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Ferritin, fibrinojen ve prokalsitonin düzeyleri gebelerde COVID-19 klinik seyrini nasıl etkiler?

Year 2021, , 940 - 946, 27.12.2021
https://doi.org/10.31832/smj.932304

Abstract

Amaç: Coronavirus Disease 2019 (COVID-19) birçok insanı olduğu kadar gebeleri de etkileyen bir pandemidir. Çalışmamızın amacı inflamatuar belirteçlerin gebelerde COVID-19 seyrine etkisini araştırmaktır.
Gereç ve yöntem: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pozitif olan 125 ve negatif olan 40 gebenin dahil edildiği bu kesitsel tipe tanımlayıcı çalışmada, COVID-19 olan hastalar oksijen satürasyonu, akciğer tutulumu bulgularına göre hafif orta ve ağır olarak gruplandırılmıştır. Fibirnojen, ferritin ve prokalsitonin değerleri karşılaştırılmıştır.
Bulgular: SARS-CoV-2 durumuna göre gebelerin ferritin (p=0,241) ve prokalsitonin (p=0,579) değerleri arasında da anlamlı fark saptanmazken, testi pozitif gebelerin fibrinojen değerleri anlamlı olarak yüksek bulunmuştur (p<0,001). SARS-CoV-2 pozitif olan katılımcıları kendi içerisinde klinik durumuna hafif, orta ve ağır olarak gruplandırıp baktığımızda ise; fibrinojen (p<0,001) değerleri arasında anlamlı fark saptanmıştır. İkili karşılaştırmada klinik seyri hafif olan grupta fibrinojen değeri orta (p<0,001) ve ağır (p<0,001) olan gruptan, klinik seyri orta olan grubun fibrinojen değeri ise ağır olan gruptan anlamlı olarak düşük saptanmıştır (p=0,007)
Sonuç: Hastalığın ağırlığı arttıkça fibrinojen seviyelerinin de arttığını tespit ettik. Fibrinojen gebelerde COVID-19 klinik durumunun ağırlığı ile ilgili bir gösterge olabilir ancak bu bulguyu güçlendirmek için daha büyük örnekleme sahip prospektif, izleme dayalı çalışmalar gerekmektedir.

References

  • 1. World Health Organization. Director-General’s remarks at the media briefing on 2019-nCoV on 11 February 2020. https://www.who.int/dg/speeches/detail/who-director-general-s- remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020. 2020. p. 2020. (Erişim tarihi: 29.04.2021)
  • 2. Ramanathan K, Antognini D, Combes A, Paden M, Zakhary B, Ogino M,, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395(10223):497–506.
  • 3. Schwartz D. The Effects of Pregnancy on Women with COVID-19: Maternal and Infant Outcomes. Clin Infect Dis 2020;71(16):2042–2044.
  • 4. Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta Obstet Gynecol Scand 2020;99(7):823–829.
  • 5. Levi M, Toh CH, Thachil J, Watson HG. Guidelines for the diagnosis and management of disseminated intravascular coagulation. Br J Haematol 2009;145(1):24–33.
  • 6. Di Micco P, Russo V, Carannante N, Imparato M, Cardillo G, Lodigiani C. Prognostic Value of Fibrinogen among COVID-19 Patients Admitted to an Emergency Department: An Italian Cohort Study. J Clin Med 2020;9(12):4134.
  • 7. Lippi G, Cervellin G. Procalcitonin for diagnosing and monitoring bacterial infections : for or against ? Clin Chem Lab Med 2018;56(8):1193–1195.
  • 8. Kell DB, Pretorius E. Serum ferritin is an important inflammatory disease marker, as it is mainly a leakage product from damaged cells. Metallomics 2014;6(4):748–773.
  • 9. Ruddell RG, Hoang-Le D, Barwood J, Rutherford P, Piva T, Watters D, et al. Ferritin functions as a proinflammatory cytokine via iron- independent PKC-ζ/NFκB-regulated signalling in rat hepatic stellate cells. Hepatology 2010;49(3):887–900.
  • 10. Dahan S, Segal G, Katz I, Hellou T, Tietel M, Bryk G, et al. Ferritin as a Marker of Severity in COVID-19 Patients: A Fatal Correlation. IMAJ 2020;22(8):494–500.
  • 11. Delahoy M, Whitaker M, O’Halloran A, Chai SJ, Kirley PD, Alden N, et al. Characteristics and maternal and birth outcomes of hospitalized pregnant women with laboratory-confirmed COVID-19 — COVID-NET, 13 States, March 1–August 22, 2020. MMWR 2020;69(38):1347-1354. 12. Clinical spectrum of SARS-CoV-2 infection. https://www.covid19treatmentguidelines.nih.gov/overview/clinical-spectrum/ (Erişim tarihi 29.04.2021).
  • 13. Bi X, Su Z, Yan H, Du J, Wang J, Chen L, et al. Prediction of severe illness due to COVID-19 based on an analysis of initial Fibrinogen to Albumin Ratio and Platelet count. Platelets [Internet] 2020;31(5):674–679.
  • 14. Han H, Yang L, Liu R, Liu F, Liu F, Wu KL, et al. Prominent changes in blood coagulation of patients with SARS-CoV-2 infection. Clin Chem Lab Med 2020;58(7):1116–1120.
  • 15. Minasyan H, Flachsbart F. Blood coagulation: a powerful bactericidal mechanism of human innate immunity. Int Rev Immunol [Internet] 2019;38(1):3–17.
  • 16. Delvaeye M, Conway EM. Coagulation and innate immune responses: Can we view them separately? Blood [Internet]. 2009;114(12):2367–2374.
  • 17. Xiang JZ, Cao DY, Yang YYY, Cezmi YY, Gao AAY. Clinical characteristics of 140 patients infected with SARS- CoV-2 in Wuhan , China. Allergy 2020;00:1–12.
  • 18. Guan W, Ni Z, Hu Y, Liang W, Ou C, He J,et al. Clinical Characteristics of Coronavirus Disease 2019 in China. New 2020;382:1708–1720.
  • 19. Lippi G, Plebani M. Procalcitonin in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis. Clin Chim Acta 2020;505:190–191.
  • 20. Van Berkel M, Kox M, Frenzel T, Pickkers P, Schouten J, Van Berkel M, et al. Biomarkers for antimicrobial stewardship: A reappraisal in COVID-19 times? Crit Care 2020;24(1):1–4.
  • 21. Liu W, Wang Q, Zhang Q, Chen L, Chen J, Zhang B, et al. Coronavirus disease 2019 (COVID-19) during pregnancy: a case series. Preprints 2020;2020020373.
  • 22. Banchini F, Cattaneo GM, Capelli P. Serum ferritin levels in inflammation : a retrospective comparative analysis between COVID-19 and emergency surgical non- COVID-19 patients. World J Emerg Surg 2021;16:9.
  • 23. Cheng L, Li H, Li L, Liu C, Chen H, Li Y. Ferritin in the coronavirus disease 2019 ( COVID-19 ): A systematic review and meta-analysis. J Clin Lab Anal 2020;34:e23618.
  • 24. Colafrancesco S, Alessandri C, Conti F, Priori R. COVID-19 gone bad : A new character in the spectrum of the hyperferritinemic syndrome ? Autoimmun Rev 2020;19:102573.

