Begüm Şeyda AVCİ, Adem KAYA, Hilmi Erdem SÜMBÜL, Ferhat İÇME, Hasan YEŞİLAĞAÇ, Nevzat ÜNAL, Önder YEŞİLOĞLU, Hayri ÇINAR, Tuba TURUNÇ

Covid-19 ile ilişkili pnömoni şiddeti ile koagulopati ve mortalite arasındaki ilişki

Amaç: Çalışmamızda covid-19 ilişkili pnömoninin şiddetine bağlı olarak koagulasyon parametrelerinde oluşan değişim ile mortalitenin öngörülebilmesi araştırıldı. Gereç ve Yöntem: Çalışmaya toplam 137 covid-19 nedenli pnömonisi bulunan hasta dahil edildi. Pnömoni şiddetine göre hastalar hafif, orta ve şiddetli olarak üç gruba ayrıldı. Pnömoni şiddetine göre tam kan sayımındaki parametreler ile biyokimyasal parametrelerin düzeyleri gruplar arasında karşılaştırıldı. Mortaliteye göre kan parametreleri incelenerek bu parametrelerin mortalite üzerine net etkisini belirlemek için ROC analizleri ve regresyon analizleri yapıldı. Bulgular: Pnömoni şiddeti Protrombin zamanı (PTZ), International normalized ratio (INR) ve Aktive parsiyel tromboplastin zamanı (aPTT) değerlerinde artış kaydedilmiş olup PTZ ve INR değerlerinde gruplar arasında istatistiksel olarak anlamlı farklılık belirlenmiştir. Mortal seyreden olgularda PTZ, INR ve aPTT düzeylerinin daha yüksek olduğu belirlendi. Koagulasyon parametresinin (aPTT+PTZ) >45,1 saniye (sn) cut-off değerine göre 93,5% duyarlılık ve 97,5% özgüllükle belirlendi. Sonuç: Covid-19 ilişkili pnömoni şiddetinin artışına ikincil olarak düzeyi yükselen koagulasyon parametresinin (aPTT+PTZ) mortalitenin öngörülmesinde başarılı sonuçlar sunduğu belirlenmiş olup klinik kullanımda önerebileceğimiz bir parametre olabilir.

Relationship between Covid-19-associated pneumonia severity with coagulopathy and mortality

Purpose: In the present study, the possibility of predicting mortality with the change in coagulation parameters depending on the severity of Covid-19-associated pneumonia was investigated. Materials and Methods: A total of 137 patients with Covid-19-associated pneumonia were included in the study. The patients were divided into three groups according to the severity of pneumonia as mild, moderate and severe. According to the severity of pneumonia, the parameters of complete blood count and the levels of biochemical parameters were compared between the groups. By examining blood parameters according to mortality, ROC analysis and regression analysis were performed to determine the net effect of these parameters on mortality. Results: As the severity of pneumonia increased, Prothrombin time (PT), International normalized ratio (INR) and Activated partial thromboplastin time (aPTT) values were also increased, and a statistically significant difference was found between the groups in PT and INR values. PT, INR and aPTT levels were higher in cases with mortality. Mortality can be predicted with 93.5% sensitivity and 97.5% specificity. according to the >45.1 seconds(sec) cut-off value of the coagulation parameter (aPTT+PT. Conclusion: The coagulation parameter (aPTT + PT), whose level increases secondarily to the increase in Covid-19-associated pneumonia severity, provides successful results in predicting mortality, and may be a parameter that we can recommend in clinical use.

Keywords:

Covid-19 infection, coagulation, PT, INR, aPTT, mortality,

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