Effectiveness of Laboratory Parameters as Morbidity
and Mortality Indicators in Patients with Coronavirus
Disease-2019 Admitted to the Intensive Care Unit

Effectiveness of Laboratory Parameters as Morbidity and Mortality Indicators in Patients with Coronavirus Disease-2019 Admitted to the Intensive Care Unit

Öz:

Objective: Laboratory parameters may predict the severity and mortality of coronavirus disease-2019 (COVID-19). We investigated the relationship of laboratory findings obtained at admission and 72nd hour and mortality and morbidity of patients with pneumonia who were treated in two intensive care units. Materials and Methods: Chart data of 75 patients (March-May 2020) were retrospectively analysed. Patient characteristics and laboratory parameters were compared according to the presence of COVID-19 and mortality. Patients with COVID-19 were compared according to mortality and gender. Results: The mean patient age was 74.7±11.3 years. COVID-19 positivity was not associated with marked differences in laboratory values. Lung disease, bedridden status, worse renal function scores, and high C-reactive protein level was more often observed in non-survivors (p<0.05). A decline in D-dimer level was more apparent in survivors; the increase in ferritin and neutrophillymphocyte ratio was more apparent in non-survivors (not significant). Among patients with COVID19, women had higher mean platelet volume than men (p=0.033). The rise in ferritin level was more pronounced in men, whereas the rise in neutrophil-lymphocyte ratio and platelet-lymphocyte ratio was higher in women. Conclusion: In this geriatric cohort, chronic lung disease and bedridden status were the main determinants of mortality. Moreover, different patterns of inflammatory markers may help predict the severity of COVID-19

Anahtar Kelime:

Koronavirüs Hastalığı-2019 Tanısıyla Yoğun Bakıma Alınan Hastalarda Morbidite ve Mortalitenin Belirteçleri Olarak Laboratuvar Parametrelerinin Etkinliği

Öz:

Amaç: Laboratuvar parametreleri koronavirüs hastalığı-2019’un (COVID-19) şiddet ve mortalitesini ön görebilir. Pnömoni teşhisiyle iki yoğun bakım ünitesinde tedavi edilen hastalarda ilk kabulde ve 72 saat sonra elde edilen laboratuvar bulguları ile mortalite ve morbidite arasındaki ilişkiyi inceledik. Gereç ve Yöntem: Toplam 75 hastanın kayıtlarından (Mart-Mayıs 2020) gelen bilgiler geriye dönük incelendi. Hasta özellikleri ve laboratuvar parametreleri COVID-19 ve mortalite varlığına göre karşılaştırıldı. COVID-19+ olan hastalar, mortalite ve cinsiyete göre de karşılaştırıldı. Bulgular: Ortalama yaş 74,7±11,3 yıl idi. COVID-19 pozitifliği laboratuvar değerlerinde belirgin değişikliklerle ikişkili değildi. Akciğer hastalığı, yatağa bağımlılık, kötü böbrek fonksiyon skorları ve yüksek C-reaktif protein eks hastalarda daha yaygın idi (p<0,05). D-dimerde azalma sağ kalanlarda daha belirgin idi; ferritin ve nötrofil-lenfosit oranı ölenlerde daha görünür idi (istatistiksel olarak anlamlı değil). COVID-19 hastaları arasında kadınların ortalama trombosit hacmi erkeklerden daha yüksekti (p=0,033). Ferritin yüksekliği erkeklerde daha belirgin iken, nötrofil-lenfosit ve trombositlenfosit oranları kadınlarda daha yüksek saptandı. Sonuç: Bu geriatrik kohortta kronik akciğer hastalığı ve yatağa bağımlılık mortalitenin temel belirleyicileri olarak saptandı. Ayrıca enflamatuvar belirteçlerin farklı paternleri de COVID-19’da hastalık şiddetinin ön görülmesine yardımcı olabilir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. World Health Organization. DirectorGeneral’s remarks at the media briefing on 2019-nCoV on 11 February 2020. Available from URL: https://www.who. int/dg/speeches/detail/who-directorgeneral-s-remarks-at-the-media-briefingon-2019-ncov-on-11-february-2020 (Accessed February 12, 2020).
2. 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;323:1061-9.
3. Goyal P, Choi JJ, Pinheiro LC, Schenck EJ, Chen R, Jabri A, et al. Clinical Characteristics of Covid-19 in New York City. N Engl J Med 2020;382:2372-4.
4. 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;382:1708-20.
5. Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med 2020;180:934- 43.
6. 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 COVID19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395:1054-62.
7. Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiol 2020;5:802-10.
8. 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;395:507-13.
9. World Health Organization. Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected: interim guidance. Published January 28, 2020. Available from URL: https://www. who.int/publications-detail/clinicalmanagementof-severe-acute-respiratoryinfection-when-novelcoronavirus-(ncov)- infection-is-suspected Accessed January 31, 2020.
10. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA 2020;323:1239–42.
11. Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID19 in the New York City Area. JAMA 2020;323:2052-9.
12. Onder G, Rezza G, Brusaferro S. CaseFatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy. JAMA 2020;323:1775-6.
13. Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE, et al. Factors associated with COVID-19- related death using OpenSAFELY. Nature 2020;584:430-6.
14. CDC COVID-19 Response Team. Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) - United States, February 12-March 16, 2020. MMWR Morb Mortal Wkly Rep 2020;69:343-6.
15. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497- 506.
16. Wei X, Xiao YT, Wang J, Chen R, Zhang W, Yang Y, et al. (2020). Sex differences in severity and mortality among patients with COVID-19: evidence from pooled literature analysis and insights from integrated bioinformatic analysis. arXiv 2003.13547v13541.
17. Taskesen T, Sekhon H, Wroblewski I, Goldfarb M, Ahmad MB, Nguyen QT, et al. Usefulness of Mean Platelet Volume to Predict Significant Coronary Artery Disease in Patients With NonSTElevation Acute Coronary Syndromes. Am J Cardiol 2017;119:192-6.
18. Suh B, Shin DW, Kwon HM, Yun JM, Yang HK, Ahn E, et al. Elevated neutrophil to lymphocyte ratio and ischemic stroke risk in generally healthy adults. PLoS One 2017;12:e0183706.
19. Öztürk ZA, Kuyumcu ME, Yesil Y, Savas E, Yıldız H, Kepekçi Y, et al. Is there a link between neutrophil-lymphocyte ratio and microvascular complications in geriatric diabetic patients? J Endocrinol Invest 2013;36:593-9.
20. Bozkurt D, Ozkurt D, Kılavuz A, Caferov N, Köse T, Akcicek F. Non-Traditional mortality predictors for geriatric intensive care unit patients. Turkish Journal of Geriatrics 2018;21:323–32.
21. Wang C, Deng R, Gou L, Fu Z, Zhang X, Shao F, et al. Preliminary study to identify severe from moderate cases of COVID-19 using combined hematology parameters. Ann Transl Med 2020;8:593.
22. Kim CH, Park JT, Kim EJ, Han JH, Han JS, Choi JY, et al. An increase in red blood cell distribution width from baseline predicts mortality in patients with severe sepsis or septic shock Crit Care 2013;17:R282.

