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Hipertansiyon Tanılı Covid-19 Hastalarında Fibrinojen ve D-dimer Düzeylerinin İncelenmesi

Year 2022, Volume: 12 Issue: 3, 416 - 421, 29.09.2022
https://doi.org/10.31832/smj.953008

Abstract

Amaç: 2019 aralık ayında başlayan Sars-Cov-2 adı verilen koronavirüs ailesine ait olan koronavirüs nedeniyle mart 2020 ayında tüm dünyada pandemi ilan edildi ve virüsün yol açtığı hastalık Covid-19 olarak anılmaya başlandı. Yaklaşık 176.000.000 kişiyi etkileyen pandemide 12/06/21 tarihi ile 3.500.000 dan fazla insanın vefat ettiği bildirilmiştir. Hipertansiyon tanısı olan hastalarda Covid-19 hastalarında ölüm oranlarının, hastane yatışlarının ve gelişen diğer komorbiditelerin daha fazla olduğu bilinmektedir. CRP, fibrinojen, D-dimer gibi laboratuvar değerlerinin Covid-19 için hastalık ilerleyişini belirlemede önemli olduğu da bilinmektedir. Bu çalışmamızda kliniğimizde Covid-19 nedenli takip edilen hipertansiyon tanısı olan hastaların hastane başvurusu anında bakılan Fibrinojen, Crp, D-dimer gibi Covid-19 için hastalık progresyonu belirteçlerinin hipertansiyonu olmayan hastalara kıyasla farklı olup olmadığı ve hipertansif Covid-19 hastalarında hastalık gidişatını belirlemek için bu parametrelerin kullanımının klinik fayda sağlayıp sağlamadığını belirlemeyi amaçladık

Gereç ve Yöntem: İç hastalıkları kliniği servis ve yoğun bakımlarında 15/03/2020 ile 15/01/2021 tarihleri arasında Covid-19 nedenli takip edilen 590 hastanın verileri geriye dönük olarak incelendi. Hastaların yaşı cinsiyeti gibi demografik verileri ile beraber laboratuvar değerleri hastane otomasyon sisteminden tarandı. Veriler SPSS programına kaydedildi ve istatistiksel analizler yapıldı. Hastalar ölüm ve şifa sağlanan hastalar olarak 2 grupta incelendi.

Bulgular: Hipertansiyonu olan hastaların ortalama yaşlarına bakıldığında 69,77±17,5 (n:310) iken hipertansiyonu olmayan hastaların yaş ortalaması 61,04±10,6 (n:280) olarak saptandı (p:0,000). Hipertansiyonu olan hastalarda D-dimer düzeylerine bakldığında 1270 (37-20200) n:295 ugFEU/L iken hipertansiyonu olmayan hastalarda 875(4-38800) n:266 (p:0,009) olarak görülmüştür. Fibrinojen düzeyleri ise hipertansif olan hastalarda 434,6±143,9 mg/dl n:279 iken hipertansif olmayan hastalarda 403,6±135,7 mg/dl n:240 (p:0,012) olarak saptanmıştır.

Sonuç: Hipertansiyon tanısı olan Covid-19 hastalarında yüksek fibrinojen ve D-dimer düzeyleri kötü prognostik faktör olarak değerlendirilebilir.

