Eozinopeni; Covid-19 tanısında, basit, hızlı ve güvenilir bir biyobelirteç olabilir mi?

Yıl 2020, Cilt: 42 Sayı: 4, 422 - 433, 31.12.2020

Muzaffer Katar Osman Demir

https://doi.org/10.7197/cmj.822996

Cited By: 1

Öz

Giriş
Covid-19 hastalığı moleküler, serolojik veya radyolojik yöntemlerle teşhis edilir. Bu tanı yöntemlerine ulaşılamadığı veya sonuçlanmasının çok zaman aldığı durumlarda, Covid-19 hastalarının basit ve kolay erişilebilir laboratuvar biyobelirteçleri ile etkin teşhisine ihtiyaç vardır.
Amaç
Covid-19' hastalığında 'eozinopeni'nin tanısal performansını araştırdık.
Materyal ve Yöntemler
Çalışmamız bir retrospektif vaka-kontrol çalışmasıdır. 15 Mart - 15 Haziran 2020 tarihleri arasında Covid-19 tanısı alan 30 hastanın kaydedilmiş klinik, laboratuvar ve radyolojik verileri uygun istatistiksel yöntemler kullanılarak 30 sağlıklı kişi ile karşılaştırıldı.
Bulgular
Hem hastalar hem de kontroller sırasıyla 57.2 ± 15.46 ve 60.07 ± 20.59 yaş ortalamaları ile 10 (% 33.3) kadın ve 200 (% 66.6) erkekten oluşuyordu. Hastaların başvuru sırasındaki eozinofil sayıları kontrollere göre anlamlı olarak düşüktü (p <0.001). Yatıştan bir hafta sonra eozinofil sayıları başvuru düzeylerine göre anlamlı olarak arttı (p = 0,004). Hastalarda yatış anında 'Eozinopeni'nin güvenilir bir göstergesi olan Nötrofil / Eozinofil oranı bir hafta sonrasına göre anlamlı derecede yüksekti (p: 0,041). Başvuru eozinofil sayımları,% 66,7 duyarlılık,% 93,3 özgüllük ve ≤0,04x103 / µL kesme seviyesi ile hasta ve kontrolleri ayırt etti. ROC analizi; (AUC): 0.856, p <0.001.
Sonuç
Covid-19 şüpheli hastaların benzer semptomları olan diğer hastalardan basit bir hemogram parametresi eozinofil sayımı ile hızlı bir şekilde izole edilmesi ve ampirik tedaviye başlanması halk sağlığı açısından büyük fayda sağlayacaktır.

Anahtar Kelimeler

Covid-19, Eozinopeni, Lenfopeni, Nötropeni, Tanı

Could Eosinopenia be a simple, fast and reliable biomarker in diagnosis of Covid-19?

Öz

Objective: Monitoring CBC subsets, particularly eosinophils. and inflammation markers, during admission and treatment of severe COVID-19 patients, can reveal key indicators of disease progression and stage to provide a basis for diagnosis and treatment for clinicians.

Method: Our study is a retrospective case-control study. After taking aproval of Ministry of Health and Ethics Committee, the recorded clinical, laboratory and radiological data of 30 patients who were diagnosed with Covid-19, between 15 March and 15 June 2020, were compared with 30 healthy person by using appropriate statistical methods.

Results: Both patients and conrols included 10 (33.3%) females and 20 (66.6%) males with a mean age of 57.2 ± 15.46 and 60.07 ± 20.59 respectively. Eosinophil counts of the patients on admission were significantly lower than the controls (p <0.001). Eosinophil counts one week after admission were increased significantly compared to the admission levels (p= 0.004). Neutrophil/Eosinophil ratio, which is a reliable indicator of 'Eosinopenia' in patients on admission was significantly higher than that of one week later (p= 0.041). EO1, NE1, NE2, PLT2/LYM2, LYM1/CRP1 and LYM2/CRP2 were the most predictive indexes. The AUCs of them were; 0.856, 0.778, 0.719, 0.738, 0.747 and 0.702 respectively, the cut-off values were; 0.04, 3.32, 3.21, 144,59, 1.99 and 7.84 respectively, the sensitivity and specificity were 66.7% and 93.3% for EO1; 53.3% and 93.3% for NE1; 46.7% and 93.3% for NE2; and 80.1% and 80.5% for PLT2/LYM2; and 100% and 66.7% for LYM1/CRP1and 100% and 53.3% for LYM2/CRP2; respectively. 

Conclusions: Tracking of CBC subsets, particularly Eosinophil, and CBC indexes is helpful in the early screening, diagnosis, treatment and follow up of critical COVID-19 patients.

Anahtar Kelimeler

Covid-19, Diagnosis, Eosinopenia, Lymphopenia, Neutropenia

Kaynakça

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