Prognostic value of laboratory parameters in patients with SARS-COV-2 infection

Yıl 2022, , 100 - 104, 28.12.2022

Adem Keskin

https://doi.org/10.46239/ejbcs.1002024

Öz

In this study, it was aimed to evaluate the laboratory findings that are important in the prognosis process of coranavirus-19 (COVID-19), which is assumed to be the latest global biohazard for humanity. For this purpose, a literature review was conducted based on COVID-19 disease and laboratory findings. As a result of this literature review, the study was created by evaluating 25 articles. Laboratory findings are categorized under three main headings. These headings are hematological parameters, coagulation parameters and inflammatory parameters. It has been determined that low lymphocyte count in hematological parameters is a condition seen at every stage of the disease. High neutrophil count is a sign of worsening prognosis. With the increase in the severity of the disease, an increase in the neutrophil/lymphocyte ratio was noted. In addition, low thrombocyte levels may also be observed. In coagulation parameters, increased prothrombin time and high D-dimer levels are prominent in patients with severe COVID-19 disease. High levels of C-reactive protein (CRP), one of the inflammatory parameters, can be observed at every stage of the disease. In addition, as the course of the disease worsens, C-reactive protein levels rise more and more. In addition, an increase in procalcitonin and ferritin levels is observed as the condition of the disease worsens. As a result, while lymphocytopenia and high CRP levels were prominent throughout the course of the disease, increased prothrombin time, neutrophil/lymphocyte ratio, neutrophil count, D-dimer, procalcitonin and ferritin levels emerged with the disease becoming more aggressive.

Anahtar Kelimeler

SARS-CoV-2, Coronavirus, COVID-19, Laboratory parameters, Prognosis

SARS-COV-2 enfeksiyonu olan hastalarda laboratuvar parametrelerin prognoz değeri

Öz

Bu çalışmada, insanlık için en son küresel biyolojik tehlike olduğu varsayılan koranavirüs-19 (COVID-19) hastalığının prognoz sürecinde önem arz eden laboratuvar parametrelerini değerlendirmek amaçlanmıştır. Bu amaç doğrultusunda, COVID-19 hastalığı ve laboratuvar parametrelerinin esas alındığı literatür taraması yapılmıştır. Bu literatür taraması sonucunda 25 adet makalenin değerlendirilmesi ile çalışma oluşturulmuştur. Laboratuvar parametreleri, üç ana başlık altında kategorize edilmiştir. Bu başlıklar, hematolojik parametreler, koagulasyon parametreleri ve inflamatuar parametrelerdir. Hematolojik parametrelerde lenfosit sayısının düşük çıkması, hastalığın her aşamasında görülen bir durum olduğu saptanmıştır. Prognozun kötüye gidişatında nötrofil sayısının yüksekliği ön plana çıkmaktadır. Hastalığın şiddetinin artması ile birlikte nötrofil/lenfosit oranında yükseklik belirtilmiştir. Buna ek olarak trombosit düşüklüğü de gözlenebilmektedir. Koagulasyon parametrelerinde ise, COVID-19 hastalığını ağır geçirenlerde artan protrombin zamanı ve D-dimer düzeylerinin yüksekliği ön plana çıkmaktadır. İnflamatuar parametrelerden C-reaktif protein (CRP) düzeylerinin yüksekliği, hastalığın her aşamasında gözlenebilen bir durumdur. Buna ek olarak, hastalığın seyri kötüye gittikçe C-reaktif protein düzeyleri de daha çok yükselmektedir. Ayrıca, prokalsitonin ve ferritin yüksekliği de hastalığın durumu ağırlaştıkça gözlenmektedir. Sonuç olarak, hastalığın seyri boyunca, lenfositopeni ve CRP düzeylerinin yüksekliği ön plana çıkarken, hastalığın daha agresif bir hale dönmesiyle birlikte, artan protrombin zamanı, nötrofil/lenfosit oranı, nötrofil sayısı, D-dimer, prokalsitonin ve ferritin düzeyleri yüksekliği ortaya çıkmıştır.

