Hafif, şiddetli ve kritik COVID-19 hastalarında trombosit alt gruplarının prognoz ve mortalite ile ilişkisi
Öz
Amaç: Bu çalışmada amaç, trombosit sayısı (PLT), ortalama trombosit hacmi (MPV), trombosit dağılım genişliği (PDW), Plateletkrit (PCT) ve trombosit büyük hücre oranı (P-LCR) dahil olmak üzere trombositle ilgili göstergelerin yeni koronavirüs hastalığı 2019 (COVID-19)’da mortalite üzerine etkili biyobelirteçler olup olamayacağını araştırmaktadır.
Çalışma planı: Çalışmaya, COVID-19 tanılı 380 hastadan rastgele ve retrospektif olarak 98 hasta çalışmamıza dahil edildi. COVID-19 tanısı, Dünya Sağlık Örgütü (DSÖ) yönergelerine göre ve kantitatif polimer zincir reaksiyonu (qPCR) kullanılarak yapıldı. Ayancık Devlet Hastanesi ve Diyarbakır Gazi Yaşargil Eğitim ve Araştırma Hastanesi'ndeki çalışmaya alınan hastaların özgeçmişine ait bilgiler ile klinik ve laboratuvar verileri hastane bilgi sisteminden alındı. Tüm hastalar günlük olarak takip edildi ve hafif, şiddetli ve kritik hastalar olmak üzere üç kategoriye ayrıldı. Veri analizi SPSS-26 for Windows (Statistical Package for Social Science, SPSS Inc. Chicago IL, USA®Z) kullanılarak yapıldı ve %95 güven düzeyi seçildi. P < 0.5 istatistiksel olarak anlamlı kabul edildi.
Bulgular: Katılımcıların %64,3'ü 65 yaş ve üzerinde, %54,1'i erkek, %60,2'si taburcu oldu, %39,8'i exitus (ex) oldu ve %35,7'sinin durumu kritikti. Ölüm oranı erkeklerde ve 65 yaş ve üzerinde daha yüksekti. Taburcu olan hastalarda PLT (190,24) ve PCT (0,21) ölçümleri daha yüksek bulunurken, ex hastalarda MPV (10,67), PDW (16,15) ve P-LCR (30,82) ölçümleri daha yüksekti. Belirlenen cut-off değerine göre pozitif olan hastaların ölüm durumunu en iyi tahmin eden ölçüm PDW (0,621), yaşayan hastaları en iyi tahmin eden ölçüm ise PLT (0,925) idi.
Sonuç: Çalışmamızda yüksek MPV, PDW ve P-LCR ile düşük trombosit değerlerinin COVID-19 hastalığının kötü prognozu ile ilişkili olduğu ve PDW ve PCT ölçümlerinin COVID-19 hastalarında mortaliteyi öngörmede daha etkili olduğu sonucuna varıldı. MPV, PDW, P-LCR, PDW ve PCT gibi laboratuvar parametreleri, klinisyenlere COVID-19 hastalığından prognoz ve mortalite tahminleri sağlayabilir.
Anahtar Kelimeler
COVID-19 Trombosit sayısı Trombosit indeksleri Prognoz Hastalık şiddeti Ölüm oranı
Destekleyen Kurum
yoktur
Proje Numarası
yoktur
Teşekkür
yoktur
Kaynakça
- Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J. et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 Mar 17;323(11):1061-1069. doi: 10.1001/jama.2020.1585. Erratum in: JAMA. 2021 Mar 16;325(11):1113.
- Yang X, Yu Y, Xu J, Shu H, Liu H, Wu Y, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. The Lancet Respiratory Medicine. 2020;8(5):475-81.
- Bal T, Dogan S, Cabalak M, Dirican E. Lymphocyte-to-C-reactive protein ratio may serve as an effective biomarker to determine COVID-19 disease severity. Turkish Journal of Biochemistry. 2020;1(ahead-of-print).
- Connors JM, Levy JH. Thromboinflammation and the hypercoagulability of COVID‐19. Journal of Thrombosis and Haemostasis. 2020;18(7):1559-61.
