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HEMATOLOGICAL FINDINGS OF CHILDREN DIAGNOSED WITH COVID 19 AND THE DIAGNOSTIC ROLE OF HEMATOLOGICAL INDICES IN THE DIAGNOSIS OF COVID 19

Yıl 2021, Cilt: 22 Sayı: 6, 473 - 478, 18.10.2021
https://doi.org/10.18229/kocatepetip.821471

Öz

OBJECTIVE: The coronavirus-2 (SARS-CoV-2) outbreak, reported in Wuhan, China at the end of 2019, has a clinical picture with acute respiratory failure, currently affecting more than 100 countries. In our study, evaluation of hematological findings of children with COVID-19 positive mild-moderate clinic was performed and the diagnostic role of various hematological indices-leukocyte, neutrophil, monocyte, lymphocyte and platelet counts, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR)- was examined.
MATERIAL AND METHODS: The study included 15 children diagnosed with COVID-19 from nasopharyngeal swab samples by RT-PCR, and a control group of 21 healthy children of similar age and sex. The patients' age, gender, admission complaints, COVID-19 contact history, and first complete blood count parameters were recorded retrospectively from information of the patient files.
RESULTS: The ages of the children diagnosed with COVID-19 (median±SD) were 8.7±5.7 years and the female/male ratio was 8/7, the healthy control group's age (median±SD) was 7.4±2.8 years, and the female/male ratio was 11/10. The most common complaints of patients with positive COVID-19 tests were fever and cough. A statistically significant difference was found between neutrophil, lymphocyte, and NLR between the COVID-19 positive children and the healthy control group (p=0.048, p=0.040, p=0.024, respectively). In the ROC analysis, when the predictive value for NLR is taken as 1.02, it predicts area under the curve (AUC) of 0.724, 95%CI (0.549-0.899), sensitivity 73%, specificity 62% for the diagnosis of COVID-19 in children.
CONCLUSIONS: Abnormalities were detected in hematological parameters and indexes of children diagnosed with COVID-19 compared to healthy controls. The most prominent of these are lymphopenia and an increase in the NLR rate. We think that the evaluation of peripheral blood parameters can be considered as an important reference value in evaluating the prognosis of COVID-19.

Kaynakça

  • 1.Song W, Li J, Zou N, et al. Clinical features of pediatricpatients with coronavirus disease (COVID-19). J Clin Virol. 2020;127:104377.
  • 2. De Rojas T, Pérez-Martínez A, Cela E, et al. COVID-19 infection in children and adolescents with cancer in Madrid. Pediatr Blood Cancer. 2020;67(7):28397.
  • 3. Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr. 2020;109(6):1088-1095.
  • 4. Sankar J, Dhochak N, Kabra SK, et al. COVID-19 in Children: Clinical Approach and Management. Indian J Pediatr. 2020;87(6):433-442.
  • 5. Frater JL, Zini G, d'Onofrio G, et al. COVID-19 and the clinical hematology laboratory. Int J Lab Hematol. 2020;42(1):11-18.
  • 6. Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med. 2020;58(7):1131-1134.
  • 7. Fan BE, Chong VCL, Chan SSW, et al. Hematologic parameters in patients with COVID-19 infection. Am J Hematol. 2020;95(6):131-134.
  • 8. Qin C, Zhou L, Hu Z, Zhang S, et al. Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71(15):762-768.
  • 9. Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis. Clin Chim Acta. 2020;506:145- 148.
  • 10. Lippi G, Plebani M. The critical role of laboratory medicine during coronavirus disease 2019 (COVID-19) and other viral outbreaks. Clin Chem Lab Med. 2020;58(7):1063- 1069.
  • 11. Yang AP, Liu JP, Tao WQ, Li HM. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol. 2020;84:106504.
  • 12. Jiehao C, Jin X, Daojiong L, et al. A Case Series of Children With 2019 Novel Coronavirus Infection: Clinical and Epidemiological Features. Clin Infect Dis. 2020;71(6):1547-1551.
  • 13. Dhochak N, Singhal T, Kabra SK, et al. Pathophysiology of COVID-19: Why Children Fare Better than Adults? Indian J Pediatr. 2020;87(7):537-546.
  • 14. Brodin P. Why is COVID-19 so mild in children? Acta Paediatr. 2020;109(6):1082-1083.
  • 15. Sun S, Cai X, Wang H, et al. Abnormalities of peripheral blood system in patients with COVID-19 in Wenzhou, China. Clin Chim Acta. 2020;507:174-180.
  • 16. Zeng F, Li L, Zeng J, et al. Can we predict the severity of coronavirus disease 2019 with a routine blood test? Pol Arch Intern Med. 2020 29;130(5):400-406.
  • 17. She J, Liu L, Liu W. COVID-19 epidemic: Disease characteristics in children. J Med Virol. 2020;92(7):747-754.
  • 18. Yang Y, Lu Q, Liu M, et al. Epidemiological and clinical features of the 2019 novel coronavirus outbreak in China. Med Rxiv (PrePrint). doi:2020. 10.1101/2020.02.10.20021675.
  • 19. Zheng F, Liao C, Fan QH, et al. Clinical Characteristics of Children with Coronavirus Disease 2019 in Hubei, China. Curr Med Sci. 2020;40(2):275-280.
  • 20. Huang I, Pranata R. Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis. J Intensive Care. 2020;(24):8-36.
  • 21. Xu H, Zhong L, Deng J, Peng J, Dan H, Zeng X, Li T, Chen Q. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci. 2020 24;12(1):8.
  • 22. Chen R, Sang L, Jiang M, et al. Medical Treatment Expert Group for COVID-19. Longitudinal hematologic and immunologic variations associated with the progression of COVID-19 patients in China. J Allergy Clin Immunol. 2020;146(1):89-100.

