Да ли би Де Ритисов резултат могао бити користан предиктор морталитета код пацијената са Цовид-19 који захтевају интензивну негу?
Де Ритисов резултат као предиктор смртности од Цовид-19
Sažetak
Инфламаторни маркери се истражују као могући предиктори морталитета у популацији интензивне неге. Инфекција Цовид-19 изазива значајну количину инфламаторног оптерећења. Де Ритисов скор је предложен као нови маркер болести у стањима која карактерише упала. У овом раду, имали смо за циљ да упоредимо Де Ритисове резултате умрлих и преживјелих пацијената Цовид-19 у институционалној јединици интензивне неге.
У студију су укључени пацијенти лечени у јединици интензивне неге са дијагнозом инфекције цовид-19. Упоређени су Де Ритисови резултати умрлих и преживелих субјеката.
Де Ритисов скор преживелих и умрлих испитаника износио је 1,12 (0,3-6,9)% и 1,43 (0,2-16) респективно (п=0,03). Де Ритисов скор је био значајно и позитивно повезан са нивоима ЛДХ (р=0,37, п<0,001), Д-димера (р=0,38, п<0,001) и ЦРП (р=0,19, п=0,01). Осетљивост и специфичност Де Ритисовог скора у предвиђању морталитета када је био већи од прага од 1,32% износили су 60%, односно 61% (АУЦ: 0,61, п=0,03, 95% интервал поверења: 0,52-0,7). Повећање скора по јединици Де Ритис повећало је шансе за смртност за 96% код пацијената са Цовид-19 који се лече у јединици интензивне неге (п=0,03, ОР: 0,96, 95% интервал поверења: 0,86-0,98).
Де Ритисов резултат може бити користан маркер лоше прогнозе код пацијената са Цовид-19 у јединицама интензивне неге.
Reference
1. Karagoz I, Aktas G, Yoldas H, Yildiz I, Ogun MN, Bilgi M, et al. Association Between Hemogram Parameters and Survival of Critically Ill Patients. Journal of intensive care medicine. 2019;34(6):511-3.
2. Karagoz I, Ozer B, Ital I, Turkoglu M, Disikirik A, Ozer S. C-reactive protein-to-serum albumin ratio as a marker of prognosis in adult intensive care population. Bratislavske lekarske listy. 2023;124(4):277-9.
3. Hu X, Liang J, Hao W, Zhou J, Gao Y, Gong X, et al. Prognostic value of inflammatory markers for in-hospital mortality in intensive care patients with acute ischemic stroke: a retrospective observational study based on MIMIC-IV. Frontiers in neurology. 2023;14:1174711.
4. Aktas G. A comprehensive review on rational and effective treatment strategies against an invisible enemy; SARS Cov-2 infection. Exp Biomed Res. 2020;3(4):293-311.
5. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. Jama. 2020;323(13):1239-42.
6. Aktas G, Balci B, Yilmaz S, Bardak H, Duman TT, Civil C. Characteristics of Covid-19 infection with the original SARS-Cov-2 virus and other variants: A comparative review. J Bionic Mem. 2022;2(3):96-112.
7. Aktas G. Hematological predictors of novel Coronavirus infection. Revista da Associacao Medica Brasileira (1992). 2021;67Suppl 1(Suppl 1):1-2.
8. Khalid A, Ali Jaffar M, Khan T, Abbas Lail R, Ali S, Aktas G, et al. Hematological and biochemical parameters as diagnostic and prognostic markers in SARS-COV-2 infected patients of Pakistan: a retrospective comparative analysis. Hematology (Amsterdam, Netherlands). 2021;26(1):529-42.
9. Atak BM, Kahveci G, Bilgin S, Kurtkulagi O, Duman TT, Demirkol ME, et al. Haemoglobin and red cell distribution width levels in internal medicine patients indicate recurrent hospital admission during COVID-19. Fam Med Prim Care Rev. 2022;24(1):32-6.