How do levels of ferritin, fibrinogen and procalcitonin affect the clinical course of COVID-19 in pregnant women?

Year 2021, , 940 - 946, 27.12.2021
https://doi.org/10.31832/smj.932304

Abstract

Objective: Coronavirus disease 2019 (COVID 19) is a pandemic affecting pregnant women as well as lots of people. The aim of our study is to investigate the effects of inflammatory markers on the course of COVID-19 in pregnant women.
Materials and methods: In this cross-sectional descriptive study, which included 125 pregnant women who were positive for Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and 40 women who were negative, patients with COVID-19 were grouped as mild, moderate, and severe according to oxygen saturation, lung involvement findings. Fibrinogen, ferritin, and procalcitonin values of the participants were compared.
Results: While there was no significant difference between the ferritin (p = 0,241) and procalcitonin (p = 0,579) values of pregnant women according to the SARS-CoV-2 status, the fibrinogen values of pregnant women with positive test were found to be significantly higher (p<0,001). When we categorize the participants who are positive for SARS-CoV-2 as mild, moderate, and severe; a significant difference was found between fibrinogen (p<0,001) values. In paired comparison, the fibrinogen value of the group with mild disease was found to be significantly lower than the group with moderate (p<0,001) and severe (p<0,001), and the group with a moderate disease compared to the group with severe (p = 0,007).
Conclusion: We found that as the severity of the disease increased, fibrinogen levels also increased. Fibrinogen may be an indicator of the severity of the COVID-19 clinical course in pregnant women, but prospective, follow-up studies with larger samples are required to reinforce this finding.

