Yoğun bakımda COVID-19 Pnömonisi olan SARS-COV-2 RT-PCR Pozitif ve Negatif Hastalarin Karşılaştırılması
Öz
Amaç: Yoğun bakıma kabul edilen RT-PCR pozitif ve toraks tomografisinde Coronavirüs-19 pnömonisi bulguları olan RT-PCR negatif hastaları sağkalım ve laboratuvar sonuçları açısından karşılaştırmayı amaçladık.
Gereç ve Yöntem: Solunum yetmezliği ile kabul edilen, görüntülemede tipik pnömoni bulguları olan hastalar çalışmaya alındı. Hastalar RT-PCR negatif ve RT-PCR pozitif olarak gruplandı. Gruplar tanımlayıcı özellikler, sağkalım, laboratuvar, tedaviler, yatış süreleri açısından karşılaştırıldı.
Bulgular: RT-PCR positif grubun Lactat, D-dimer, lökosit, nötrofil sayıları diğer gruptan düşük (p<0.05), Ferritin ve CRP değerleri yüksekti (p<0.01). Semptom başlangıcı ve kabul arasındaki süre PCR-pozitif grupta yüksekti (p=0.016). RT-PCR negatif grupta PaO2/FiO2 oranı 193.58±60.26, RT-PCR pozitif grupta 111.16±58.51 bulundu (p=0.01). Gruplar arasında yatış süreleri, solunum tedavileri ve sağkalım açısından fark yoktu (p>0.05).
Sonuç: Grupların yoğun bakıma kabullerinde farklı inflamasyon fazlarında olabileceklerini düşünmekteyiz ancak sağkalım açısından gruplar arası farklılık olmadığını gördük.
Anahtar Kelimeler
Destekleyen Kurum
YOK
Kaynakça
- 1-Berlin DA, Gulick RM, Martinez FJ. Severe Covid-19. N Engl J Med. 2020 Dec 17;383(25):2451-2460. doi: 10.1056/NEJMcp2009575.
- 2-Zhou M, Zhang X, Qu J. Coronavirus Disease 2019 (COVID-19): A Clinical Update. Front Med. 2020 Apr;14(2):126-135. doi: 10.1007/s11684-020-0767-8.
- 3-Fang Y, Zhang H, Xie J, et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology. 2020 Aug;296(2): E115-E117. doi: 10.1148/radiol.2020200432.
- 4-Ufuk F, Savaş R. Chest CT Features of the Novel Coronavirus Disease (COVID-19). Turk J Med Sci. 2020 Jun 23;50(4):664-678. doi: 10.3906/sag-2004-331.
- 5-Dogan O, Devrim E. Laboratory Tests in Diagnosis and Follow-Up. In: Memikoğlu O, Genç V, eds. COVID-19. Ankara: Ankara University Press, 2021. p. 183-188.
- 6-Gibson PG, Qin L, Puah SH. COVID-19 Acute Respiratory Distress Syndrome (ARDS): Clinical Features and Differences from Typical pre-COVID-19 ARDS. Med J Aust. 2020 Jul;213(2):54-56. doi:10.5694/mja2.50674.
- 7-Montenegro F, Unigarro L, Paredes G, et al. Acute Respiratory Distress Syndrome (ARDS) Caused by the Novel Coronavirus Disease (COVID-19): A Practical Comprehensive Literature Review. Expert Rev Respir Med. 2021 Feb;15(2):183-195. doi: 10.1080/17476348.2020.1820329.
- 8-Sherren PB, Ostermann M, Agarwal S, Meadows CIS, Ioannou N, Camporota L. COVID-19-Related Organ Dysfunction and Management Strategies on the Intensive Care Unit: A Narrative Review. Br J Anaesth. 2020 Dec;125(6):912-925. doi: 10.1016/j.bja.2020.08.050
- 9-Singhal T. A Review of Coronavirus Disease-2019 (COVID-19). Indian J Pediatr. 2020 Apr;87(4):281-286. doi: 10.1007/s12098-020-03263-6.
- 10- Chua RL, Lukassen S, Trump S, et al. COVID-19 severity correlates with airway epithelium-immune cell interactions identified by single-cell analysis. Nat Biotechnol. 2020 Aug;38(8):970-979. doi: 10.1038/s41587-020-0602-4.
- 11-Wang Y, Lu X, Li Y, et al. Clinical Course and Outcomes of 344 Intensive Care Patients with COVID-19. Am J Respir Crit Care Med. 2020 Jun 1;201(11):1430-1434. doi: 10.1164/rccm.202003-0736LE.
- 12- Wu C, Chen X, Cai Y, et al. Risk Factors Associated with Acute Respiratory Distress Syndrome and Death in Patients with Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. 2020 Jul 1;180(7):934-943. doi:10.1001/jamainternmed.2020.0994.