10. Tel BMA, Bilgin S, Kurtkulagi O, Kahveci G, Duman TT, Sagdic T, et al. Frailty in diabetic subjects during COVID-19 and its association with HbA1c, mean platelet volume and monocyte/lymphocyte ratio. Clin Diabetol. 2022;11(2):119-26.
11. Duman TT, Erge E, Tel BMA, Kiziltunc C, Aktas G. De Ritis score as an inflammatory marker in Hashimoto's thyroiditis. Precision Med Sci. 2023:1-5.
12. Pilarczyk K, Carstens H, Heckmann J, Canbay A, Koch A, Pizanis N, et al. The aspartate transaminase/alanine transaminase (DeRitis) ratio predicts mid-term mortality and renal and respiratory dysfunction after left ventricular assist device implantation. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 2017;52(4):781-8.
13. Lu Z, Ma G, Chen L. De-Ritis Ratio Is Associated with Mortality after Cardiac Arrest. Disease markers. 2020;2020:8826318.
14. Kaushal K, Kaur H, Sarma P, Bhattacharyya A, Sharma DJ, Prajapat M, et al. Serum ferritin as a predictive biomarker in COVID-19. A systematic review, meta-analysis and meta-regression analysis. Journal of critical care. 2022;67:172-81.
15. Lee H, Lee SE, Byun SS, Kim HH, Kwak C, Hong SK. De Ritis ratio (aspartate transaminase/alanine transaminase ratio) as a significant prognostic factor after surgical treatment in patients with clear-cell localized renal cell carcinoma: a propensity score-matched study. BJU international. 2017;119(2):261-7.
16. Eryilmaz-Eren E, Turunc-Ozdemir A, Kanat A, Ture Z, Kilinc-Toker A, Celik I. The association of De Ritis ratio with the severity of Crimean–Congo hemorrhagic fever. Future Virology. 2023;18(9):575-82.
17. Zhao PY, Yao RQ, Ren C, Li SY, Li YX, Zhu SY, et al. De Ritis Ratio as a Significant Prognostic Factor in Patients with Sepsis: A Retrospective Analysis. The Journal of surgical research. 2021;264:375-85.
18. Gao F, Chen C, Lu J, Zheng J, Ma XC, Yuan XY, et al. De Ritis ratio (AST/ALT) as an independent predictor of poor outcome in patients with acute ischemic stroke. Neuropsychiatric disease and treatment. 2017;13:1551-7.
19. Albitar O, Ballouze R, Ooi JP, Sheikh Ghadzi SM. Risk factors for mortality among COVID-19 patients. Diabetes research and clinical practice. 2020;166:108293.
20. Noor FM, Islam MM. Prevalence and Associated Risk Factors of Mortality Among COVID-19 Patients: A Meta-Analysis. Journal of community health. 2020;45(6):1270-82.
21. Shi Q, Zhang X, Jiang F, Zhang X, Hu N, Bimu C, et al. Clinical Characteristics and Risk Factors for Mortality of COVID-19 Patients With Diabetes in Wuhan, China: A Two-Center, Retrospective Study. Diabetes care. 2020;43(7):1382-91.
22. Mikami T, Miyashita H, Yamada T, Harrington M, Steinberg D, Dunn A, et al. Risk Factors for Mortality in Patients with COVID-19 in New York City. Journal of general internal medicine. 2021;36(1):17-26.
23. Mosquera-Sulbaran JA, Pedreañez A, Carrero Y, Callejas D. C-reactive protein as an effector molecule in Covid-19 pathogenesis. Reviews in medical virology. 2021;31(6):e2221.
24. Yitbarek GY, Walle Ayehu G, Asnakew S, Ayele FY, Bariso Gare M, Mulu AT, et al. The role of C-reactive protein in predicting the severity of COVID-19 disease: A systematic review. SAGE open medicine. 2021;9:20503121211050755.
25. Ikeagwulonu RC, Ugwu NI, Ezeonu CT, Ikeagwulonu ZC, Uro-Chukwu HC, Asiegbu UV, et al. C-Reactive Protein and Covid-19 Severity: A Systematic Review. West African journal of medicine. 2021;Vol. 38(10):1011-23.
