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Covid-19 Enfeksiyonunda Anti-Trombin-3, Protein C ve Protein S Düzeylerinin İncelenmesi

Year 2021, , 381 - 387, 29.06.2021
https://doi.org/10.31832/smj.845215

Abstract

Amaç: SARS-CoV-2 virüsünün etkeni olduğu COVİD-19 enfeksiyonu salgın oluşturan önemli bir hastalıktır. COVİD-19 hastalarının birçoğunda kanama ve pıhtılaşma bozukluklarının geliştiği yapılan çalışmalarla gösterilmiştir. Çalışmamızda, ağırlıklı olarak pıhtılaşma eğilimi gözlenen bu hasta grubunda, vücudun doğal antikoagülan proteinleri olan Antitrombin-3 (AT3), protein C (PC) ve protein S (PS) düzeylerinin incelenmesi amaçlandı.
Gereç ve Yöntemler: 15 Mart-31 Mayıs tarihleri arasında COVID-19 tanısıyla hastaneye yatışı yapılan 22 hasta çalışmaya alındı. Hastaların yaşı, cinsiyeti, kronik hastalıkları, servis / yoğun bakım yatışı, AT3, PC, PS düzeyleri, PT, aPTT, INR, D-Dimer, fibrinojen, rutin laboratuar parametreleri ve mortalite oranları retrospektif olarak değerlendirildi. Bağımsız değişkenler ile yoğun bakım ihtiyacı ve mortalite oranları istatistiksel olarak karşılaştırıldı.
Bulgular: Çalışmaya 14’ü servis, 8’i yoğun bakım ünitesinde (YBÜ) takip edilen toplam 22 hasta dahil edildi. Hastaların 17’si (%77,3) erkek, yaş ortalaması 66.6±33,78 yıl idi. Toplam 20 (%90,9) hastanın en az bir kronik hastalığı vardı. Bunların %36,3 sı Diyabet (DM), %54,5 ‘i hipertansiyon idi. Hastalarda nefes darlığı (%86,3) ve öksürük (%77,2) en sık görülen şikayetler idi. Takibinde 4 hastada ölüm gerçekleşti.
Tartışma: Servis- YBÜ hastaları ve mortal- nonmortal hastalar olarak yapılan iki farklı karşılaştırmalar arasında, AT3, PC, PS, düzeyleri arasında istatistiksel olarak anlamlı bir farklılık saptanmadı. Mortal hastalarda nonmortal gruba göre ortalama PTT düzeyleri anlamlı olarak yüksek bulunurken, faktör 9 düzeyleri de YBÜ grubunda servis hastalarına göre anlamlı olarak yüksek tespit edildi.
Sonuç: Çalışmamız sonuçlarına göre COVID-19 hastalarında AT3, PC ve PS düzeyleri ile hastalık şiddeti arasında ilişki tespit edilmedi.

References

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  • 2. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395:1054–62.
  • 3. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost 2020;18:844–7.
  • 4. Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost 2020;18:1094–9.
  • 5. Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, et al. Hematological findings and complications of COVID-19. Am J Hematol 2020. https://doi.org/10.1002/ajh.25829.
  • 6. Levi M, Thachil J, Iba T, Levy JH. Coagulation abnormalities and thrombosis in patients with COVID-19. Lancet Haematol. 2020;7(6):e438-e440. doi:10.1016/S2352-3026(20)30145-9)
  • 7. Panigada M, Bottino N, Tagliabue P, Grasselli G, Novembrino C, Chantarangkul V, et al. Hypercoagulability of COVID-19 patients in Intensive Care Unit. A Report of Thromboelastography Findings and other Parameters of Hemostasis. J Thromb Haemost 2020. https://doi.org/10.1111/jth.14850.
  • 8. Levi M, Scully M. How I treat disseminated intravascular coagulation. Blood 2018; 131: 845–54.
  • 9. Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382: 1708–20.
  • 10. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost 2020; 18: 844–47.,
  • 11. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497–50.
  • 12. Zhang L, Yan X, Fan Q, Liu H, Liu X, Liu Z, et al. D-dimer levels on admission to predict in-hospital mortality in patient swith Covid-19. J Thromb Haemost. 2020 Jun;18(6):1324–9.
  • 13. Tabatabai A, Rabin J, Menaker J, Madathil R, Galvagno S, Menne A, et al. Factor VIII and Functional Protein C Activity in CriticallyI ll Patients With Coronavirus Disease 2019: A Case Series. A A Pract. 2020 May;14(7):e01236.
  • 14. Qin C, Zhou L, Hu Z, et al. Dysregulation of immune response in patients with COVID-19 in Wuhan, China. Clin Infect Dis. 2020. DOI:10.1093/cid/ciaa248)
  • 15. Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475–481.
  • 16. Henry BM, de Oliveira MHS, Benoit S, et al. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med. 2020.
  • 17. Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis. Clin Chim Acta 2020;506:145–8.
  • 18. Yang X, Yang Q, Wang Y, Wu Y, Xu J, Yu Y, et al. Thrombocytopenia and its association with mortality in patients with COVID-19. J ThrombHaemost 2020;18:1469–72.
Year 2021, , 381 - 387, 29.06.2021
https://doi.org/10.31832/smj.845215

