Assessment of Some Biochemistry Parameters in Hospitalized Patients Evaluated with CT and RT-PCR for The Diagnosis of Covid-19

Yıl 2022, Cilt: 11 Sayı: 1, 95 - 104, 19.03.2022

Ayşegül Sümer , Lütfiye Nur Uzun

Öz

Aralık 2019’da Wuhan, Hubei Çin’de arda arda görülen pnömoni vakalarının sebebinin yeni bir tip koronovirus (2019-nCoV) olduğu bildirilmiştir. Bu çalışmada COVID-19 tanısı RT-PCR testi ile doğrulanmış veya BT görüntülemesinde buzlu cam alanları tespit edilmiş hastaların laboratuar bulgularının değerlendirilmesi amaçlanmıştır. Tek merkezli retrospektif olarak planlanan çalışmaya çeşitli dışlama kriterleri ile 51 kişi dahil edilmiştir. Karşılaştırma, RT-PCR testi yapılan, bilgisayarlı akciğer tomografisi yapılan ve sonuçlarına göre dört gruba ayrılan hastaların laboratuvar bulguları ölçülerek yapıldı. Tüm verilere elektronik sağlık kayıtları aracılığıyla erişildi. İstatistiksel analiz yöntemi olarak yüzde ve frekanslara ek olarak Fisher Exact Test, Tek Yönlü ANOVA, Kruskall Wallis Testi, post-hoc düzeltilmiş Bonferonni testi kullanıldı. Laboratuvar bulgularında WBC, NEU, EOS, Protrombin zamanı, INR ve Troponin seviyelerinde COVID-19 lehine önemli veriler elde edildi. Hastanın kliniğe kabulünde laboratuvar bulgularının ön tanı olarak kullanılabileceği, ayrıca hastalığın klinik şiddetini belirlemeye ve prognozu öngörmeye yardımcı olabileceği sonucuna varıldı.

Anahtar Kelimeler

covid 19, Klinik özellikler, laboratuvar bulguları

Assessment of Some Biochemistry Parameters in Hospitalized Patients Evaluated with CT and RT-PCR for The Diagnosis of Covid-19

Öz

It was reported that a new type of coronavirus (2019-nCoV) was the cause of repeated pneumonia cases in Wuhan, Hubei Province, China in December 2019. The aim of this study was to evaluate the laboratory results of the patients diagnosed with COVID-19 as confirmed by RT-PCR test or presence of ground-glass opacities on CT imaging. 51 people with various exclusion criteria were included in the single-center study planned retrospectively. Comparison was made by measuring the laboratory findings of the patients who underwent RT-PCR test, who underwent computed lung tomography and who were divided into four groups according to their results. All data were accessed via electronic health records. Fisher Exact Test, One Way ANOVA, Kruskall Wallis Test were used as statistical analysis method in addition to percentages and frequencies and adjusted Bonferonni test were used for post-hoc analysis. In laboratory findings, significant data were obtained in favor of COVID-19 at WBC, NEU, EOS, Prothrombin time, INR and Troponin levels. It was concluded that laboratory findings can be used as a preliminary diagnosis in the admission of the patient to the clinic, and also help to determine the clinical severity of the disease and predict the prognosis.

