Barış ÇİL, İbrahim DEMİR, Mehmet KABAK, İclal HOCANLI, Mahsuk TAYLAN, Mustafa FİDANTEN

COVİD-19 Hastalarında Toraks BT Skoru: Nötrofil-Lenfosit Oranı, Monosit, Laktat Dehidrojenaz, Albümin ve Ferritin Arasındaki İlişki

Amaç: Lökopeni, lenfopeni, nötrofil/lenfosit oranı yükselmesi, laktat dehidrojenaz yüksekliği, D-dimer ve ferritin yüksekliği, düşük albümin gibi çeşitli laboratuvar ve hayati parametreler COVID-19 enfeksiyonunun tanı ve ciddiyetinin değerlendirilmesinde kullanılabilir. Yöntemler: Toraks bilgisayarlı tomografi (BT) skorları, lenfopeni, nötrofil/lenfosit oranı, nötrofil, lenfosit, laktat dehidrojenaz, albümin, C-reaktif protein, beyaz kan hücreleri, trombositler, bazofil, eozinofil, monositler, prokalsitonin, D-dimer, COVID-19 tanısı konulan 693 hastanın ferritin, yaş, cinsiyet, yatış birimleri, oda havasında oksijensiz parmak ucu satürasyonları, ek hastalıkları ve semptomları kaydedildi. Hastaların parametreleri göğüs BT skorunun ciddiyetine göre karşılaştırıldı. Bulgular: Bu çalışma sonucunda ağır grupta nötrofil/lenfosit oranı orta ve hafif gruba göre anlamlı derecede yüksek bulundu. Göğüs BT skoru arttıkça, laktat dehidrojenaz düzeyi, şiddetli grupta hafif gruba göre istatistiksel olarak anlamlı düzeyde daha yüksekti. Ağır grupta albümin düzeyleri hafif gruba göre istatistiksel olarak anlamlı düzeyde daha düşük bulundu. Şiddetli grupta monosit düzeyleri orta ve hafif gruplara göre istatistiksel olarak anlamlı düzeyde daha düşük bulundu. Ferritin düzeyi şiddetli grupta orta ve hafif gruplara göre istatistiksel olarak anlamlı düzeyde daha yüksekti. Hastaların göğüs BT skorlarına göre ciddi BT skoru olan hastaları ağır olmayan hastalardan ayırt etmek için hematolojik ve biyokimyasal parametrelerin kullanılmasının pratik etkinliği ROC Analizi kullanılarak incelendiğinde, nötrofil/lenfosit oranı değerinin yüksek olduğu görüldü. en güçlü tahmin yeteneği (AUC, 0.787, SD=0.057, P<0.001, %95 CI 0.682-0.683). nötrofil/lenfosit oranının cut-off değeri 5,58 olarak ayarlandığında %68,2 duyarlılığa ve %68,3 özgüllüğe sahip olduğu bulundu. Sonuç: Nötrofil/lenfosit oranı, lenfosit, laktat dehidrojenaz, albümin, monosit ve ferritin incelenerek COVID-19'un akciğer tutulumunun arttığı öngörülerek yakın klinik ve laboratuvar takibine başlanabilir ve sağlık merkezlerinde erken tedaviye başlanabilir. göğüs BT taramasının mümkün olmadığı veya sık BT taramalarından kaçınmak için.

Anahtar Kelimeler:

Nötrofil-lenfosit oranı, Göğüs BT skoru, COVID-19

Chest CT Score in COVID-19 Patients: The Relationship Between Neutrophil-Lymphocyte Ratio, Monocyte, Lactate Dehydrogenase, Albumin And Ferritin

Objective: Various Laboratory and vital parameters, including leukopenia, lymphopenia, neutrophil/lymphocyte ratio elevation, lactate dehydrogenase elevation, D-dimer and ferritin elevation, and low albumin can be used in the diagnosis and assessment of the severity of COVID-19 infection . Methods: The chest computed tomography (CT) scores, lymphopenia, neutrophil/lymphocyte ratio, neutrophil, lymphocyte, lactate dehydrogenase, albumin, C-reactive protein, white blood cells, platelets, basophil, eosinophil, monocytes, procalcitonin, D-dimer, ferritin, ages, genders, hospitalization units, oxygen-free fingertip saturations in room air, additional diseases and symptoms of 693 patients diagnosed with COVID-19 were recorded. The parameters of the patients were compared according to the severity of the chest CT score. Results: As a result of this study neutrophil/lymphocyte ratio was found to be significantly higher in the severe group when compared to the moderate group and the mild group. As chest CT score increased, lactate dehydrogenase level was higher at a statistically significant level in the severe group than in the mild group. Albumin levels were found to be lower in the severe group at a statistically significant level than in the mild group. Monocyte levels were found to be lower in the severe group at a statistically significant level when compared to the moderate and mild groups. Ferritin level was higher in the severe group at a statistically significant level when compared to the moderate and mild groups. When the practical effectiveness of using hematological and biochemical parameters to differentiate patients with severe CT scores from non-severe patients based on the chest CT score of the patients was examined by using the ROC Analysis, it was found that the neutrophil/lymphocyte ratio value had the strongest predictive ability (AUC, 0.787, SD=0.057, P<0.001, 95% CI 0.682-0.683). neutrophil/lymphocyte ratio was found to have 68.2% sensitivity and 68.3% specificity when the cut-off value was set at 5.58 Conclusion: Close clinical and laboratory follow-up can be started by examining neutrophil/lymphocyte ratio, lymphocyte, lactate dehydrogenase, albumin, monocyte and ferritin, predicting that the lung involvement of COVID-19 has increased and early treatment can be started in healthcare centers where chest CT scan is not possible or to avoid frequent CT scans.

Keywords:

Neutrophil-lymphocyte ratio, Chest CT score, COVID-19,

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