COVİD-19 HASTALARINDA NÖTROFİL / LENFOSİT ORANI VE VİTAMİN D DÜZEYLERİ İLE MORTALİTENİN İLİŞKİSİ

AMAÇ: Koronavirüs Hastalığı 2019 (COVID-19) akut solunum yetmezliğinin eşlik ettiği ve ölümle sonuçlanabilen bir klinik tabloya yol açabilir. Her ne kadar Polimeraz Zincir Reaksiyon (PCR) testi COVID-19’un teşhisinde altın standart olsa da, hastalığın teşhisini koymak için daha hızlı ve düşük maliyetli teknikler araştırılmaktadır. Tedavi açısından ise hastaların immün sistemlerini güçlendirmeyi amaçlayan tedavi yöntemlerinin, COVID-19'un klinik seyrini hafifletmede etkili olabileceği ileri sürülmektedir. Çalışmadaki ana amacımız COVID-19 hastalarında vitamin D düzeyleri ile nötrofil/lenfosit oranı(NLR) oranlarını araştırmak ve karşılaştırmaktır. Ayrıca çalışmada COVID-19 hastalarında vitamin D ve NLR'nin mortalite için öngörücü olup olamayacağını da araştırmayı hedefliyoruz. GEREÇ VE YÖNTEM: Retrospektif olarak yapılan bu çalışmaya acil servise başvuran, daha sonrasında yoğun bakım yatış kararı verilen 317 COVID-19 hastası alındı. Her hasta için hastadan sorumlu hekim tarafından kaydedilen bir demografik bilgi formu oluşturuldu. Hastalara ait kaydedilen verilerin hepsi vitamin D ve NLR oranları ile karşılaştırıldı. BULGULAR: Çalışmada vitamin D düzeyleri ile COVID-19 hastalarının hastanede kalış süreleri, bilgisayarlı tomografi (BT) bulguları ve mortalitesi arasındaki ilişki incelendi. Analiz sonucunda vitamin D düzeyleri ve yukarıda bahsedilen parametreler arasında bir ilişki bulunamamıştır. Benzer şekilde NLR ile hastalarının hastanede kalış süreleri, BT bulguları ve mortalitesi arasındaki ilişki incelenmiş olup, anlamlı bir ilişki saptanmamıştır. SONUÇ: Bu çalışmanın sonuçlarına baktığımızda vitamin D ve NLR düzeylerinin COVID-19 tanısı alan hastaların hastanede yatış süresini veya hastane içi mortalitesini öngörmede yardımcı olmadığı söylenebilir. Ancak hem vitamin D hem de NLR düzeylerinin hastanede yatış süresi ve hastane içi mortalite ile ilişkili olduğunu gösteren çalışmalarda vardır. Bu nedenle bu hipotezleri test etmek için daha fazla randomize kontrollü çalışmalar ve büyük ölçekli kohort çalışmalarının gerekli olduğunu düşünmekteyiz.

Anahtar Kelimeler:

Nötrofil/lenfosit oranı, Vitamin D, COVID-19

THE RELATIONSHIP BETWEEN NEUTROPHIL / LYMPHOCYTE RATIO AND VITAMİN D LEVELS AND MORTALITY IN COVID-19 PATIENTS

OBJECTIVE: Coronavirus Disease 2019 (COVID-19) may also lead to a clinical picture accompanied by acute respiratory failure and may result in death. Although the Polymerase Chain Reaction (PCR) test is the gold standard for diagnosing COVID-19, faster and less costly techniques are being sought to diagnose the disease. In terms of treatment, it is suggested that treatment methods aimed at strengthening the immune systems of patients may be effective in alleviating the clinical course of COVID-19. Our main aim in the study is to research and compare vitamin D levels and neutrophil/lymphocyte ratio (NLR) ratios in COVID-19 patients. In addition, we aim to research whether vitamin D and NLR can be predictive for mortality in COVID-19 patients. MATERIAL AND METHODS: In this retrospective study, 317 COVID-19 patients who applied to the emergency department and were later admitted to the intensive care unit were included. A demographic information form was created for each patient, which was recorded by the physician responsible for the patient. All recorded data of the patients were compared with vitamin D and NLR ratios. RESULTS: In the study, the relationship between vitamin D levels and the length of hospital stay, computed tomography (CT) findings and mortality of COVID-19 patients was examined. As a result of the analysis, no relationship was found between vitamin D levels and the above-mentioned parameters. Similarly, the relationship between NLR and patients' length of stay in hospital, CT findings and mortality was examined, and no significant relationship was found. CONCLUSIONS: When we look at the results of this study, it can be said that vitamin D and NLR levels are not helpful in predicting the length of hospital stay or in-hospital mortality of patients diagnosed with COVID-19. However, there are studies showing that both vitamin D and NLR levels are associated with length of hospital stay and in-hospital mortality. Therefore, we think that more randomized controlled studies and large-scale cohort studies are necessary to test these hypotheses.

Keywords:

Neutrophil/lymphocyte ratio, Vitamin D, COVID-19,

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