COVID-19 Nedeniyle Takip Edilen Hastalarda Kan Parametrelerindeki Zamansal Anormalliklerin Sağkalım Üzerine Etkisi: Retrospektif Bir Çalışma

Abstract

Amaç: Bu çalışmada, hastanede yatarak tedavi gören Covid-19 hastalarında, özellikler trombosit parametrelerindeki değişimlerin diğer periferik kan parametreleri ve zamansal değişimle birlikte sağ kalım üzerine etkisi araştırılmıştır Gereç ve Yöntemler: Covid-19 tanısı ile hastaneye yatırılarak tedavi edilen 149 hasta çalışmaya dahil edildi. Başvuru anında, hastaneye yatışın üçüncü, yedinci ve son günlerinde ve taburculuk sonrası birinci ayda kaydedilen laboratuvar parametreleri, hemoglobin (Hb, g/dL), hematokrit (%), beyaz kan hücresi (lökositx109/L), trombosit (hücre/mm3) sayımı, lenfosit (hücre/μL) sayımı, ortalama trombosit hacmi (fL), trombosit dağılım genişliği (%), plateletkrit (%) ve platelet lenfosit oranı idi. Bulgular: Toplamda, 139 hasta (%93,9) taburculuk sonrası birinci ayda hayatta idi. Hayatta kalan hastalarda, hayatta olmayanlara göre ilk başvuru (13,3 ve 12,2 g/dL, p=0,023) ve yatışın üçüncü (12,6 ve 11,7 g/dL, p=0,033) ve yedinci (12,5 ve 9,8 g/dL, p=0,014) günlerinde saptanan medyan Hb düzeyleri ile ilk başvuru (1200 ve 800 hücre/μL, p=0, 014) ve üçüncü yatış gününe (1400 ve 1200 hücre/μL, p=0,043) ait lenfosit sayıları anlamlı şekilde daha yüksekti. Hayatta kalan hastalarda, ilk başvuru (5800 ve 7900 x109/L, p=0, 014), hastaneye yatışın üçüncü (5400 ve 6047 x109/L, p=0,007), yedinci (6100 ve. 8400 x109/L, p=0, 040) ve son (6200 ve 17700 x109/L, p=0, 018) günlerinde saptanan lökosit değerleri ve ilk başvuru (165 ve 294,5, p=0,002) ve yatışın üçüncü günü (150 ve 223, p=0.003) saptanan PLR değerleri anlamlı şekilde daha düşük bulundu. Sonuç: Sonuç olarak, bulgularımız periferik kandaki değişimlerin, özellikle de platelet/lenfosit oranının takibinin klinik önemine ve kötü prognostik seyirli COVID-19 hastaların tespitinde hekimlere öngörüde bulunma açısından yararlı olabileceğine işaret etmektedir.

Keywords

• COVID-19
• hospitalizasyon
• periferik kan

Abnormalities of Peripheral Blood Parameters in Hospitalized Patients with COVID-19: A Temporal Change Analysis in Relation to Survival

Abstract

Aim: This study aimed to investigate the abnormalities and temporal changes in peripheral blood parameters, with particular emphasis on platelet indices, in relation to survival status among hospitalized COVID-19 patients. Material and Methods: A total of 149 patients hospitalized with the diagnosis of COVID-19 were included. Laboratory parameters were recorded on initial admission, 3rd, 7th and last day of hospitalization, and post-discharge first month and included hemoglobin (Hb, g/dL), hematocrit (%), white blood cell (WBC) (x109/L), platelet (cells/mm3) and lymphocyte counts (cells/μL), mean platelet volume (MPV, fL), platelet distribution width (PDW, %), plateletcrit (PCT,%) and platelet-to-lymphocyte ratio ( PLR), and analysed. Results: Overall, 139 (93.9%) patients survived. Survivors vs. non-survivors had significantly higher median levels for Hb at initial admission (13.3 vs. 12.2 g/dL, p=0.023), 3rd day (12.6 vs. 11.7 g/dL, p=0.033) and 7th day of hospitalization (12.5 vs. 9.8 g/dL, p=0.014) and for lymphocyte counts at initial admission (1200 vs. 800 cells/μL, p=0.014) and 3rd day (1400 vs. 1200 cells/μL, p=0.043) of hospitalization. They also had significantly lower WBC counts at initial admission (5800 vs. 7900 x109/L, p=0.014), 3rd day (5400 vs. 6047 x109/L, p=0.007) and 7th day (6100 vs. 8400 x109/L, p=0.040) and last day (6200 vs. 17700 x109/L, p=0.018) of hospitalization and lower PLR at initial admission (165 vs. 294.5, p=0.002) and 3rd hospitalization day (150 vs. 223, p=0.003). Conclusion: In conclusion, our findings emphasize clinical significance of dynamic monitoring of peripheral blood parameters, as combined with PLR, in assisting clinicians to identify COVID-19 patients with increased risk of worse outcomes.

Keywords

• COVID-19
• hospitalization
• peripehral blood
• survival

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