- 13-Yılmaz H, Yüksel M. Alterations in Hematological Parameters in the COVID-19 Process. In: Memikoğlu O, Genç V, eds. COVID-19. Ankara: Ankara University Press, 2021. p. 189-196.
- 14-Zeng F, Huang Y, Guo Y, et al. Association of Inflammatory Markers with the Severity of COVID-19: A Meta-Analysis. Int J Infect Dis. 2020 Jul; 96:467-474. doi: 10.1016/j.ijid.2020.05.055.
- 15- Yang X, Yu Y, et al. Clinical Course and Outcomes of Critically Ill Patients with SARS-CoV-2 Pneumonia in Wuhan, China: A Single- Centered, Retrospective, Observational Study. Lancet Respir Med. 2020 May;8(5):475-481. doi: 10.1016/S2213-2600(20)30079-5.
- 16-Iyer M, Jayaramayya K, Subramaniam MD, et al. COVID-19: An Update on Diagnostic and Therapeutic Approaches. BMB Rep. 2020 Apr;53(4):191-205. doi: 10.5483/BMBRep.2020.53.4.080
- 17-Razonable RR, Pennington KM, Meehan AM, et al. Collaborative Multidisciplinary Approach to the Management of Coronavirus Disease 2019 in the Hospital Setting. Mayo Clin Proc. 2020 Jul;95(7):1467-1481. doi: 10.1016/j.mayocp.2020.05.010.
- 18- Markanday A. Acute Phase Reactants in Infections: Evidence-Based Review and a Guide for Clinicians. Open Forum Infect Dis. 2015 Jul 3;2(3): ofv098. doi: 10.1093/ofid/ofv098.
- 19-Velavan TP, Kieu Linh LT, Kreidenweiss A, Gabor J, Krishna S, Kremsner PG. Longitudinal Monitoring of Lactate in Hospitalized and Ambulatory COVID-19 Patients. Am J Trop Med Hyg. 2021 Jan 11;104(3):1041–4. doi:10.4269/ajtmh.20-1282.
- 20-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 Apr 7;323(13):1239-1242. doi: 10.1001/jama.2020.2648.
- 21-Phua J, Weng L, Ling L, et al. Intensive Care Management of Coronavirus Disease 2019 (COVID-19): Challenges and Recommendations. Lancet Respir Med. 2020 May;8(5):506-517. doi: 10.1016/S2213-2600(20)30161-2.
Comparison of SARS-CoV-2 RT-PCR Positive and Negative Patients with COVID-19 Pneumonia in Intensive Care Unit
Öz
Aim: We aimed to compare RT-PCR positive and RT-PCR negative patients with radiologically confirmed COVID-19 pneumonia admitted to the intensive care unit (ICU) in terms of outcome and laboratory results in the inflammation process.
Material / Method: Patients who were admitted to the ICU due to respiratory failure and had typical COVID-19 pneumonia findings on thorax tomography were included in the study. Patients were grouped as RT-PCR negative and RT-PCR positive. Groups were compared for descriptive and laboratory characteristics, treatments, length of stay and outcome.
Results: Lactate, D-dimer levels, and leukocyte, neutrophil counts of the RT-PCR positive group were lower than the other group (p<0.05). Ferritin and CRP values were higher in the RT-PCR positive group (p<0.01). The duration between symptom onset and admission to ICU was longer in the PCR-positive group(p=0.016). PaO2/FiO2 ratio was 193.58±60.26 in RT-PCR negative group, and 111.16±58.51 in RT-PCR positive group (p=0.01). There was no statistically significant difference between the groups in terms of length of stay, respiratory therapies or outcome (p>0.05).
Conclusion: We may say that RT-PCR negative and RT-PCR positive patients were in different inflammation period in admission. We concluded that there was no difference between groups in terms of outcome.
Anahtar Kelimeler
COVID-19 Intensive care unit pneumonia reverse transcriptase
Kaynakça
- 1-Berlin DA, Gulick RM, Martinez FJ. Severe Covid-19. N Engl J Med. 2020 Dec 17;383(25):2451-2460. doi: 10.1056/NEJMcp2009575.
- 2-Zhou M, Zhang X, Qu J. Coronavirus Disease 2019 (COVID-19): A Clinical Update. Front Med. 2020 Apr;14(2):126-135. doi: 10.1007/s11684-020-0767-8.
- 3-Fang Y, Zhang H, Xie J, et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology. 2020 Aug;296(2): E115-E117. doi: 10.1148/radiol.2020200432.
- 4-Ufuk F, Savaş R. Chest CT Features of the Novel Coronavirus Disease (COVID-19). Turk J Med Sci. 2020 Jun 23;50(4):664-678. doi: 10.3906/sag-2004-331.
