Hemogram Parametreleri SARS CoV-2 Enfeksiyonunda Geniş Pulmoner Tutulumu Öngörebilir mi?

Abstract

Amaç: Pandeminin başlangıcından bu yana, yeni koronavirüs enfeksiyonu SARS CoV-2, önemli bir ekonomik maliyetin yanı sıra büyük morbidite ve mortaliteye neden oldu. Hafif pulmoner tutulumu olan SARS CoV-2 hastalarının klinik ve laboratuvar bulgularını ileri akciğer tutulumu olan deneklerle karşılaştırmayı amaçladık. Gereç ve Yöntemler: Bu çalışmada, Bolu Abant İzzet Baysal Universitesi Hastanesi’nde SARS CoV-2 enfeksiyonu nedeniyle yatırılan hastalarda hemogram indeksleri ile akciğer tutulumu arasındaki ilişki araştırıldı. Bu retrospektif çalışmada SARS CoV-2'li olguların toraks BT görüntüleri incelendi. Akciğerlerde hastalığa bağlı radyolojik patern, akciğer tutulum yüzdesi, hemogram parametreleri, eritrosit sedimantasyon hızı (ESR), C-reaktif protein (CRP), aspartat ve alanin transaminazlar (AST ve ALT), laktat dehidrojenaz (LDH), ileri ve hafif akciğer tutulumu olan hastalarda D-dimer, ferritin, total bilirubin, albümin, kreatinin kinaz, serum kreatinin değerleri karşılaştırıldı. Bulgular: İleri akciğer tutulumu (%50'den fazla), ESR (r=0,32, p<0,001), CRP (r=0,37, p<0,001), LDH (r=0,46, p<0,001), D-dimer (r=0,19, p<0,001), ferritin (r=0,37, p<0,001), ortalama platelet volümü (MPV) (r=0,13, p<0,001), nötrofil/lenfosit oranı (NLR) (r=0,33, p<0,001) ve platelet/lenfosit oranı (PLR) (r =0,27, p<0,001) ile pozitif ve anlamlı korelasyon gösterdi. Sonuç: SARS CoV-2 hastalarında MPV, PLR ve NLR'nin ileri pulmoner tutulumun erken belirleyicileri olabileceğini düşünüyoruz. Doktorlar, yüksek MPV, PLR veya NLR seviyelerinde bu komplikasyonun farkında olmalıdır.

Keywords

• Ortalama trombosit hacmi
• nötrofil/lenfosit oranı
• trombosit/lenfosit oranı
• pulmoner tutulum
• SARS-CoV-2

Could Hemogram Parameters Predict Extensive Pulmonary Involvement in SARS CoV-2 Infection?

Abstract

Aim: Since the start of the pandemic, the novel coronavirus infection SARS CoV-2 has caused huge morbidity and mortality, as well as a significant economic cost. We aimed to compare clinical and laboratory findings of the SARS CoV-2 patients with mild pulmonary involvement to those in subjects with advanced pulmonary involvement. Material and Methods: In this study, the relationship between hemogram indices and pulmonary involvement in patients hospitalized for SARS CoV-2 infection at Bolu Abant Izzet Baysal University Hospital was investigated. We analyzed the thorax CT images of the subjects with SARS CoV-2 in present retrospective study. Radiological pattern of disease-related in the lungs, percentage of lung involvement, hemogram parameters, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), aspartate and alanine transaminases (AST and ALT), lactate dehydrogenase (LDH), D-dimer, ferritin, total bilirubin, albumin, creatinine kinase, serum creatinine in patients with advanced and mild pulmonary involvement were compared. Results: Advanced pulmonary involvement (greater than 50%) was positively and significantly correlated with ESR, (r=0.32, p<0.001), CRP (r=0.37, p<0.001), LDH (r=0.46, p<0.001), D-dimer (r=0.19, p<0.001), ferritin (r=0.37, p<0.001), mean platelet volume (MPV) (r=0.13, p<0.001), the neutrophil to lymphocyte ratio (NLR) (r=0.33, p<0.001) and platelet to lymphocyte ratio (PLR) (r=0.27, p<0.001). Conclusion: We suggest that MPV, PLR and NLR could be early predictors of advanced pulmonary involvement in SARS CoV-2 patients. Physicians should aware of this complication in the setting of elevated MPV, PLR or NLR levels.

Keywords

• Mean platelet volume
• neutrophil/lymphocyte ratio
• platelet/lymphocyte ratio
• pulmonary involvement
• SARS Cov-2

References

1. Aktas G. A comprehensive review on rational and effective treatment strategies against an invisible enemy; SARS Cov-2 infection. Exp Biomed Res. 2020; 3(4): 293-311.
2. Lavezzo E, Franchin E, Ciavarella C, Cuomo-Dannenburg G, Barzon L, Del Vecchio C, et al. Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo'. Nature. 2020; 584(7821): 425-9.
3. Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P, et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology. 2020; 296(2): E115-e117.
4. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of chest CT and RT-PCR testing for coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology. 2020; 296(2): E32-E40.
5. Pan F, Ye T, Sun P, Gui S, Liang B, Li L, et al. Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID-19) pneumonia. Radiology. 2020: 295(3): 715-21.
6. Obuchowski NA. Computing sample size for receiver operating characteristic studies. Invest Radiol 1994; 29: 238-43.
7. Yang J, Zheng Y, Gou X, Pu, K, Chen, Z, Guo, Q, et al. Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. Int J Infect Dis. 2020; 94:5.
8. Atkins JL, Masoli JA, Delgado J, Pilling LC, Kuo CL, Kuchel GA, et al. Preexisting comorbidities predicting COVID-19 and mortality in the UK biobank community cohort. J Gerontol A Biol Sci Med Sci. 2020; 75(11): 2224-30.

