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The relationship between procalcitonin, D-dimer, ferritin, troponin and lactate levels with COVID-19

Year 2021, Volume: 5 Issue: 1, 30 - 35, 23.04.2021
https://doi.org/10.30565/medalanya.808806

Abstract

Aim: Coronavirus disease-2019 patients may experience an increase in inflammation or clotting disorders. It is believed that some biomarkers can be decisive in decision to hospitalize. Our aim in this study was to investigate the relationship between serum procalcitonin, troponin, D-dimer, ferritin and lactate levels, and Coronavirus disease-2019.


Methods: Patients suspected of suffering from the Coronavirus disease-2019 and whose serum biochemistry and blood gas tests were performed, were included in the study. The relationships between the blood parameters of the patients with negative or positive Polymerase Chain Reaction test results, and those who were hospitalized or non-hospitalized, were examined.


Results: Out of a total of 452 patients, 244 (54%) were male and 208 (46%) were female. There was a statistically significant difference between polymerase chain reaction test positive and test negative groups in terms of procalcitonin, D-dimer, lactate and troponin levels (p˂0.005). There was no statistically significant difference between hospitalized and non hospitalized patient in terms of ferritin (p=0.224). However, there was a significant difference in terms of procalcitonin, D-dimer and troponin levels (p˂0.005).


Conclusion: Our results revealed that high serum procalcitonin, D-dimer, lactate and troponin levels are associated with the decision to hospitalize Coronavirus disease- 2019 patients, whereas ferritin levels played no such role.

References

  • 1. Dikmen AU, Kına MH, Özkan S, İlhan MN. Epidemiology of COVID-19: What We Learn From Pandemic. Journal Biotechnol and Strategic Health Res. 2020;1(Özel Sayı):29-36. doi: 10.34084/bshr.715153.
  • 2. Goyal P, Choi JJ, Pinheiro LC, Schenck EJ, Chen R, Jabri A, et al. Clinical Characteristics of COVID-19 in New York City. N Engl J Med. 2020;382(24):2372-4 doi: 10.1056/NEJMc2010419.
  • 3. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844-7. doi: 10.1111/jth.14768.
  • 4. WHO Coronavirus Disease (COVID-19) Dashboard Data last updated: 2021/02/21, 04:21 pmCEST
  • 5. Fan BE, Chong VCL, Chan SSW, Lim GH, Lim KGH, Tan GB, et al. Hematologic parameters in patients with COVID-19 infection. Am J Hematol. 2020;95(6):E131-4 doi: 10.1002/ajh.25774.
  • 6. Zhang J, Dong X, Cao Y, Yuan Y, Yang Y, Yan Y, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020;75(7):1730-41 doi:10.1111/all.14238.
  • 7. Aziz M, Fatima R, Assaly R. Elevated interleukin-6 and severe COVID-19: a meta-analysis. J Med Virol. 2020;92(11):2283-5 doi: 10.1002/jmv.25948.
  • 8. Bryant JE, Azman AS, Ferrari MJ, Arnold BF, Boni MF, Boum Y, et al. Serology for SARSCoV-2: Apprehensions, opportunities, Sci Immunol. 2020;5(47):eabc6347 doi: 10.1126/sciimmunol.abc6347.
  • 9. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology. 2020;296(2):E32-40. doi: 10.1148/radiol.2020200642.
  • 10. Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, et al. Clinical and immunologic features in severe and moderate coronavirus disease 2019. J. Clin. Invest. 2020;130(5):2620–9. doi: 10.1172/JCI137244.
  • 11. Terpos E, Ntanasis‐Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M et al. Hematological findings and complications of COVID-19. American J Hematol. 2020;95(7): 834-47. doi: 10.1002/ajh.25829.
  • 12. Li T, Lu H, Zhang W. Clinical observation and management of COVID19 patients. Emerg Microbes Infect. 2020;9(1):687-90. doi: 10.1080/22221751.2020.1741327.
  • 13. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5.
  • 14. Abbaspour N, Hurrell R, Kelishadi R. Review on iron and its importance for human health. J Res Med Sci. 2014;19(2):164–74. PMID: 24778671
  • 15. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054–62. doi: 10.1016/S0140-6736(20)30566-3.
  • 16. Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020:180(7):934-43. doi: 10.1001/jamainternmed.2020.0994.
  • 17. Snijders D, Schoorl M, Schoorl M, Bartels PC, van der Werf TS, Boersma WG. D-dimer levels in assessing severity and clinical outcome in patients with community-acquired pneumonia. A secondary analysis of a randomised clinical trial. Eur J Intern Med. 2012;23(5):436-41. doi: 10.1016/j.ejim.2011.10.019.
  • 18. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223): 507-13. doi: 10.1016/S0140-6736(20)30211-7.
  • 19. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5.
  • 20. Lippi G, Cervellin G. Procalcitonin for diagnosing and monitoring bacterial infections: for or against?. Clin Chem Lab Med. 2018;56(8):1193-5. doi:10.1515/cclm-2018-0312.
  • 21. Creamer AW, Kent AE and Albur M. Procalcitonin in respiratory disease: use as a biomarker for diagnosis and guiding antibiotic therapy. Breathe. 2019;15(4):296–304. doi: 10.1183/20734735.0258-2019.
  • 22. Lippi G, Plebani M. Procalcitonin in patients with severe coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chim Acta. 2020;505:190-1. doi:10.1515/ cclm-2020-0198.
  • 23. Tersalvi G, Vicenzi M, Calabretta D, Biasco L, Pedrazzini G, Winterton D. Elevated troponin in patients with Coronavirus Disease 2019 (COVID-19): possible mechanisms. J Card Fail. 2020;26(6):470-5. doi: 10.1016/j.cardfail.2020.04.009.
  • 24. Vrsalovic M, Presecki AV. Cardiac troponins predict mortality in patients with COVID-19: A meta-analysis of adjusted risk estimates. J Infect. 2020;81(3):e99-100. doi: 10.1016/j.jinf.2020.05.022.
  • 25. Fu YQ, Bai K, Liu CJ. The impact of admission serum lactate on children with moderate to severe traumatic brain injury. PloS One. 2019;14(9):e0222591 doi: 10.1371/journal.pone.0222591.
  • 26. Kubat E, Çalışkan A, Ünal EU, Usanmaz SE, Türkcan BS, Sarıtaş, A et al. Effect of Selective Antegrade Cerebral Perfusion with Moderately Hypothermic Lower Body Circulatory Arrest on Biomarkers Related to Endothelial Function. Acta Med. Alanya 2020;4(1):48-55. doi: 10.30565/medalanya.642337

