Bir üniversite hastanesinde covid-19 tanısı ile değerlendirilen hastaların toraks BT bulguları ile hematolojik parametrelerin karşılaştırılması
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Dosyalar
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve amaç: Tüm dünyayı etkisi altına alıp milyonlarca kişinin ölümüne sebep olan
Covid-19 hastalığının patogenezi ile ilgili pek çok çalışma mevcuttur. Bunlardan biri de artan
hücre içi demir ve ferritindir. Böylece reaktif oksijen türleri açığa çıkarak pıhtılaşma
bozukluğu ve akciğer patolojilerine neden olmaktadır. Bu çalışmada Covid-19 hastalarında
demir ve ferritin başta olmak üzere bazı hematolojik parametreler ile Toraks BT bulguları
karşılaştırılarak, bu hematolojik parametrelerin hastalardaki viral pnömoni gelişimi ile ilişkisi
ve pnömoni gelişmesini öngörebilme yeteneği araştırıldı.
Yöntem: Çalışmaya Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Hastanesine 01/04/2020 ile 01/12/2020 tarihleri arasında başvuran ve RT-PCR pozitifliği ile
Covid-19 tanısı konulan hastalar alındı. Hastaların demografik verileri, vital bulguları,
laboratuvar bulguları ile Toraks BT bulguları ve sonlanımları karşılaştırıldı. Sonuçlar SPSS
25.0 paket programı ile istatistiksel olarak değerlendirildi.
Bulgular: Çalışmaya 1473 hasta dahil edildi. Dahil edilen hastaların %46,2’si kadın,
%53,8’i erkek idi. Hastaların yaş ortalaması 58,54±17,22 olarak bulundu. Hastaların
%58,2’sinde Toraks BT Covid-19 pnömonisi için tipik iken, %30,2’sinde pnömoni bulgusu
yoktu. Toraks BT’de tipik bulguları olanların %9,6’sı evde izolasyon, %80,5’i servis yatışı,
%9,9’u YBÜ yatışı olarak sonlandı. Toraks BT’si tipik olanlar için Ferritin yüksekliği anlamlı
bulundu (ortanca=295,7 ug/L, p=0,001). BT’de pnömonisi olmayan hastalarda ise monosit,
lenfosit, hemoglobin ve demir yüksekliği anlamlıydı (sırasıyla p=0,001, p=0,001, p=0,032,
p=0,001). Ayrıca YBÜ yatışı olan hastalarda lökosit, ferritin, CRP, PCT, laktat değerlerinin
yüksekliği ile demir ve hemoglobin düşüklüğü anlamlı bulundu (sırasıyla p=0,001, p=0,001,
p=0,001, p=0,001, p=0,001, p=0,001, p=0,001). YBÜ yatışı olan hastaların %91,9’unda en az
bir ek hastalık bulunmaktaydı (p=0,001) ve yaş ortancası 72 idi (p=0,001).
Aim of the study: There are many studies on the pathogenesis of Covid-19 disease, which affects the whole world and causes the death of millions of people. One of them is increased intracellular iron and ferritin. Thus, reactive oxygen species are released and cause coagulation disorders and lung pathologies. In this study, some hematological parameters, especially iron and ferritin, and Thorax CT findings were compared in Covid-19 patients, and the ability of these hematological parameters to predict the development of viral pneumonia in patients was investigated. Method: Patients who applied to Necmettin Erbakan University Meram Medical Faculty Hospital between 01/04/2020 and 01/12/2020 and were diagnosed with Covid-19 with RT-PCR positivity were included in the study. Demographic data, vital signs, laboratory findings, and Thorax CT findings and outcomes of the patients were compared. The results were statistically evaluated with the SPSS 25.0 package program. Findings: 1473 patients were included in the study. Of the included patients, 46.2% were female and 53.8% were male. The mean age of all patients was 58.54±17,22. Thorax CT was typical for Covid-19 pneumonia in 58.2% of the patients, while 30.2% had no signs of pneumonia. Of those with typical findings on thorax CT, 9.6% ended up in isolation at home, 80.5% in service admission, and 9.9% in ICU. Typical for thorax CT were significantly Ferritin height (median = 295.7 ug / L, p = 0.001). In patients without pneumonia on CT, the elevation of monocytes, lymphocytes, hemoglobin and iron was significant (p=0.001, p=0.001, p=0.032, p=0.001, respectively). In addition, high levels of leukocyte, ferritin, CRP, PCT, lactate, and low levels of iron and hemoglobin were found to be significant in patients hospitalized in the ICU (p=0.001, p=0.001, p=0.001, p=0.001, p=0.001, p=0.001, p=0.001, respectively). 91.9% of the patients admitted to the ICU had any additional disease (p=0.001), and the median age was 72 (p=0.001). Result: Low serum iron levels and high ferritin, leukocyte, CRP, PCT, and lactate levels in patients with a diagnosis of Covid-19 have the potential to predict the development of viral pneumonia, which can be documented by thoracic CT scans, and the need for hospitalization in the ICU.
Aim of the study: There are many studies on the pathogenesis of Covid-19 disease, which affects the whole world and causes the death of millions of people. One of them is increased intracellular iron and ferritin. Thus, reactive oxygen species are released and cause coagulation disorders and lung pathologies. In this study, some hematological parameters, especially iron and ferritin, and Thorax CT findings were compared in Covid-19 patients, and the ability of these hematological parameters to predict the development of viral pneumonia in patients was investigated. Method: Patients who applied to Necmettin Erbakan University Meram Medical Faculty Hospital between 01/04/2020 and 01/12/2020 and were diagnosed with Covid-19 with RT-PCR positivity were included in the study. Demographic data, vital signs, laboratory findings, and Thorax CT findings and outcomes of the patients were compared. The results were statistically evaluated with the SPSS 25.0 package program. Findings: 1473 patients were included in the study. Of the included patients, 46.2% were female and 53.8% were male. The mean age of all patients was 58.54±17,22. Thorax CT was typical for Covid-19 pneumonia in 58.2% of the patients, while 30.2% had no signs of pneumonia. Of those with typical findings on thorax CT, 9.6% ended up in isolation at home, 80.5% in service admission, and 9.9% in ICU. Typical for thorax CT were significantly Ferritin height (median = 295.7 ug / L, p = 0.001). In patients without pneumonia on CT, the elevation of monocytes, lymphocytes, hemoglobin and iron was significant (p=0.001, p=0.001, p=0.032, p=0.001, respectively). In addition, high levels of leukocyte, ferritin, CRP, PCT, lactate, and low levels of iron and hemoglobin were found to be significant in patients hospitalized in the ICU (p=0.001, p=0.001, p=0.001, p=0.001, p=0.001, p=0.001, p=0.001, respectively). 91.9% of the patients admitted to the ICU had any additional disease (p=0.001), and the median age was 72 (p=0.001). Result: Low serum iron levels and high ferritin, leukocyte, CRP, PCT, and lactate levels in patients with a diagnosis of Covid-19 have the potential to predict the development of viral pneumonia, which can be documented by thoracic CT scans, and the need for hospitalization in the ICU.
Açıklama
Anahtar Kelimeler
Ferritin, Lökosit, Toraks BT, Viral pnömoni, Ferritin, Leukocyte, Thorax CT, Viral pneumonia
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Argın, S, (2021). Bir üniversite hastanesinde covid-19 tanısı ile değerlendirilen hastaların toraks BT bulguları ile hematolojik parametrelerin karşılaştırılması. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Acil Tıp Anabilim Dalı, Konya.
