The Relationship Between Acute Phase Reactants Levels at the Time of Admission and Comorbid Conditions with Mortality in Patients Diagnosed With Covid-19

Year 2024, Volume: 34 Issue: 2, 218 - 222, 30.04.2024

Muhammet Ali Erinmez , Ramazan Köylü , Öznur Köylü

https://doi.org/10.54005/geneltip.1376569

Abstract

Background/aims: The covid-19 pandemic, which is a global problem, is still one of the most important health problems today. Treatment and vaccine studies are as important in predicting prognosis and mortality as early diagnosis and prevention of the disease, which continues unabated. İn this study, it was aimed to evaluate the success of laboratory values, comorbid conditions and intensive care scoring at the time of first admission of patients admitted to intensive care with the diagnosis of Covid-19 in predicting mortality.
Methods: The study was conducted in a 3rd step adult emergency deparment. The study included 106 patients who were admitted to the emergency department and subsequently admitted to intensive care, had a positive Covid-19 polymerase chain reaction(PCR) test and met the inclusion criteria.
Results: The average age of 10 patients included in the study was 71.85. 65.09 percent of these patients are male and 24.1% are female. While 29 of the patients were survivors, 77 were deceased. İn deceased patients; Procalcitonin, lactate, leukocyte, neutrophil, urea, creatine, asti crpi ferritin, d-dimer values were found to be higher than the other group. Lymphocyte, lymphocyte percentage and pH values were found to be significantly low. Sequential Organ Failure Score(SOFA) and Acute Physiology and Chronic Health Evaluation(APACHE) 2 scores were found to be higher in deceased patients.
Conclusion: Ferritin, lactate, urea and pH values, comorbid conditions, Sequantial Organ Failure Score and Acute Sphysiology and Chronic Health Assessment 2 can be used to predict mortality in covid-19 disease.

Keywords

covid-19, CRP, d-dimer, ferritin, fibrinogen

Covid-19 Tanılı Hastalarda Başvuru Anındaki Akut Faz Reaktanları Düzeyi İle Komorbid Durumlarının Mortalite İle İlişkisi

Abstract

Amaç: Global bir problem olan covid-19 pandemisi günümüzde hala en önemli sağlık sorunlarının başında gelmektedir. Tedavi ve aşı çalışmaları hız kesmeden devam etmekte olan hastalığın erken tanınması ve önlenmesi kadar prognozu ve mortaliteyi öngörmekte bir o kadar önemlidir. Bu çalışmada covid-19 tanısı ile yoğun bakıma yatırılan hastaların ilk başvuru anındaki laboratuar değerlerinin, komorbid durumlarının ve yoğun bakım skorlamalarının mortaliteyi öngörme başarılarının değerlendirilmesi amaçlanmıştır.
Yöntem: Çalışma üçüncü basamak erişkin acil servisinde gerçekleştirilmiştir. Çalışmaya acil servise başvuran ve akabinde yoğun bakım yatışı verilen, covid-19 polimeraz zincir reaksiyon(pcr) testi pozitif ve dahil edilme kriterlerini karşılayan 106 hasta dahil edilmiştir.
Bulgular: Çalışmaya dahil edilen 106 hastanın yaş ortalaması 71.85 idi. Bu hastaların yüzde 65,09’unu erkek, %34,1’ini kadın cinsiyet oluşturmakta. Hastaların 29’u survival iken 77’si vefat eden hastalardan oluşmakta idi. Vefat eden hastalarda; procalsitonin, laktat, lökosit, nötrofil, üre, kreatin, ast, crp, ferritin, d-dimer değerleri diğer gruba göre yüksek saptanmıştır. Lenfosit, lenfosit yüzdesi ve ph değerleri ise anlamlı düşük olduğu tespit edilmiştir. Ardışık Organ Yetmezliği Skoru(SOFA) ve Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi(APACHE) 2 skorları vefat eden hastalarda daha yüksek tespit edilmiştir.
Sonuç: Ferritin, laktat, üre ve ph değerleri, komorbid durumlar, Ardışık Organ Yetmezliği Skoru ve Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi covid-19 hastalığında mortalite öngörmede kullanılabilir.