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References

  • 1. Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020;91: 157–160.
  • 2. COVID Live Update: 176,146,336 Cases and 3,802,744 Deaths from the Coronavirus - Worldometer. [cited 12 Jun 2021]. Available: https://www.worldometers.info/coronavirus/
  • 3. Yegorov S, Goremykina M, Ivanova R, Good SV, Babenko D, Shevtsov A, et al. Epidemiological and Clinical Characteristics, and Virologic Features of COVID-19 Patients in Kazakhstan: a Nation-Wide, Retrospective, Cohort Study. doi:10.1101/2021.01.06.20249091
  • 4. He X, Lau EHY, Wu P, Deng X, Wang J, Hao X, et al. Temporal dynamics in viral shedding and transmissibility of COVID-19. Nat Med. 2020;26: 672–675.
  • 5. Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol. 2020;30: 4381–4389.
  • 6. Chen Z, Zhang F, Hu W, Chen Q, Li C, Wu L, et al. Laboratory markers associated with COVID-19 progression in patients with or without comorbidity: A retrospective study. J Clin Lab Anal. 2021;35: e23644.
  • 7. Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? The Lancet. Respiratory medicine. 2020. p. e21.
  • 8. Tadic M, Cuspidi C, Mancia G, Dell’Oro R, Grassi G. COVID-19, hypertension and cardiovascular diseases: Should we change the therapy? Pharmacol Res. 2020;158: 104906.
  • 9. Salazar M, Barochiner J, Espeche W, Ennis I. [COVID-19 and its relationship with hypertension and cardiovascular disease]. Hipertens Riesgo Vasc. 2020;37: 176–180.
  • 10. Klok FA, Kruip MJHA, van der Meer NJM, Arbous MS, Gommers DAMPJ, Kant KM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020;191: 145–147.
  • 11. The Lancet Haematology. COVID-19 coagulopathy: an evolving story. Lancet Haematol. 2020;7: e425.
  • 12. Llitjos J-F, Leclerc M, Chochois C, Monsallier J-M, Ramakers M, Auvray M, et al. High incidence of venous thromboembolic events in anticoagulated severe COVID-19 patients. J Thromb Haemost. 2020;18: 1743–1746.
  • 13. Mosesson MW. Fibrinogen and fibrin structure and functions. J Thromb Haemost. 2005;3. doi:10.1111/j.1538-7836.2005.01365.x
  • 14. Sesso HD, Jiménez MC, Wang L, Ridker PM, Buring JE, Gaziano JM. Plasma Inflammatory Markers and the Risk of Developing Hypertension in Men. J Am Heart Assoc. 2015;4. doi:10.1161/JAHA.115.001802
  • 15. Iba T, Levy JH, Levi M, Thachil J. Coagulopathy in COVID-19. J Thromb Haemost. 2020;18. doi:10.1111/jth.14975
  • 16. [No title]. [cited 8 Jun 2021]. Available: https://covid19.saglik.gov.tr/Eklenti/39061/0/covid-19rehberieriskinhastatedavisipdf.pdf
  • 17. (hq) WH. COVID-19 Clinical management: living guidance. World Health Organization; 25 Jan 2021 [cited 8 Jun 2021]. Available: https://www.who.int/publications/i/item/WHO-2019-nCoV-clinical-2021-1
  • 18. Li X, Ma X. Acute respiratory failure in COVID-19: is it “typical” ARDS? Crit Care. 2020;24: 198.
  • 19. Doyle AE. Hypertension and vascular disease. Am J Hypertens. 1991;4: 103S–106S.
  • 20. Zhang X, Li S, Niu S. ACE2 and COVID-19 and the resulting ARDS. Postgrad Med J. 2020;96: 403–407.
  • 21. Hayıroğlu Mİ, Çınar T, Tekkeşin Aİ. Fibrinogen and D-dimer variances and anticoagulation recommendations in Covid- 19: current literature review. Rev Assoc Med Bras. 2020;66: 842–848.
  • 22. Lowe GDO. Fibrin D-dimer and cardiovascular risk. Semin Vasc Med. 2005;5: 387–398.
  • 23. Banerjee AK, Pearson J, Gilliland EL, Goss D, Lewis JD, Stirling Y, et al. A six year prospective study of fibrinogen and other risk factors associated with mortality in stable claudicants. Thromb Haemost. 1992;68: 261–263.
  • 24. Grobler C, Maphumulo SC, Grobbelaar LM, Bredenkamp JC, Laubscher GJ, Lourens PJ, et al. Covid-19: The Rollercoaster of Fibrin(Ogen), D-Dimer, Von Willebrand Factor, P-Selectin and Their Interactions with Endothelial Cells, Platelets and Erythrocytes. Int J Mol Sci. 2020;21. doi:10.3390/ijms21145168
  • 25. Lip GY, Blann AD, Jones AF, Lip PL, Beevers DG. Relation of endothelium, thrombogenesis, and hemorheology in systemic hypertension to ethnicity and left ventricular hypertrophy. Am J Cardiol. 1997;80: 1566–1571.
Year 2022, Volume: 12 Issue: 3, 416 - 421, 29.09.2022
https://doi.org/10.31832/smj.953008

