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Koroner arter hastalığı tanısı alan COVID-19 hastalarında hastane içi mortalite ile inflamasyon belirteçleri arasındaki ilişki

Yıl 2021, Cilt 11, Sayı 3, 267 - 271, 24.05.2021
https://doi.org/10.16899/jcm.869095

Öz

Giriş: Enflamasyon, koroner arter hastalıklarının temelinde ve olumsuz sonlanımlarında önemli rol oynar. Nötrofil-lenfosit oranı (NLR), sistemik immün inflamasyon indeksi (SII) ve CRP ise inflamatuar durumu yansıtan basit ve kullanışlı belirteçlerdir. Çalışmamızın amacı bu belirteçlerin koroner arter hastalığı tanılı COVID-19 hastalarında hastane içi mortaliteyi öngörmede kullanılabilirliğini değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışmamız 111 (48 erkek, 63 kadın) yeni tanı COVID-19 hastasından oluşuyordu. Nötrofil (N), lenfosit (L) değerleri kullanılarak NLR (N/L) ve N,L ve trombosit (P) değerleri kullanılarak sistemik immün inflamasyon indeksi SII (NxP / L) elde edildi. NLR, SII ve CRP değerlerinin hastane içi mortaliteyle olan ilişkileri incelendi. Bulgular: Tedavi sürecinde 16 hastada ölüm izlendi. N, L ve P değerleri hayatını kaybenler ve şifa ile taburcu olan grup arasında kıyaslandığında istatiksel farklılıklar izlenmedi ( p= 0.971, p=0.256, p=0.759 sırasıyla). Bunların kombinasyonu ile elde edilen SII ve NLR değerleri içinde gruplar arasında istatiksel farklılıklar izlenmezken (p=0.872, p=0.979 sırasıyla), CRP değerlerinde ise hastane içi ölüm izlenen grupta istatiksel anlamlıydı (p<0.001). Logistik regresyon analizinde, CRP’nin (odds oranı [OO]= 1.078 ,%95 güven aralığı [GA]: 1.0225-1.133, p= 0.003) hastane içi mortaliteyle ilşkili olduğu gösterildi. ROC analizinde hastane içi mortaliteyi tahmin etmede CRP için 3.1 mg/dL kestirim değerleri %87 hassasiyet ve %58 özgüllük ile anlamlı bulundu (p<0.001). Sonuç: Koroner girişim öyküsü olan koroner arter hastalığı tanılı COVID-19 hastalarında CRP seviyeleri hastane içi ölümle ilişkilidir.

