Klinik Araştırma
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COVID-19 Hastalarında Hemoglobin Seviyeleri ve Yoğun Bakım Mortalitesi Arasındaki İlişki

Yıl 2022, Cilt: 12 Sayı: 5, 660 - 664, 30.09.2022
https://doi.org/10.16899/jcm.1079769

Öz

Amaç: Bu çalışmanın amacı, hemoglobin seviyelerinin, COVID-19 hastalarında mortaliteyi ön görmede etkili olup olmadığının araştırılmasıdır.
Gereç ve Yöntem: Bu retrospektif çalışmaya yoğun bakımda takip edilen 156 COVID-19 hastası dahil edildi. Demografik özellikleri, klinik verileri ve laboratuar bulguları kaydedildi.
Bulgular: Anemi grubu ve normal hemoglobin değerleri olan grubun başvuru esnasındaki ortalama yaş, cinsiyet oranları, komorbiditeleri, semptomları, ortalama APACHE-2 ve SOFA değerleri arasında anlamlı fark yoktu. Normal hemoglobin değerleri olan grubun ortalama lenfosit ve laktat değerleri istatiksel olarak anlamlı düzeyde yüksek bulundu (p<0,05). Anemi grubunda ise ortalama prokalsitonin ve D-dimer değerleri anlamlı düzeyde yüksek bulundu (p<0,05). COVID-19 hastalığının ağırlığı mekanik ventilasyon ihtiyacı, inotropik ajan ve renal replasman tedavisi ihtiyacı yanı sıra Akut Respiratuar Distres Sendrom (ARDS), akut böbrek yetmezliği (ABY) ve çoklu organ yetmezliği gelişimi ile değerlendirildi. Hasta sonuçları yoğun bakımda kalış süresi ve yoğun bakım mortalitesi olarak belirlendi. COVID-19 hastalığının ağırlığını belirleyen parametreler ve hasta sonuçları açısından anemi grubu ve normal grup arasında anlamlı fark bulunmadı. Ancak başvuru esnasındaki ve yoğun bakımın son günündeki hemoglobin seviyeleri ölen grupta sağkalanlara göre anlamlı olarak düşük tespit edildi (p<0,05).
Sonuç: Bu çalışmada, ölen COVID-19 hastalarında hemoglobin seviyeleri daha düşük bulundu. Bununla birlikte anemi ve mortalite arasında anlamlı bir ilişki saptanmadı. COVID-19 hastalarında hemoglobin seviyelerinin mortaliteye etkisinin değerlendirilmesi için daha ileri çalışmalara ihtiyaç vardır.