Keywords

covid-19, CRP, d-dimer, ferritin, fibrinojen

References

• Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13.
• Guan W-j, Ni Z-y, Hu Y, Liang W-h, Ou C-q, He J-x, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.
• Ferrer RJMi. COVID-19 Pandemic: the greatest challenge in the history of critical care. Med İntensiva (Engl Ed). 2020.
• Wang B, Li R, Lu Z, Huang YJA. Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis. Aging (Albany NY). 2020;12(7):6049.
• Bartziokas K, Papaioannou AI, Loukides S, Papadopoulos A, Haniotou A, Papiris S, et al. Serum uric acid as a predictor of mortality and future exacerbations of COPD. The European respiratory journal. 2014;43(1):43-53.
• Bezuidenhout MC, Wiese OJ, Moodley D, Maasdorp E, Davids MR, Koegelenberg CF, et al. Correlating arterial blood gas, acid-base and blood pressure abnormalities with outcomes in COVID-19 intensive care patients. Annals of clinical biochemistry. 2021;58(2):95-101.
• Carlino MV, Valenti N, Cesaro F, Costanzo A, Cristiano G, Guarino M, et al. Predictors of Intensive Care Unit admission in patients with coronavirus disease 2019 (COVID-19). Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace. 2020;90(3).
• Song YJ, Kim A, Kim GT, Yu HY, Lee ES, Park MJ, et al. Inhibition of lactate dehydrogenase A suppresses inflammatory response in RAW 264.7 macrophages. Mol Med Rep. 2019;19(1):629-37.
• Tan L, Wang Q, Zhang D, Ding J, Huang Q, Tang Y-Q, et al.Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Signal Transduct Target Ther. 2020;5(1):1-3.
• Henry BM, Cheruiyot I, Vikse J, Mutua V, Kipkorir V, Benoit J, et al. Lymphopenia and neutrophilia at admission predicts severity and mortality in patients with COVID-19: a meta-analysis. Acta Biomed. 2020;91(3):e2020008.
• Li X, Wang L, Yan S, Yang F, Xiang L, Zhu J, et al. Clinical characteristics of 25 death cases with COVID-19: a retrospective review of medical records in a single medical center, Wuhan, China. Int J Infect Dis. 2020;94:128-32.
• Huang I, Pranata R, Lim MA, Oehadian A, Alisjahbana BJTaird. C-reactive protein, procalcitonin, D-dimer, and ferritin in severe coronavirus disease-2019: a meta-analysis. Ther Adv Respir Dis. 2020;14:1753466620937175.
• Liu F, Li L, Xu M, Wu J, Luo D, Zhu Y, et al. Prognostic value of interleukin-6, C-reactive protein, and procalcitonin in patients with COVID-19. J Clin Virol. 2020;127:104370.
• Houghton R, Moore N, Williams R, El-Bakri F, Peters J, Mori M, et al. C- reactive protein guided use of procalcitonin in COVID-19. JAC Antimicrob Resist. 2021.
• Di Micco P, Russo V, Carannante N, Imparato M, Cardillo G, Lodigiani CJJoCM. Prognostic value of fibrinogen among COVID-19 patients admitted to an emergency department: an Italian cohort study. J Clin Med 2020;9(12):4134.
• Eljilany I, Elzouki A-NJVh, management r. D-Dimer, fibrinogen, and IL-6 in COVID 19 patients with suspected venous thromboembolism: a narrative review. Vasc Health Risk Manag. 2020;16:455.
• Lippi G, Lavie CJ, Sanchis-Gomar FJPicd. Cardiac troponin I in patients with coronavirus disease 2019 (COVID-19): evidence from a meta-analysis. Prog Cardiovasc Dis. 2020;63(3):390.
• Jauzzi JJCm. Troponin and BNP use in COVID-19. American Collage of Cardyology, Cardyology Magazine 2020;18.
• Vargas-Vargas M, Cortés-Rojo CJRPdSP. Ferritin levels and COVID-19.Rev Panam Salud Publica 2020;44:e72.
• Dahan S, Segal G, Katz I, Hellou T, Tietel M, Bryk G, et al. Ferritin as a Marker of Severity in COVID-19 Patients: A Fatal Correlation. Isr Med Assoc J 2020;22(8):494-500.