Anahtar Kelimeler

covid 19, Clinical characteristics, Laboratory findings

Kaynakça

• 1. Zhou, P, Yang, X.L, Wang, X.G, Hu, B, Zhang, L, Zhang, W, Si, H.R, Zhu, Y, Li, B, Huang, C.L, Chen, H.D, Chen, J, Luo, Y, Guo, H, Jiang, R.D, Liu, M.Q, Chen, Y, Shen, R.S, Wang, X, Zheng, X.S, Zhao, K, Chen, Q.J, Deng, F, Liu, L.L, Yang, B, Zhan, F.X, Wang, Y.Y, Xiao, G.F. and Shi, Z.L. (2020). "A Pneumonia Outbreak Associated with a New Coronavirus of Probable Bat Origin". Nature, 579, 270-273. doi: 10.1038/s41586-020-2012-7.
• 2. Zhu, N, Zhang, D, Wang, W, Li, X, Yang, B, Song, J, Zhao, X, Huang, B, Shi, W, Lu, R, Niu, P, Zhan, F, Ma, X, Wang, D, Xu, W, Wu, G, Gao, G.F. and Tan, W. (2020). "A Novel Coronavirus from Patients with Pneumonia in China, 2019". N Engl J Med, 382 (8), 727-733. Doi: 10.1056/NEJMoa2001017.
• 3. Huang, C, Wang, Y, Li, X, Ren, L, Zhao, J, Hu, Y, Zhang, L, Fan, G, Xu, J, Gu, X, Cheng, Z, Yu, T, Xia, J, Wei, Y, Wu, W, Xie, X, Yin, W, Li, H, Liu, M, Xiao, Y, Gao, H, Guo, L, Xie, J, Wang, G, Jiang, R, Gao, Z, Jin, Q, Wang, J. and Cao, B. (2020). "Clinical Features of Patients Infected with 2019 Novel Coronavirus in Wuhan, China". Lancet, 395, 497-506. doi: 10.1016/S0140-6736(20)30183-5.
• 4. Wu, Y, Ho, W, Huang, Y, Jin, D.Y, Li, S, Liu, S.L, Liu, X, Qiu, J, Sang, Y, Wang, Q, Yuen, K.Y. and Zheng, Z.M. (2020). "SARS-CoV-2 is an Appropriate Name for the New Coronavirus". Lancet, 395 (10228), 949-950. doi: 10.1016/ S0140-6736(20)30557-2.
• 5. Xiao, S, Wu, Y. and Liu, H. (2020). "Evolving Status of the 2019 Novel Coronavirus Infection: Proposal of Conventional Serologic Assays for Disease Diagnosis and Infection Monitoring". J Med Virol, 92, 464-467. doi: 10.1002/jmv.25702.
• 6. Plaçais, L. and Richier, Q. (2020). "COVID-19: Clinical, Biological and Radiological Characteristics in Adults, Infants and Pregnant Women. An Up-To-Date Review at the Heart of the Pandemic". La Rev Med Interne, 41 (5), 308-318. doi: 10.1016/j.revmed.2020.04.004.
• 7. Zhou, F, Yu, T, Du, R, Fan, G, Liu, Y, Liu, Z, Xiang, J, Wang, Y, Song, B, Gu, X, Guan, L, Wei, Y, Li, H, Wu, X, Xu, J, Tu, S, Zhang, Y, Chen, H. and Cao, B. (2020). "Clinical Course and Risk Factors for Mortality of Adult Inpatients with COVID-19 in Wuhan, China: A Retrospective Cohort Study". Lancet, 8, 395 (10229), 1054-1062. doi: 10.1016/S0140-6736(20)30566-3.
• 8. Ai, T, Yang, Z, Hou, H, Zhan, C, Chen, C, Lv, W, Tao, Q, Sun, Z. and Xia, L. (2020). "Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases". Radiology, 296 (2), 32-40. doi: 10.1148/radiol.2020200642.
• 9. Li, R, Tian, J, Yang, F, Lv, L, Yu, J, Sun, G, Ma, Y, Yang, X. and Ding, J. (2020) "Clinical Characteristics of 225 Patients with COVID-19 in a Tertiary Hospital Near Wuhan, China". J Clin Virol, 127, 104363. doi: 10.1016/j.jcv.2020.104363.
• 10. Şit, D. ve Kayabaşı, H. (2020). "SARS-CoV-2 ile İlişkili Akut Böbrek Hasarı". Dicle Tıp Derg, 47 (2), 498-507. doi: 10.5798/dicletip.755786.
• 11. Wu, C, Chen, X, Cai, Y, Xia, J, Zhou, X, Xu, S, Huang, H, Zhang, L, Zhou, X, Du, C, Zhang, Y, Song, J, Wang, S, Chao, Y, Yang, Z, Xu,J, Zhou, X, Chen, D, Xiong, W, Xu, L, Zhou, F, Jiang, J, Bai, C, Zheng, J. and Song, Y. (2020). "Risk Factors Associated with Acute Respiratory Distress Syndrome and Death in Patients with Coronavirus Disease 2019 Pneumonia in Wuhan, China". JAMA Intern Med, 180 (7), 934-943. Doi: 10.1001/jamainternmed.2020.0994.
• 12. Chen, N, Zhou, M, Dong, X, Qu, J, Gong, F, Han, Y, Qiu, Y, Wang, J, Liu, Y, Wei Y, Xia, J, Yu, T, Zhang, X. and Zhang, L. (2020). "Epidemiological and Clinical Characteristics of 99 Cases of 2019 Novel Coronavirus Pneumonia in Wuhan, China: a Descriptive Study". Lancet, 395 (10223), 507-513. doi: 10.1016/S0140-6736(20)30211-7.
