COVID-19 Hastalarında TNF-α Düşüşünü Etkileyen Faktörler

Abstract

Amaç: Tümör nekrozis faktör-alfa (TNF-α) hücrenin hayatta kalması, farklılaşması ve çoğalması da dahil çeşitli işlevlere sahiptir. TNF-α, COVID-19 enfeksiyonu sırasında ortaya çıkan sitokin fırtınası sırasında hücre ölümünü etkileyebilir. Bu çalışmada COVID-19 hastalarında TNF-α düşüşüne etki eden faktörleri araştırmak amaçlandı. Gereç ve Yöntemler: Çalışmaya COVID-19 enfeksiyonu olan toplam 44 kişi dahil edildi. Kan sayımı, biyokimyasal incelemeler ve D-dimer incelemeleri yapıldı. Hastaların ek hastalıkları ve başlangıç semptomları kaydedildi. TNF-α, CRP ve ferritin değerleri yatışının 1. ve 7. günlerinde iki kez ölçüldü. Bu değerlerdeki değişim komorbiditelere, başlangıç semptomlarına ve steroid kullanımına göre incelendi. Bulgular: Toplam 44 hastanın %56,8'i erkek (25/44) ve %43,2'si kadındı (19/44). TNF-α düşüşü diyabetik olmayan hastalarda istatistiksel olarak anlamlı bulunurken, diyabetik hastalarda TNF-α düşüşü anlamsız bulundu. CRP düşüşü hem diyabetik hem de diyabetik olmayan hastalarda istatistiksel olarak anlamlı bulunurken, ferritin düşüşü hem diyabetik hem de diyabetik olmayan hastalarda anlamsız bulundu. Akciğer hastalığı olmayanlarda TNF-α ve CRP istatistiksel olarak anlamlı düzeyde düşerken, akciğer hastalığı olanlarda hem TNF-α hem de CRP düşüşlerinin anlamlı olmadığı görüldü. TNF-α ve CRP'deki azalma steroid ile tedavi edilmeyenlerde anlamlı değilken, TNF-α ve CRP'deki azalma steroid tedavisi alanlarda istatistiksel olarak anlamlıydı. Sonuç: Steroidler TNF-α düzeyini düşürürler. Akciğer hastalığı ve diyabeti olanlarda TNF-α düşüşü anlamlı değildir.

Keywords

• Tümör nekrozis faktör-alfa
• C-reaktif protein
• Diyabetes Mellitus
• COVID-19

Factors Affecting TNF-α Decrease in COVID-19 Patients

Abstract

Aim: Tumor necrosis factor-alpha (TNF-α) have several functions, including cell survival, differentiation, and proliferation. TNF-α may effect the cell death during the cytokine storm that occurred during COVID-19 infection. We aimed to investigate, the factors that affects the TNF-α decrease in COVID-19 patients. Material and Methods: Totally 44 individuals with COVID-19 infection were included the study. Blood counts, biochemical examinations and D-dimer examinations were obtained. Comorbidities and initial symptoms of the patients were recorded. TNF-α, CRP and ferritin values were measured twice on the 1st and 7th days of hospitalization. The change in this values were examined according to comorbidities, initial symptoms and steroid usage. Results: Of a total of 44 patients, 56.8% were male (25/44) and 43.2 % were female (19/44). TNF-α decrease was found to be statistically significant in non-diabetic patients, while TNF-α decrease was found to be insignificant in diabetic patients. CRP decrease was found to be statistically significant in both diabetic and non-diabetic patients while ferritin decrease was insignificant in both diabetic and non-diabetic patients. While TNF-α and CRP decreased statistically significantly in those without lung disease, it was observed that both TNF-α and CRP decreases were not significant in those with lung disease. The decrease in TNF-α and CRP was statistically insignificant in those who did not treated with steroids, while the decrease in TNF-α and CRP was significant in those who treated with steroids. Conclusion: Steroids decreases the TNF-α levels. TNF decrease is not significant in those with diabetes and lung disease.

Keywords

• Tumor necrosis factor-alpha
• C-reactive protein
• Diabetes mellitus
• COVID-19

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