Kaynakça

  • Dae-Gyun A, Hye-Jin S, Mi-Hwa K, et al. Status of Epidemiology, Diagnosis, Therapeutics, and Vaccines for Novel Coronavirus Disease 2019 (COVID-19) J. Microbiol Biotechnol 2020;30:313–24
  • Borges do Nascimento IJ, Cacic N, Abdulazeem HM, et al. Novel Coronavirus infection (COVID-19) in humans: a scoping review and meta-analysis. J Clin Med 2020;9:E941.
  • Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study.Lancet 2020; 395:507513.
  • Sharon EF, Aibek A, Jack LH, et al. Pulmonary and cardiac pathology in African American patients with COVID-19: an autopsy series from New Orleans Lancet Respir Med 2020;8:681–6.
  • Gattinoni L, Coppola S, Cressoni M, et al. Covid-19 Does not lead to a "Typical" acute respiratory distress syndrome. Am J Respir Crit Care Med 2020;201:1299–300.
  • Lang M, Som A, Mendoza DP, et al. Hypoxaemia related to COVID-19: vascular and perfusion abnormalities on dual-energy CT. Lancet Infect Dis 2020;20:1365-6.
  • Deng YY, Zheng Y, Cai GY, et al. Single-cell RNA sequencing data suggest a role for angiotensin-converting enzyme- 2 in kidney impairment in patients infected with 2019-nCoV, Chin Med J 2020;133:1129-31.
  • Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382:1708-20.
  • Fan BE, Chong VCL, Chan SSW, et al. Hematologic parameters in patients with COVID-19 infection. Am J Hematol 2020;95:E131–4.
  • Petek ET, Sergio AGO, Erand L, et al. Anemia and iron metabolism in COVID-19:a systematic review nd meta-analysis. Eur J Epidemiol 2020;35:763-73
  • Zhe X, Lei S, Yijin W, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndromeLancet Respir Med 2020;8:420-22.
  • Wang Z, Yang B, Li Q, et al., Clinical features of 69 cases with coronavirus disease 2019 in Wuhan, China, Clin Infect Dis 2020;71:769-77.
  • Huang Y, Tu M, Wang S, et al. Clinical characteristics of laboratory confirmed positive cases of SARS-CoV-2 infection in Wuhan, China: A retrospective single center analysis. Travel Med Infect Dis 2020;36:101606.
  • Wang L, Duan Y, Zhang W, et al. Epidemiologic and clinical characteristics of 26 cases of COVID-19 arising from patient-to-patient transmission in Liaocheng. China Clin Epidemiol 2020;12:387–91.
  • Xu T, Huang R, Zhu L, et al. Epidemiological and clinical features of asymptomatic patients with SARS-CoV-2 infection. J Med Virol 2020;92:1884-9.
  • Hebert PC, Mc Donald BJ, Tinmouth A. Clinical consequences of anemia and red cell transfusion in the critically ill. Crit Care Clin 2004;20:225-35
  • Kitchens CS. Are transfusions overrated? Surgical outcome of Jehovah’s Witnesses.Kitchen CS. Am J Med 1993;94:117-9.
  • Liu Y, Du X, Chen J, et al. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect 2020;81:6–12.
  • Cai SH, Liao W, Chen SW, et al. Association between obesity and clinical prognosis in patients infected with SARS-CoV-2. Infect Dis Poverty 2020;9:80.
  • Giacomelli A, Ridolfo AL, Milazzo L, et al. 30-day mortality in patients hospitalized with COVID-19 during the first wave of the Italian epidemic: a prospective cohort study. Pharmacol Res 2020;158:104931.
  • Cen Y, Chen X, Shen Y, et al. Risk factors for disease progression in patients with mild to moderate coronavirus disease 2019-a multi-centre observational study. Clin Microbiol Infect 2020;26(9):1242-7.

The Relationship Between Hemoglobin Levels and Intensive Care Mortality in COVID-19 Patients

Yıl 2022, Cilt: 12 Sayı: 5, 660 - 664, 30.09.2022
https://doi.org/10.16899/jcm.1079769

Öz

Objective: We aimed to investigate whether hemoglobin levels in COVID-19 patients can serve as a valuable predictor of mortality.
Material and Method: This retrospective study included 156 COVID-19 cases who were admitted to the intensive care unit (ICU), demographic characteristics, clinical data, and laboratory findings were recorded.
Results: There are no significant differences in mean age, gender ratio, comorbidities, symptoms, mean APACHE-2, and SOFA values upon admission observed between the anemic and normal groups. The normal hemoglobin (Hgb) group’s mean lymphocyte and lactate values were statistically high(p<0.05), and mean procalcitonin and D-dimer values were high in the anemic group (p<0.05). The severity of COVID-19 in patients was evaluated by the requirement of mechanical ventilation, inotropic agents, and renal replacement treatments as well as the development of acute respiratory distress syndrome (ARDS), acute renal failure (ARF), and multiple organ failure (MOF). Patient outcomes were lengths of ICU stays and ICU mortality. No significant difference was observed in any of the severity parameters or outcomes between the anemic and normal groups. Hemoglobin levels upon admission and final ICU days for the non-survivors group were significantly low than for the survivors group (p<0.05).
Conclusions: We found decreased hemoglobin levels in non-surviving COVID-19 patients. However, we could not find a relationship between anemia and mortality. Further trials are needed to evaluate the impact of hemoglobin levels on mortality in COVID-19 patients.

