The Uloga biohemijskih markera u predviđanju ishoda teško oboljelih COVID-19 pacijenata primljenih na jedinicu intenzivnog lečenja

  • Bosa Mirjanić-Azarić University Clinical Centre of the Republic of Srpska, Department of Clinical Biochemistry
  • Ivana Pejić Opsta bolnica Gradiška, Gradiška, Republika Srpska, Bosna i Hercegovina
  • Smiljana Mijić Aqualab laboratorija, Banja Luka, Republika Srpska, Bosna i Hercegovina
  • Aleksandra Pejčić Opsta bolnica Gradiška, Gradiška, Republika Srpska, Bosna i Hercegovina
  • Anita Đurđević Švraka Opsta bolnica Gradiška, Gradiška, Republika Srpska, Bosna i Hercegovina
  • Dragan Švraka Univerzitetski klinički centar Republike Srpske, Banja Luka, Bosna i Hercegovina
  • Darija Knežević Univerzitetski klinički centar Republike Srpske, Banja Luka, Bosna i Hercegovina
  • Tatjana Milivojac Univerzitet u Banjoj Luci, Medicinski fakultet, Banja Luka, Republika Srpska, Bosna i Hercegovina
  • Nataša Bogavac-Stanojević Univerzitet u Beogradu, Farmaceutski fakultet, Beograd, Srbija
DOI: https://doi.org/10.5937/jomb0-40641
Ključne reči: COVID-19; odnos neutrofili-limfociti; sistemski inflamantorni indeks; D-dimer; magnezijum; feritin.

Sažetak


Uvod: Pandemija teškog akutnog respiratornog sindroma koronavirusa 2 (SARS-CoV-2) je multisistemska bolest  izazvana difuznim sistemskim procesom koji uključuje kompleksne interakcije inflamatornih, imunoloških i koagulacionih kaskadnih procesa. Cilj ove studije je da utvrdi najefikasnije biomarkere u proceni lošeg ishoda pacijenata u jedinici intenzivne nege obolelih od teškog oblika bolesti COVID-19.

Metode: Retrospektivna opservaciona studija je uključivala 69 preminulih i 20 preživelih pacijenata lečenih u jedinici intenzivne nege u Opštoj bolnici Gradiška u periodu od 01.03.2021. do 01.04.2022. godine. Procenjivane su vrednosti leukocita, limfocita, neutrofila, trombocita, hemoglobina, odnosa neutrofila i limfocita (NLR), odnosa trombocita i limfocita (PLR), sistemskog inflamantornog indeksa (SII). Takođe, procenjivane su vrednosti interleukina-6, feritina, CRP, D-dimera, magnezijuma, bilirubina i aktivnost laktat dehidrogenaze.

Rezultati: Prilikom prijema u jedinicu intenzivne nege postojala je značajna razlika u vrednostima sledećih parametara između preminulih i preživelih pacijenata: leukociti x 109/L 11,5 (8,86-14,75) naspram 9,4 (5,9-11,9), p=0,026; neutrofili x109/L 10,15 (7,81-12,74) naspram 8,60 (4,8-10,3) p=0,022; NLR 15,01 (10,60-24,33) naspram 9,45 (5,10-14,90) p=0,02; SII 3712 (2240-6543) naspram 1949 (993-3720) p=0,003. Tokom vremena koncentracija magnezijuma je značajno rasla u grupi preminulih pacijenata, dok je koncentracija hemoglobina i broj trombocita opadao. ROC analiza je pokazala sledeće AUC vrednosti: leukociti 0,774; neutrofili 0,781; NLR 0,786; SII 0,776;  D-dimer 0,741 i bilirubin 0,713.

Zaključak: U ovoj retrospektivnoj studiji leukociti, neutrofili, NLR, SII, D-dimer i bilirubin, određeni pri prijemu u bolnicu, su imali visoku vrijednost u predviđanju smrti među pacijentima s teškim COVID-19.

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Objavljeno
2023/03/14
Broj časopisa
Vol. 42 Br. 3 (2023): Journal of Medical Biochemistry
Rubrika
Original paper

Sva prava zadržana (c) 2023 Bosa Mirjanić-Azarić, Ivana Pejic, Smiljana Mijic, Aleksandra Pejcic, Anita Djurdjevic Svraka, Dragan Svraka, Darija Knezevic, Tatjana Milivojac, Natasa Bogavac-Stanojevic

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