COVİD 19 TANILI ÇOCUKLARIN HEMATOLOJİK BULGULARI VE COVİD 19 TANISINDA HEMATOLOJİK İNDEKSLERİN TANISAL ROLÜ

Yıl 2021, Cilt: 22 Sayı: 6, 473 - 478, 18.10.2021
https://doi.org/10.18229/kocatepetip.821471

Öz

AMAÇ: Çin’in Wuhan kentinde 2019 yılı sonunda bildirilen koronavirüs 2 (SARS-CoV-2) salgını, şu anda 100’den fazla ülkenin etkilendiği, akut solunum yetmezliği ile giden bir tablodur. Çalışmamızda; COVID-19 pozitif hafif-orta şiddette kliniğe sahip çocukların hematolojik bulgularının değerlendirilmesi ve bu hastalığı öngörmede çeşitli hematolojik indekslerin - lökosit, nötrofil, monosit, lenfosit ve trombosit sayıları, nötrofil/lenfosit oranı (NLR) and platelet/lenfosit oranı (PLR), monosit/lenfosit oranı (MLR)- diagnostik rolü araştılmıştır.
GEREÇ VE YÖNTEM: Çalışmaya nazofarengeal sürüntü örneklerinden RT-PCR ile COVID-19 tanısı konulan 15 çocuk ile benzer yaş ve cinsiyette 21 sağlıklı çocuktan oluşan kontrol grubu alındı. Hastaların dosya bilgilerinden retrospektif olarak yaşları, cinsiyetleri, başvuru şikayetleri, COVID-19 temas öyküsü, başvurularında alınan ilk tam kan sayımı parametreleri kayıt edildi.
BULGULAR: COVID-19 tanısı konulan çocukların yaşları (median±SD) 8.7±5.7 yıl ve kız/erkek oranı 8/7, sağlıklı kontrol grubunun yaşları (median±SD) 7.4±2.8 yıl ve kız/erkek oranı 11/10 idi. COVID-19 testi pozitif saptanan hastaların en sık başvuru şikayeti ateş ve öksürüktü. COVID-19 pozitif çocuklarla sağlıklı kontrol grup arasında nötrofil, lenfosit ve NLR arasında istatistiksel anlamlı fark tespit edildi (p=0.048, p=0.040, p =0.024, sırasıyla). ROC analizinde, NLR için kestirim değeri 1.02 alındığında eğri altındaki alan (AUC) of 0.724, %95 CI (0,549-0,899), sensivite %73, spesifite %62 olarak çocuklarda COVID-19 tanısını predikte etmektedir.
SONUÇ: COVID-19 tanılı çocukların hematolojik parametre ve indekslerinde sağlıklı kontrollere göre anormallikler tespit edilmiştir. Bunlardan en belirgin olanları lenfopeni ve NLR oranında artıştır. Periferik kan parametrelerinin değerlendirilmesinin COVID-19'un prognozunu değerlendirmesinde önemli referans değer olarak değerlendirilebileceğini düşünmekteyiz

