Araştırma Makalesi
BibTex RIS Kaynak Göster

COVID-19’lu Yatan Hastalarda Nötrofil/Lenfosit Oranı, Lenfosit/Monosit Oranı, Platelet/Lenfosit Oranı ve Hematolojik Parametrelerin Hastalığın Şiddet ve Prognozu ile İlişkisi

Yıl 2021, , 251 - 261, 05.06.2021
https://doi.org/10.26453/otjhs.876015

Öz

Amaç: Hastanede yatan COVID-19’lu hastalarda nötrofil/lenfosit oranı (NLR), lenfosit/monosit oranı (LMR), platelet/lenfosit oranı (PLR) ve hematolojik parametrelerin hastalığın şiddeti ve prognozunu belirlemedeki değerini araştırmaktır.
Materyal ve Metot: Çalışma bir göğüs hastalıkları kliniğinde Nisan-Eylül 2020 tarihleri arasında COVID-19 nedeniyle yatan 182 hasta ve 91 kontrol grubu ile retrospektif olarak gerçekleştirildi. Takipte hematolojik parametreler ile diğer parametreler arasındaki ilişki ve farklılıklar araştırıldı.
Bulgular: Lenfosit, monosit, eozinofil, bazofil, hemoglobin, trombosit ve LMR anlamlı olarak daha düşüktü. NLR ve PLR daha yüksekti. Taburcu aşamasında, hematolojik parametreler ve PLR’de anlamlı artış bulundu. Radyolojik pnömoni şiddet skoru ile NLR (r=0.234, p=0.001) ve PLR (r=0.128, p=0.042) arasında anlamlı pozitif korelasyon ve LMR ile anlamlı ters korelasyon (r=-0.206, p=0.003) vardı. NLR (r=0.140, p=0.030) ve PLR (r=0.125, p=0.046) ile semptom-taburcu süresi arasında pozitif yönlü, LMR ile hem semptom-taburcu (r=-0.137, p=0.032) hem de hastanede kalış süresi (r=-0.135, p=0.034) arasında ters yönlü korelasyon tespit edildi. Hastaneye kabul ve taburculukta CRP ile NLR ve PLR arasında da pozitif bir korelasyon vardı.
Sonuç: NLR, LMR ve PLR, COVİD-19’lu hastalarda hastalığın takibinde CRP’yle birlikte kullanılabilecek, hastalığın şiddetiyle anlamlı korelasyon gösteren, tedaviye yanıtı izlemede ve prognozu öngörmede faydalanılabilecek hematolojik prediktörler olarak bulunmuştur.

Kaynakça

  • Adhikari SP, Meng S, Wu Y-J, et al. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infectious diseases of poverty. 2020;9(1):1-12.
  • Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-733.
  • Wu F, Zhao S, Yu B, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020;579(7798):265-269.
  • Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
  • Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-1720.
  • Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. Jama. 2020;323(11):1061-1069.
  • Liu J, Liu Y, Xiang P, et al. Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage. Journal of Translational Medicine. 2020;18:1-12.
  • Qin C, Zhou L, Hu Z, et al. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71(15):762-768.
  • Ying H, Deng Q, He B, et al. The prognostic value of preoperative NLR, d-NLR, PLR and LMR for predicting clinical outcome in surgical colorectal cancer patients. Medical Oncology (Northwood, London, England). 2014;31(12):305-305.
  • Chan AS, Rout A. Use of Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in COVID-19. J Clin Med Res. 2020;12(7):448-453.
  • Chung M, Bernheim A, Mei X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology. 2020;295(1):202-207.
  • Li K, Fang Y, Li W, et al. CT image visual quantitative evaluation and clinical classification of coronavirus disease (COVID-19). Eur Radiol. 2020;30(8):4407-4416.
  • Wang H, Xing Y, Yao X, et al. Retrospective study of clinical features of COVID-19 in inpatients and their association with disease severity. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research. 2020;26:e927674-e927674.
  • Asghar MS, Khan NA, Haider Kazmi SJ, et al. Hematological parameters predicting severity and mortality in COVID-19 patients of Pakistan: a retrospective comparative analysis. J Community Hosp Intern Med Perspect. 2020;10(6):514-520.
  • Ufuk F, Demirci M, Sagtas E, Akbudak I, Ugurlu E, Sari T. The prognostic value of pneumonia severity score and pectoralis muscle Area on chest CT in adult COVID-19 patients. European Journal of Radiology. 2020;131:109271-109271.
  • Mousavi SA, Rad S, Rostami T, et al. Hematologic predictors of mortality in hospitalized patients with COVID-19: a comparative study. Hematology. 2020;25(1):383-388.
  • Rees EM, Nightingale ES, Jafari Y, et al. COVID-19 length of hospital stay: a systematic review and data synthesis. BMC medicine. 2020;18(1):1-22.
  • Rosenthal N, Cao Z, Gundrum J, Sianis J, Safo S. Risk factors associated with in-hospital mortality in a US national sample of patients with COVID-19. JAMA network open. 2020;3(12):e2029058-e2029058.
  • Gandhi RT, Lynch JB, Del Rio C. Mild or moderate COVID-19. N Engl J Med. 2020;383(18):1757-1766.

