The Relation of Hepcidin, Vitamin D and Inflammatory Parameters, and Effects on Intensive Care Unit Outcome in Critically Ill COVID-19 Patients

Abstract

Objectives: Aim of this study was to evaluate hepcidin levels and its correlation with inflammatory markers, vitamin D levels as well as its effects on intensive care unit (ICU) mortality in critically ill coronavirus disease-2019 (COVID-19) patients. Materials and Methods: Adult patients those were admitted to pandemic ICU between March 1st, 2021 and May 17th 2021 were prospectively included to the study. Hepcidin levels and inflammatory markers on day 1, 2, 3 and 7, admission vitamin D levels, length of ICU stay and ICU mortality were recorded and analysed. Results: Median age of patients was 60.5 (52.50-71.25) and 20 (66.7%) of them was male. It was observed that hepcidin levels and lymphocyte counts were increased significantly from day 1 to day 7 (p=0.01 and p<0.01, respectively). In contrast, C-reactive protein (CRP) and procalsitonin levels were decreased from day 1 to day 7 (p=0.01 and p<0.01, respectively). In the analysis admission hepcidin levels and inflammatory markers [IL-6 (p=0.61), CRP (p=0.82) and ferritin (p=0.27)], vitamin D (p=0.13) and iron level (p=0.90) was not correlated. There was no correlation between hepcidin levels and ICU mortality (p=0.95) Conclusion: In this study, hepcidin levels were above normal limits in critically ill COVID-19 patients. However, our findings do not support the use of hepcidin, IL6, serum ferritin, and vitamin D levels in predicting COVID-19 mortality.

Keywords

• ICU
• Hepcidin
• Mortality

Kritik COVID-19 Hastalarında Hepsidin, D Vitamini ve Enflamasyon Belirteçlerinin İlişkisi ve Yoğun Bakım Ünitesi Sonuçlarına Etkisi

Abstract

Amaç: Bu çalışmada amacımız kritik koronavirüs hastalığı-2019 (COVID-19) hastalarında hepsidin düzeylerinin değişimi ve D vitamini düzeylerinin, enflamatuvar belirteçler, yoğun bakım ünitesi (YBÜ) yatış süresi ve yoğun bakım sonucu ile ilişkisinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: 1 Mart 2021 ile 17 Mayıs 2021 arasında hastanemiz pandemi YBÜ’de yatışı yapılan yetişkin hastalar prospektif olarak çalışmaya dahil edildi. Hastaların 1, 2, 3 ve 7. gün hepsidin düzeyleri ve diğer enflamatuvar belirteçleri, kabul vitamin D düzeyleri, yoğun bakım yatış süreleri ve yoğun bakım sonuçları kaydedilerek incelendi. Bulgular: Hastaların ortanca yaşı 60,5 (52,50-71,25) ve 20’si (%66,7) erkekti. Hepsidin ve lenfosit sayısının 1. günden 7. güne olan süre içerisinde anlamlı olarak yükseldiği gözlendi (p=0,01 ve p<0,01, sırasıyla). C-reaktif protein (CRP) ve prokalsitonin seviyelerinin ise 1. günden 7. güne olan süre içerisinde gerilediği gözlendi (p<0,01 ve p<0,01, sırasıyla). Hastaların YBÜ’ye kabulünde çalışılan hepsidin düzeyi ile enflamatuvar parametreler [IL-6 (p=0,61), CRP (p=0,82) ve ferritin (p=0,27)], D vitamini (p=0,13) ve demir düzeyi (p=0,90) arasında korelasyon saptanmadı. Hepsidin düzeyleri ile yoğun bakım mortalitesi arasında ilişki tespit edilemedi (p=0,95). Sonuç: Bu çalışma ile kritik COVID-19 hastalarında hepsidin düzeylerinin normal sınırlar üzerinde seyrettiği tespit edilmiştir. Ancak bulgularımız, hepsidin, IL6, serum ferritin ve D vitamini düzeylerinin COVID-19 mortalite tahmininde kullanımını destekler nitelikte değildir.

Keywords

• Yoğun Bakım
• Hepsidin
• Mortalite

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