Kaynakça

  • Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-73.
  • Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506. Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, et al. The SOFA (Sepsis-related organ failure assessment) score to describe organ dysfunction/failure. On be- half of the working group on Sepsis-related problems of the European society of intensive care medicine. Intensive Care Med. 1996;22:707-10.
  • Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844-47.
  • Gupta R, Joshi P, Mohan V, Reddy KS, Yusuf S. Epidemiology and causation of coronary heart disease and stroke in India. Heart 2008;94:16–26.
  • Habib SS, Kurdi MI, Aseri ZA, Suriya MO. CRP levels are higher in patients with ST elevation than non-ST elevation acute coronary syndrome. Arq Bras Cardiol 2011;961:13–7.
  • Baiyewu O, Elugbadebo O, Oshodi Y. Burden of COVID-19 on mental health of older adults in a fragile healthcare system: the case of Nigeria: dealing with inequalities and inadequacies. Int Psychogeriatr. 2020;32(10):1181-85.
  • Hussain A, Bhowmik B, do Vale Moreira NC. COVID-19 and diabetes: Knowledge in progress. Diabetes Res Clin Pract. 2020;162:108142.
  • Schiffrin EL, Flack JM, Ito S, Muntner P, Webb RC. Hypertension and COVID-19. Am J Hypertens. 2020;33(5):373-74.
  • Villa E, Saccocci M, Messina A, Maffeo D, Pitì A, Bianchetti F, et al. COVID-19 e coronaropatia: uso selettivo e collaborativo delle risorse durante le crisi sanitarie [COVID-19 and coronary artery disease: selective and collaborative use of resources during public health crisis]. G Ital Cardiol (Rome). 2020;21(5):360-63.
  • Swiatkiewicz I, Kozinski M, Magielski P, Fabiszak T, Sukiennik EP, Navarese EP, et al. Value of CRP in predicting left ventricular remodeling in patients with a first ST-segment elevation myocar- dial infarction. Mediators Inflamm 2012;2012:250867.
  • Dursun I, Kul S, Bayraktar A, Erkan H, Turan T, Sayin MR, et al. Association of Aortic Valve Sclerosis and Clinical Factors in Patients With Acute Myocardial Infarction. Am J Med Sci. 2019;357(6):474-82.
  • Luo F, Feng C, Zhuo C. C-Reactive Protein and All-Cause Mortality in Patients with Stable Coronary Artery Disease: A Secondary Analysis Based on a Retrospective Cohort Study. Med Sci Monit. 2019;25:9820-28.
  • Yang Y, Xu Y, Wang J, Zhai X, Jiang H. Predictive efficacy of neutrophil-to-lymphocyte ratio for long-term prognosis in new onset acute coronary syndrome: a retrospective cohort study. BMC Cardiovasc Disord. 2020;20(1):500.
  • Chen JH, Zhai ET, Yuan YJ, Wu KM, Xu JB, Peng JJ, et al. Systemic immune-inflammation index for predicting prognosis of colorectal cancer. World J Gastroenterol. 2017;23(34):6261-272.
  • Yang, X., Yang, Q., Wang, Y., Wu, Y., Xu, J., Yu, Y, et al. Thrombocytopenia and its association with mortality in patients with COVID-19. J Thromb Haemost. 2020;18(6):1469-72. Xu P, Zhou Q, Xu J. Mechanism of thrombocytopenia in COVID-19 patients. Ann Hematol. 2020;99(6):1205-08.

Relationship between in-hospital mortality and inflammation markers in COVID-19 patients with the diagnosis of coronary artery disease

Yıl 2021, Cilt 11, Sayı 3, 267 - 271, 24.05.2021
https://doi.org/10.16899/jcm.869095

Öz

Introduction: Inflammation plays an important role in the basis of coronary artery diseases and their adverse outcomes. Neutrophil-lymphocyte ratio (NLR), Systemic Immune Inflammation Index (SII) and C-reactive protein (CRP) are simple and useful markers that reflect the inflammatory state. Our study evaluated the usability of these markers in predicting in-hospital mortality in patients with COVID-19 with the diagnosis of coronary artery disease. Material and Method: Our study population consisted of 111 (48 male, 63 female) newly diagnosed patients with COVID-19. Neutrophil-lymphocyte ratio (NLR) was estimated using neutrophil (N), and lymphocyte (L) counts and the systemic immune inflammation index SII (NxP / L) was calculated using N, L and platelet (P) values. The relationship of NLR, SII and CRP values with in-hospital mortality was investigated. Results: During the treatment process, 16 patients exited. Any statistically significant intergroup difference was not observed as for SII and NLR values obtained by their use in combination (p = 0.872, p = 0.979, respectively), CRP values were statistically significant in the group with in-hospital mortality (p <0.001). In logistic regression analysis, CRP (odds ratio [OR] = 1.078, 95% confidence interval [CI]: 1.0225-1.133, p = 0.003) was associated with in-hospital mortality. In ROC analysis, the cut-off values of 3.1 mg / dL, for CRP were significant with 87% sensitivity and 58% specificity in predicting in-hospital mortality (p <0.001). Conclusions: CRP levels are associated with in-hospital mortality in patients with COVID-19 who had also received coronary artery disease with a history of coronary intervention.

