The Relationship Between Blood Eosinophil Levels and COVID-19 Mortality

Öz

Aim: COVID-19 is a global pandemic caused by severe acute respiratory syndrome (SARS-COV-2). The objective of this study is to determine the relationship between blood eosinophil levels and the severity and mortality of COVID-19. Methods: The data of 678 patients were retrospectively collected from the electronic database of a hospital by researchers between March 2020 and December 2021. This is a descriptive study, and no specific sampling method was employed. The data were evaluated based on three groups of patients (moderate, severe, and chronic). Eosinophil values within the first 24 hours following hospital admission were obtained. The data was analyzed through IBM SPSS Statistics (20.0) software. Parametric tests were used for the statistical evaluations when the normality assumptions were met. Mann-Whitney U was used for two independent groups and multivariate logistic regression analysis was used to identify the relations. p-value < 0.05 was considered statistically significant. Results: In our study, it was found that eosinophil levels did not have an effect on disease severity (p=0.941). The COVID-19 related mortality rate was 14.6%, and the rate of severe/critical disease progression was 27.3%. Upon examining hematological parameters, it was observed that critical cases had significantly higher NEU values (p=0.001) and PCT values (p=0.024). LYM (p=0.007), HGB (p=0.029), PLT (p=0.023), HCT (p=0.005), MCV (p=0.039), MCH (p=0.048), MCHC (p=0.001), and RDW (p=0.023) were significantly lower in the severe group. It was determined that age, HCT, MCV, MCHC, urea, uric acid, sodium and potassium parameters were not significant risk factors for mortality (p>0.05). A reduction in MCHC (OR: 0.996; p=0.007) and sodium (p=0.031) demonstrated a mitigating effect on disease severity. The predictive effect of other parameters was found to be statistically insignificant. Conclusion: The effect of eosinophil levels on the severity and mortality of COVID-19 has not been found, whereas a decrease in MCHC and sodium levels showed a mitigating effect on disease severity. Further research is needed to investigate the clinical significance of these indicators in COVID-19 patients.

Anahtar Kelimeler

• COVID-19
• Disease Severity
• Eosinophils
• Mortality

KAN EOZİNOFİL SEVİYELERİ İLE COVİD-19 MORTALİTESİ ARASINDAKİ İLİŞKİ

Öz

Amaç: COVID-19, şiddetli akut solunum yolu sendromu SARS-COV-2’nin neden olduğu küresel bir pandemidir. Bu çalışmanın amacı, kan eozinofil düzeyleri ile COVID-19'un şiddeti ve mortalitesi arasındaki ilişkiyi belirlemektir. Yöntem: 678 hastanın verileri, Mart 2020 ile Aralık 2021 tarihleri arasında araştırmacılar tarafından bir hastanenin elektronik veri tabanından geriye dönük olarak toplandı. Bu tanımlayıcı bir çalışmadır ve özel bir örnekleme yöntemi kullanılmamıştır. Veriler, hastaların üç grubuna (orta, şiddetli ve kronik) dayanarak değerlendirildi. Hastaneye yatışı takip eden ilk 24 saat içinde alınan eozinofil değerleri elde edildi. Veriler, IBM SPSS Statistics (20.0) yazılımı kullanılarak analiz edildi. Normal dağılım varsayımlarının karşılandığı durumlarda parametrik testler kullanıldı. İki bağımsız grup için Mann-Whitney U testi ve ilişkileri belirlemek için çok değişkenli lojistik regresyon analizi kullanıldı. p değeri <0,05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Çalışmamızda eozinofil düzeylerinin hastalık şiddetinde etkili olmadığı bulunmuştur (p=0,941). COVID-19’a bağlı ölüm oranı %14,6, şiddetli/kritik hastalık seyri oranı ise %27,3 olarak bulunmuştur. Hematolojik parametreler incelendiğinde, kritik vakaların anlamlı derecede daha yüksek NEU değerlerine (p=0,001) ve PCT değerlerine (p=0,024) sahip olduğu gözlenmiştir. LYM (p=0,007), HGB (p=0,029), PLT (p=0,023), HCT (p=0,005), MCV (p=0,039), MCH (p=0,048), MCHC (p=0,001) ve RDW (p=0,023) parametreleri şiddetli grupta anlamlı derecede düşüktür. Yaş, HCT, MCV, MCHC, üre, ürik asit, sodyum ve potasyum parametrelerinin mortalite için anlamlı risk faktörleri olmadığı belirlenmştir (p>0,05). MCHC'de azalma (OR: 0,996; p=0,007) ve sodyumda azalma (p=0,031) hastalık şiddeti üzerinde hafifletici bir etki göstermiştir. Diğer parametrelerin etkisi istatistiksel olarak anlamlı bulunmamıştır. Sonuç: Eozinofil düzeyinin COVID-19'un şiddeti ve mortalitesi üzerine etkisi bulunmamış olup, MCHC'de azalma ve sodyumda azalma hastalık şiddeti üzerinde hafifletici bir etki göstermiştir. Bu göstergelerin COVID-19 hastalarındaki klinik önemini araştırmak için daha fazla araştırmaya ihtiyaç vardır.

Anahtar Kelimeler

• Covid-19
• Hastalık Şiddeti
• Eozinofiller
• Mortalite

Kaynakça

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