COVİD-19 tanısı alan hastalarda yatarak tedavi görmeyi öngörmede 3 prediktör: yaş, laktat dehidrogenaz ve nötrofil/lenfosit oranı

Öz

Özet Amaç: Aralik 2019’da Çin’in Hubei eyaleti Wuhan’da nedeni bilinmeyen pnömoni salgını yaşandı ve bu hastalık Dünya Sağlık Örgütü (WHO) tarafından koronavirüs hastalığı (COVİD-19) olarak adlandırıldı. COVİD-19 hızlıca dünyaya yayıldı. Bu hastalık hastalarda farklı şiddette seyretmektedir. Bu nedenle hastalar yatarak tedavi veya ayaktan tedavi gibi farklı alternatifler ile tedavi edilmektedir. Bu çalışmada bizim amacımız biyokimyasal parametreler ile hastaların ayakta tedavi veya yatarak tedavi almasındaki ilişkiyi araştırmaktır. Gereç ve yöntem: Çok merkezli retrospektif kohort çalışmamızda hastalar iki gruba ayrıldı; yatan hastalar ve ayaktan tedavi alan hastalar. Yatarak tedavi alan 60 hasta olmak üzere 102 hasta çalışmaya alındı. Koronavirüs; WHO’nun kılavuzuna göre gerçek zamanlı polimeraz zincir reaksiyonu (PZR) yöntemiyle SARS-CoV-2 RNA saptanmasıyla belirlenmiştir. Kan parametrelerinde nötrofil/lenfosit oranı (NLR) hesaplanmıştır. Bulgular: Yatan hasta grubunda daha ileri yaş (32,0 (26,0-39,3); 54,0 (38,3-59,3), p<0,001), kan değerlerinde daha yüksek laktat dehidrogenaz (LDH) (195,0 (156,5-225,3); 248,5 (200,3-334,5), p<0,001) ve daha yüksek NLR (1,56 (1,08-2,62); 2,60 (1,65-4,90), p<0,001) görüldü. Sonraki adımda lojistik regresyon analizinde; ileri yaş (OR:1,072 95 % CI:1,031-1,115, p=0,001), yüksek LDH (OR:1,021 95 %CI:1,009-1,034, p=0,001) yüksek NLR (OR:1,402 95 % CI:1,049-1,874, p=0,023) yatarak tedavi almayı bağımsız olarak predikte etti. Sonuç: COVİD-19 hastalarında ileri yaş, yüksek LDH ve yüksek NLR değerleri hastanede yatarak tedavi almayı öngördürmüştür. Anahtar Kelimeler: Koronavirüs, laktat dehidrogenaz, nötrofil/lenfosit oranı (NLR) Abstract Purpose: In December 2019, an unknown pneumonia epidemic was detected in Wuhan, Hubei province, China which was subsequently designated coronavirus disease 2019 (COVID 2019) by WHO in February 2020. COVID- 19 continues to spread rapidly all over the world. Patients may experience the disease at different severity. Therefore, they can be treated by choosing alternative approaches including outpatient treatment or hospitalization. Our aim in the present study is to investigate the relationship between some biochemical parameters on admission and treatment location preference (inpatient or outpatient) Materials and methods: At our multi-center retrospective cohort study, we divided the study into 2 groups as inpatients and outpatients. A total of 102 patients, 60 of whom received inpatient treatment, were enrolled. Coronavirus was determined by detecting SARS-CoV-2 RNA with a real-time PCR method in accordance with the WHO guide. Blood parameters were recorded and NLR was calculated. Results: Inpatient group was older (32.0 (26.0-39.3) vs 54.0 (38.3-59.3), p<0.001) and had significantly higher level of LDH (195.0 (156.5-225.3) vs 248.5 (200.3-334.5), p<0.001) and NLR (1.56 (1.08-2.62) vs 2.60 (1.65-4.90), p<0.001) in blood samples. In forward stepwise logistic regression analysis; advanced age (OR:1.072 95 % CI:1.031-1.115, p=0.001), high LDH (OR:1.021 95 %CI:1.009-1.034, p=0.001) and NLR (OR:1.402 95 % CI:1.049-1.874, p=0.023) were shown as independent predictors of hospitalization Conclusion: Advanced age, high LDH, and NLR level predicted hospitalization in patients with COVID-19. Keywords: Coronavirus, laktate dehydrogenase, neutrophil/ lymphocyte ratio (NLR)

Anahtar Kelimeler

• Koronavirüs
• laktat dehidrogenaz
• nötrofil/lenfosit oranı (NLR)
• yaş

3 predictors of hospitalization patients with coronavirus (Covid-19): old age, lactate dehydrogenase and neutrophil/lymphocyte ratio

Abstract

References

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