Covid-19 ile enfekte serum veya plazmada analiz edilen (CRP, Prokalsitonin, Ferritin, D-Dimer, Fibrimojen, AST, ALT, LDH) Biyokimya laboratuvar sonuçlarının retrospektif olarak ROC analizi, lojistik regresyon analizi ve diğer istatistiki testler ile değerlendirilmesi
Yükleniyor...
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
2019 yılı sonlarında, Çin'in Hubei eyaletinin Wuhan şehrinde başlayıp tüm dünyaya yayılan ve
2 yılı aşkın bir süredir devam eden Covid-19 salgını, pandemi olarak yaşanmaktadır. 7 Ocak 2020‘de
etken daha önce insanlarda tespit edilmemiş yeni bir Corona virus (2019-nCoV) olarak tanımlanmış ve
SARS-CoV-2 olarak isimlendirilmiştir. Yarasaların olası doğal konak olabileceği düşünülmektedir.
Tedavi konusundaki çalışmalar henüz yeterli aşamaya gelmemiştir. Covid-19 hastalığına karşı
ülkemizin de üretmiş olduğu ve acil onay almış aşılar olmasına rağmen Covid-19‘un ölümcül özelliği
halen devam etmektedir. Bu nedenle bulaşın erken tanımlanması, önlenmesi ve en önemlisi maske,
mesafe, temizlik kuralına uymak büyük önem taşımaktadır.
Bu çalışmada, Covid-19 tanısı alan ve ayaktan, servis ile yoğun bakım ünitesinde tedavi
gören hastalarda izlenen laboratuar parametrelerinden; Alanin Aminotransferazlar (ALT), Aspartat
Aminotransferazlar (AST), C-Reaktif Protein (CRP), Laktat Dehidrojenaz (LDH), Ferritin,
Prokalsitonin (PCT), D-Dimer ve Fibrinojen düzeylerinin; hastalığın önlenmesi, tedavi ve takibinin
mortaliteyi öngörmesi açısından ROC analizi ve diğer istatistiksel analizler ile retrospektif olarak
değerlendirilmesi amaçlanmıştır.
Konya Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Hastanesi Sağlık Bilimleri
Klinik Araştırmalar Etik Kurulu onayı onaylanmıştır. Çalışmaya Nisan 2020-Ekim 2020 tarihleri
arasında hastanemiz Klinik Mikrobiyoloji ve Enfeksiyon Hastalıkları Kliniği, Covid-19 Polikliniği ile
Acil Servis bölümlerine soğuk algınlığı semptomları ile başvuruda bulunan ve Dünya Sağlık Örgütü
rehberine göre Covid-19 tanısı alan 100 ayaktan takip, 100 serviste takip ve 100 yoğun bakım
ünitesinde destek tedavisi alan hasta verileri incelenerek hastaların yaşı ve cinsiyeti, komorbid
hastalıkları, vital bulguları, yatış esnasındaki biyokimyasal (Ast, Alt, Crp, Ldh, Ferritin, Pct) ve
hematolojik (Fibrinojen ve D-dimer) değerleri incelenmiştir. Covid-19 PCR ve akciğer
tomografilerindeki parankimal tutulumları ile hastanede yatış süreleri kaydedilmiştir. İstatistiksel
analiz için verilerin dağılımı ROC testi ile incelenecektir. İstatistiksel analizler SPSS 21.0 paket
programı ile yapılacak, anlamlılık düzeyi <0,05 olarak dikkate alınacaktır.
Çalışmamız 100 ayaktan tedavi alan, 100 serviste yatan ve 100 yoğun bakım ünitesinde
destek tedavisi alan toplam 300 hastadan oluşmaktadır. Hastaların genel cinsiyet dağılımı
incelendiğinde 162 (%60.4)‘sinin erkek, 138 (%39.6)‘inin ise kadın olduğu görülmüştür. Hasta
grupları arasında yapılan istatistiki çalışma sonucunda yatış süresi ile crp, prokalsitonin, d-dimer,
ferritin, ldh, fibrinojen, testleri arasında anlamlılık derecesi yüksek çıkmıştır (p<0,001). ROC analizi sonucu crp, prokalsitonin, d-dimer, ferritin, ldh, fibrinojen testleri Covid-19 hastalarında, hastaneye
yatış ve mortalite açısından tanı ve prognozu büyük önem taşımaktadır.
Soğuk algınlığı belirtileriyle Covid-19 polikliniğine başvuran hastaların crp, pct, ferritin, d-dimer, ldh, fibrinojen değerinin yüksekliği Covid-19 pnömonisini ve hastalığın ciddiyetini öngörmede
kullanılabilecek biyobelirteçler olarak dikkate alınmalıdır. Ayrıca başvuru anında hastanın genel
durumu, Toraks BT görüntülemesi tanı için önemli bir avantaj sağlamaktadır. Hastalığın hızlı
yayılması ileri yaşlardaki bireylerde ağır seyretmesi nedeniyle erken teşhisin önemini artırmaktadır.
