Investigation of Aggravating Risk Factors in COVID-19 Infection

Year 2023, , 46 - 53, 20.01.2023

Dilek Yekenkurul , Nevin Ince , Mustafa Yıldırım , Mehmet Ali Sungur , Elif Eşcan , Fatih Davran , Hasan Baki Altınsoy , Betül Dönmez , Guleser Akpinar

https://doi.org/10.33631/sabd.1078545

Abstract

Aim: Coronavirus disease-2019 caused an epidemic that started in China about two years ago but affected the whole world. It was aimed to evaluate patients followed up with coronavirus disease-2019 infection, to determine risk factors and indicators for severe infection.
Material and Methods: Patients who received treatment as inpatient with coronavirus disease-2019 infection between March 15- June 01 2020 were investigated. Patients were divided into two groups according to their oxygen saturation; patients with oxygen saturation over 90% were group 1, patients with 90% or less were determined as group 2. This two groups were compared in terms of aggravating risk factors.
Results: In this study, 90 patients (46 female, 44 male) were included. Moderate-severe pneumonic involvement in computed tomography of thorax (p=0.002) and high fever (p<0.001) were thought to be indicators for severe infection. Presence of chronic disease (p=0.018) and asthma (p=0.041) were found to be aggravating risk factors. High levels of tests such as C-reactive protein, erythrocyte sedimentation rate, ferritin, neutrophil-lymphocyte ratio, lactate dehydrogenase (p<0.001), procalcitonin, D-dimer, creatine kinase, triglyceride, and low levels of tests such as lymphocytes, hemoglobin were thought to indicate severe disease.
Conclusion: Parameters such as low level of lymphocyte and high level of C-reactive protein, D-dimer, ferritin are frequently used as indicators of poor prognosis. However, we also believe that high level of procalcitonin, lactate dehydrogenase, erythrocyte sedimentation rate, creatine kinase and triglyceride, low level of hemoglobin, in addition the presence of asthma and high fever may be indicators of poor prognosis.

Keywords

Coronavirus disease-2019, aggravating factors, oxygen saturation

Supporting Institution

The authors declared that this study has received no financial support.

COVID-19 Enfeksiyonunda Ağırlaştırıcı Risk Faktörlerinin Araştırılması

Abstract

Amaç: Koronavirüs hastalığı-2019, yaklaşık iki yıl önce Çin'de başlayan ancak tüm dünyayı etkisi altına alan bir salgına neden olmuştur. Koronavirüs hastalığı-2019 enfeksiyonu ile takip edilen hastaların değerlendirilmesi, ciddi enfeksiyon için risk faktörlerinin ve göstergelerinin belirlenmesi amaçlanmıştır.
Gereç ve Yöntemler: Koronavirüs hastalığı-2019 enfeksiyonu ile 15 Mart- 01 Haziran 2020 tarihleri arasında yatarak tedavi gören hastalar araştırıldı. Hastalar oksijen satürasyonlarına göre iki gruba ayrıldı; oksijen satürasyonu % 90'ın üzerinde olan hastalar grup 1, % 90 ve altı olan hastalar grup 2 olarak belirlendi. Bu iki grup ağırlaştırıcı risk faktörleri açısından karşılaştırıldı.
Bulgular: Bu çalışmaya 90 hasta (46 kadın, 44 erkek) dahil edildi. Bilgisayarlı toraks tomografisinde orta-şiddetli pnömonik tutulum (p=0,002) ve yüksek ateş (p<0,001) ciddi enfeksiyon belirteçleri olarak düşünüldü. Kronik hastalık (p=0.018) ve astım (p=0.041) varlığı ağırlaştırıcı risk faktörleri olarak bulundu. C-reaktif protein, eritrosit sedimentasyon hızı, ferritin, nötrofil-lenfosit oranı, laktat dehidrogenaz (p<0,001), prokalsitonin, D-dimer, kreatin kinaz, trigliserid gibi testlerin yüksek ve lenfosit, hemoglobin gibi testlerin düşük olmasının şiddetli hastalığı gösterdiği düşünüldü.
Sonuç: Lenfosit düşüklüğü ve C-reaktif protein, D-dimer, ferritin yüksekliği gibi parametreler kötü prognoz göstergesi olarak sıklıkla kullanılmaktadır. Ancak prokalsitonin, laktat dehidrogenaz, eritrosit sedimentasyon hızı, kreatin kinaz vetrigliserid seviyelerinin yüksek, hemoglobin düzeylerinin düşük olmasının yanında astım ve yüksek ateş varlığının da kötü prognoz göstergesi olabileceği kanaatindeyiz.

