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

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.

Anahtar Kelimeler

• COVİD-19
• nötrofil lenfosit oranı
• lenfosit monosit oranı
• platelet lenfosit oranı
• radyolojik pnömoni şiddet skoru

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

Abstract

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.

Keywords

• COVID-19
• neutrophil lymphocyte ratio
• lymphocyte monocyte ratio
• platelet lymphocyte ratio
• radiological pneumonia severity score

Kaynakça

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