İbrahim EKER, Ayşegül BÜKÜLMEZ, Ayhan PEKTAS, Yeter DÜZENLİ KAR, Nilgün EROĞLU, Mehmet ÇELEGEN, Yiğit ŞENOL, Ayşe ÇITAK, Baran GÜL, Begüm SOYALAN, Deniz DURMUŞ, Melissa KARATAŞ

Koronavirus ile İlişkili Multisistem İnflamatuar Sendrom Tanılı Çocuklarda Trombosit Kitle İndeksi Prognostik Bir Belirteç Olarak Kullanılabilir mi?

Amaç: Trombosit kitle indeksinin (TKİ) MIS-C tanısı alan çocuklarda prognostik bir belirteç olup olmadığının değerlendirilmesi. Gereç ve Yöntemler: Mart 2020 ile Kasım 2021 tarihleri arasında üniversite hastanemizde MIS-C tanısı konan ve tedavi gören 31 çocuk çalışmaya dahil edildi. Hastaneye yatış anındaki, yoğun bakıma yatış anındaki ve hastanedeki yatış süresince demografik veriler, klinik bulgular ve laboratuvar değerleri retrospektif olarak değerlendirildi. Her hastanın yatış anındaki TKİ değerleri hesaplandı ve kaydedildi. Bulgular: TKİ ile ferritin (r= -0.635, orta, p<0.001), CRP (r= -0.377, zayıf, p= 0.036) ve prokalsitonin (r= -0.481, zayıf, p= 0.006) düzeyleri arasında istatistiksel olarak anlamlı negatif korelasyon bulundu. TKİ ile lökosit sayısı (r= 0.367, zayıf, p= 0.042) ve lenfosit sayısı (r= 0.384, zayıf, p= 0.033) arasında istatistiksel olarak anlamlı pozitif ilişki bulundu. Yoğun bakım gerektiren hastaların ortanca TKİ değerlerinin (1701.35 fl/nl), yoğun bakım gerektirmeyen hastaların ortanca TKİ değerlerinden (2523.94 fl/nl) istatistiksel olarak daha düşük olduğu saptandı (p= 0.005). Ferritin düzeyi >400 ng/ml olan hastaların ortanca TKİ değerlerinin (1415.2; 533.4 – 3600.5), ferritin düzeyi ≤400 ng/ml olan hastaların ortalama TKİ değerlerinden (2705.7; 1395.2 – 9167.6) istatistiksel olarak daha düşük olduğu saptandı (p= 0.005). Sonuç: Çalışmamızdaki bulgular, MIS-C’li çocuklarda tanı anında tespit edilen düşük TKİ düzeylerinin, daha şiddetli klinik seyire yol açabileceğini ortaya koymaktadır.

Anahtar Kelimeler:

çocuk, Koronavirüs Hastalığı, Kitle İndeksi, Multisistem İnflamatuar Sendrom, Trombosit, Prognoz

Can Platelet Mass Index Be Used as a Prognostic Marker in Children Diagnosed with Multisystem Inflammatory Syndrome Associated with Coronavirus?

Objective: We’ve aimed at evaluating whether the platelet mass index (PMI) can be a prognostic marker for children diagnosed with MIS-C. Material and Methods: 31 children diagnosed with MIS-C and treated at our university hospital between March 2020 and November 2021 were included. Demographic data, clinical findings and laboratory values at the time of hospitalization, admission to the intensive care unit and duration of hospitalization were evaluated retrospectively. PMI of each patient at the time of hospitalization was calculated and recorded. Results: There was a statistically significant negative correlation between PMI and ferritin (r= -0.635, moderate, p<0.001), CRP (r= -0.377, weak, p= 0.036), and procalcitonin (r= -0.481, weak, p=0.006) levels. There was a statistically significant positive relationship between PMI and leukocyte count (r=0.367, weak, p=0.042) and lymphocyte count (r=0.384, weak, p=0.033). Median PMI values of the patients requiring intensive care (1701.35 fl/nl) were lower, compared to the median PMI values of the patients not requiring intensive care (2523.94 fl/nl), however, statistical results could not be reached due to the low (4 of 31) number of patients requiring intensive care. Median PMI values of the patients whose ferritin level was >400 ng/ml (1415.2; 533.4 – 3600.5) were statistically lower compared to the median PMI values of the patients whose ferritin level was ≤400 ng/ml (2705.7; 1395.2 – 9167.6).Conclusion: The findings in our study demonstrate that low PMI levels identified in children with MIS-C at the time of diagnosis may be with more severe clinical courses

Keywords:

Child, Coronavirus Disease, Mass ındex, Multisystem Inflammatory Syndrome, Platelet, Prognosis,

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