• 13. Li, Y, Yao, L, Li, J, Chen L, Song, Y, Cai, Z. and Yang, C. (2020). "Stability Issues of RT‐PCR Testing of SARS‐CoV‐2 for Hospitalized Patients Clinically Diagnosed with COVID‐19". J Med Virol, 92 (7), 903-908. doi: 10.1002/jmv.25786.
• 14. Merza, M.A, Al Mezori, A.A.H, Mohammed, H.M. and Abdulah, D.M. (2020). COVID-19 Outbreak in Iraqi Kurdistan: The First Report Characterizing Epidemiological, Clinical, Laboratory, and Radiological Findings of the Disease". Diabetes Metab Syndr Clin Res Rev, 14 (4), 547-554. doi: 10.1016/j.dsx.2020.04.047.
• 15. Zhang, G, Zhang, J, Wang, B, Zhu, X, Wang, Q. and Qiu, S. (2020). "Analysis of Clinical Characteristics and Laboratory Findings of 95 Cases of 2019 Novel Coronavirus Pneumonia in Wuhan, China: A Retrospective Analysis". Respir Res, 21 (1), 1-10. doi: 10.1186/s12931-020-01338-8.
• 16. Wei, X, Zeng, W, Su, J, Wan, H, Yu, X, Cao, X, Tan, W. and Wang, H. (2020). "Hypolipidemia is Associated with the Severity of COVID-19". J Clin Lipidol, 14 (3), 297-304. doi: 10.1016/j.jacl.2020.04.008.
• 17. Xu, B, Fan, C, Wang, A, Zou, Y, Yu, Y, He, C, Xia, W, Zhang, J. and Miao, Q. (2020). "Suppressed T Cell-Mediated İmmunity in Patients with COVID-19: A Clinical Retrospective Study in Wuhan, China". J Infect, 81 (1), 51-60. doi: 0.1016/j.jinf.2020.04.012.
• 18. Ferrari, D, Motta, A, Strollo, M, Banfi, G. and Locatelli, M. (2020). "Routine Blood Tests as a Potential Diagnostic Tool for COVID-19". Clin Chem Lab Med, 58 (7), 1095-1099. Doi: 10.1515/cclm-2020-0398.
• 19. Lu, G. and Wang, J. (2020). "Dynamic Changes in Routine Blood Parameters of a Severe COVID-19 Case". Clin Chim Acta, 508, 98-102. doi: 10.1016/j.cca.2020.04.034.
• 20. Feldman, C. and Anderson, R. (2021). "The Role of Co-Infections and Secondary Iinfections in Patients with COVID-19". Pneumonia, 13 (1), 1-15. doi: 10.1186/s41479-021-00083-w.
• 21. Kermali, M, Khalsa, R.K, Pillai, K, Ismail, Z. and Harky, A. (2020). "The Role of Biomarkers in Diagnosis of COVID-19–A Systematic Review". Life Sci, 254, 117788. doi: 10.1016/j.lfs.2020.117788.
• 22. Qin, C, Zhou, L, Hu, Z, Zhang, S, Yang, S, Tao, Y, Xie, C, Ma, K, Shang, K, Wang, W. and Tian, D.S. (2020). "Dysregulation of Immune Response in Patients with COVID-19 in Wuhan, China". Clin Infect Dis, 71 (15), 762-768.
• 23. Jin, A, Yan, B, Hua, W, Feng, D, Xu, B, Liang, L. and Guo, C. (2020). "Clinical Characteristics of Patients Diagnosed with COVID-19 in Beijing". Biosaf Health, 2 (2), 104-111. doi: 10.1016/j.bsheal.2020.05.003.
• 24. Mardani, R, Vasmehjani, A.A, Zali, F, Gholami, A. Nasab, S.D.M, Kaghazian, H, Kaviani, M. and Ahmadi, N. (2020). "Laboratory Parameters in Detection of COVID-19 Patients with Positive RT-PCR; A Diagnostic Accuracy Study". Arch Acad Emerg Med, 8 (1), e43.
• 25. Cheng, Y, Luo, R, Wang, K, Zhang, M, Wang, Z, Dong, L, Li, J, Yao, Y, Ge, S. and Xu, G. (2020). "Kidney Disease is Associated with In-hospital Death of Patients with COVID-19". Kidney Int. Kidney Int, 97 (5), 829-838. doi: 10.1016/j.kint.2020.03.005.
• 26. Xiang, Y.T, Yang, Y, Li, W, Zhang, L, Zhang, Q, Cheung, T. and Ng, C. (2020). "Timely Mental Health Care for the 2019 Novel Coronavirus Outbreak is Urgently Needed". The Lancet Psychiatry, 7 (3), 228-229. doi: 10.1016/S2215-0366(20)30046-8.
• 27. Velavan T.P. and Meyer C.G. (2020). "The COVID‐19 Epidemic". Trop Med Int Heal, 25 (3), 278. doi: 10.1111/tmi.13383.
• 28. Shi, S, Qin, M, Shen, B, Cai, Y, Liu, T, Yang, F, Gong, W, Liu, X, Liang, J, Zhao, Q, Huang, H, Yang, B. and Huang, C. (2020). "Association of Cardiac Injury with Mortality in Hospitalized Patients with COVID-19 in Wuhan, China". JAMA Cardiol, 5 (7), 802- 810. doi: 10.1001/jamacardio.2020.0950.