Evaluation of the Effect of Biomarker Levels Associated with Disease Severity on Mortality in COVID-19 Patients in the Gaziantep Region of Turkey
Öz
This study aimed to investigate the effect of clinical and some specific laboratory parameters on the prognosis and mortality of critically ill COVID-19 patients who need to be followed in the intensive care unit (ICU). This is a retrospective cohort study. A total of 180 patients treated in the ICU were included in the study. The data of clinical and levels of D-dimer, cardiac troponin I (cTnI), Ferritin, and CK-MB were researched. The multivariate and univariate logistic regression models were employed to investigate the risk factors affiliated with in-hospital death. There was a significant difference in mortality between women and men (p=0.002). Hypertension was the most common comorbid disease, mortality was detected to be significantly greater in patients over 65 years of age. The serum D-dimer, cTnI, CK-MB, and ferritin levels were found to be higher in patients at risk. In the multivariate logistic regression model, we detected that ferritin above 300 μg/l (p=0.05) alongside cancer was associated with mortality. This study showed that advanced age is an important risk factor as well as the mortality of patients with cancer –especially those with a ferritin value above 300 μg/l and patients with a high cTnI value.
Anahtar Kelimeler
Kaynakça
- Asakura, H., & Ogawa, H. (2021). COVID-19-associated coagulopathy and disseminated intravascular coagulation. International Journal of Hematology, 113(1), 45–57.
- Bayrakçı, O. (2022). Prognosis of Covid-19 according to pneumonia types. Asian J Res Inf Dis, 9(1), 8–12.
- Bornstein, S. R., Dalan, R., Hopkins, D., Mingrone, G., & Boehm, B. O. (2020). Endocrine and metabolic link to coronavirus infection. Nature Reviews. Endocrinology, 16(6), 297–298.
- Cordeanu, E.-M., Duthil, N., Severac, F., Lambach, H., Tousch, J., Jambert, L., … Stephan, D. (2020). Prognostic value of troponin elevation in COVID-19 hospitalized patients. Journal of Clinical Medicine, 9(12), 4078.
- Doruk, Ö.G., Örmen, M., Tuncel, E.(2021) Biochemical and hematological parameters in Covid-19. J DEU Med (Special Issue 1): S71-S80.
- Freda, B. J., Tang, W. H. W., Van Lente, F., Peacock, W. F., & Francis, G. S. (2002). Cardiac troponins in renal insufficiency: review and clinical implications. Journal of the American College of Cardiology, 40(12), 2065–2071.
- Guan, W.-J., Ni, Z.-Y., Hu, Y., Liang, W.-H., Ou, C.-Q., He, J.-X., … China Medical Treatment Expert Group for Covid-19. (2020). Clinical characteristics of Coronavirus disease 2019 in China. The New England Journal of Medicine, 382(18), 1708–1720.
- Huang, Y., Hu, Z., Hu, D., Quan, Z., Zhou, X., Fan, G., … Hu, D. (2021). Clinical characteristics, risk factors, and cardiac manifestations of cancer patients with COVID-19. Journal of Applied Physiology (Bethesda, Md.: 1985), 131(3), 966–976.
- Imazio, M., Klingel, K., Kindermann, I., Brucato, A., De Rosa, F. G., Adler, Y., & De Ferrari, G. M. (2020). COVID-19 pandemic and troponin: indirect myocardial injury, myocardial inflammation, or myocarditis? Heart (British Cardiac Society), 106(15), 1127–1131.
- Kociol, R. D., Pang, P. S., Gheorghiade, M., Fonarow, G. C., O’Connor, C. M., & Felker, G. M. (2010). Troponin elevation in heart failure prevalence, mechanisms, and clinical implications. Journal of the American College of Cardiology, 56(14), 1071–1078.
- Majure, D. T., Gruberg, L., Saba, S. G., Kvasnovsky, C., & Hirsch, J. S. (2021). Jauhar R; Northwell Health COVID-19 Research Consortium. The usefulness of elevated troponin to predict death in patients with COVID-19 and myocardial injury. Am J Cardiol, 138, 100–106.
- Qin, C., Zhou, L., Hu, Z., Zhang, S., Yang, S., Tao, Y., … Tian, D.-S. (2020). Dysregulation of immune response in patients with Coronavirus 2019 (COVID-19) in Wuhan, China. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 71(15), 762–768.
- Richardson, S., Hirsch, J. S., Narasimhan, M., Crawford, J. M., McGinn, T., Davidson, K. W., … Zanos, T. P. (2020). Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA: The Journal of the American Medical Association, 323(20), 2052–2059.
- Salazar, M., Barochiner, J., Espeche, W., & Ennis, I. (2020). COVID-19, hipertensión y enfermedad cardiovascular. Hipertension y riesgo vascular, 37(4), 176–180.
- Shi, S., Qin, M., Cai, Y., Liu, T., Shen, B., Yang, F., … Huang, C. (2020). Characteristics and clinical significance of myocardial injury in patients with severe coronavirus disease 2019. European Heart Journal, 41(22), 2070–2079.