Kaynakça

  • 1.Song W, Li J, Zou N, et al. Clinical features of pediatricpatients with coronavirus disease (COVID-19). J Clin Virol. 2020;127:104377.
  • 2. De Rojas T, Pérez-Martínez A, Cela E, et al. COVID-19 infection in children and adolescents with cancer in Madrid. Pediatr Blood Cancer. 2020;67(7):28397.
  • 3. Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr. 2020;109(6):1088-1095.
  • 4. Sankar J, Dhochak N, Kabra SK, et al. COVID-19 in Children: Clinical Approach and Management. Indian J Pediatr. 2020;87(6):433-442.
  • 5. Frater JL, Zini G, d'Onofrio G, et al. COVID-19 and the clinical hematology laboratory. Int J Lab Hematol. 2020;42(1):11-18.
  • 6. Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med. 2020;58(7):1131-1134.
  • 7. Fan BE, Chong VCL, Chan SSW, et al. Hematologic parameters in patients with COVID-19 infection. Am J Hematol. 2020;95(6):131-134.
  • 8. Qin C, Zhou L, Hu Z, Zhang S, et al. Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71(15):762-768.
  • 9. Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis. Clin Chim Acta. 2020;506:145- 148.
  • 10. Lippi G, Plebani M. The critical role of laboratory medicine during coronavirus disease 2019 (COVID-19) and other viral outbreaks. Clin Chem Lab Med. 2020;58(7):1063- 1069.
  • 11. Yang AP, Liu JP, Tao WQ, Li HM. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol. 2020;84:106504.
  • 12. Jiehao C, Jin X, Daojiong L, et al. A Case Series of Children With 2019 Novel Coronavirus Infection: Clinical and Epidemiological Features. Clin Infect Dis. 2020;71(6):1547-1551.
  • 13. Dhochak N, Singhal T, Kabra SK, et al. Pathophysiology of COVID-19: Why Children Fare Better than Adults? Indian J Pediatr. 2020;87(7):537-546.
  • 14. Brodin P. Why is COVID-19 so mild in children? Acta Paediatr. 2020;109(6):1082-1083.
  • 15. Sun S, Cai X, Wang H, et al. Abnormalities of peripheral blood system in patients with COVID-19 in Wenzhou, China. Clin Chim Acta. 2020;507:174-180.
  • 16. Zeng F, Li L, Zeng J, et al. Can we predict the severity of coronavirus disease 2019 with a routine blood test? Pol Arch Intern Med. 2020 29;130(5):400-406.
  • 17. She J, Liu L, Liu W. COVID-19 epidemic: Disease characteristics in children. J Med Virol. 2020;92(7):747-754.
  • 18. Yang Y, Lu Q, Liu M, et al. Epidemiological and clinical features of the 2019 novel coronavirus outbreak in China. Med Rxiv (PrePrint). doi:2020. 10.1101/2020.02.10.20021675.
  • 19. Zheng F, Liao C, Fan QH, et al. Clinical Characteristics of Children with Coronavirus Disease 2019 in Hubei, China. Curr Med Sci. 2020;40(2):275-280.
  • 20. Huang I, Pranata R. Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis. J Intensive Care. 2020;(24):8-36.
  • 21. Xu H, Zhong L, Deng J, Peng J, Dan H, Zeng X, Li T, Chen Q. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci. 2020 24;12(1):8.
  • 22. Chen R, Sang L, Jiang M, et al. Medical Treatment Expert Group for COVID-19. Longitudinal hematologic and immunologic variations associated with the progression of COVID-19 patients in China. J Allergy Clin Immunol. 2020;146(1):89-100.
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Makaleler-Araştırma Yazıları
Yazarlar

