenli lojistik regresyon analizine göre yaş, APACHE II skoru, nötrofil/lenfosit oranı ve lenfosit sayısı mortalite ile ilişkiliydi. Sonuç: YBÜ'ye kabul edilen hastalar için laboratuvar parametreleri ve enflamatuar biyobelirteçler COVID-19'da tanı, takip ve prognoza yardımcı olabilir. Hemogram parametrelerinin kombinasyonlarının klinik takip ve prognozu öngörmede etkili olduğuna inanıyoruz

Keywords

• Yoğın bakım
• Mortalite
• Covid-19
• lenfosit
• lökosit lenfosit oranı

Importance and comparison of inflammatory biomarkers in COVID-19 patients follow-up in intensive care unit

Abstract

Aims: This study aimed to determine the power of laboratory parameters and biomarkers in predicting the prognosis of patients admitted to the intensive care units (ICU) with COVID-19 in a state hospital. Methods: In this retrospective study, the hospital automation system of all patients admitted to Bolu İzzet Baysal State Hospital’s ICUs because of COVID-19 between March 2020 and December 2021 were recorded and examined. Demographic data, blood tests, APACHE II score, and inflammatory biomarkers were also recorded. The results of patients who survived and did not survive were compared. Results: The study included 452 patients and the mortality was 72.6%. Exitus patients had higher APACHE II scores and age. The mortality rate was significantly higher in patients with neurological disorders. For patients who did not survive, blood leukocyte, procalcitonin, LDH, and creatinine levels were higher, whereas blood lymphocyte and thrombocyte levels were lower. Based on the ROC analyses, the lymphocyte count AUC was 0.624, APACHE II score AUC was 0.618, serum procalcitonin level AUC was 0.584, and platelet count was 0.560. Age, APACHE II score, neutrophil-to-lymphocyte ratio, and lymphocyte count were associated with mortality according to a univariate logistic regression analysis. Age (OR (95 CI%)1.02 (1.00-1.04, p=0.018)), APACHE II (OR (95 CI%)1.05 (1.01-1.09, p=0.018)), and neutrophil to lymphocyte ratio (OR (95 CI%) 1.02 (1.01-1.03, p=0.003)) were associated with mortality according to multivariate logistic regression Conclusion: For patients admitted to the ICU, laboratory parameters and inflammatory biomarkers can help in diagnosis, follow-up, and prognosis in COVID-19. We believe that combinations of hemogram parameters are effective in predicting clinical follow-up and prognosis.

Keywords

• Intensive care unit
• mortality
• COVID-19
• lymphocyte
• neutrophil-to-lymphocyte ratio

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