COVİD 19'DA ÖNE ÇIKAN BİYOKİMYASAL PARAMETRELERİN VE D VİTAMİNİNİN DEĞERLENDİRİLMESİ

Yıl 2022, Cilt: 13 Sayı: 4, 444 - 450, 30.12.2022

Elif Menekşe , Muhammed Emin Düz , Aydın Balcı , Mustafa Durmaz

https://doi.org/10.18663/tjcl.899895

Öz

Amaç: Bu çalışmada hastalığın seyrini tahmin etmek ve yoğun bakım ünitesine yatırılacak hastaları önceden belirlemek için potansiyel koagülasyon ve inflamasyon biyobelirteçlerini ve son dönemde sıkça vurgulanan D vitaminini değerlendirmeyi amaçladık.
Gereç ve Yöntemler: Bu retrospektif vaka-kontrol çalışması, Mart 2020'den Haziran 2020'ye kadar Amasya Sabuncuoğlu Şerefeddin Eğitim ve Araştırma Hastanesi'nde COVİD-19 tanısı alıp tedavi edilen 121 hasta üzerinde yapıldı. COVİD-19 ile ilişkili olabilecek D-dimer, fibrinojen, ferritin ve 25-OH Vitamin D'yi değerlendirdik. Hastalar, sadece polimeraz zincir reaksiyon pozitifliği (PCR +), sadece bilgisayarlı tomografi pozitifliği (CT +) ve hem PCR + hem de CT + olmak üzere üç gruba ayrıldı.
Bulgular: Yaş ortalaması 53 olan 121 hasta incelendi (% 52 erkek). Sadece CT + hastalar diğer hastalardan daha yaşlıydı (p <0.001). D-dimer, ferritin ve fibrinojen seviyeleri tüm hastalar arasında CT + olan grupta oldukça yüksekti (sırasıyla p = 0.001, p = 0.001 ve p <0.001). Hem PCR + hem de CT + olanlar ve diğerleri, CT + olanlar ve diğerleri, PCR + olanlar ve diğerleri karşılaştırıldığında D vitamini düzeyleri arasında anlamlı fark bulunamadı (p = 0.277, p = 0.350, p = 0.397). Bununla beraber tüm gruplarda D vitamini düzeylerinin yetersiz olduğu tespit edildi.
Sonuç: COVİD-19'a koagülopati eşlik edebileceğinden başvuru esnasındaki D-dimer ve fibrinojen seviyeleri öngörü sağlamaktadır. Serum ferritini ise, COVİD-19 hastalarında kötü prognoz için potansiyel risk faktörü göstergesidir.

Anahtar Kelimeler

D-dimer, Ferritin, Fibrinojen, Vitamin D, COVİD 19, covid-19; d-dimer; ferritin; fibrinogen; vitamin d

EVALUATION OF FEATURED BIOCHEMICAL PARAMETERS AND VITAMIN D IN COVID-19

Öz

Aim: We aimed to evaluate potential coagulation and inflammatory biomarkers. The recently discussed vitamin D levels predict the course ef the disease and determine the patients to be admitted to the intensive care unit in advance.
Materials and Methods: This retrospective case-control study was conducted on 121 patients diagnosed and treated with COVID-19 disease, from March 2020 to June 2020 at the Amasya Sabuncuoğlu Şerefeddin Training and Research Hospital, Amasya, Turkey. D-dimer, Fibrinogen, Ferritin, and 25-OH Vitamin D levels that could be associated with COVID-19 infections were evaluated. The patients were divided into three groups: only Polymerase Chain Reaction positivity (PCR+), only Computerized Tomography positivity (CT+) and both PCR+ and CT+ among COVID-19 cases.
Results: 121 patients with at mean age of 53 were investigated (52% male). Only CT+ cases were significantly older than other patients, p<0.001. D-dimer, Ferritin, and Fibrinogen levels were considerably higher in CT+ patients among all subjects, p =0.001, p =0.001, and p<0.001, respectively. There were no apparent differences in vitamin D levels between PCR+ and CT+ and others, CT+ and, PCR+ and others, p=0.277, p=0.350, p=0.397. However, we found that vitamin D levels were deficient in all groups.
Conclusion: Since coagulopathy may accompany COVID-19, D-dimer and fibrinogen levels are predictive during admission. Serum ferritin demonstrates a potential risk factor for poor prognosis in COVID‐19 patients.