Yeter Düzenli Kar 0000-0003-2917-7750

Konca Altınkaynak Bu kişi benim 0000-0002-7031-1459

Emine Hafize Erdeniz 0000-0003-2669-0890

Yayımlanma Tarihi 18 Ekim 2021
Kabul Tarihi 30 Aralık 2020
Yayımlandığı Sayı Yıl 2021 Cilt: 22 Sayı: 6

Kaynak Göster

APA Düzenli Kar, Y., Altınkaynak, K., & Erdeniz, E. H. (2021). HEMATOLOGICAL FINDINGS OF CHILDREN DIAGNOSED WITH COVID 19 AND THE DIAGNOSTIC ROLE OF HEMATOLOGICAL INDICES IN THE DIAGNOSIS OF COVID 19. Kocatepe Tıp Dergisi, 22(6), 473-478. https://doi.org/10.18229/kocatepetip.821471
AMA Düzenli Kar Y, Altınkaynak K, Erdeniz EH. HEMATOLOGICAL FINDINGS OF CHILDREN DIAGNOSED WITH COVID 19 AND THE DIAGNOSTIC ROLE OF HEMATOLOGICAL INDICES IN THE DIAGNOSIS OF COVID 19. KTD. Ekim 2021;22(6):473-478. doi:10.18229/kocatepetip.821471
Chicago Düzenli Kar, Yeter, Konca Altınkaynak, ve Emine Hafize Erdeniz. “HEMATOLOGICAL FINDINGS OF CHILDREN DIAGNOSED WITH COVID 19 AND THE DIAGNOSTIC ROLE OF HEMATOLOGICAL INDICES IN THE DIAGNOSIS OF COVID 19”. Kocatepe Tıp Dergisi 22, sy. 6 (Ekim 2021): 473-78. https://doi.org/10.18229/kocatepetip.821471.
EndNote Düzenli Kar Y, Altınkaynak K, Erdeniz EH (01 Ekim 2021) HEMATOLOGICAL FINDINGS OF CHILDREN DIAGNOSED WITH COVID 19 AND THE DIAGNOSTIC ROLE OF HEMATOLOGICAL INDICES IN THE DIAGNOSIS OF COVID 19. Kocatepe Tıp Dergisi 22 6 473–478.
IEEE Y. Düzenli Kar, K. Altınkaynak, ve E. H. Erdeniz, “HEMATOLOGICAL FINDINGS OF CHILDREN DIAGNOSED WITH COVID 19 AND THE DIAGNOSTIC ROLE OF HEMATOLOGICAL INDICES IN THE DIAGNOSIS OF COVID 19”, KTD, c. 22, sy. 6, ss. 473–478, 2021, doi: 10.18229/kocatepetip.821471.
ISNAD Düzenli Kar, Yeter vd. “HEMATOLOGICAL FINDINGS OF CHILDREN DIAGNOSED WITH COVID 19 AND THE DIAGNOSTIC ROLE OF HEMATOLOGICAL INDICES IN THE DIAGNOSIS OF COVID 19”. Kocatepe Tıp Dergisi 22/6 (Ekim 2021), 473-478. https://doi.org/10.18229/kocatepetip.821471.
JAMA Düzenli Kar Y, Altınkaynak K, Erdeniz EH. HEMATOLOGICAL FINDINGS OF CHILDREN DIAGNOSED WITH COVID 19 AND THE DIAGNOSTIC ROLE OF HEMATOLOGICAL INDICES IN THE DIAGNOSIS OF COVID 19. KTD. 2021;22:473–478.
MLA Düzenli Kar, Yeter vd. “HEMATOLOGICAL FINDINGS OF CHILDREN DIAGNOSED WITH COVID 19 AND THE DIAGNOSTIC ROLE OF HEMATOLOGICAL INDICES IN THE DIAGNOSIS OF COVID 19”. Kocatepe Tıp Dergisi, c. 22, sy. 6, 2021, ss. 473-8, doi:10.18229/kocatepetip.821471.
Vancouver Düzenli Kar Y, Altınkaynak K, Erdeniz EH. HEMATOLOGICAL FINDINGS OF CHILDREN DIAGNOSED WITH COVID 19 AND THE DIAGNOSTIC ROLE OF HEMATOLOGICAL INDICES IN THE DIAGNOSIS OF COVID 19. KTD. 2021;22(6):473-8.

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