The Covid-19 epidemic, which started in Wuhan, China's Hubei province at the end of 2019, spread all over the world and has been going on for more than 2 years, is experienced as a pandemic. On January 7, 2020, the agent was identified as a new Coronavirus (2019-nCoV) that has not been detected in humans before and was named SARS-CoV-2. Bats are thought to be possible natural hosts. Studies on treatment have not reached a sufficient stage yet. Despite the fact that there are vaccines produced by our country against the Covid-19 disease and received urgent approval, the deadly feature of Covid-19 still continues. For this reason, it is of great importance to identify and prevent the contagion early, and most importantly, to comply with the mask, distance and cleaning rules. In this study, among the laboratory parameters monitored in patients diagnosed with Covid 19 and treated in the outpatient, service and intensive care unit; Alanine Aminotransferases (ALT), Aspartate Aminotransferases (AST), C-Reactive Protein (CRP), Lactate Dehydrogenase (LDH), Ferritin, Procalcitonin (PCT), D-Dimer and Fibrinogen levels; In this study, it was aimed to evaluate the disease retrospectively with ROC analysis and other statistical analyzes in terms of the prevention, treatment and follow-up of the disease in terms of predicting mortality. Konya Necmettin Erbakan University Meram Medical Faculty Hospital Health Sciences Clinical Research Ethics Committee approval was approved. Between April 2020 and October 2020, 100 outpatient follow-ups, 100 inpatient follow-ups and 100 patients who applied to the Emergency Department of the Clinical Microbiology and Infectious Diseases Clinic of our hospital with cold symptoms and were diagnosed with Covid-19 according to the World Health Organization guideline, were included in the study. The patient's age and gender, comorbid diseases, vital signs, biochemical (AST, ALT, CRP, LDH, ferritin, PCT) and hematological (fibrinogen and D-dimer) values during hospitalization were examined by examining the data of patients receiving supportive treatment in the intensive care unit. Parenchymal involvement in Covid-19 PCR and lung tomography, and hospitalization times were recorded. For statistical analysis, the distribution of the data will be examined by the ROC test. Statistical analyzes will be made with the SPSS 21.0 package program, and the significance level will be considered as <0.05. Any statistical study of the disease, regarding d-dimer duration and crp, procalcitonin, procalcitonin, burner, applicability. ROC analysis crp, procalcitonin, d-dimer, ferritin, ldh, fibrinogen engineering diagnosis and prognosis of Covid-19 patients, hospitalized and children are of great importance. High levels of crp, pct, ferritin, d-dimer, ldh, and fibrinogen should be considered as biomarkers that can be used to predict Covid-19 pneumonia and the severity of the disease in patients who applied to the Covid-19 outpatient clinic with cold symptoms. In addition, the general condition of the patient at the time of application and Thorax CT imaging provide an important advantage for diagnosis. The rapid spread of the disease increases the importance of early diagnosis due to its severe course in older individuals.
The Covid-19 epidemic, which started in Wuhan, China's Hubei province at the end of 2019, spread all over the world and has been going on for more than 2 years, is experienced as a pandemic. On January 7, 2020, the agent was identified as a new Coronavirus (2019-nCoV) that has not been detected in humans before and was named SARS-CoV-2. Bats are thought to be possible natural hosts. Studies on treatment have not reached a sufficient stage yet. Despite the fact that there are vaccines produced by our country against the Covid-19 disease and received urgent approval, the deadly feature of Covid-19 still continues. For this reason, it is of great importance to identify and prevent the contagion early, and most importantly, to comply with the mask, distance and cleaning rules. In this study, among the laboratory parameters monitored in patients diagnosed with Covid 19 and treated in the outpatient, service and intensive care unit; Alanine Aminotransferases (ALT), Aspartate Aminotransferases (AST), C-Reactive Protein (CRP), Lactate Dehydrogenase (LDH), Ferritin, Procalcitonin (PCT), D-Dimer and Fibrinogen levels; In this study, it was aimed to evaluate the disease retrospectively with ROC analysis and other statistical analyzes in terms of the prevention, treatment and follow-up of the disease in terms of predicting mortality. Konya Necmettin Erbakan University Meram Medical Faculty Hospital Health Sciences Clinical Research Ethics Committee approval was approved. Between April 2020 and October 2020, 100 outpatient follow-ups, 100 inpatient follow-ups and 100 patients who applied to the Emergency Department of the Clinical Microbiology and Infectious Diseases Clinic of our hospital with cold symptoms and were diagnosed with Covid-19 according to the World Health Organization guideline, were included in the study. The patient's age and gender, comorbid diseases, vital signs, biochemical (AST, ALT, CRP, LDH, ferritin, PCT) and hematological (fibrinogen and D-dimer) values during hospitalization were examined by examining the data of patients receiving supportive treatment in the intensive care unit. Parenchymal involvement in Covid-19 PCR and lung tomography, and hospitalization times were recorded. For statistical analysis, the distribution of the data will be examined by the ROC test. Statistical analyzes will be made with the SPSS 21.0 package program, and the significance level will be considered as <0.05. Any statistical study of the disease, regarding d-dimer duration and crp, procalcitonin, procalcitonin, burner, applicability. ROC analysis crp, procalcitonin, d-dimer, ferritin, ldh, fibrinogen engineering diagnosis and prognosis of Covid-19 patients, hospitalized and children are of great importance. High levels of crp, pct, ferritin, d-dimer, ldh, and fibrinogen should be considered as biomarkers that can be used to predict Covid-19 pneumonia and the severity of the disease in patients who applied to the Covid-19 outpatient clinic with cold symptoms. In addition, the general condition of the patient at the time of application and Thorax CT imaging provide an important advantage for diagnosis. The rapid spread of the disease increases the importance of early diagnosis due to its severe course in older individuals.
Açıklama
Doktora Tezi
Anahtar Kelimeler
Covid-19, CRP, D-Dimer, Ferritin, Pandemi, Pandemic
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Hayırlıoğlu, M. F. (2022). Covid-19 ile enfekte serum veya plazmada analiz edilen (CRP, Prokalsitonin, Ferritin, D-Dimer, Fibrimojen, AST, ALT, LDH) Biyokimya laboratuvar sonuçlarının retrospektif olarak ROC analizi, lojistik regresyon analizi ve diğer istatistiki testler ile değerlendirilmesi. (Yayımlanmamış doktora tezi). Necmettin Erbakan Üniversitesi, Sağlık Bilimleri Enstitüsü Tıbbi Biyokimya Anabilim Dalı, Konya.
