The place of age and hematological parameters in hospitalization of pediatric COVID-19 patients

Öz

Objective: To examined the relationship between hematologic parameters and prognosis in patients diagnosed with COVID-19 in the pediatric emergency department. Methods: This study was designed as a retrospective cross-sectional study. A total of 605 patients admitted to the emergency department were analyzed. WBC, lymphocyte, monocyte, neutrophil and platelet counts, hemoglobin, creatinine, albumin and CRP levels were recorded. Neutrophil-lymphocyte ratio (NLR), SII (platelet count × neutrophil count/lymphocyte count), lymphocyte-CRP ratio (LCR), platelet-NLR (P/NLR) and platelet-CRP ratio (P/CRP) were obtained. Cases were classified according to hospitalization status and age groups. Results: A total of 656 pediatric patients were admitted to a tertiary hospital emergency department with COVID-19 rt-PCR positivity.51 patients were excluded. 225 (37.2%) of the patients were hospitalized patients.80.00% of patients under 1 year were hospitalized, whereas 26.9% of the 15-17 age group were hospitalized. WBC levels were significantly higher in hospitalized patients only in the 7-14 age group (p=0.007); lymphocyte and CRP levels were not observed to be significant in terms of hospitalization in any age group. Conclusion: In pediatric patients infected with Covid-19, hospitalization of younger patients was prioritized over all hematologic parameters due to the uncertainty of the process and prognosis at the beginning.

Anahtar Kelimeler

• COVID-19
• hematologic parameters
• hospitalization
• children

Çocuk COVID-19 hastalarının hastaneye yatışında yaş ve hematolojik parametrelerin yeri

Öz

Amaç: Çocuk acil servisinde COVID-19 tanısı alan hastalarda hematolojik parametreler ile prognoz arasındaki ilişkiyi incelemek. Yöntemler: Bu retrospektif kesitsel çalışmada, acil servise başvuran toplam 605 hastanın WBC, lenfosit, monosit, nötrofil ve trombosit sayıları, hemoglobin, kreatinin, albümin ve CRP düzeyleri kaydedildi. Nötrofil-lenfosit oranı (NLR), SII (trombosit sayısı × nötrofil sayısı/lenfosit sayısı), lenfosit-CRP oranı (LCR), trombosit-NLR (P/NLR) ve trombosit-CRP oranı (P/CRP) elde edildi.Vakalar yatış durumları ve yaş gruplarına göre sınıflandırıldı. Bulgular: Acil servisine COVID-19 rt-PCR pozitifliği ile toplam 656 pediatrik hasta başvurdu. 51 hasta çalışma dışı bırakıldı. Hastaların 225'i (%37,2) hastanede yatan hastalardı. 1 yaşın altındaki hastaların %80,00'i hastaneye yatırılırken, 15-17 yaş grubunun %26,9'u hastaneye yatırıldı. WBC düzeyleri sadece 7-14 yaş grubunda hastaneye yatan hastalarda daha yüksek bulunmuş (p=0.007); lenfosit ve CRP düzeyleri hiçbir yaş grubunda hastaneye yatış açısından anlamlı bulunmamıştır. Sonuç: Covid-19 ile enfekte çocuk hastalarda, başlangıçta sürecin ve prognozun belirsizliği nedeniyle küçük hastaların hastaneye yatırılması tüm hematolojik parametrelerden daha öncelikli olmuştur.

Anahtar Kelimeler

• COVID-19
• hastane yatışı
• çocuk
• hematolojik parametreler

Kaynakça

1. 1. Mallapaty S. How do children spread the coronavirus? the science still isn't clear. Nature 2020;581(7807):127e8. https://doi.org/10.1038/d41586-020- 01354-0
2. 2. Bi Q, Wu Y, Mei S, Ye C, Zou X, Zhang Z, et al. Epidemiology and transmission of covid-19 in 391 cases and 1286 of their close contacts in shenzhen, China: a retrospective cohort study. Lancet Infect Dis 2020. https://doi.org/10.1016/S1473-3099(20)30287-5.
3. 3. Radia T, Williams N, Agrawal P, Harman K, Weale J, Cook J,et al. Multi-system inflammatory syndrome in children & adolescents (MIS-C): A systematic review of clinical features and presentation. Paediatr Respir Rev. 2021 Jun;38:51-57. doi: 10.1016/j.prrv.2020.08.001.
4. 4. Curbelo J, Luquero Bueno S, Galván-Román JM, Ortega-Gómez M, Rajas O, FernándezJiménez G, et al. Inflammation biomarkers in blood as mortality predictors in communityacquired pneumonia admitted patients: Importance of comparison with neutrophil count percentage or neutrophil-lymphocyte ratio. PLoS One. 2017 Mar 16;12(3):e0173947. doi: 10.1371/journal.pone.0173947. Erratum in: PLoS One. 2019 Feb 22;14(2):e0212915.
5. 5. Peng J, Qi D, Yuan G, Deng X, Mei Y, Feng L, et al. Diagnostic value of peripheral hematologic markers for coronavirus disease 2019 (COVID-19): A multicenter, crosssectional study. J Clin Lab Anal. 2020 Oct;34(10):e23475. doi: 10.1002/jcla.23475.
6. 6. Guner Ozenen G, Sahbudak Bal Z, Umit Z, Bilen NM, Yildirim Arslan S, Yurtseven A, el al. Demographic, clinical, and laboratory features of COVID-19 in children: The role of mean platelet volume in predicting hospitalization and severity. J Med Virol. 2021 May;93(5):3227- 3237. doi: 10.1002/jmv.26902.
7. 7. Alkan G, Sert A, Emiroglu M, Tuter Oz SK, Vatansev H. Evaluation of hematological parameters and inflammatory markers in children with COVID-19. Ir J Med Sci. 2022 Aug;191(4):1725-1733. doi: 10.1007/s11845- 021-02762-5.
8. 8. Milenkovic J, Djindjic B, Djordjevic B, Stojiljkovic V, Stojanovic D, Petrovic S, et al. Platelet-derived immuno inflammatory indices show best performance in early prediction of COVID-19 progression. J Clin Lab Anal. 2022 Sep;36(9):e24652. doi: 10.1002/jcla.24652.

9. 9. Karbuz A, Akkoc G, Bedir Demirdag T, Yilmaz Ciftdogan D, Ozer A, Cakir D, et al. Epidemiological, Clinical, and Laboratory Features of Children With COVID-19 in Turkey. Front Pediatr. 2021 May 7;9:631547. doi:10.3389/fped.2021.631547.
10. 10. Ding Y, Yan H, Guo W. Clinical Characteristics of Children With COVID-19: A Meta-Analysis. Front Pediatr. 2020 Jul 3;8:431. doi:10.3389/fped.2020.00431.