The Association of Neutrophil/Lymphocyte Ratio, Lymphocyte/Monocyte Ratio, Platelet/Lymphocyte Ratio and Hematological Parameters with Severity and Prognosis in Hospitalized Patients with COVID-19

Yıl 2021, , 251 - 261, 05.06.2021
https://doi.org/10.26453/otjhs.876015

Öz

Objective: To investigate neutrophil/lymphocyte (NLR), lymphocyte/monocyte (LMR), platelet/lymphocyte (PLR) ratios, and the value of these parameters in determining disease severity and progression in hospitalized COVID-19 patients.
Materials and Methods: Study was conducted retrospectively with 182 in-patients and 91 controls due to COVID-19 between April-September 2020 in the chest diseases clinic. Hematological parameters and rates were compared with controls’ parameters. Correlations and differences between hematological parameters and other parameters were investigated.
Results: Lymphocyte, monocyte, eosinophil, basophil, hemoglobin, thrombocyte, and LMR were significantly lower. NLR and PLR were higher. There were significant increases in hematological parameters and PLR on discharge. A positive correlation existed between radiological pneumonia severity score, and NLR (r=0.234, p=0.001) and PLR (r=0.128, p=0.042), and significant inverse correlation with LMR (r=-0.206, p=0.003). Positive correlations were detected between NLR (r=0.140, p=0.030) and PLR (r=0.125, p=0.046), and symptom-discharge time, and inverse correlation between LMR, and both symptom-discharge (r=-0.137, p=0.032) and hospital stay time (r=-0.135, p=0.034). A positive correlation existed between CRP, and NLR and PLR on admission and discharge.
Conclusion: NLR, LMR and PLR were found as hematological predictors to be used with CRP in following-up COVID-19, showing a significant correlation with disease severity, monitoring responses to treatment and predicting prognosis.

Kaynakça

  • Adhikari SP, Meng S, Wu Y-J, et al. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infectious diseases of poverty. 2020;9(1):1-12.
  • Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-733.
  • Wu F, Zhao S, Yu B, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020;579(7798):265-269.
  • Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
  • Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-1720.
  • Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. Jama. 2020;323(11):1061-1069.
  • Liu J, Liu Y, Xiang P, et al. Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage. Journal of Translational Medicine. 2020;18:1-12.
  • Qin C, Zhou L, Hu Z, et al. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71(15):762-768.
  • Ying H, Deng Q, He B, et al. The prognostic value of preoperative NLR, d-NLR, PLR and LMR for predicting clinical outcome in surgical colorectal cancer patients. Medical Oncology (Northwood, London, England). 2014;31(12):305-305.
  • Chan AS, Rout A. Use of Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in COVID-19. J Clin Med Res. 2020;12(7):448-453.
  • Chung M, Bernheim A, Mei X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology. 2020;295(1):202-207.
  • Li K, Fang Y, Li W, et al. CT image visual quantitative evaluation and clinical classification of coronavirus disease (COVID-19). Eur Radiol. 2020;30(8):4407-4416.
  • Wang H, Xing Y, Yao X, et al. Retrospective study of clinical features of COVID-19 in inpatients and their association with disease severity. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research. 2020;26:e927674-e927674.
  • Asghar MS, Khan NA, Haider Kazmi SJ, et al. Hematological parameters predicting severity and mortality in COVID-19 patients of Pakistan: a retrospective comparative analysis. J Community Hosp Intern Med Perspect. 2020;10(6):514-520.
  • Ufuk F, Demirci M, Sagtas E, Akbudak I, Ugurlu E, Sari T. The prognostic value of pneumonia severity score and pectoralis muscle Area on chest CT in adult COVID-19 patients. European Journal of Radiology. 2020;131:109271-109271.
  • Mousavi SA, Rad S, Rostami T, et al. Hematologic predictors of mortality in hospitalized patients with COVID-19: a comparative study. Hematology. 2020;25(1):383-388.
  • Rees EM, Nightingale ES, Jafari Y, et al. COVID-19 length of hospital stay: a systematic review and data synthesis. BMC medicine. 2020;18(1):1-22.
  • Rosenthal N, Cao Z, Gundrum J, Sianis J, Safo S. Risk factors associated with in-hospital mortality in a US national sample of patients with COVID-19. JAMA network open. 2020;3(12):e2029058-e2029058.
  • Gandhi RT, Lynch JB, Del Rio C. Mild or moderate COVID-19. N Engl J Med. 2020;383(18):1757-1766.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi
Yazarlar

Celalettin Korkmaz 0000-0001-8602-0368

Soner Demirbaş 0000-0002-9072-0217

Hülya Vatansev 0000-0002-8382-3904

Sebnem Yosunkaya 0000-0002-7859-8941

Turgut Teke 0000-0001-5955-6255

Adil Zamani Bu kişi benim 0000-0002-6743-7181

Necdet Poyraz 0000-0001-9299-189X

Pınar Yılmaz Bu kişi benim 0000-0002-8519-5382

Mehmet Uyar 0000-0002-3954-7471

Yayımlanma Tarihi 5 Haziran 2021
Gönderilme Tarihi 10 Şubat 2021
Kabul Tarihi 21 Mart 2021
Yayımlandığı Sayı Yıl 2021

Kaynak Göster

AMA Korkmaz C, Demirbaş S, Vatansev H, Yosunkaya S, Teke T, Zamani A, Poyraz N, Yılmaz P, Uyar M. The Association of Neutrophil/Lymphocyte Ratio, Lymphocyte/Monocyte Ratio, Platelet/Lymphocyte Ratio and Hematological Parameters with Severity and Prognosis in Hospitalized Patients with COVID-19. OTSBD. Haziran 2021;6(2):251-261. doi:10.26453/otjhs.876015

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