26. Fialek B, Pruc M, Smereka J, Jas R, Rahnama-Hezavah M, Denegri A, et al. Diagnostic value of lactate dehydrogenase in COVID-19: A systematic review and meta-analysis. Cardiology journal. 2022;29(5):751-8.
27. Li C, Ye J, Chen Q, Hu W, Wang L, Fan Y, et al. Elevated Lactate Dehydrogenase (LDH) level as an independent risk factor for the severity and mortality of COVID-19. Aging. 2020;12(15):15670-81.
28. Cheng L, Li H, Li L, Liu C, Yan S, Chen H, et al. Ferritin in the coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis. Journal of clinical laboratory analysis. 2020;34(10):e23618.
29. Lin Z, Long F, Yang Y, Chen X, Xu L, Yang M. Serum ferritin as an independent risk factor for severity in COVID-19 patients. The Journal of infection. 2020;81(4):647-79.
2. Karagoz I, Ozer B, Ital I, Turkoglu M, Disikirik A, Ozer S. C-reactive protein-to-serum albumin ratio as a marker of prognosis in adult intensive care population. Bratislavske lekarske listy. 2023;124(4):277-9.
3. Hu X, Liang J, Hao W, Zhou J, Gao Y, Gong X, et al. Prognostic value of inflammatory markers for in-hospital mortality in intensive care patients with acute ischemic stroke: a retrospective observational study based on MIMIC-IV. Frontiers in neurology. 2023;14:1174711.
4. Aktas G. A comprehensive review on rational and effective treatment strategies against an invisible enemy; SARS Cov-2 infection. Exp Biomed Res. 2020;3(4):293-311.
5. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. Jama. 2020;323(13):1239-42.
6. Aktas G, Balci B, Yilmaz S, Bardak H, Duman TT, Civil C. Characteristics of Covid-19 infection with the original SARS-Cov-2 virus and other variants: A comparative review. J Bionic Mem. 2022;2(3):96-112.
7. Aktas G. Hematological predictors of novel Coronavirus infection. Revista da Associacao Medica Brasileira (1992). 2021;67Suppl 1(Suppl 1):1-2.
8. Khalid A, Ali Jaffar M, Khan T, Abbas Lail R, Ali S, Aktas G, et al. Hematological and biochemical parameters as diagnostic and prognostic markers in SARS-COV-2 infected patients of Pakistan: a retrospective comparative analysis. Hematology (Amsterdam, Netherlands). 2021;26(1):529-42.
9. Atak BM, Kahveci G, Bilgin S, Kurtkulagi O, Duman TT, Demirkol ME, et al. Haemoglobin and red cell distribution width levels in internal medicine patients indicate recurrent hospital admission during COVID-19. Fam Med Prim Care Rev. 2022;24(1):32-6.
10. Tel BMA, Bilgin S, Kurtkulagi O, Kahveci G, Duman TT, Sagdic T, et al. Frailty in diabetic subjects during COVID-19 and its association with HbA1c, mean platelet volume and monocyte/lymphocyte ratio. Clin Diabetol. 2022;11(2):119-26.
11. Duman TT, Erge E, Tel BMA, Kiziltunc C, Aktas G. De Ritis score as an inflammatory marker in Hashimoto's thyroiditis. Precision Med Sci. 2023:1-5.
12. Pilarczyk K, Carstens H, Heckmann J, Canbay A, Koch A, Pizanis N, et al. The aspartate transaminase/alanine transaminase (DeRitis) ratio predicts mid-term mortality and renal and respiratory dysfunction after left ventricular assist device implantation. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 2017;52(4):781-8.
13. Lu Z, Ma G, Chen L. De-Ritis Ratio Is Associated with Mortality after Cardiac Arrest. Disease markers. 2020;2020:8826318.
14. Kaushal K, Kaur H, Sarma P, Bhattacharyya A, Sharma DJ, Prajapat M, et al. Serum ferritin as a predictive biomarker in COVID-19. A systematic review, meta-analysis and meta-regression analysis. Journal of critical care. 2022;67:172-81.