Abstract

References

  • 1. Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y, et al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol 2020. https://doi.org/10.1016/j.jaci.2020.04.006.
  • 2. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395:1054–62.
  • 3. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost 2020;18:844–7.
  • 4. Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost 2020;18:1094–9.
  • 5. Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, et al. Hematological findings and complications of COVID-19. Am J Hematol 2020. https://doi.org/10.1002/ajh.25829.
  • 6. Levi M, Thachil J, Iba T, Levy JH. Coagulation abnormalities and thrombosis in patients with COVID-19. Lancet Haematol. 2020;7(6):e438-e440. doi:10.1016/S2352-3026(20)30145-9)
  • 7. Panigada M, Bottino N, Tagliabue P, Grasselli G, Novembrino C, Chantarangkul V, et al. Hypercoagulability of COVID-19 patients in Intensive Care Unit. A Report of Thromboelastography Findings and other Parameters of Hemostasis. J Thromb Haemost 2020. https://doi.org/10.1111/jth.14850.
  • 8. Levi M, Scully M. How I treat disseminated intravascular coagulation. Blood 2018; 131: 845–54.
  • 9. Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382: 1708–20.
  • 10. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost 2020; 18: 844–47.,
  • 11. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497–50.
  • 12. Zhang L, Yan X, Fan Q, Liu H, Liu X, Liu Z, et al. D-dimer levels on admission to predict in-hospital mortality in patient swith Covid-19. J Thromb Haemost. 2020 Jun;18(6):1324–9.
  • 13. Tabatabai A, Rabin J, Menaker J, Madathil R, Galvagno S, Menne A, et al. Factor VIII and Functional Protein C Activity in CriticallyI ll Patients With Coronavirus Disease 2019: A Case Series. A A Pract. 2020 May;14(7):e01236.
  • 14. Qin C, Zhou L, Hu Z, et al. Dysregulation of immune response in patients with COVID-19 in Wuhan, China. Clin Infect Dis. 2020. DOI:10.1093/cid/ciaa248)
  • 15. Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475–481.
  • 16. Henry BM, de Oliveira MHS, Benoit S, et al. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med. 2020.
  • 17. Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis. Clin Chim Acta 2020;506:145–8.
  • 18. Yang X, Yang Q, Wang Y, Wu Y, Xu J, Yu Y, et al. Thrombocytopenia and its association with mortality in patients with COVID-19. J ThrombHaemost 2020;18:1469–72.
There are 18 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Ahmed Bilal Genç 0000-0002-1607-6355

Selcuk Yaylacı 0000-0002-6768-7973

Hamad Dheir 0000-0002-3569-6269

Tuba Hacıbekiroglu 0000-0003-1814-5972

Deniz Çekiç 0000-0002-7114-9334

Didar Şenocak 0000-0001-9840-9004

Kubilay İşsever 0000-0002-1376-1488

Gizem Kılıçcıoğlu This is me 0000-0002-3700-4983

Gökhan Oturak 0000-0003-1608-8433

Erdem Çokluk 0000-0002-6205-5109

Oğuz Karabay 0000-0003-1514-1685

Ali Tamer 0000-0003-2005-0737

Publication Date June 29, 2021
Submission Date December 22, 2020
Published in Issue Year 2021

Cite

AMA Genç AB, Yaylacı S, Dheir H, Hacıbekiroglu T, Çekiç D, Şenocak D, İşsever K, Kılıçcıoğlu G, Oturak G, Çokluk E, Karabay O, Tamer A. Covid-19 Enfeksiyonunda Anti-Trombin-3, Protein C ve Protein S Düzeylerinin İncelenmesi. Sakarya Tıp Dergisi. June 2021;11(2):381-387. doi:10.31832/smj.845215

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