Kovid-19 Hastalarında NLR, D-Dimer ve MPV Değerleri Mortaliteyi ve Klinik Ciddiyeti Öngörebilir Mi?

Öz

Amaç: Bu çalışmada amacımız Kovid-19 hastalarında nötrofil/lenfosit oranı (NLR), D-dimer ve ortalama trombosit hacmi (MPV) parametrelerinin mortalite ve klinik ciddiyet ile olan ilişkisini tespit etmektir. Materyal ve Metot: Retrospektif olarak planlanan bu çalışmaya Mart 2020 ile Eylül 2020 tarihleri arasında acil servise başvuran Kovid-19 hastaları dahil edildi. Hastaların sosyodemografik özellikleri, laboratuvar parametreleri ve görüntüleme sonuçları hastanenin elektronik kayıt sisteminden elde edildi. Hastalar mortalite gelişimine ve klinik takip şekline göre gruplandırıldı. Bulgular: Çalışmaya 700 hasta alınmış olup hastaların yaş ortalaması 49,1±18,2 yıldı. Hastaların %5,4’ünde (n=38) mortalite gelişti. Mortalite gelişen hastaların NLR, D-dimer ve MPV düzeyleri sağ kalanlardan daha yüksekti (p<0,001; p<0,001 ve p=0,035 sırasıyla). ROC analizinde >6 NLR düzeylerinin ((%71,05 sensitivite ve %92,15 spesifite; AUC: 0,900 (%95 GA 0,858-0,941, p<0,001)), >8,45 MPV düzeylerinin (%68,4 sensitivite ve %53,9 spesifite; AUC: 0,601 (%95 GA 0,564-0,638, p=0,019)) ve >0,57 D-dimer düzeylerinin (%81,6 sensitivite ve %73,9 spesifite; AUC:0,841 (%95 GA 0,812-0,867 p<0,001)) mortalite için belirleyici olduğu görüldü. Sonuç: Kovid-19 hastalarında başvuru anında alınan NLR, D-dimer ve MPV düzeylerindeki yükseklik mortalite için bir gösterge olarak kullanılabilir. NLR ve D-dimer düzeylerindeki yükseklikler hastalığın ciddiyetini ve klinik takip şeklini belirlemede kullanışlıdır.

Anahtar Kelimeler

• -dimer
• kovid-19
• mortalite
• nötrofil/lenfosit oranı
• ortalama trombosit hacmi

Can NLR, D-Dimer, and MPV Values Predict Mortality and Clinical Severity in Covid-19 Patients?

Abstract

Objective: In this study, we aim to determine the relationship between neutrophil/lymphocyte ratio (NLR), D-dimer, and mean platelet volume (MPV) parameters with mortality and clinical severity in Covid-19 patients. Materials and Methods: This retrospectively planned study included Covid-19 patients admitted to the emergency department between March 2020 and September 2020. Sociodemographic characteristics, laboratory parameters, and imaging results of the patients were obtained. The patients were grouped according to the development of mortality and clinical follow-up. Results: Seven hundred patients were included in the study and the mean age of the patients was 49.1±18.2 years. Mortality developed in 5.4% (n=38) of the patients. NLR, D-dimer, and MPV levels of patients who developed mortality were higher than those who survived (p<0.001; p <0.001 and p=0.035, respectively). In ROC analysis, >6 NLR levels, >8.45 MPV levels, and >0.57 D-dimer levels were found to be predictive for mortality (p<0.001; p=0.019; p <0.001, respectively). Conclusions: The high NLR, D-dimer, and MPV levels obtained at the time of admission in Covid-19 patients can be used as an indicator of mortality. Elevated NLR and D-dimer levels are useful in determining the severity of the disease and clinical follow-up.

Keywords

• Covid-19
• D-dimer
• mean platelet volume
• mortality
• neutrophil/lymphocyte ratio

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