9. Liu X, Zhou H, Zhou Y, Wu X, Zhao Y, Lu Y, et al. Risk factors associated with disease severity and length of hospital stay in COVID-19 patients. J Infect. 2020; 81(1): e95-e97.
10. Rees EM, Nightingale ES, Jafari Y, Waterlow NR, Clifford S, B Pearson CA, et al. COVID-19 length of hospital stay: a systematic review and data synthesis. BMC Med. 2020; 18(1): 70.
11. Xiang J, Wen J, Yuan X, Xiong S, Zhou X, Liu C, et al. Potential biochemical markers to identify severe cases among COVID-19 patients. MedRxiv. 2020.03.19.20034447.
12. Hanif W, Ali O, Shahzad H, Younas M, Iqbal H, Afzal K. Biochemical Markers in COVID-19 in Multan. J Coll Physicians Surg Pak. 2020; 30(10): 1026-29.
13. Aktas G, Kocak MZ, Duman TT, Erkus E, Atak B, Sit M, et al. Mean Platelet Volume (MPV) as an inflammatory marker in type 2 diabetes mellitus and obesity. Bali Med J. 2018; 7(3): 650-3.
14. Dagistan Y, Dagistan E, Gezici AR, Halicioglu S, Akar S, Özkan N, et al. Could red cell distribution width and mean platelet volume be a predictor for lumbar disc hernias? Ideggyogyaszati szemle. 2016; 69(11-12): 411-4.
15. Cakir L, Aktas G, Enginyurt O, Cakir SA. Mean platelet volume increases in type 2 diabetes mellitus independent of HbA1c level. Acta Medica Mediterr. 2014; 30(2): 425-8.
16. Aktas G, Alcelik A, Tekce BK, Tekelioglu V, Sit M, Savli H. Red cell distribution width and mean platelet volume in patients with irritable bowel syndrome. Prz Gastroenterol. 2014; 9(3): 160-3.
17. Bai M, Xing L, Feng J, Huang L, Li J, Liang G. Mean platelet volume as a possible marker for monitoring the disease activity in ulcerative colitis. Int J Lab Hematol. 2016; 38(4): e77-9.
18. Aktaş G, Sit M, Tekce H, Alcelik A, Savli H, Simsek T, et al. Mean platelet volume in nasal polyps. West Indian Md J. 2013; 62(6): 515-8.
19. Cakir L, Aktas G, Mercimek OB, Enginyurt O, Kaya Y, Mercimek K. Are red cell distribution width and mean platelet volume associated with rheumatoid arthritis? Biomed Res. 2016; 27(2): 292-4.
20. Sit M, Kargi E, Aktas G, Dikbas O, Alcelik A, Savli H. Mean platelet volume should be a useful indicator in diagnosis of hashimoto’s thyroiditis. Acta Medica Mediterr. 2014; 30: 1263-6.
21. Sincer I, Gunes Y, Mansiroglu AK, Cosgun M, Aktas G. Association of mean platelet volume and red blood cell distribution width with coronary collateral development in stable coronary artery disease. Postepy Kardiol Interwencyjnej= Adv Interv Cardiol. 2018; 14(3): 263-9.
22. Omran A, Maaroof A, Mohammad Saleh MH, Abdelwahab A. Salivary C‐reactive protein, mean platelet volume and neutrophil lymphocyte ratio as diagnostic markers for neonatal sepsis. Jornal de Pediatria (Versão em Português). 2018; 94(1): 82-7.
23. Aktas G, Cakiroglu B, Sit M, Uyeturk U, Alcelik A, Savli H, et al. Mean platelet volume: a simple indicator of chronic prostatitis. Acta Medica Mediterr. 2013; 29: 551-4.
24. Sit M, Aktas G, Erkol H, Yaman S, Keyif F, Savli H. Neutrophil to lymphocyte ratio is useful in differentiation of malign and benign thyroid nodules. P R Health Sci J. 2019; 38(1): 60-3.
25. Duman TT, Aktas G, Atak BM, Kocak MZ, Erkus E, Savli H. Neutrophil to lymphocyte ratio as an indicative of diabetic control level in type 2 diabetes mellitus. Afr Health Sci. 2019; 19(1): 1602-6.
26. Aktas G, Duman TT, Kurtkulagi O, Tel BMA, Bilgin S, Kahveci G. Liver Steatosis is Associated Both with Platelet Distribution Width, Neutrophil/Lymphocyte and Monocyte/Lymphocyte Ratios. Prim Health Care. 2020; 10(4): 1-4.
27. Aktas G, Duman TT, Atak BM, Kurtkulagi O, Bilgin S, Basaran E, et al. Irritable bowel syndrome is associated with novel inflammatory markers derived from hemogram parameters. Fam Med Prim Care Rev. 2020; 22(2): 107-10.
28. Posul E, Yilmaz B, Aktas G, Kurt M. Does neutrophil-to-lymphocyte ratio predict active ulcerative colitis? Wien Klin Wochenschr. 2015; 127(7-8): 262-5.
29. Atak B, Aktas G, Duman TT, Erkus E, Kocak MZ, Savli H. Diabetes control could through platelet-to-lymphocyte ratio in hemograms. Rev Assoc Med Bras. 2019; 65(1): 38-42.
30. Raungkaewmanee S, Tangjitgamol S, Manusirivithaya S, Srijaipracharoen S, Thavaramara T. Platelet to lymphocyte ratio as a prognostic factor for epithelial ovarian cancer. J Gynecol Oncol. 2012; 23(4): 265-73.
31. Gary T, Pichler M, Belaj K, Hafner F, Gerger A, Froehlich H, et al. Platelet-to-lymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients. PloS one 2013; 8(7): e67688.