- 5-Dogan O, Devrim E. Laboratory Tests in Diagnosis and Follow-Up. In: Memikoğlu O, Genç V, eds. COVID-19. Ankara: Ankara University Press, 2021. p. 183-188.
- 6-Gibson PG, Qin L, Puah SH. COVID-19 Acute Respiratory Distress Syndrome (ARDS): Clinical Features and Differences from Typical pre-COVID-19 ARDS. Med J Aust. 2020 Jul;213(2):54-56. doi:10.5694/mja2.50674.
- 7-Montenegro F, Unigarro L, Paredes G, et al. Acute Respiratory Distress Syndrome (ARDS) Caused by the Novel Coronavirus Disease (COVID-19): A Practical Comprehensive Literature Review. Expert Rev Respir Med. 2021 Feb;15(2):183-195. doi: 10.1080/17476348.2020.1820329.
- 8-Sherren PB, Ostermann M, Agarwal S, Meadows CIS, Ioannou N, Camporota L. COVID-19-Related Organ Dysfunction and Management Strategies on the Intensive Care Unit: A Narrative Review. Br J Anaesth. 2020 Dec;125(6):912-925. doi: 10.1016/j.bja.2020.08.050
- 9-Singhal T. A Review of Coronavirus Disease-2019 (COVID-19). Indian J Pediatr. 2020 Apr;87(4):281-286. doi: 10.1007/s12098-020-03263-6.
- 10- Chua RL, Lukassen S, Trump S, et al. COVID-19 severity correlates with airway epithelium-immune cell interactions identified by single-cell analysis. Nat Biotechnol. 2020 Aug;38(8):970-979. doi: 10.1038/s41587-020-0602-4.
- 11-Wang Y, Lu X, Li Y, et al. Clinical Course and Outcomes of 344 Intensive Care Patients with COVID-19. Am J Respir Crit Care Med. 2020 Jun 1;201(11):1430-1434. doi: 10.1164/rccm.202003-0736LE.
- 12- Wu C, Chen X, Cai Y, et al. Risk Factors Associated with Acute Respiratory Distress Syndrome and Death in Patients with Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. 2020 Jul 1;180(7):934-943. doi:10.1001/jamainternmed.2020.0994.
- 13-Yılmaz H, Yüksel M. Alterations in Hematological Parameters in the COVID-19 Process. In: Memikoğlu O, Genç V, eds. COVID-19. Ankara: Ankara University Press, 2021. p. 189-196.
- 14-Zeng F, Huang Y, Guo Y, et al. Association of Inflammatory Markers with the Severity of COVID-19: A Meta-Analysis. Int J Infect Dis. 2020 Jul; 96:467-474. doi: 10.1016/j.ijid.2020.05.055.
- 15- Yang X, Yu Y, et al. Clinical Course and Outcomes of Critically Ill Patients with SARS-CoV-2 Pneumonia in Wuhan, China: A Single- Centered, Retrospective, Observational Study. Lancet Respir Med. 2020 May;8(5):475-481. doi: 10.1016/S2213-2600(20)30079-5.
- 16-Iyer M, Jayaramayya K, Subramaniam MD, et al. COVID-19: An Update on Diagnostic and Therapeutic Approaches. BMB Rep. 2020 Apr;53(4):191-205. doi: 10.5483/BMBRep.2020.53.4.080
- 17-Razonable RR, Pennington KM, Meehan AM, et al. Collaborative Multidisciplinary Approach to the Management of Coronavirus Disease 2019 in the Hospital Setting. Mayo Clin Proc. 2020 Jul;95(7):1467-1481. doi: 10.1016/j.mayocp.2020.05.010.
- 18- Markanday A. Acute Phase Reactants in Infections: Evidence-Based Review and a Guide for Clinicians. Open Forum Infect Dis. 2015 Jul 3;2(3): ofv098. doi: 10.1093/ofid/ofv098.
- 19-Velavan TP, Kieu Linh LT, Kreidenweiss A, Gabor J, Krishna S, Kremsner PG. Longitudinal Monitoring of Lactate in Hospitalized and Ambulatory COVID-19 Patients. Am J Trop Med Hyg. 2021 Jan 11;104(3):1041–4. doi:10.4269/ajtmh.20-1282.
- 20-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 Apr 7;323(13):1239-1242. doi: 10.1001/jama.2020.2648.
- 21-Phua J, Weng L, Ling L, et al. Intensive Care Management of Coronavirus Disease 2019 (COVID-19): Challenges and Recommendations. Lancet Respir Med. 2020 May;8(5):506-517. doi: 10.1016/S2213-2600(20)30161-2.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 29 Ekim 2022 |
| Gönderilme Tarihi | 3 Haziran 2022 |
| Kabul Tarihi | 25 Temmuz 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 4 Sayı: 3 |
Hitit Medical Journal Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı (CC BY NC) ile lisanslanmıştır.