Anahtar Kelimeler

SARS-CoV-2, Koronavirüs, COVID-19, Laboratuvar parametreleri, Prognoz

Kaynakça

• Abbasi-Oshaghi E, Mirzaei F, Farahani F, Khodadadi I, Tayebini H. 2020. Diagnosis and treatment of coronavirus disease 2019 (COVID-19): Laboratory, PCR, and chest CT imaging findings. International Journal of Surgery, 79: 143-153.
• Bashash D, Abolghasemi H, Salari S, Olfatifar M, Eshghi P, Akbari ME. 2020. Elevation of D-Dimer, But Not PT and aPTT, Reflects the Progression of COVID-19 Toward an Unfavorable Outcome: A Meta-Analysis. IJBC., 12(2):47-53.
• Benvenuto D, Giovanetti M, Ciccozzi A, Spoto S, Angeletti S, Ciccozzi M. 2020. The 2019-new coronavirus epidemic: evidence for virus evolution, J. Med. Virol., 92(4): 455-459.
• Dasgupta A, Sepulveda JL. 2013. Accurate Results in the Clinical Laboratory A Guide to Error Detection and Correction. In: Sepulveda JL, eds. Chapter 1 - Variation, Errors, and Quality in the Clinical Laboratory. ISBN: 978-0-12-415783-5. Elsevier, 1-8.
• Goudouris ES. 2021. Laboratory diagnosis of COVID-19. J Pediatr (Rio J), 97:7-12.
• Hu R, Hanc C, Pei S, Yin M, Chen X. 2020. Procalcitonin levels in COVID-19 patients. International Journal of Antimicrobial Agents, 56(2): 106051
• Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X. 2020. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet, 395(10223):497-506.
• Kernan KF, Carcillo JA. 2017. Hyperferritinemia and inflammation. Int. Immunol., 29(9): 401-409.
• Lagunas-Rangel FA. 2020. Neutrophil-to-lymphocyte ratio and lymphocyte-to-C-reactive protein ratio in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis. J. Med. Virol., 92(10):1733-1734.
• Liu J, Liu Y, Xiang P, Pu L, Xiong H, Li C, Zhang M, Tan J, Xu Y, Song R. 2019. Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage. J. Transl. Med., 18(2020):1-12.
• Liu Y, Du J, Chen J, Jin Y, Peng L, Wang HHX, Luo M, Chen L, Zhao Y. 2020. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. Journal of Infection, 81(1) e6-e12.
• Lu H, Stratton CV, Tang YW. The Wuhan SARS-CoV-2–What's Next for China, J. Med. Virol. 92(6):546-547.
• Pourbagheri-Sigaroodi A, Bashash D, Fateh F, Abolghasemi H. 2020. Laboratory findings in COVID-19 diagnosis and prognosis. Clin Chim Acta, 510: 475-482.
• Ruan Q, Yang K, Wang W, Jiang L, Song J. 2020. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med., 46(5):846-848.
• Skevaki C, Fragkou PC, Cheng C, Xie M, Renza H. 2020. Laboratory characteristics of patients infected with the novel SARS-CoV-2 virus. Journal of Infection, 81(2): 205-212.
• Tan C, Huang Y, Shi F, Tan K, Ma Q, Chen Y, Jiang X, Li X. 2020. C-reactive protein correlates with computed tomographic findings and predicts severe COVID-19 early. Journal of Medical Virology, 92:856–862.
• Tan L, Wang Q, Zhang D, Ding J, Huang Q, Tang YQ, Wang Q, Miao H. 2020. Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Signal Transduction Targeted Therapy, 5(1):1–3.
• Tang N, Li D, Wang X, Sun Z. 2020. Abnormal Coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J. Thromb. Haemost., 18(4): 844-847.
• Velavan TP, Meyer CG. 2020. Mild versus severe COVID-19: Laboratory markers. International Journal of Infectious Diseases, 95: 304-307.
• Vieira LMF, Emery E, Andriolo A. 2020. COVID-19: laboratory diagnosis for clinicians. An updating article. Sao Paulo Medical Journal, 138(03): 259-266.
• Wang B, Hu C, Hu F, Zhu X, Liu J, Zhang B, Wang H, Xiang Z, Cheng Y. 2020. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA, 323(11): 1061-1069.
• Wang T, Du Z, Zhu F, Cao Z, An Y, Gao Y, Jiang B. Comorbidities and multi-organ injuries in the treatment of COVID-19. The Lancet, 395(10228): E52.
• Wu Z, McGoogan ZM. 2020. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention, JAMA, 323(13):1239-1242.
• Xu Z., Shi L, Wang Y, Zhang J, Huang L, Zhang C, Liu S, Zhao P, Liu H, Zhu L. 2020. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respiratory Med., 8(4):420–422.
• Yang AP, Liu J, Tao W, Li HM. 2020. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int. Immunopharmacol., 84: 106504.
• Yuan J, Zou R, Zeng L, Kou S, Lan J, Li X, Liang Y, Ding X, Tan G, Tang S. 2020. The correlation between viral clearance and biochemical outcomes of 94 COVID-19 infected discharged patients. Inflamm. Res., 69(6):599-606.
• Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X. 2020. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet, 395(10229):1054-1062.