Kaynakça

  • Dae-Gyun A, Hye-Jin S, Mi-Hwa K, et al. Status of Epidemiology, Diagnosis, Therapeutics, and Vaccines for Novel Coronavirus Disease 2019 (COVID-19) J. Microbiol Biotechnol 2020;30:313–24
  • Borges do Nascimento IJ, Cacic N, Abdulazeem HM, et al. Novel Coronavirus infection (COVID-19) in humans: a scoping review and meta-analysis. J Clin Med 2020;9:E941.
  • Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study.Lancet 2020; 395:507513.
  • Sharon EF, Aibek A, Jack LH, et al. Pulmonary and cardiac pathology in African American patients with COVID-19: an autopsy series from New Orleans Lancet Respir Med 2020;8:681–6.
  • Gattinoni L, Coppola S, Cressoni M, et al. Covid-19 Does not lead to a "Typical" acute respiratory distress syndrome. Am J Respir Crit Care Med 2020;201:1299–300.
  • Lang M, Som A, Mendoza DP, et al. Hypoxaemia related to COVID-19: vascular and perfusion abnormalities on dual-energy CT. Lancet Infect Dis 2020;20:1365-6.
  • Deng YY, Zheng Y, Cai GY, et al. Single-cell RNA sequencing data suggest a role for angiotensin-converting enzyme- 2 in kidney impairment in patients infected with 2019-nCoV, Chin Med J 2020;133:1129-31.
  • Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382:1708-20.
  • Fan BE, Chong VCL, Chan SSW, et al. Hematologic parameters in patients with COVID-19 infection. Am J Hematol 2020;95:E131–4.
  • Petek ET, Sergio AGO, Erand L, et al. Anemia and iron metabolism in COVID-19:a systematic review nd meta-analysis. Eur J Epidemiol 2020;35:763-73
  • Zhe X, Lei S, Yijin W, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndromeLancet Respir Med 2020;8:420-22.
  • Wang Z, Yang B, Li Q, et al., Clinical features of 69 cases with coronavirus disease 2019 in Wuhan, China, Clin Infect Dis 2020;71:769-77.
  • Huang Y, Tu M, Wang S, et al. Clinical characteristics of laboratory confirmed positive cases of SARS-CoV-2 infection in Wuhan, China: A retrospective single center analysis. Travel Med Infect Dis 2020;36:101606.
  • Wang L, Duan Y, Zhang W, et al. Epidemiologic and clinical characteristics of 26 cases of COVID-19 arising from patient-to-patient transmission in Liaocheng. China Clin Epidemiol 2020;12:387–91.
  • Xu T, Huang R, Zhu L, et al. Epidemiological and clinical features of asymptomatic patients with SARS-CoV-2 infection. J Med Virol 2020;92:1884-9.
  • Hebert PC, Mc Donald BJ, Tinmouth A. Clinical consequences of anemia and red cell transfusion in the critically ill. Crit Care Clin 2004;20:225-35
  • Kitchens CS. Are transfusions overrated? Surgical outcome of Jehovah’s Witnesses.Kitchen CS. Am J Med 1993;94:117-9.
  • Liu Y, Du X, Chen J, et al. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect 2020;81:6–12.
  • Cai SH, Liao W, Chen SW, et al. Association between obesity and clinical prognosis in patients infected with SARS-CoV-2. Infect Dis Poverty 2020;9:80.
  • Giacomelli A, Ridolfo AL, Milazzo L, et al. 30-day mortality in patients hospitalized with COVID-19 during the first wave of the Italian epidemic: a prospective cohort study. Pharmacol Res 2020;158:104931.
  • Cen Y, Chen X, Shen Y, et al. Risk factors for disease progression in patients with mild to moderate coronavirus disease 2019-a multi-centre observational study. Clin Microbiol Infect 2020;26(9):1242-7.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Orjinal Araştırma
Yazarlar

Kezban Özmen Süner 0000-0002-9822-4031

Havva Kocayigit 0000-0002-8719-7031

Gürkan Demir 0000-0002-7193-5394

Yakup Tomak 0000-0001-7458-0501

Selcuk Yaylacı 0000-0002-6768-7973

Ali Fuat Erdem 0000-0001-6994-397X

Erken Görünüm Tarihi 11 Temmuz 2022
Yayımlanma Tarihi 30 Eylül 2022
Kabul Tarihi 6 Temmuz 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 12 Sayı: 5

Kaynak Göster

AMA Özmen Süner K, Kocayigit H, Demir G, Tomak Y, Yaylacı S, Erdem AF. The Relationship Between Hemoglobin Levels and Intensive Care Mortality in COVID-19 Patients. J Contemp Med. Eylül 2022;12(5):660-664. doi:10.16899/jcm.1079769