15. Lee H, Lee SE, Byun SS, Kim HH, Kwak C, Hong SK. De Ritis ratio (aspartate transaminase/alanine transaminase ratio) as a significant prognostic factor after surgical treatment in patients with clear-cell localized renal cell carcinoma: a propensity score-matched study. BJU international. 2017;119(2):261-7.
16. Eryilmaz-Eren E, Turunc-Ozdemir A, Kanat A, Ture Z, Kilinc-Toker A, Celik I. The association of De Ritis ratio with the severity of Crimean–Congo hemorrhagic fever. Future Virology. 2023;18(9):575-82.
17. Zhao PY, Yao RQ, Ren C, Li SY, Li YX, Zhu SY, et al. De Ritis Ratio as a Significant Prognostic Factor in Patients with Sepsis: A Retrospective Analysis. The Journal of surgical research. 2021;264:375-85.
18. Gao F, Chen C, Lu J, Zheng J, Ma XC, Yuan XY, et al. De Ritis ratio (AST/ALT) as an independent predictor of poor outcome in patients with acute ischemic stroke. Neuropsychiatric disease and treatment. 2017;13:1551-7.
19. Albitar O, Ballouze R, Ooi JP, Sheikh Ghadzi SM. Risk factors for mortality among COVID-19 patients. Diabetes research and clinical practice. 2020;166:108293.
20. Noor FM, Islam MM. Prevalence and Associated Risk Factors of Mortality Among COVID-19 Patients: A Meta-Analysis. Journal of community health. 2020;45(6):1270-82.
21. Shi Q, Zhang X, Jiang F, Zhang X, Hu N, Bimu C, et al. Clinical Characteristics and Risk Factors for Mortality of COVID-19 Patients With Diabetes in Wuhan, China: A Two-Center, Retrospective Study. Diabetes care. 2020;43(7):1382-91.
22. Mikami T, Miyashita H, Yamada T, Harrington M, Steinberg D, Dunn A, et al. Risk Factors for Mortality in Patients with COVID-19 in New York City. Journal of general internal medicine. 2021;36(1):17-26.
23. Mosquera-Sulbaran JA, Pedreañez A, Carrero Y, Callejas D. C-reactive protein as an effector molecule in Covid-19 pathogenesis. Reviews in medical virology. 2021;31(6):e2221.
24. Yitbarek GY, Walle Ayehu G, Asnakew S, Ayele FY, Bariso Gare M, Mulu AT, et al. The role of C-reactive protein in predicting the severity of COVID-19 disease: A systematic review. SAGE open medicine. 2021;9:20503121211050755.
25. Ikeagwulonu RC, Ugwu NI, Ezeonu CT, Ikeagwulonu ZC, Uro-Chukwu HC, Asiegbu UV, et al. C-Reactive Protein and Covid-19 Severity: A Systematic Review. West African journal of medicine. 2021;Vol. 38(10):1011-23.
26. Fialek B, Pruc M, Smereka J, Jas R, Rahnama-Hezavah M, Denegri A, et al. Diagnostic value of lactate dehydrogenase in COVID-19: A systematic review and meta-analysis. Cardiology journal. 2022;29(5):751-8.
27. Li C, Ye J, Chen Q, Hu W, Wang L, Fan Y, et al. Elevated Lactate Dehydrogenase (LDH) level as an independent risk factor for the severity and mortality of COVID-19. Aging. 2020;12(15):15670-81.
28. Cheng L, Li H, Li L, Liu C, Yan S, Chen H, et al. Ferritin in the coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis. Journal of clinical laboratory analysis. 2020;34(10):e23618.
29. Lin Z, Long F, Yang Y, Chen X, Xu L, Yang M. Serum ferritin as an independent risk factor for severity in COVID-19 patients. The Journal of infection. 2020;81(4):647-79.
Objavljeno
2025/11/19
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Rubrika
Originalni rad / Original article