APA	Kazancioglu L, Erdivanlı B, Kazdal H, ÖZDEMİR A, koyuncu t, HIZAL A, Özdemir A, Bahçeci İ, BATCIK S, ersöz t (2021). Effectiveness of Laboratory Parameters as Morbidity and Mortality Indicators in Patients with Coronavirus Disease-2019 Admitted to the Intensive Care Unit. , 33 - 43. 10.4274/tybd.galenos.2021.05914
Chicago	Kazancioglu Leyla,Erdivanlı Başar,Kazdal Hizir,ÖZDEMİR Abdullah,koyuncu tolga,HIZAL AYSE,Özdemir Asiye,Bahçeci İlkay,BATCIK SULE,ersöz tahir Effectiveness of Laboratory Parameters as Morbidity and Mortality Indicators in Patients with Coronavirus Disease-2019 Admitted to the Intensive Care Unit. (2021): 33 - 43. 10.4274/tybd.galenos.2021.05914
MLA	Kazancioglu Leyla,Erdivanlı Başar,Kazdal Hizir,ÖZDEMİR Abdullah,koyuncu tolga,HIZAL AYSE,Özdemir Asiye,Bahçeci İlkay,BATCIK SULE,ersöz tahir Effectiveness of Laboratory Parameters as Morbidity and Mortality Indicators in Patients with Coronavirus Disease-2019 Admitted to the Intensive Care Unit. , 2021, ss.33 - 43. 10.4274/tybd.galenos.2021.05914
AMA	Kazancioglu L,Erdivanlı B,Kazdal H,ÖZDEMİR A,koyuncu t,HIZAL A,Özdemir A,Bahçeci İ,BATCIK S,ersöz t Effectiveness of Laboratory Parameters as Morbidity and Mortality Indicators in Patients with Coronavirus Disease-2019 Admitted to the Intensive Care Unit. . 2021; 33 - 43. 10.4274/tybd.galenos.2021.05914
Vancouver	Kazancioglu L,Erdivanlı B,Kazdal H,ÖZDEMİR A,koyuncu t,HIZAL A,Özdemir A,Bahçeci İ,BATCIK S,ersöz t Effectiveness of Laboratory Parameters as Morbidity and Mortality Indicators in Patients with Coronavirus Disease-2019 Admitted to the Intensive Care Unit. . 2021; 33 - 43. 10.4274/tybd.galenos.2021.05914
IEEE	Kazancioglu L,Erdivanlı B,Kazdal H,ÖZDEMİR A,koyuncu t,HIZAL A,Özdemir A,Bahçeci İ,BATCIK S,ersöz t "Effectiveness of Laboratory Parameters as Morbidity and Mortality Indicators in Patients with Coronavirus Disease-2019 Admitted to the Intensive Care Unit." , ss.33 - 43, 2021. 10.4274/tybd.galenos.2021.05914
ISNAD	Kazancioglu, Leyla vd. "Effectiveness of Laboratory Parameters as Morbidity and Mortality Indicators in Patients with Coronavirus Disease-2019 Admitted to the Intensive Care Unit". (2021), 33-43. https://doi.org/10.4274/tybd.galenos.2021.05914