- Tang, N., Li, D., Wang, X., & Sun, Z. (2020). Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. Journal of Thrombosis and Hemostasis: JTH, 18(4), 844–847.
- Thygesen, K., Mair, J., Katus, H., Plebani, M., Venge, P., Collinson, P., … Study Group on Biomarkers in Cardiology of the ESC Working Group on Acute Cardiac Care. (2010). Recommendations for the use of cardiac troponin measurement in acute cardiac care. European Heart Journal, 31(18), 2197–2204.
- Yang, G., Tan, Z., Zhou, L., Yang, M., Peng, L., Liu, J., Cai, J., Yang, R., Han, J., Huang, Y., & He, S. (2020). Effects of Angiotensin II Receptor Blockers and ACE (Angiotensin-Converting Enzyme) Inhibitors on Virus Infection, Inflammatory Status, and Clinical Outcomes in Patients With COVID-19 and Hypertension: A Single-Center Retrospective Study. Hypertension (Dallas, Tex. : 1979), 76(1), 51–58.
- Zuin, M., Rigatelli, G., Zuliani, G., Rigatelli, A., Mazza, A., & Roncon, L. (2020). Arterial hypertension and risk of death in patients with COVID-19 infection: Systematic review and meta-analysis. The Journal of Infection, 81(1), e84–e86.
- Zhang, L., Yan, X., Fan, Q., Liu, H., Liu, X., Liu, Z., & Zhang, Z. (2020). D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. Journal of thrombosis and hemostasis: JTH, 18(6), 1324–1329.
- Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., Liu, Z., Xiang, J., Wang, Y., Song, B., Gu, X., Guan, L., Wei, Y., Li, H., Wu, X., Xu, J., Tu, S., Zhang, Y., Chen, H., & Cao, B. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet (London, England), 395(10229), 1054–1062.
Türkiye'nin Gaziantep Bölgesinde COVID-19 Hastalarında Hastalık Şiddetiyle İlişkili Biyobelirteç Düzeylerinin Mortalite Üzerine Etkisinin Değerlendirilmesi
Öz
Bu çalışma, yoğun bakım ünitesinde (YBÜ) takip edilmesi gereken kritik COVID-19 hastalarının prognoz ve mortalitesi üzerine klinik ve bazı özellikli laboratuvar parametrelerinin etkisini araştırmayı amaçlamıştır. Bu retrospektif bir kohort çalışmasıdır. Yoğun bakımda tedavi edilen toplam 180 hasta çalışmaya dahil edildi. D-dimer, kardiyak troponin I (cTnI), Ferritin ve CK-MB klinik verileri ve düzeyleri araştırıldı. Hastane içi ölümle ilişkili risk faktörlerini araştırmak için çok değişkenli ve tek değişkenli lojistik regresyon modelleri kullanıldı. Kadınlar ve erkekler arasında mortalite açısından anlamlı fark vardı (p=0,002). Hipertansiyon en sık görülen komorbid hastalıktı, mortalite 65 yaş üstü hastalarda anlamlı olarak daha yüksek saptandı. Risk altındaki hastalarda serum D-dimer, cTnI, CK-MB ve ferritin düzeyleri daha yüksek bulundu. Çok değişkenli lojistik regresyon modelinde, kanserle birlikte 300 μg/l'nin (p=0.05) üzerindeki ferritinin mortalite ile ilişkili olduğunu saptandı. Bu çalışma kanserli hastalarda, özellikle ferritin değeri 300 μg/l'nin üzerinde olanlarda ve cTnI değeri yüksek olan hastalarda, ileri yaşın mortalitesi kadar önemli bir risk faktörü olduğunu göstermiştir. Serum D-dimer, cTnI, CK-MB ve ferritin düzeyleri yüksek olan hastalarda mortalite anlamlı olarak daha yüksekti.
Anahtar Kelimeler
Kaynakça
- Asakura, H., & Ogawa, H. (2021). COVID-19-associated coagulopathy and disseminated intravascular coagulation. International Journal of Hematology, 113(1), 45–57.
- Bayrakçı, O. (2022). Prognosis of Covid-19 according to pneumonia types. Asian J Res Inf Dis, 9(1), 8–12.
- Bornstein, S. R., Dalan, R., Hopkins, D., Mingrone, G., & Boehm, B. O. (2020). Endocrine and metabolic link to coronavirus infection. Nature Reviews. Endocrinology, 16(6), 297–298.
- Cordeanu, E.-M., Duthil, N., Severac, F., Lambach, H., Tousch, J., Jambert, L., … Stephan, D. (2020). Prognostic value of troponin elevation in COVID-19 hospitalized patients. Journal of Clinical Medicine, 9(12), 4078.
- Doruk, Ö.G., Örmen, M., Tuncel, E.(2021) Biochemical and hematological parameters in Covid-19. J DEU Med (Special Issue 1): S71-S80.
- Freda, B. J., Tang, W. H. W., Van Lente, F., Peacock, W. F., & Francis, G. S. (2002). Cardiac troponins in renal insufficiency: review and clinical implications. Journal of the American College of Cardiology, 40(12), 2065–2071.