Kaynakça

  • Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-73.
  • Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506. Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, et al. The SOFA (Sepsis-related organ failure assessment) score to describe organ dysfunction/failure. On be- half of the working group on Sepsis-related problems of the European society of intensive care medicine. Intensive Care Med. 1996;22:707-10.
  • Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844-47.
  • Gupta R, Joshi P, Mohan V, Reddy KS, Yusuf S. Epidemiology and causation of coronary heart disease and stroke in India. Heart 2008;94:16–26.
  • Habib SS, Kurdi MI, Aseri ZA, Suriya MO. CRP levels are higher in patients with ST elevation than non-ST elevation acute coronary syndrome. Arq Bras Cardiol 2011;961:13–7.
  • Baiyewu O, Elugbadebo O, Oshodi Y. Burden of COVID-19 on mental health of older adults in a fragile healthcare system: the case of Nigeria: dealing with inequalities and inadequacies. Int Psychogeriatr. 2020;32(10):1181-85.
  • Hussain A, Bhowmik B, do Vale Moreira NC. COVID-19 and diabetes: Knowledge in progress. Diabetes Res Clin Pract. 2020;162:108142.
  • Schiffrin EL, Flack JM, Ito S, Muntner P, Webb RC. Hypertension and COVID-19. Am J Hypertens. 2020;33(5):373-74.
  • Villa E, Saccocci M, Messina A, Maffeo D, Pitì A, Bianchetti F, et al. COVID-19 e coronaropatia: uso selettivo e collaborativo delle risorse durante le crisi sanitarie [COVID-19 and coronary artery disease: selective and collaborative use of resources during public health crisis]. G Ital Cardiol (Rome). 2020;21(5):360-63.
  • Swiatkiewicz I, Kozinski M, Magielski P, Fabiszak T, Sukiennik EP, Navarese EP, et al. Value of CRP in predicting left ventricular remodeling in patients with a first ST-segment elevation myocar- dial infarction. Mediators Inflamm 2012;2012:250867.
  • Dursun I, Kul S, Bayraktar A, Erkan H, Turan T, Sayin MR, et al. Association of Aortic Valve Sclerosis and Clinical Factors in Patients With Acute Myocardial Infarction. Am J Med Sci. 2019;357(6):474-82.
  • Luo F, Feng C, Zhuo C. C-Reactive Protein and All-Cause Mortality in Patients with Stable Coronary Artery Disease: A Secondary Analysis Based on a Retrospective Cohort Study. Med Sci Monit. 2019;25:9820-28.
  • Yang Y, Xu Y, Wang J, Zhai X, Jiang H. Predictive efficacy of neutrophil-to-lymphocyte ratio for long-term prognosis in new onset acute coronary syndrome: a retrospective cohort study. BMC Cardiovasc Disord. 2020;20(1):500.
  • Chen JH, Zhai ET, Yuan YJ, Wu KM, Xu JB, Peng JJ, et al. Systemic immune-inflammation index for predicting prognosis of colorectal cancer. World J Gastroenterol. 2017;23(34):6261-272.
  • Yang, X., Yang, Q., Wang, Y., Wu, Y., Xu, J., Yu, Y, et al. Thrombocytopenia and its association with mortality in patients with COVID-19. J Thromb Haemost. 2020;18(6):1469-72. Xu P, Zhou Q, Xu J. Mechanism of thrombocytopenia in COVID-19 patients. Ann Hematol. 2020;99(6):1205-08.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Orjinal Araştırma
Yazarlar

Uğur KÜÇÜK (Sorumlu Yazar)
ÇANAKKALE ONSEKİZ MART ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, KARDİYOLOJİ ANABİLİM DALI
0000-0003-4669-7387
Türkiye


Sevil ALKAN ÇEVİKER
ÇANAKKALE ONSEKİZ MART ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ENFEKSİYON HASTALIKLARI VE KLİNİK MİKROBİYOLOJİ ANABİLİM DALI
0000-0003-1944-2477
Türkiye


Alper ŞENER
ÇANAKKALE ONSEKİZ MART ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ENFEKSİYON HASTALIKLARI VE KLİNİK MİKROBİYOLOJİ ANABİLİM DALI
0000-0003-2774-8601
Türkiye

Yayımlanma Tarihi 24 Mayıs 2021
Kabul Tarihi 18 Şubat 2021
Yayınlandığı Sayı Yıl 2021, Cilt 11, Sayı 3

Kaynak Göster

AMA Küçük U. , Alkan Çeviker S. , Şener A. Relationship between in-hospital mortality and inflammation markers in COVID-19 patients with the diagnosis of coronary artery disease. J Contemp Med. 2021; 11(3): 267-271.