Anahtar Kelimeler

covid-19; d-dimer; ferritin; fibrinogen; vitamin d

Kaynakça

• Referans 1. Berekaa MM. Insights into the COVID-19 pandemic: Origin, pathogenesis, diagnosis, and therapeutic interventions. Frontiers in bioscience (Elite edition). 2021;13:117-39.
• Referans 2. Danwang C, Endomba FT, Nkeck JR, Wouna DLA, Robert A, Noubiap JJ. A meta-analysis of potential biomarkers associated with severity of coronavirus disease 2019 (COVID-19). Biomark Res. 2020;8:37.
• Referans 3. Mardani R, Ahmadi Vasmehjani A, Zali F, Gholami A, Mousavi Nasab SD, Kaghazian H, et al. Laboratory Parameters in Detection of COVID-19 Patients with Positive RT-PCR; a Diagnostic Accuracy Study. Arch Acad Emerg Med. 2020;8(1):e43.
• Referans 4. Khourssaji M, Chapelle V, Evenepoel A, Belkhir L, Yombi JC, van Dievoet MA, et al. A biological profile for diagnosis and outcome of COVID-19 patients. Clin Chem Lab Med. 2020;58(12):2141-50.
• Referans 5. Luo HC, You CY, Lu SW, Fu YQ. Characteristics of coagulation alteration in patients with COVID-19. Ann Hematol. 2021;100(1):45-52.
• Referans 6. Long H, Nie L, Xiang X, Li H, Zhang X, Fu X, et al. D-Dimer and Prothrombin Time Are the Significant Indicators of Severe COVID-19 and Poor Prognosis. BioMed Research International. 2020;2020:6159720.
• Referans 7. Ikewaki N, Rao KS, Archibold AD, Iwasaki M, Senthilkumar R, Preethy S, et al. Coagulopathy associated with COVID-19 - Perspectives & Preventive strategies using a biological response modifier Glucan. Thromb J. 2020;18:27.
• Referans 8. Fu L, Wang B, Yuan T, Chen X, Ao Y, Fitzpatrick T, et al. Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: A systematic review and meta-analysis. J Infect. 2020;80(6):656-65.
• Referans 9. Kernan KF, Carcillo JA. Hyperferritinemia and inflammation. Int Immunol. 2017;29(9):401-9.
• Referans 10. Zdrenghea MT, Makrinioti H, Bagacean C, Bush A, Johnston SL, Stanciu LA. Vitamin D modulation of innate immune responses to respiratory viral infections. Rev Med Virol. 2017;27(1).
• Referans 11. Panagiotou G, Tee SA, Ihsan Y, Athar W, Marchitelli G, Kelly D, et al. Low serum 25-hydroxyvitamin D (25[OH]D) levels in patients hospitalized with COVID-19 are associated with greater disease severity. Clin Endocrinol (Oxf). 2020;93(4):508-11.
• Referans 12. Munshi R, Hussein MH, Toraih EA, Elshazli RM, Jardak C, Sultana N, et al. Vitamin D insufficiency as a potential culprit in critical COVID-19 patients. Journal of medical virology. 2021;93(2):733-40.
• Referans 13. Merzon E, Tworowski D, Gorohovski A, Vinker S, Golan Cohen A, Green I, et al. Low plasma 25(OH) vitamin D level is associated with increased risk of COVID-19 infection: an Israeli population-based study. The FEBS journal. 2020;287(17):3693-702.
• Referans 14. Hastie CE, Mackay DF, Ho F, Celis-Morales CA, Katikireddi SV, Niedzwiedz CL, et al. Vitamin D concentrations and COVID-19 infection in UK Biobank. Diabetes Metab Syndr. 2020;14(4):561-5.
• Referans 15. Laird E, Rhodes J, Kenny RA. Vitamin D and Inflammation: Potential Implications for Severity of Covid-19. Ir Med J. 2020;113(5):81.
• Referans 16. Hayiroglu MI, Cinar T, Tekkesin AI. Fibrinogen and D-dimer variances and anticoagulation recommendations in Covid-19: current literature review. Rev Assoc Med Bras (1992). 2020;66(6):842-8.
• Referans 17. Perricone C, Bartoloni E, Bursi R, Cafaro G, Guidelli GM, Shoenfeld Y, et al. COVID-19 as part of the hyperferritinemic syndromes: the role of iron depletion therapy. Immunologic research. 2020;68(4):213-24.
• Referans 18. Iba T, Levy JH, Levi M, Thachil J. Coagulopathy in COVID-19. J Thromb Haemost. 2020;18(9):2103-9.
• Referans 19. Thachil J, Tang N, Gando S, Falanga A, Cattaneo M, Levi M, et al. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost. 2020;18(5):1023-6.
• Referans 20. Doğan E SN. Türkiye’de Batı Karadeniz bölgesindeki çocukların D vitamini düzeyleri. Pamukkale Tıp Dergisi. 2021;14(1):1-10.
• Referans 21. In: Ross AC, Taylor CL, Yaktine AL, Del Valle HB, editors. Dietary Reference Intakes for Calcium and Vitamin D. The National Academies Collection: Reports funded by National Institutes of Health. Washington (DC)2011.
• Referans 22. Malabanan A, Veronikis IE, Holick MF. Redefining vitamin D insufficiency. Lancet. 1998;351(9105):805-6.
• Referans 23. Priemel M, von Domarus C, Klatte TO, Kessler S, Schlie J, Meier S, et al. Bone mineralization defects and vitamin D deficiency: histomorphometric analysis of iliac crest bone biopsies and circulating 25-hydroxyvitamin D in 675 patients. J Bone Miner Res. 2010;25(2):305-12.
• Referans 24. Cashman KD, Dowling KG, Skrabakova Z, Gonzalez-Gross M, Valtuena J, De Henauw S, et al. Vitamin D deficiency in Europe: pandemic? Am J Clin Nutr. 2016;103(4):1033-44.
• Referans 25. Bouillon R, Carmeliet G, Lieben L, Watanabe M, Perino A, Auwerx J, et al. Vitamin D and energy homeostasis: of mice and men. Nat Rev Endocrinol. 2014;10(2):79-87.