- Nalbant A, Kaya T, Varim C, Yaylaci S, Tamer A, Cinemre H. Can the neutrophil/lymphocyte ratio (NLR) have a role in the diagnosis of coronavirus 2019 disease (COVID-19)? Rev Assoc Med Bras (1992). 2020 Jun;66(6):746-751.
- Liu Y, Sun W, Guo Y, Chen L, Zhang L, Zhao S, et al. Association between platelet parameters and mortality in coronavirus disease 2019: retrospective cohort study. Platelets. 2020;31(4):490-6.
- Terpos E, Ntanasis‐Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, et al. Hematological findings and complications of COVID‐19. American journal of hematology. 2020;95(7):834-47.
- Santimone I, Di Castelnuovo A, De Curtis A, Spinelli M, Cugino D, Gianfagna F, et al. White blood cell count, sex and age are major determinants of heterogeneity of platelet indices in an adult general population: results from the MOLI-SANI project. haematologica. 2011;96(8):1180.
- Güçlü E, Kocayiğit H, Okan HD, Erkorkmaz U, Yürümez Y, Yaylacı S. et al. Effect of COVID-19 on platelet count and its indices. Rev Assoc Med Bras (1992). 2020 Aug;66(8):1122-1127.
- He J, Wei Y, Chen J, Chen F, Gao W, Lu X. Dynamic trajectory of platelet-related indicators and survival of severe COVID-19 patients. Critical Care. 2020;24(1):1-4.
- Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: a meta-analysis. Clinica chimica acta. 2020;506:145-8.
- Canzano P, Brambilla M, Porro B, Cosentino N, Tortorici E, Vicini S, et al. Platelet and Endothelial Activation as Potential Mechanisms Behind the Thrombotic Complications of COVID-19 Patients. JACC: Basic to Translational Science. 2021;6(3):202-18.
- Zhang D, Zhou X, Yan S, Tian R, Su L, Ding X, et al. Correlation between cytokines and coagulation-related parameters in patients with coronavirus disease 2019 admitted to ICU. Clinica Chimica Acta. 2020;510:47-53.
- Cerit L, Cerit Z. Relationship between coronary tortuosity and plateletcrit coronary tortuosity and plateletcrit. Cardiovasc J Afr. 2017;28(6):385-8.
- Besada MSD, Elsayed AA, Ali AE, Hashem AA. Platelet indicies as an indicators of diabetic nephropathy. SVU-International Journal of Medical Sciences. 2021;4(1):41-8.
Relationship of platelet subgroups with prognosis and mortality in patients with mild, severe and critical COVID-19
Öz
Introduction: This study investigates whether platelet-related indicators including platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), Plateletcrit (PCT), and platelet large cell ratio (P-LCR) could be effective biomarkers in the prognostic of 2019-novel coronavirus disease (COVID-19) fatality.
Methods: Out of 380 patients diagnosed with COVID-19, 98 patients were randomly and retrospectively were included in our study. Detection of COVID-19 was performed according to the World Health Organization (WHO) guidelines and using quantitative polymer chain reaction (qPCR). Clinical and laboratory data and medical records for all study participants were collected from a digital version of their health history at Ayancik State Hospital and Diyarbakır Gazi Yaşargil Training and Research Hospital. All patients were followed up daily until discharge or death and were eventually classified into three categories: Mild, severe, and critical patients. Data analysis was performed using SPSS-26 for Windows (Statistical Package for Social Science, SPSS Inc. Chicago IL, USA®Z), and a 95% confidence level was selected. P < 0.5 was considered statistically significant.
Results: Of participants, 64.3% of the patients are 65 years and older, 54.1% are male, 60.2% survived, 39.8 % died and 35.7% are in critical condition. The mortality rate is higher in males and 65 years and older. While PLT (190,24) and PCT (0,21) measurements were higher in surviving patients, MPV (10,67), PDW (16,15) and P-LCR (30,82) measurements were higher in deceased patients. PDW and PCT measurements are more effective in predicting mortality state according to Roc analysis. The measurement that best predicts the deceased status of patients who are positive according to the cut-off value determined is PDW (0.621), and the measurement that best estimates the surviving patients is PLT (0.925).
