ABSTRACT
BACKGROUND AND AIM: The source of COVID-19, which was declared a pandemic in March 2020, is coronavirus called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Our immune system to eliminate infectious agents such as SARS-COV-2;It uses cellular elements such as lymphocytes, monocytes/macrophages, neutrophils, dendritic cells, NK cells and platelets, dissolved molecules such as cytokines, chemokines, acute phase proteins and complements that work in harmony with each other. Cytokines are regulatory proteins. They undertake tasks such as proliferation, differentiation and activation of cellular elements such as leukocytes. In this study, it was aimed to investigate relationship between cytokines and immunophenotypic characters of leukocyte subgroups in COVID-19 patients. METHODS: In this study, 51 COVID-19 patients (18-71 years) were included who outpatient applied to Mersin University Hospital and were positive for COVID-19 according to PCR (Bio-Speedy RT-qPCR Detection Kit, Bioeksen, Turkey) analysis. Samples taken on the application day were included in the study. Immunophenotype analyzes were measured by flow cytometry using the FACSCalibur (Becton Dickinson, USA) instrument. Cytokine levels (IL-1β and IL-6) were studied with the ELISA method (DSX-4-Plate Automated, Dynex, USA). RESULTS: Correlations of cytokines and leukocyte subgroups were examined, respectively, in CD3+ T-lymphocytes (r=-0,034-r=-0,096), CD4+ T-Helper (r=-0,035-r=-0,074), CD8+ T-cytotoxic (r=0,097-r=0,135), CD19+ B-lymphocytes (r=0,020-r=0,09), HLA-DR+ lymphocytes (r=0,064-r=0,006), CD56+ NK cells (r=-0,023-r=0,57). No correlation was observed between IL-1β and IL-6 and leukocyte subgroups (P>0.05). A strong positive correlation was found between IL-1β and IL-6 (r=0.894, p<0.05). CONCLUSIONS: New approaches are needed in the treatment of COVID-19 patients, especially in patients with cytokine storm. Due to do there was no significant correlation between IL-1β and IL-6 and the immunophenotypic characters of leukocyte subgroups, and a strong positive correlation was observed between IL-1β and IL-6, it was thought that monitoring proinflammatory cytokines in patients would be of clinical benefit.
ABSTRACT
Introduction: The sudden emergence and rapid spread of the Coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 has dangered global health. For this reason, there has been an urgent need to develop strategies to control the spread of the virus. In this study, we aimed to evaluate the clinical, laboratory and chest computed tomography (CT) findings of COVID-19 cases with positive results of SARS-CoV-2 reverse transcription quantitative polymerase chain reaction (RT-qPCR). Materials and Methods: A total of 278 patients aged 18 years and over who had positive SARS-CoV-2 RT-qPCR results and had access to laboratory and chest CT examinations between 15 April 2020 and 31 August 2020 were included in the study. Clinical classification of patients was performed as asymptomatic, mild and severe. Demographic information, laboratory tests and chest CT results of the patients were created with the data obtained from the hospital system and the relevant branch physicians. The data were analyzed statistically. Results: In the study, 150 (54%) of the patients were males and 128 (46%) were females. Forty-two (15%) of these patients were classified as asymptomatic, 200 (72%) as mild and 36 (13%) as severe cases. Mean age of the patients was found to be 45.5 ± 17.5 years and 72 (25.9%) patients were found to have at least one comorbidity. Findings consistent with COVID-19 pneumonia were observed in the chest CT examinations of 42.4% (118/278) of the patients. The rate of findings in chest CT of severe patients (91.7%) was found higher than mild (38.5%) and asymptomatic cases (19%) (p< 0.05). When we examined the laboratory findings;59.4% of the patients had elevated CRP, 42.1% lymphopenia, 41.1% elevated LDH, 40.6% elevated creatinine, 36% elevated AST, 20.1% leukopenia, 8% elevated ALT, 7.2% elevated leukocyte, 5.4% elevated troponin I and 3.3% elevated CK-MB were detected. In severe patients, lymphopenia (83.3%), neutrophil elevation (41.7%), CRP elevation (97.2%), LDH elevation (91.3%), troponin I elevation (21.4%) and AST elevation (63.9%) findings were observed at a higher rate than asymptomatic and mild cases (p< 0.05). Conclusion: In our study, it was shown that the findings of high age, hypertension, diabetes mellitus, dyspnea, lymphopenia and the increase in neutrophil, CRP, LDH, troponin I and AST values were associated with severe clinical presentation. These findings are thought to be helpful in understanding the differences between clinical classes in COVID-19 patients.