Abstract

Project Number

yok

References

  • 1. Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020;91: 157–160.
  • 2. COVID Live Update: 176,146,336 Cases and 3,802,744 Deaths from the Coronavirus - Worldometer. [cited 12 Jun 2021]. Available: https://www.worldometers.info/coronavirus/
  • 3. Yegorov S, Goremykina M, Ivanova R, Good SV, Babenko D, Shevtsov A, et al. Epidemiological and Clinical Characteristics, and Virologic Features of COVID-19 Patients in Kazakhstan: a Nation-Wide, Retrospective, Cohort Study. doi:10.1101/2021.01.06.20249091
  • 4. He X, Lau EHY, Wu P, Deng X, Wang J, Hao X, et al. Temporal dynamics in viral shedding and transmissibility of COVID-19. Nat Med. 2020;26: 672–675.
  • 5. Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol. 2020;30: 4381–4389.
  • 6. Chen Z, Zhang F, Hu W, Chen Q, Li C, Wu L, et al. Laboratory markers associated with COVID-19 progression in patients with or without comorbidity: A retrospective study. J Clin Lab Anal. 2021;35: e23644.
  • 7. Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? The Lancet. Respiratory medicine. 2020. p. e21.
  • 8. Tadic M, Cuspidi C, Mancia G, Dell’Oro R, Grassi G. COVID-19, hypertension and cardiovascular diseases: Should we change the therapy? Pharmacol Res. 2020;158: 104906.
  • 9. Salazar M, Barochiner J, Espeche W, Ennis I. [COVID-19 and its relationship with hypertension and cardiovascular disease]. Hipertens Riesgo Vasc. 2020;37: 176–180.
  • 10. Klok FA, Kruip MJHA, van der Meer NJM, Arbous MS, Gommers DAMPJ, Kant KM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020;191: 145–147.
  • 11. The Lancet Haematology. COVID-19 coagulopathy: an evolving story. Lancet Haematol. 2020;7: e425.
  • 12. Llitjos J-F, Leclerc M, Chochois C, Monsallier J-M, Ramakers M, Auvray M, et al. High incidence of venous thromboembolic events in anticoagulated severe COVID-19 patients. J Thromb Haemost. 2020;18: 1743–1746.
  • 13. Mosesson MW. Fibrinogen and fibrin structure and functions. J Thromb Haemost. 2005;3. doi:10.1111/j.1538-7836.2005.01365.x
  • 14. Sesso HD, Jiménez MC, Wang L, Ridker PM, Buring JE, Gaziano JM. Plasma Inflammatory Markers and the Risk of Developing Hypertension in Men. J Am Heart Assoc. 2015;4. doi:10.1161/JAHA.115.001802
  • 15. Iba T, Levy JH, Levi M, Thachil J. Coagulopathy in COVID-19. J Thromb Haemost. 2020;18. doi:10.1111/jth.14975
  • 16. [No title]. [cited 8 Jun 2021]. Available: https://covid19.saglik.gov.tr/Eklenti/39061/0/covid-19rehberieriskinhastatedavisipdf.pdf
  • 17. (hq) WH. COVID-19 Clinical management: living guidance. World Health Organization; 25 Jan 2021 [cited 8 Jun 2021]. Available: https://www.who.int/publications/i/item/WHO-2019-nCoV-clinical-2021-1
  • 18. Li X, Ma X. Acute respiratory failure in COVID-19: is it “typical” ARDS? Crit Care. 2020;24: 198.
  • 19. Doyle AE. Hypertension and vascular disease. Am J Hypertens. 1991;4: 103S–106S.
  • 20. Zhang X, Li S, Niu S. ACE2 and COVID-19 and the resulting ARDS. Postgrad Med J. 2020;96: 403–407.
  • 21. Hayıroğlu Mİ, Çınar T, Tekkeşin Aİ. Fibrinogen and D-dimer variances and anticoagulation recommendations in Covid- 19: current literature review. Rev Assoc Med Bras. 2020;66: 842–848.
  • 22. Lowe GDO. Fibrin D-dimer and cardiovascular risk. Semin Vasc Med. 2005;5: 387–398.
  • 23. Banerjee AK, Pearson J, Gilliland EL, Goss D, Lewis JD, Stirling Y, et al. A six year prospective study of fibrinogen and other risk factors associated with mortality in stable claudicants. Thromb Haemost. 1992;68: 261–263.
  • 24. Grobler C, Maphumulo SC, Grobbelaar LM, Bredenkamp JC, Laubscher GJ, Lourens PJ, et al. Covid-19: The Rollercoaster of Fibrin(Ogen), D-Dimer, Von Willebrand Factor, P-Selectin and Their Interactions with Endothelial Cells, Platelets and Erythrocytes. Int J Mol Sci. 2020;21. doi:10.3390/ijms21145168
  • 25. Lip GY, Blann AD, Jones AF, Lip PL, Beevers DG. Relation of endothelium, thrombogenesis, and hemorheology in systemic hypertension to ethnicity and left ventricular hypertrophy. Am J Cardiol. 1997;80: 1566–1571.
There are 25 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Deniz Çekiç 0000-0002-7114-9334

Ahmed Cihad Genç 0000-0002-7725-707X

Kubilay İşsever 0000-0002-1376-1488

İlhan Yıldırım 0000-0003-0600-7249

Ahmet Nalbant 0000-0003-4756-3575

Sümeyye Çekiç 0000-0002-0745-1766

Ahmed Bilal Genç 0000-0002-1607-6355

Hamad Dheir 0000-0002-3569-6269

Selcuk Yaylacı 0000-0002-6768-7973

Ali Tamer 0000-0003-2005-0737

Project Number yok
Publication Date September 29, 2022
Submission Date July 30, 2021
Published in Issue Year 2022 Volume: 12 Issue: 3

Cite

AMA Çekiç D, Genç AC, İşsever K, Yıldırım İ, Nalbant A, Çekiç S, Genç AB, Dheir H, Yaylacı S, Tamer A. Hipertansiyon Tanılı Covid-19 Hastalarında Fibrinojen ve D-dimer Düzeylerinin İncelenmesi. Sakarya Tıp Dergisi. September 2022;12(3):416-421. doi:10.31832/smj.953008

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