Prokalsitonin, D-Dimer, Ferritin, Troponin ve Laktat Düzeylerinin COVID-19 Hastalığı ile İlişkisi

Year 2021, Volume: 5 Issue: 1, 30 - 35, 23.04.2021
https://doi.org/10.30565/medalanya.808806

Abstract

Amaç: Koronavirüs hastalığı-2019 hastalarında enflamasyon artışı veya pıhtılaşma bozukluğu artışı görülebilmektedir. Bazı biyobelirteçlerin, hastaneye yatış yapılmasında belirleyici olabileceği düşünülmektedir. Bu çalışmadaki amacımız, serum prokalsitonin, troponin, D-dimer, ferritin ve laktat düzeyleri ile Koronavirüs hastalığı-2019 arasındaki ilişkiyi araştırmaktı.


Metod: Koronavirüs hastalığı-2019 şüphesi olan, kan biyokimya ve kan gazı tetkikleri çalışılan hastalar çalışmaya dahil edildi. Polimeraz zincir reaksiyonu test sonuçları negatif veya pozitif olan hastalar ve taburcu veya servise yatışı yapılan hastaların kan sonuçları arasındaki ilişkileri incelendi.


Bulgular: Toplam 452 hastanın, 244 (% 54)‘ü erkek ve 208 (%46)’i kadın idi. Polimeraz zincir reaksiyonu testi pozitif olan grup ile negatif olan grup arasında prokalsitonin, D-dimer, laktat ve troponin düzeyleri istatistiksel olarak anlamlı bulundu (p˂0.005). Yatış yapılan hastalar ile yapılmayan hastalar arasında ferritin seviyesinde istatistiksel olarak bir anlamlılık yoktu (p=0.224). Ancak prokalsitonin, D-dimer, troponin seviyelerinde anlamlı bir farklılık çıktı (p˂0.005).


Sonuç: Elde ettiğimiz sonuçlarla yüksek serum prokalsitonin, D-dimer, laktat ve troponin düzeylerinin Koronavirüs hastalığı-2019 hastalarının hastaneye yatışı ile ilişkisinin olduğunu söyleyebiliriz. Ancak ferritin düzeylerinin hastaneye yatış endikasyonunda bir rolü yoktu.