Conclusions: In our study, it was concluded that high MPV, PDW and P-LCR and low platelet values are associated with poor prognosis of COVID-19 disease, and PDW and PCT measurements are more effective in predicting mortality in patients with COVID-19 infection. Laboratory parameters such as MPV, PDW, P-LCR, PDW, and PCT can provide clinicians with predictions of prognosis and mortality from COVID-19 disease.
Anahtar Kelimeler
COVID-19 Platelets count Platelet indices Prognosis Disease severity Mortality
Proje Numarası
yoktur
Kaynakça
- Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J. et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 Mar 17;323(11):1061-1069. doi: 10.1001/jama.2020.1585. Erratum in: JAMA. 2021 Mar 16;325(11):1113.
- Yang X, Yu Y, Xu J, Shu H, Liu H, Wu Y, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. The Lancet Respiratory Medicine. 2020;8(5):475-81.
- Bal T, Dogan S, Cabalak M, Dirican E. Lymphocyte-to-C-reactive protein ratio may serve as an effective biomarker to determine COVID-19 disease severity. Turkish Journal of Biochemistry. 2020;1(ahead-of-print).
- Connors JM, Levy JH. Thromboinflammation and the hypercoagulability of COVID‐19. Journal of Thrombosis and Haemostasis. 2020;18(7):1559-61.
- Nalbant A, Kaya T, Varim C, Yaylaci S, Tamer A, Cinemre H. Can the neutrophil/lymphocyte ratio (NLR) have a role in the diagnosis of coronavirus 2019 disease (COVID-19)? Rev Assoc Med Bras (1992). 2020 Jun;66(6):746-751.
- Liu Y, Sun W, Guo Y, Chen L, Zhang L, Zhao S, et al. Association between platelet parameters and mortality in coronavirus disease 2019: retrospective cohort study. Platelets. 2020;31(4):490-6.
- Terpos E, Ntanasis‐Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, et al. Hematological findings and complications of COVID‐19. American journal of hematology. 2020;95(7):834-47.
- Santimone I, Di Castelnuovo A, De Curtis A, Spinelli M, Cugino D, Gianfagna F, et al. White blood cell count, sex and age are major determinants of heterogeneity of platelet indices in an adult general population: results from the MOLI-SANI project. haematologica. 2011;96(8):1180.
- Güçlü E, Kocayiğit H, Okan HD, Erkorkmaz U, Yürümez Y, Yaylacı S. et al. Effect of COVID-19 on platelet count and its indices. Rev Assoc Med Bras (1992). 2020 Aug;66(8):1122-1127.
- He J, Wei Y, Chen J, Chen F, Gao W, Lu X. Dynamic trajectory of platelet-related indicators and survival of severe COVID-19 patients. Critical Care. 2020;24(1):1-4.
- Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: a meta-analysis. Clinica chimica acta. 2020;506:145-8.
- Canzano P, Brambilla M, Porro B, Cosentino N, Tortorici E, Vicini S, et al. Platelet and Endothelial Activation as Potential Mechanisms Behind the Thrombotic Complications of COVID-19 Patients. JACC: Basic to Translational Science. 2021;6(3):202-18.
- Zhang D, Zhou X, Yan S, Tian R, Su L, Ding X, et al. Correlation between cytokines and coagulation-related parameters in patients with coronavirus disease 2019 admitted to ICU. Clinica Chimica Acta. 2020;510:47-53.
- Cerit L, Cerit Z. Relationship between coronary tortuosity and plateletcrit coronary tortuosity and plateletcrit. Cardiovasc J Afr. 2017;28(6):385-8.
- Besada MSD, Elsayed AA, Ali AE, Hashem AA. Platelet indicies as an indicators of diabetic nephropathy. SVU-International Journal of Medical Sciences. 2021;4(1):41-8.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | İç Hastalıkları |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Proje Numarası | yoktur |
| Yayımlanma Tarihi | 21 Ağustos 2023 |
| Gönderilme Tarihi | 30 Temmuz 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 3 Sayı: 2 |
e-ISSN: 2791-9935