APA	Kazancioglu L, Erdivanlı B, Kazdal H, ÖZDEMİR A, koyuncu t, HIZAL A, Özdemir A, Bahçeci İ, BATCIK S, ersöz t (2021). Effectiveness of Laboratory Parameters as Morbidity and Mortality Indicators in Patients with Coronavirus Disease-2019 Admitted to the Intensive Care Unit. Türk Yoğun Bakım Dergisi, 19(1), 33 - 43. 10.4274/tybd.galenos.2021.05914
Chicago	Kazancioglu Leyla,Erdivanlı Başar,Kazdal Hizir,ÖZDEMİR Abdullah,koyuncu tolga,HIZAL AYSE,Özdemir Asiye,Bahçeci İlkay,BATCIK SULE,ersöz tahir Effectiveness of Laboratory Parameters as Morbidity and Mortality Indicators in Patients with Coronavirus Disease-2019 Admitted to the Intensive Care Unit. Türk Yoğun Bakım Dergisi 19, no.1 (2021): 33 - 43. 10.4274/tybd.galenos.2021.05914
MLA	Kazancioglu Leyla,Erdivanlı Başar,Kazdal Hizir,ÖZDEMİR Abdullah,koyuncu tolga,HIZAL AYSE,Özdemir Asiye,Bahçeci İlkay,BATCIK SULE,ersöz tahir Effectiveness of Laboratory Parameters as Morbidity and Mortality Indicators in Patients with Coronavirus Disease-2019 Admitted to the Intensive Care Unit. Türk Yoğun Bakım Dergisi, vol.19, no.1, 2021, ss.33 - 43. 10.4274/tybd.galenos.2021.05914
AMA	Kazancioglu L,Erdivanlı B,Kazdal H,ÖZDEMİR A,koyuncu t,HIZAL A,Özdemir A,Bahçeci İ,BATCIK S,ersöz t Effectiveness of Laboratory Parameters as Morbidity and Mortality Indicators in Patients with Coronavirus Disease-2019 Admitted to the Intensive Care Unit. Türk Yoğun Bakım Dergisi. 2021; 19(1): 33 - 43. 10.4274/tybd.galenos.2021.05914
Vancouver	Kazancioglu L,Erdivanlı B,Kazdal H,ÖZDEMİR A,koyuncu t,HIZAL A,Özdemir A,Bahçeci İ,BATCIK S,ersöz t Effectiveness of Laboratory Parameters as Morbidity and Mortality Indicators in Patients with Coronavirus Disease-2019 Admitted to the Intensive Care Unit. Türk Yoğun Bakım Dergisi. 2021; 19(1): 33 - 43. 10.4274/tybd.galenos.2021.05914
IEEE	Kazancioglu L,Erdivanlı B,Kazdal H,ÖZDEMİR A,koyuncu t,HIZAL A,Özdemir A,Bahçeci İ,BATCIK S,ersöz t "Effectiveness of Laboratory Parameters as Morbidity and Mortality Indicators in Patients with Coronavirus Disease-2019 Admitted to the Intensive Care Unit." Türk Yoğun Bakım Dergisi, 19, ss.33 - 43, 2021. 10.4274/tybd.galenos.2021.05914
ISNAD	Kazancioglu, Leyla vd. "Effectiveness of Laboratory Parameters as Morbidity and Mortality Indicators in Patients with Coronavirus Disease-2019 Admitted to the Intensive Care Unit". Türk Yoğun Bakım Dergisi 19/1 (2021), 33-43. https://doi.org/10.4274/tybd.galenos.2021.05914