References

  • 1. World Health Organization. Director-General’s remarks at the media briefing on 2019-nCoV on 11 February 2020. https://www.who.int/dg/speeches/detail/who-director-general-s- remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020. 2020. p. 2020. (Erişim tarihi: 29.04.2021)
  • 2. Ramanathan K, Antognini D, Combes A, Paden M, Zakhary B, Ogino M,, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395(10223):497–506.
  • 3. Schwartz D. The Effects of Pregnancy on Women with COVID-19: Maternal and Infant Outcomes. Clin Infect Dis 2020;71(16):2042–2044.
  • 4. Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta Obstet Gynecol Scand 2020;99(7):823–829.
  • 5. Levi M, Toh CH, Thachil J, Watson HG. Guidelines for the diagnosis and management of disseminated intravascular coagulation. Br J Haematol 2009;145(1):24–33.
  • 6. Di Micco P, Russo V, Carannante N, Imparato M, Cardillo G, Lodigiani C. Prognostic Value of Fibrinogen among COVID-19 Patients Admitted to an Emergency Department: An Italian Cohort Study. J Clin Med 2020;9(12):4134.
  • 7. Lippi G, Cervellin G. Procalcitonin for diagnosing and monitoring bacterial infections : for or against ? Clin Chem Lab Med 2018;56(8):1193–1195.
  • 8. Kell DB, Pretorius E. Serum ferritin is an important inflammatory disease marker, as it is mainly a leakage product from damaged cells. Metallomics 2014;6(4):748–773.
  • 9. Ruddell RG, Hoang-Le D, Barwood J, Rutherford P, Piva T, Watters D, et al. Ferritin functions as a proinflammatory cytokine via iron- independent PKC-ζ/NFκB-regulated signalling in rat hepatic stellate cells. Hepatology 2010;49(3):887–900.
  • 10. Dahan S, Segal G, Katz I, Hellou T, Tietel M, Bryk G, et al. Ferritin as a Marker of Severity in COVID-19 Patients: A Fatal Correlation. IMAJ 2020;22(8):494–500.
  • 11. Delahoy M, Whitaker M, O’Halloran A, Chai SJ, Kirley PD, Alden N, et al. Characteristics and maternal and birth outcomes of hospitalized pregnant women with laboratory-confirmed COVID-19 — COVID-NET, 13 States, March 1–August 22, 2020. MMWR 2020;69(38):1347-1354. 12. Clinical spectrum of SARS-CoV-2 infection. https://www.covid19treatmentguidelines.nih.gov/overview/clinical-spectrum/ (Erişim tarihi 29.04.2021).
  • 13. Bi X, Su Z, Yan H, Du J, Wang J, Chen L, et al. Prediction of severe illness due to COVID-19 based on an analysis of initial Fibrinogen to Albumin Ratio and Platelet count. Platelets [Internet] 2020;31(5):674–679.
  • 14. Han H, Yang L, Liu R, Liu F, Liu F, Wu KL, et al. Prominent changes in blood coagulation of patients with SARS-CoV-2 infection. Clin Chem Lab Med 2020;58(7):1116–1120.
  • 15. Minasyan H, Flachsbart F. Blood coagulation: a powerful bactericidal mechanism of human innate immunity. Int Rev Immunol [Internet] 2019;38(1):3–17.
  • 16. Delvaeye M, Conway EM. Coagulation and innate immune responses: Can we view them separately? Blood [Internet]. 2009;114(12):2367–2374.
  • 17. Xiang JZ, Cao DY, Yang YYY, Cezmi YY, Gao AAY. Clinical characteristics of 140 patients infected with SARS- CoV-2 in Wuhan , China. Allergy 2020;00:1–12.
  • 18. Guan W, Ni Z, Hu Y, Liang W, Ou C, He J,et al. Clinical Characteristics of Coronavirus Disease 2019 in China. New 2020;382:1708–1720.
  • 19. Lippi G, Plebani M. Procalcitonin in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis. Clin Chim Acta 2020;505:190–191.
  • 20. Van Berkel M, Kox M, Frenzel T, Pickkers P, Schouten J, Van Berkel M, et al. Biomarkers for antimicrobial stewardship: A reappraisal in COVID-19 times? Crit Care 2020;24(1):1–4.
  • 21. Liu W, Wang Q, Zhang Q, Chen L, Chen J, Zhang B, et al. Coronavirus disease 2019 (COVID-19) during pregnancy: a case series. Preprints 2020;2020020373.
  • 22. Banchini F, Cattaneo GM, Capelli P. Serum ferritin levels in inflammation : a retrospective comparative analysis between COVID-19 and emergency surgical non- COVID-19 patients. World J Emerg Surg 2021;16:9.
  • 23. Cheng L, Li H, Li L, Liu C, Chen H, Li Y. Ferritin in the coronavirus disease 2019 ( COVID-19 ): A systematic review and meta-analysis. J Clin Lab Anal 2020;34:e23618.
  • 24. Colafrancesco S, Alessandri C, Conti F, Priori R. COVID-19 gone bad : A new character in the spectrum of the hyperferritinemic syndrome ? Autoimmun Rev 2020;19:102573.
There are 23 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Huri Güvey 0000-0002-8603-6981

Canan Soyer Çalışkan 0000-0002-9889-5249

Samettin Çelik 0000-0002-6407-1129

Merve Yılmaz 0000-0002-3421-8548

Zehra Yılmaz 0000-0003-1162-8648

Publication Date December 27, 2021
Submission Date May 3, 2021
Published in Issue Year 2021

Cite

AMA Güvey H, Soyer Çalışkan C, Çelik S, Yılmaz M, Yılmaz Z. Ferritin, fibrinojen ve prokalsitonin düzeyleri gebelerde COVID-19 klinik seyrini nasıl etkiler?. Sakarya Tıp Dergisi. December 2021;11(4):940-946. doi:10.31832/smj.932304

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