References

  • 1. Dikmen AU, Kına MH, Özkan S, İlhan MN. Epidemiology of COVID-19: What We Learn From Pandemic. Journal Biotechnol and Strategic Health Res. 2020;1(Özel Sayı):29-36. doi: 10.34084/bshr.715153.
  • 2. Goyal P, Choi JJ, Pinheiro LC, Schenck EJ, Chen R, Jabri A, et al. Clinical Characteristics of COVID-19 in New York City. N Engl J Med. 2020;382(24):2372-4 doi: 10.1056/NEJMc2010419.
  • 3. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844-7. doi: 10.1111/jth.14768.
  • 4. WHO Coronavirus Disease (COVID-19) Dashboard Data last updated: 2021/02/21, 04:21 pmCEST
  • 5. Fan BE, Chong VCL, Chan SSW, Lim GH, Lim KGH, Tan GB, et al. Hematologic parameters in patients with COVID-19 infection. Am J Hematol. 2020;95(6):E131-4 doi: 10.1002/ajh.25774.
  • 6. Zhang J, Dong X, Cao Y, Yuan Y, Yang Y, Yan Y, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020;75(7):1730-41 doi:10.1111/all.14238.
  • 7. Aziz M, Fatima R, Assaly R. Elevated interleukin-6 and severe COVID-19: a meta-analysis. J Med Virol. 2020;92(11):2283-5 doi: 10.1002/jmv.25948.
  • 8. Bryant JE, Azman AS, Ferrari MJ, Arnold BF, Boni MF, Boum Y, et al. Serology for SARSCoV-2: Apprehensions, opportunities, Sci Immunol. 2020;5(47):eabc6347 doi: 10.1126/sciimmunol.abc6347.
  • 9. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology. 2020;296(2):E32-40. doi: 10.1148/radiol.2020200642.
  • 10. Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, et al. Clinical and immunologic features in severe and moderate coronavirus disease 2019. J. Clin. Invest. 2020;130(5):2620–9. doi: 10.1172/JCI137244.
  • 11. Terpos E, Ntanasis‐Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M et al. Hematological findings and complications of COVID-19. American J Hematol. 2020;95(7): 834-47. doi: 10.1002/ajh.25829.
  • 12. Li T, Lu H, Zhang W. Clinical observation and management of COVID19 patients. Emerg Microbes Infect. 2020;9(1):687-90. doi: 10.1080/22221751.2020.1741327.
  • 13. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5.
  • 14. Abbaspour N, Hurrell R, Kelishadi R. Review on iron and its importance for human health. J Res Med Sci. 2014;19(2):164–74. PMID: 24778671
  • 15. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054–62. doi: 10.1016/S0140-6736(20)30566-3.
  • 16. Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020:180(7):934-43. doi: 10.1001/jamainternmed.2020.0994.
  • 17. Snijders D, Schoorl M, Schoorl M, Bartels PC, van der Werf TS, Boersma WG. D-dimer levels in assessing severity and clinical outcome in patients with community-acquired pneumonia. A secondary analysis of a randomised clinical trial. Eur J Intern Med. 2012;23(5):436-41. doi: 10.1016/j.ejim.2011.10.019.
  • 18. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223): 507-13. doi: 10.1016/S0140-6736(20)30211-7.
  • 19. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5.
  • 20. Lippi G, Cervellin G. Procalcitonin for diagnosing and monitoring bacterial infections: for or against?. Clin Chem Lab Med. 2018;56(8):1193-5. doi:10.1515/cclm-2018-0312.
  • 21. Creamer AW, Kent AE and Albur M. Procalcitonin in respiratory disease: use as a biomarker for diagnosis and guiding antibiotic therapy. Breathe. 2019;15(4):296–304. doi: 10.1183/20734735.0258-2019.
  • 22. Lippi G, Plebani M. Procalcitonin in patients with severe coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chim Acta. 2020;505:190-1. doi:10.1515/ cclm-2020-0198.
  • 23. Tersalvi G, Vicenzi M, Calabretta D, Biasco L, Pedrazzini G, Winterton D. Elevated troponin in patients with Coronavirus Disease 2019 (COVID-19): possible mechanisms. J Card Fail. 2020;26(6):470-5. doi: 10.1016/j.cardfail.2020.04.009.
  • 24. Vrsalovic M, Presecki AV. Cardiac troponins predict mortality in patients with COVID-19: A meta-analysis of adjusted risk estimates. J Infect. 2020;81(3):e99-100. doi: 10.1016/j.jinf.2020.05.022.
  • 25. Fu YQ, Bai K, Liu CJ. The impact of admission serum lactate on children with moderate to severe traumatic brain injury. PloS One. 2019;14(9):e0222591 doi: 10.1371/journal.pone.0222591.
  • 26. Kubat E, Çalışkan A, Ünal EU, Usanmaz SE, Türkcan BS, Sarıtaş, A et al. Effect of Selective Antegrade Cerebral Perfusion with Moderately Hypothermic Lower Body Circulatory Arrest on Biomarkers Related to Endothelial Function. Acta Med. Alanya 2020;4(1):48-55. doi: 10.30565/medalanya.642337
There are 26 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Research Article
Authors

Levent Şahin 0000-0003-0193-4393

Ali Gür 0000-0002-7823-0266

Publication Date April 23, 2021
Submission Date October 10, 2020
Acceptance Date November 17, 2020
Published in Issue Year 2021 Volume: 5 Issue: 1

Cite

Vancouver Şahin L, Gür A. The relationship between procalcitonin, D-dimer, ferritin, troponin and lactate levels with COVID-19. Acta Med. Alanya. 2021;5(1):30-5.

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