ABSTRACT
Background/aim: Viral infections of the respiratory tract are generally related to many factors such as excessive production of cytokines, inflammation, cellular death, redox imbalance or oxidative stress. The aim of this study was to determine the serum levels of thiol and IMA in patients with severe COVID-19 pneumonia to evaluate oxidative stress. Study design: This was a prospective, sectional cohort study conducted at a pandemics hospital between 01.01.2022 and 01.02.2022. Methods: A total of 153 patients who had been confirmed with severe COVID-19 pneumonia in the emergency unit were prospectively analyzed. The control group was formed by 50 healthy volunteers with similar age and no chronic disease history. Thiol and IMA levels were statistically compared both in the patient and the control groups, and within the patient groups (survived and non-survival). Results: While 96 out of 153 patients had survived, 57 patients had non-survival. There was a statistically significant distinction between the survived and non-survival patients with regard to Thiol and IMA levels (p < 0.001). The thiol levels in the patient group were significantly lower compared to the control group, and the IMA levels were significantly higher (p < 0.001). The sensitivity, specificity and NPV were 70.2%, 86.5% and 83% when thiol cut-off value was ≤345.2 µmol/L (AUC: 0.886, p < 0.001). The sensitivity, specificity and NPV were 70.2%, 85.4% and 82.8% when the IMA cut-off was >302.9 ABSU (AUC: 0.875, p < 0.001). Conclusions: Our results demonstrate that thiol and IMA levels may be used as bioindicators for risk classification and mortality in patients with serious COVID-19 pneumonia.
ABSTRACT
Aim: The study investigated heparin-binding protein (HBP) levels in patients with severe COVID-19 pneumonia and their relation to prognosis. Methods: A total of 134 patients with serious COVID-19 pneumonia were prospectively analyzed. HBP levels were statistically compared between both the patient and healthy control groups and within the patient group itself. Results: HBP was defined to be significantly higher in the patient group compared with the control group. There was a statistically significant distinction between the patients who survived and those who died with regard to HBP levels. When the cutoff value of HBP was >13.47, sensitivity (89.8%), specificity (74.1%) had area under the curve values of 0.806 (p < 0.001). Conclusion: HBP level may be used for prognosis prediction of patients with COVID-19.
Subject(s)
COVID-19 , Antimicrobial Cationic Peptides/metabolism , Biomarkers , Blood Proteins/metabolism , Humans , PrognosisABSTRACT
The aim of this study is to investigate the routine blood parameters of COVID-19 patients at the time of admission to the emergency department and their relationship with the severity of the disease and prognosis. A total of 500 patients, who were diagnosed with severe COVID-19 and hospitalized in the intensive care unit between 01.04.2020 and 01.02.2021 in the emergency department of a pandemic hospital, were retrospectively analyzed. Demographic, clinical, and laboratory data of the patients were obtained from the hospital registry system. Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) were calculated using neutrophil, lymphocyte, monocyte, and platelet counts. These patients were divided into two groups: survivors and deceased. All parameters obtained from routine blood analysis were statistically compared between these two groups. While 280 out of 500 patients survived, 220 died. Of all patients, the mean age was 67 years and 51.8% were males. There was a significant difference between the two groups in terms of age, gender, length of hospital stay, need for mechanical ventilation, white blood cell, neutrophil, lymphocyte, monocyte, eosinophil, platelet counts, CRP, ferritin, procalcitonin values, NLR, MLR, and PLR (p < 0.001 for all). While NLR alone and MLR + NEU and NLR + PLR + MLR combinations had the highest AUC values (0.930, 0.947, and 0.939, respectively), MLR and PLR alone showed the lowest AUC values (0.875 and 0.797, respectively). The sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs) in the prediction of death according to the cutoff values of the parameters have been determined. A significant correlation was determined between age, NLR, MLR, and PLR and duration of hospital stay (p < 0.001 for all). Routine blood parameters and NLR, MLR, and PLR can assist emergency physicians to identify the severity and early prognosis of COVID-19 patients.
ABSTRACT
STUDY OBJECTIVE: The number of critically ill patients admitted to the emergency department increases daily. To decrease mortality, interventions and treatments should be conducted in a timely manner. It has been found that the neutrophil-lymphocyte ratio (NLR) is related to mortality in some disease groups, such as acute coronary syndrome and pulmonary emboli. The effect of the NLR on mortality is unknown in critically ill patients who are admitted to the emergency department. Our aim in this study is to evaluate the effect of the NLR on mortality in critically ill patients. METHODS: This study was planned as a prospective, observational cohort study. Patients who were admitted to the emergency department because they were critically ill and required the intensive care unit were included in the study. Demographic characteristics, Acute Physiology and Chronic Health Evaluation II (APACHE II), Sepsis-related Organ Failure Assessment, Glasgow Coma Score, and NLR values were recorded upon emergency department admission. The patients were followed up for sepsis, ventilator-associated pneumonia, multiorgan failure, in-hospital mortality, and 6-month mortality. RESULTS: The median (interquartile range) age of the 373 patients was 74 (190) years, and 54.4% were men. Neutrophil-lymphocyte ratio values were divided into quartiles, as follows: less than 3.48, 3.48 to 6.73, 6.74-13.6, and more than 13.6. There was no difference among these 4 groups regarding demographic characteristics, APACHE II score, Sepsis-related Organ Failure Assessment score, Glasgow Coma Score, and length of hospital stay (P>.05). In the multivariable Cox regression model, in-hospital mortality and 6-month mortality NLR were hazard ratio (HR), 1.63 (1.110-2.415; P=.01) and HR, 1.58 (1.136-2.213; P=.007), respectively, and APACHE II scores were detected as independent indicators. CONCLUSION: The NLR is a simple, cheap, rapidly available, and independent indicator of short- and long-term mortalities. We suggest that the NLR can provide direction to emergency department physicians for interventions, particularly within a few hours after admission, in the critically ill patient group.