- Guan, W.-J., Ni, Z.-Y., Hu, Y., Liang, W.-H., Ou, C.-Q., He, J.-X., … China Medical Treatment Expert Group for Covid-19. (2020). Clinical characteristics of Coronavirus disease 2019 in China. The New England Journal of Medicine, 382(18), 1708–1720.
- Huang, Y., Hu, Z., Hu, D., Quan, Z., Zhou, X., Fan, G., … Hu, D. (2021). Clinical characteristics, risk factors, and cardiac manifestations of cancer patients with COVID-19. Journal of Applied Physiology (Bethesda, Md.: 1985), 131(3), 966–976.
- Imazio, M., Klingel, K., Kindermann, I., Brucato, A., De Rosa, F. G., Adler, Y., & De Ferrari, G. M. (2020). COVID-19 pandemic and troponin: indirect myocardial injury, myocardial inflammation, or myocarditis? Heart (British Cardiac Society), 106(15), 1127–1131.
- Kociol, R. D., Pang, P. S., Gheorghiade, M., Fonarow, G. C., O’Connor, C. M., & Felker, G. M. (2010). Troponin elevation in heart failure prevalence, mechanisms, and clinical implications. Journal of the American College of Cardiology, 56(14), 1071–1078.
- Majure, D. T., Gruberg, L., Saba, S. G., Kvasnovsky, C., & Hirsch, J. S. (2021). Jauhar R; Northwell Health COVID-19 Research Consortium. The usefulness of elevated troponin to predict death in patients with COVID-19 and myocardial injury. Am J Cardiol, 138, 100–106.
- Qin, C., Zhou, L., Hu, Z., Zhang, S., Yang, S., Tao, Y., … Tian, D.-S. (2020). Dysregulation of immune response in patients with Coronavirus 2019 (COVID-19) in Wuhan, China. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 71(15), 762–768.
- Richardson, S., Hirsch, J. S., Narasimhan, M., Crawford, J. M., McGinn, T., Davidson, K. W., … Zanos, T. P. (2020). Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA: The Journal of the American Medical Association, 323(20), 2052–2059.
- Salazar, M., Barochiner, J., Espeche, W., & Ennis, I. (2020). COVID-19, hipertensión y enfermedad cardiovascular. Hipertension y riesgo vascular, 37(4), 176–180.
- Shi, S., Qin, M., Cai, Y., Liu, T., Shen, B., Yang, F., … Huang, C. (2020). Characteristics and clinical significance of myocardial injury in patients with severe coronavirus disease 2019. European Heart Journal, 41(22), 2070–2079.
- Tang, N., Li, D., Wang, X., & Sun, Z. (2020). Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. Journal of Thrombosis and Hemostasis: JTH, 18(4), 844–847.
- Thygesen, K., Mair, J., Katus, H., Plebani, M., Venge, P., Collinson, P., … Study Group on Biomarkers in Cardiology of the ESC Working Group on Acute Cardiac Care. (2010). Recommendations for the use of cardiac troponin measurement in acute cardiac care. European Heart Journal, 31(18), 2197–2204.
- Yang, G., Tan, Z., Zhou, L., Yang, M., Peng, L., Liu, J., Cai, J., Yang, R., Han, J., Huang, Y., & He, S. (2020). Effects of Angiotensin II Receptor Blockers and ACE (Angiotensin-Converting Enzyme) Inhibitors on Virus Infection, Inflammatory Status, and Clinical Outcomes in Patients With COVID-19 and Hypertension: A Single-Center Retrospective Study. Hypertension (Dallas, Tex. : 1979), 76(1), 51–58.
- Zuin, M., Rigatelli, G., Zuliani, G., Rigatelli, A., Mazza, A., & Roncon, L. (2020). Arterial hypertension and risk of death in patients with COVID-19 infection: Systematic review and meta-analysis. The Journal of Infection, 81(1), e84–e86.
- Zhang, L., Yan, X., Fan, Q., Liu, H., Liu, X., Liu, Z., & Zhang, Z. (2020). D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. Journal of thrombosis and hemostasis: JTH, 18(6), 1324–1329.
- Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., Liu, Z., Xiang, J., Wang, Y., Song, B., Gu, X., Guan, L., Wei, Y., Li, H., Wu, X., Xu, J., Tu, S., Zhang, Y., Chen, H., & Cao, B. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet (London, England), 395(10229), 1054–1062.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Biyokimya ve Hücre Biyolojisi (Diğer) |
| Bölüm | ARAŞTIRMA MAKALESİ (Research Article) |
| Yazarlar | |
| Erken Görünüm Tarihi | 14 Haziran 2023 |
| Yayımlanma Tarihi | 31 Aralık 2023 |
| Gönderilme Tarihi | 15 Ekim 2022 |
| Kabul Tarihi | 20 Ocak 2023 |
| Yayımlandığı Sayı | Yıl 2023 |
Kaynak Göster
2022-JIF = 0.500
2022-JCI = 0.170
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