Can COVID-19 Clinic be Predicted by Biomarkers at First Admission to Hospital?

Öz

Background: Various inflammatory biomarkers have been associated with increased risk of severe disease, termed “cytokine storm,” in COVID-19 patients. In this study, it was aimed to investigate whether there is signi-ficant difference in terms of inflammatory markers suchas lymphocyte count, CRP, sedimentation, ferritin, gender and age between the patients who recovered and died. Materials and Methods: In our study, we used routine laboratory test results from patients in diagnosis and treatment process between 03.04.2020-31.12.2020. We investigated CRP, sedimentation, fibrinogen, ferritin, troponin-I, D-dimer and hemogram parameters retrospectively. We searched for statistical significance based on the parameters in the first admission blood. Results: Which included 213 patients with positive PCR test, 83 died from COVID-19-related causes, while the others were discharged. Except for the platelet counts, we found a statistically significant difference in the others. These tests were higher in patients who died at the time of first presentation. The biomarkers with the best performance in predicting ROC curve survival were Troponin-I, CRP, Ferritin, Neutrophil, and D-dimer. There was a significant difference in favor of males in mortality rates by gender. When the patients are exami-ned, it can be said that mortality increases with age. Conclusions: The COVID-19 pandemic has been a global disaster with high complication, mortality and more economic impact. In this process, cost-effective and appropriate indicators were needed to simplify the diag-nostic process and assess disease severity. Recent studies showed how biomarkers could change with COVID-19 severity. These results can be used as an aid in clinical practice to determine treatment, guide ICU admis-sion, and predict clinical course. Troponin-I, CRP, D-dimer, LDH and are interesting biomarkers that can be used for short-term risk stratification of patients admitted with COVID-19. More research on the prognostic value of biomarkers is needed to increase reliability and reproducibility.

Anahtar Kelimeler

• covid-19
• biyobelirteç
• troponin-ı
• crp
• d-dimer

Hastaneye İlk Başvurudaki Biyobelirteçlerle COVID-19 Kliniği Tahmin Edilebilir mi?

Öz

Amaç: COVID-19 hastalarında çeşitli enflamatuvar biyobelirteçlerin artmış seviyeleri bulunmuştur ve “sitokin fırtınası” olarak adlandırılan şiddetli hastalık riski ile ilişkilendirilmiştir. Bu çalışmada iyileşen ve ölen hastalar arasında lenfosit sayısı, CRP, sedimantasyon, ferritin gibi inflamatuar belirteçler ile cinsiyet ve yaş açısından anlamlı farklılık olup olmadığının araştırılması amaçlanmıştır. Materyal ve metod: Çalışmamızda 03.04.2020-31.12.2020 tarihleri arasında hastalardan teşhis ve tedavi amaçlı istenen rutin laboratuvar sonuçlarını kullandık. Bunlardan CRP, sedimantasyon, fibrinojen, ferritin, troponin-I, D-dimer ve hemogram parametreleri geriye dönük olarak baktık. Başvuru sırasında ilk istenen kandaki paramet-reler temel alınarak istatiksel anlamlılık araştırdık. Bulgular: COVID-19 PCR testi pozitif 213 hastanın olduğu retrospektif çalışmamızda; 83’ü COVID-19’a bağlı nedenlerden hayatını kaybederken, diğerleri iyileşerek taburcu oldu. Trombosit sayısı hariç diğerlerinde istatis-tiksel olarak anlamlı fark tespit ettik. Bu testler ölen hastalarda ilk başvuru anında daha yüksekti. ROC eğrisi sağkalımı tahminlemede; Troponin-I, CRP, Ferritin, Nötrofil ve D-dimer en iyi biyobelirteçlerdi. Cinsiyete göre ölüm oranlarında erkekler lehine anlamlı fark bulduk. Hastaların yaşları incelendiğinde yaşla birlikte mortalite-nin arttığı tespit ettik. Sonuç: COVID-19 pandemisi, yüksek komplikasyon, ölüm oranı ve ekonomik etki ile küresel bir felaket oldu. Bu süreçte teşhisi hızlandırmak ve hastalık şiddetini değerlendirmek için düşük maliyetli, uygun göstergelere ihtiyaç duyuldu. Bugüne kadar yapılan çalışmalar, biyobelirteçlerin COVID-19 hastalık ciddiyetine göre nasıl değişebileceğine dair kanıtlar bulunduğunu göstermektedir. Bu sonuçlar, klinik uygulamada tedaviyi belirlemek, yoğun bakım ünitesine kabulü yönlendirmek ve kliniği tahmin edebilmek için yardımcı olarak kullanılabilir. Troponin-I, CRP, D-dimer, LDH ve COVID-19 ile kabul edilen hastaların kısa vadeli risk sınıflandırması için kullanı-labilecek biyobelirteçlerdir. Güvenilirliği ve tekrarlanabilirliği artırmak için bunların prognoza etkileri üzerine daha fazla araştırma yapılmalıdır.

Anahtar Kelimeler

• covid-19
• biyobelirteç
• troponin-ı
• crp
• d-dimer

Kaynakça

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