A New Approach To Predicting Prognosis In Sars-Cov-2 Infection: "MELD Scoring"

Year 2023, , 286 - 291, 30.06.2023

Dursun Afşin , Alperen Aksakal

https://doi.org/10.54005/geneltip.1210392

Abstract

Background/Aims: The MELD score is a scoring system used to assess the severity of end-stage liver disease. In our study, we aimed to investigate the role of MELD score in predicting the course of the disease and mortality in COVID-19 disease with multi-systemic involvement.
Methods: Our study was conducted with 96 patients over the age of 18 who were diagnosed with COVID-19 by real time PCR method by taking nasopharyngeal swabs between March 2021 and March 2022. MELD score was calculated according to the blood results of the patients at the time of hospital admission. To calculate the MELD score, the equation MELD = 11.2 x ln(international normalized ratio [INR]) + 3.78 x ln(bilirubin, mg/dL) + 9.57 x ln(creatinine, mg/dL) + 6.43 was used.
Results: We found that the MELD score was significantly higher in the moderate and severe patient group compared to the mild patient group (p<0.01). When we compared the moderate and severe patient groups between themselves, the MELD score was significantly higher in the severe patient group (p<0.01). In the evaluation of the association of MELD score with mortality, a one-unit increase in MELD score was associated with a 1.26-fold (95% confidence interval: 1.10-1.44) increased mortality risk.
Conclusions: In our study evaluating the MELD score in COVID-19 patients, it was observed that the MELD score during hospitalization was closely associated with disease severity and mortality. Therefore, the MELD score may be a guiding scoring system in the early follow-up of COVID-19 patients.

Keywords

MELD, COVID-19, Mortality

Sars-Cov-2 Hastalarında Prognozun Öngörülmesine Yeni Bir Yaklaşım ‘MELD Skorlaması’

Abstract

Amaç: MELD skoru, son dönem karaciğer hastalığının şiddetini değerlendirmek için kullanılan bir skorlama sistemidir. Çalışmamızda multisistem tutulumu olan COVID-19 hastalığında MELD skorunun hastalığın seyrini ve mortaliteyi tahmin etmedeki rolünü araştırmayı amaçladık.
Gereç ve Yöntem: Çalışmamız Mart 2021 – Mart 2022 tarihleri arasında nazaofaringeal sürüntü alınarak real time PCR metoduyla COVİD-19 tanısı alan 18 yaş üstü 96 hasta ile yapılmıştır. MELD skoru hastaların hastaneye yatış anındaki kan sonuçlarına göre hesaplandı. MELD puanını hesaplamak için şu denklem kullanıldı: MELD = 11,2 x ln(uluslararası normalleştirilmiş oran [INR]) + 3,78 x ln(bilirubin, mg/dL olarak) + 9,57 x ln(kreatinin, mg/dL olarak) + 6,43.
Bulgular: MELD skorunun orta ve şiddetli hasta grubunda hafif hasta grubuna göre anlamlı olarak yüksek olduğunu bulduk (p<0.01). Orta ve ağır hasta gruplarını kendi aralarında karşılaştırdığımızda şiddetli hasta grubunda MELD skoru anlamlı olarak daha yüksekti (p<0.01).MELD skorunun mortalite ile ilişkisinin değerlendirilmesinde, MELD skorundaki bir birimlik artış, 1.26 kat (%95 güven aralığı: 1.10-1.44) artmış mortalite riski ile ilişkilendirildi.
Sonuç: COVID-19 hastalarında MELD skorunu değerlendiren çalışmamızda hastanede yatış sırasındaki MELD skorunun hastalık şiddeti ve mortalite ile yakından ilişkili olduğu gözlendi. Bu nedenle MELD skoru, COVID-19 hastalarının erken takibinde yol gösterici bir skorlama sistemi olabilir.

Keywords

MELD, COVID-19, Mortalite

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