Predictive Values of Inflammation Indexes in Predicting Mortality in Patients with COVID 19 Hospitalized in General Intensive Care Unit

Abstract

Objective: Causing a global pandemic, the coronavirus disease 2019 (COVID-19) has caused millions of people to become infected and many more to die. In this study we aimed to investigate whether routinely evaluated clinical and laboratory values ​​can predict the mortality of patients with COVID-19 disease.
Materials and Methods: In our study, routine laboratory parameters of 89 patients hospitalized in the general intensive care unit with the diagnosis of COVID 19 were retrospectively analyzed. The aggregate index of systemic inflammation (AISI) and other inflamatuar values were calculated from blood tests in patients with positive COVID-19 polymerase chain reaction test and with ground-glass opacity on lung tomography. Patients were divided into two groups as those who died (non-survivors) and those who were discharged (survivors) during the intensive care follow-ups.
Results: In our study, in 48 patients who died during follow-up, the indexes of AISI, other inflamatuar paramaters and the biochemical parameters such as troponin I, d-dimer, ferritin and procalcitonin were significantly higher than in discharged patients. Hypertension and higher AISI and ferritin levels were statistically associated with reduced survival in Cox regression analysis (Hazard ration (HR): 3.176; 95% Confident interval (CI): 1.122-8.991, p=0.03, HR: 1.114; 95% CI: 1.060-1.348, p=0.042, HR=1.072;95% CI: 1.014-1.242, p=0.011, respectively.
Conclusion: Inflammation indexes derived from blood tests and acute phase reactants such as ferritin can guide us in planning the treatment strategy and risk stratification in patients with COVID-19 in intensive care follow-ups. 

Keywords

• blood parameters
• coronavirus 2019 disease
• inflammation
• pandemic

Genel Yoğun Bakım Ünitesinde Yatan COVID 19 Hastalarında Mortaliteyi Öngörmede İnflamasyon İndekslerinin Prediktif Değerleri

Öz

Amaç: Küresel bir pandemiye neden olan koronavirüs hastalığı 2019 (COVID-19), milyonlarca insanın enfekte olmasına ve birçok insanın ölmesine neden oldu. Bu çalışmada rutin olarak değerlendirilen klinik ve laboratuvar değerlerinin COVID-19 hastalığı olan hastaların mortalitesini tahmin edip edemeyeceğini araştırmayı amaçladık.
Materyal ve Metot: Çalışmamızda COVID 19 tanısı ile genel yoğun bakım ünitesinde yatırılan 89 hastanın rutin laboratuvar parametreleri retrospektif olarak incelendi. Sistemik inflamasyonun agregat indeksi (AISI) ve diğer infalamatuar değerler COVID-19 polimeraz zincir reaksiyonu testi pozitif olan ve akciğer tomografisinde buzlu cam opasitesi olan hastalarda yapılan kan testlerinden hesaplandı. Hastalar yoğun bakım takiplerinde ölenler (sağ kalamayanlar) ve taburcu olanlar (sağ kalanlar) olarak iki gruba ayrıldı.
Bulgular: Çalışmamızda takipte ölen 48 hastada AISI, diğer inflamatuar parametreler, ferritin, troponin I, d-dimer ve prokalsitonin gibi biyokimyasal paramtereler taburcu edilen hastalardan anlamlı derecede yüksekti. Hipertansiyon ve daha yüksek AISI ve ferritin seviyeleri, Cox regresyon analizinde azalmış sağkalım ile istatistiksel olarak ilişkiliydi (Sırasıyla: Risk oranı (RO)=3,176;%95 Güven aralığı (GA), 1,122-8,991,P=0,03, RO=1,114; %95 GA, 1,060-1,348, P=0,042 ve RO=1,072;95% GA,1,014-1,242, P=0,011).
Sonuç: Kan testlerinden elde edilen inflamasyon indeksleri ile ferritin gibi akut faz reaktanları, yoğun bakım takiplerinde COVID-19'lu hastalarda tedavi stratejisini ve risk sınıflandırmasını planlamada bize yol gösterebilir. 

Anahtar Kelimeler

• koronavirüs 2019 hastalığı
• pandemi
• inflamasyon
• kan parametreleri

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