Title Laboratorijska dijagnostika u COVID-19 bolesnika Title (english) Laboratory diagnosis in Covid-19 patients Author Diana Jelčić Mentor Daniela Šupe-Domić (mentor)Committee member Esma Čečuk-Jeličić (predsjednik povjerenstva)Committee member Sendi Kuret (član povjerenstva)Committee member Daniela Šupe-Domić (član povjerenstva)Granter University of Split Defense date and country 2022-07-07, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Cilj istraživanja: istražiti da li je moguće uz pomoć analiziranih laboratorijskih parametara predvidjeti tijek i ishod bolesti COVID 19 kod starije populacije.
Ispitanici i metode: Ispitanici su 32 osobe hospitalizirane u jedinici intezivne njege KBC Split radi COVID-19 infekcije preko 60 godina starosti od kojih je 8 preživljelih i 8 preminulih muškaraca te 8 preživljelih i 8 preminulih žena. Venepunkcija uzoraka seruma izvršila se u okviru standardnog uzorkovanja krvi u skladu s Nacionalnim preporukama za uzorkovanje venske krvi (Hrvatsko društvo za medicinsku biokemiju i laboratorijsku medicinu (HDMBLM) iz ožujka 2014.godine). Razine vitamina D analizirane su imunokemijskom elektrokemoluminiscentnom metodom proizvođača Roche na analizatoru Cobas e801. Razine kalcija, magnezija i fosfora analizirane su spektrofotometrijskom metodom proizvođača Roche na analizatoru Cobas c702. Broj leukocita, limfocita, neutrofilnih granulocita te trombocita su određeni na multiparametarskom hematološkom analizatoru, Advia 2120, za dijagnostiku in vitro u kliničkim laboratorijima. Pozitivan rezultat na virus SARS-Cov-2 je dokazan molekularnom PCR metodom.
Rezultati: Napravljena je usporedba razine vitamina D u skupini osoba koje su preživjele u odnosu na skupinu umrlih osoba od posljedica COVID-19 bolesti te nije uočena statistička značajnost, preživjeli vs umrli (44.0 ± 29.7 vs 36.1 ± 18.3), p=0.376. Ono što se primjećuje je kako obje skupine imaju sniženu razinu vitamina D u serumu. Svim uključenim pacijentima je napravljena krvna slika, razina kalcija, magnezija i fosfora u serumu. Uočavamo najveću statističku značajnost kod omjera neutrofila i limfocita p=0.002, te da dob osobe utječe na ishod bolesti p=0.032 kao i ukupni broj leukocita p=0.028 i razina kalcija p=0.028. Izmjerene razine vitamina D u korelaciji s analiziranim laboratorijskim parametrima nisu pokazale međuzavisnost odnosno nema poveznice između razine vitamina D i broja leukocita, neutrofilnih granulocita, limfocita, trombocita, neutrofilno-limfocitnog omjera, trombocitno-limfocitnog omjera, kalcija, fosfora i magnezija. Multivarijabilna logistička regresijska analiza pokazala je da je samo broj leukocita statistički značajan prediktor preživljenja COVID-19 bolesti (OR 1.570, 95% CI 1.016 - 2.427; p = 0.041) kada se stavi u model zajedno s osnovnim karakteristikama poput dobi i spola te s drugim osnovnim laboratorijskim parametrima (OR 1.570, 95% CI 1.016 - 2.427; p = 0.041).
Zaključak: Ishod bolesti COVID-19 kod istraživane populacije je lošiji što je dob starija te je još veći rizik uz visoki ukupan broj leukocita. Razina vitamina D je niska u proučavanoj skupini ali ne utječe na ishod bolesti i nema prognostički značaj. Neutrofilno-limfocitni omjer je prediktor tijeka COVID-19 bolesti te bi ga trebalo uzeti u obzir kod primjene terapije u liječenju.
Abstract (english) Objectives: Investigate is it possible to predict the course and outcome of COVID-19 disease in the elderly population with the help of analyzed laboratory parameters
Subjects and methods: Respondents were 32 people hospitalized in the intensive care unit of KBC Split due to COVID-19 infection over 60 years of age, of which 8 survivors and 8 deceased men and 8 survivors and 8 deceased women. Venepuncture of serum samples was performed as part of standard blood sampling in accordance with the National Recommendations for Venous Blood Sampling (Croatian Society for Medical Biochemistry and Laboratory Medicine (HDMBLM) from March 2014). Vitamin D levels were analyzed by Roche immunochemical electrochemoluminescent method on a Cobas e801 analyzer. Calcium, magnesium and phosphorus levels were analyzed by spectrophotometric method from Roche on a Cobas c702 analyzer. A positive result for SARS-Cov-2 virus was proved by molecular PCR method.
Results: A comparison of vitamin D levels in the group of survivors compared to the group of deaths due to COVID-19 disease was made and no statistical significance was observed, survivors vs deaths (44.0 ± 29.7 vs 36.1 ± 18.3), p = 0.376. What is noticeable is that both groups have lowered serum vitamin D levels. A blood count, calcium, magnesium and serum phosphorus levels were performed on all patients involved. We observe the greatest statistical significance in the ratio of neutrophils and lymphocytes p = 0.002, and that the age of the person affects the outcome of the disease p = 0.032 as well as the total number of leukocytes p = 0.028 and calcium levels p = 0.028. Measured vitamin D levels in correlation with the analyzed laboratory parameters did not show interdependence, there is no connection between the level of vitamin D and the number of leukocytes, neutrophilic granulocytes, lymphocytes, platelets, neutrophil-lymphocyte ratio, platelet-cell lymphocyte and lymphocyte lymphocytes. Multivariable logistic regression analysis showed that only leukocyte count was a statistically significant predictor of COVID-19 disease survival (OR 1,570, 95% CI 1,016 - 2,427; p = 0.041) when placed in the model along with basic characteristics such as age and sex and others basic laboratory parameters (OR 1,570, 95% CI 1,016 - 2,427; p = 0.041).
Conclusion: The outcome of COVID-19 disease in the elderly population is worse in the older age and the higher is the risk with a high total leukocyte count. Vitamin D levels are low in the study group but do not affect disease outcome and have no prognostic significance. The neutrophil-lymphocyte ratio is a predictor of the course of COVID-19 disease and should be considered in the treatment of therapy.
Keywords
COVID-19
NLR
prediktor
vitamin D
Keywords (english)
COVID-19
NLR
predictor
vitamin D
Language croatian URN:NBN urn:nbn:hr:176:408577 Study programme Title: Medical Laboratory Diagnostics (university/undergraduate) Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2022-07-07 07:56:40
