The relationship of Eosinophil / Lymphocyte and D-Dimer / Fibrinogen ratios with the course of the disease in Covid-19 Patients

Öz

Objective: Knowing the parameters that will measure the course and follow-up of the disease in the Covid-19 pandemic, which causes an important health problem all over the world, will make an important contribution to the understanding and management of the pathophysiology of the disease. The ratio of eosinophils, which are one of the peripheral blood cells responsible for the response to parasites and allergens, to lymphocyte (ELO), appears to be a biomarker for inflammatory conditions. Similarly, it is known that D-dimer/Fibrinogen ratio (DFO) is important to determine the severity of the disease in diseases with thromboembolic events. The aim of this study was to evaluate the relationship of ELO and DFO with the course of the disease in Covid-19 patients, where inflammation and thromboembolic events are at the forefront. Method: The study was conducted as a retrospective data search. The research population included patients hospitalized for Covid-19 pneumonia between April and December 2020. The patients were divided into groups as those who recovered and were discharged within 14 days, and those who required hospitalization for more than 14 days or died. Age, gender and comorbidities of the patients, as well as laboratory values at the time of hospitalization were analyzed. Results: A total of 486 patients were included in the study. Advanced age, presence of additional disease, high CRP, Ferritin, LDH and leukocyte count, and low lymphocyte count were found to be associated with poor prognosis in the 14-day course of the disease, while ELO value was not significant. While D-dimer and fibrinogen values were not different between the patients who recovered and did not heal in the 14-day period, DFO was found to be significantly higher in both the non-healed and ex-groups. The sensitivity of DFO in determining prolonged hospitalization was 66%, its specificity was 68%, and its sensitivity was 73%, and its specificity was 67% in determining mortality. Conclusion: While ELO was not significant in the 14-day course of patients hospitalized with Covid-19 pneumonia, DFO elevation was found to be significant in showing both prolonged hospitalization and 14-day mortality.

Anahtar Kelimeler

• COVID-19
• Eosinophil
• Lymphocyte
• Eosinophil/Lymphocyte ratio
• D-dimer/Fibrinogen ratio

Covid-19 hastalarında Eozinofil / Lenfosit ve D-Dimer/ Fibrinojen oranlarının hastalık seyri ile ilişkisi

Öz

Amaç: Tüm dünyada önemli sağlık sorununa neden olan Covid-19 pandemisinde, hastalığın seyrini ve takibini ölçecek parametrelerin bilinmesi, hastalığın patofizyolojisinin anlaşılmasına ve yönetimine önemli katkı sağlayacaktır. Parazit ve allerjenlere karşı gelişen yanıttan sorumlu periferik kan hücrelerinden olan eozinofillerin, lenfosit ile olan oranı (ELO) inflamatuar durumlar için bir biyolojik belirteç olarak görülmektedir. Benzer şekilde tromboembolik olaylarla seyreden hastalıklarda D-dimer/ Fibrinojen oranının (DFO) hastalığın ağırlığını belirlemede önemli olduğu bilinmektedir. Bu araştırmada amaç inflamasyon ve tromboembolik olayların ön planda olduğu Covid-19 hastalarında ELO ve DFO’nun hastalığın seyri ile ilişkisini değerlendirmektir. Yöntem: Araştırma retrospektif veri taraması olarak yapıldı. Araştırma popülasyonu, Covid-19 pnömonisi nedeniyle Nisan – Aralık 2020 tarihleri arasında hastaneye yatırılan hastaları içermekteydi. Hastalar 14 gün içinde iyileşerek taburcu olanlar ve 14 günden uzun süre yatışı gereken veya ölenler olarak gruplara ayrıldı. Hastaların yaş, cinsiyet ve ek hastalıkları yanısıra hastaneye yatış anındaki laboratuvar değerleri analiz edildi. Bulgular: Toplam 486 hasta incelemeye alındı. İncelenen laboratuvar parametrelerinden ileri yaş, ek hastalık varlığı, CRP, Ferritin, LDH ve lökosit sayısı yüksekliği ve lenfosit sayısı düşüklüğü hastalığın 14 günlük seyrinde kötü prognoz ile ilişkili bulunurken ELO değerinde böyle bir anlamlılık bulunmadı. D-dimer ve fibrinojen değerleri, 14 günlük süreçte, iyileşen ve iyileşmeyen hastalar arasında farklı bulunmazken DFO hem iyileşmeyen grupta hem de ölen grupta anlamlı olarak yüksek bulundu. DFO’nun uzamış hastane yatışını belirlemede duyarlılığı %66 özgüllüğü %68, mortaliteyi belirlemede ise duyarlılığı %73, özgüllüğü %67 olarak hesaplandı. Sonuç: Covid-19 pnömonisi ile hastaneye yatan hastaların 14 günlük seyrinde ELO anlamlı bulunmazken DFO yüksekliği hem uzamış hastane yatışı hem de 14 günlük mortaliteyi göstermede anlamlı bulundu.

Anahtar Kelimeler

• Covid-19
• Eozinofil
• Lenfosit
• Eozinofil/Lenfosit oranı
• D-dimer/Fibrinojen oranı

Kaynakça

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