Keywords

Koronavirüs hastalığı 2019, ağırlaştırıcı faktörler, oksijen satürasyonu

References

• Phelan AL, Katz R, Gostin LO. The novel coronavirus originating in Wuhan, China: challenges for global health governance. JAMA. 2020; 323(8): 709-10.
• Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020; 382: 727-33.
• Republic of Turkey Ministry of Health Directorate General of Public Health, 2020. COVID-19 (SARS-CoV-2 infection) general information, epidemiology and diagnosis. Scientific Board Study. Avaible from:s URL: https://covid19.saglik.gov.tr/Eklenti/39551/0/covid-19rehberigenelbilgilerepidemiyolojivetanipdf.pdf Accessed January 12, 2021.
• Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020; 382(18): 1708-20.
• Komurcuoglu B. Clinical and laboratory findings of COVID-19. Eurasian J Pulmonol. 2020; 22: 16-8.
• Mizumoto K, Kagaya K, Chowell G. Early epidemiological assessment of the transmission potential and virulence of coronavirus disease 2019 (COVID-19) in Wuhan City: China. BMC Med. 2020; 15(18): 217.
• Bilgiç Z, Güner R. COVID-19: Pathogenesis, transmission routes and risk factors. Aktaş F, editor. COVID-19: Pandemic Lessons. 1st Edition. Ankara: Turkey Clinics; 2020. p.14-24.
• Liu Y, Du X, Chen J, Jin Y, Peng L, Wang HHX, et al. Neutrophil-to-lymphocyte Ratio as an Independent Risk Factor for Mortality in Hospitalized Patients With COVID-19. J Infect. 2020; 81(1): 6-12.
• 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 of Infect Dis. 2020; 94: 91-5.
• Zhang B, Zhou X, Zhu C, Song Y, Feng F, Qiu Y, et al. Immune phenotyping based on the neutrophil-to-lymphocyte ratio and IgG level predicts disease severity and outcome for patients with COVID-19. Front Mol Biosci. 2020; 7: 157.
• Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of immune response in patients with Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020; 71 (15): 762-8.
• Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229): 1054-62.
• Rod JE, Oviedo-Trespalacios O, Cortes-Ramirez J. A brief-review of the risk factors for COVID-19 severity. Rev Saude Publica. 2020; 54: 60.
• Zhang JJY, Lee KS, Ang LW, Leo YS, Young BE. Risk factors for severe disease and efficacy of treatment in patients infected with COVID-19: A systematic review, meta-analysis, and meta-regression analysis. Clin Infect Dis. 2020; 71(16): 2199-206.
• Günal Ö, Türe E, Bayburtlu M, Arslan U, Demirağ MD, Taşkın MH, et al. Evaluation of patients diagnosed with COVID-19 in terms of risk factors. Bulletin of Microbiology. 2020; 54(4): 575-82.
• Republic of Turkey Ministry of Health Directorate General of Public Health, 2021. COVID-19 (SARS-CoV-2 infection) adult patient treatment. Scientific Board Study. Avaible from:s URL:https://covid19.saglik.gov.tr/Eklenti/42169/0/covid19rehberieriskinhastayonetimivetedavi20122021v6pdf.pdf Accessed December 20, 2021.
• Karabıyık L. Intensive Care Scoring Systems. Turkish Journal of Intensive Care Medicine. 2010; 9(3): 129-43.
• World Health Organization (WHO). WHO Coronavirus Disease (COVID-19) Dashboard. Avaible from:s URL: https://covid19.who.int/ Accessed January 13, 2021.
• Republic of Turkey Ministry of Health, 2021. COVID-19 Weekly Status Report 12.10.2020 - 18.10.2020 Turkey. Avaible from:s URL: https://covid19.saglik.gov.tr/Eklenti/39168/0/covid-19-haftalik-durum-raporu---42-haftapdf.pdf?_tag1=710A3D148C11F8852B0DDC1FB4EE49DAE667F46D#:~:text=T%C3%BCrkiye'de%20toplam%209.296%20COVID,%252%2C67'dir Accessed January 13, 2021.
• Republic of Turkey Ministry of Health, General Directorate of Public Health. 2020. Drugs used in the treatment of COVID-19, drug interactions. Avaible from:s URL: https://covid19.saglik.gov.tr/Eklenti/37818/0/covid-19tedavisindekullanilanilaclar-ilacetkilesimleripdf.pdf Accessed January 13, 2021.
• Safdarian AR, Momenzadeh K, Kahe F, Farhangnia P, Rezaei N. Death due to COVID-19 in a patient with diabetes, epilepsy, and gout comorbidities. Clin Case Rep. 2021; 9: 461-4.
• Rider FK, Lebedeva AV, Mkrtchyan VR, Guekht AB. Epilepsy and COVID-19: patient management and optimization of antiepileptic therapy during pandemic. Zh Nevrol Psikhiatr Im S S Korsakova. 2020; 120(10): 100-7.