The Effect of Prognostıc Factors and Potentıal Treatment Regımens on Fatality Covid-19 Patıents

A. Dogan, Hatun Öztürk Çerik, Atila Gürgen, Aykut Özturan
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Abstract

The ongoing outbreak of the coronavirus disease 2019 (COVID-19), as named by the World Health Organization, has millions of confirmed cases worldwide and has claimed hundreds of thousands of lives. The virus was named SARS-CoV-2 in February by the International Committee on Taxonomy of Viruses. COVID-19 presents as fever, dry cough, dyspnea, headache, and pneumonia. In a small subset of severe cases, the disease quickly progresses to respiratory failure and even death. This study aimed to know the effects of clinical and laboratory features on investigated death. The diagnosis was based on typical findings in thoracic computed tomography (CT) and positive results of the Real-Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) SARS-CoV-2. The demographic characteristics of COVID-19 patients treated, accompanying comorbid conditions and laboratory criteria (blood lymphocyte counts, C Reactive Protein (CRP), D-dimer, Interleukin 6 (IL-6), blood neutrophil count/lymphocyte counts) were collected retrospectively. The results show that 121 cases, 66 (54.54%) were male, 55 (45.46%) were female, and the mean age was ± Std (Min-Max), 59.63 ± 17.4 (22-91). Neutrophil percentage (p = 0.027), neutrophil / lymphocyte ratio (NE / LE) (p = 0.028), CRP (p = <0.001), PCT (p = 0.004), D dimer (p = 0.021) and IL 6 (p = 0.047) in patients with a fatal course, higher values were found than those recovered. Blood lymphocyte count (p = 0.001) and percent (p <0.001) were lower. Number of blood white spheres (p = 0.010), blood neutrophil counts (p = 0.001) and percentage (p <0.001), NE / LE (p0.001), CRP (p <0.001), PCT (p = 0.003) and IL -6 (p <0.001) levels were higher in patients with severe clinical findings than in mild cases. The case death rate was observed as 9%. Covid-19 patients should consider blood neutrophil percentage, blood lymphocyte count, blood lymphocyte percentage, NE / LE, CRP, D dimer, and IL 6 values as an early warning in terms of prognosis. More experience was needed to assess the benefits of immune plasma, tocilizumab, IVIG treatments, and remdesivir therapy recently introduced to the treatment protocol.
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Prognostıc因素及Potentıal治疗Regımens对Covid-19病死率的影响Patıents
世界卫生组织命名的2019冠状病毒病(新冠肺炎)持续爆发,全球已确诊数百万例,并夺走数十万人的生命。该病毒于2月被国际病毒分类委员会命名为严重急性呼吸系统综合征冠状病毒2型。新冠肺炎表现为发烧、干咳、呼吸困难、头痛和肺炎。在一小部分重症病例中,这种疾病会迅速发展为呼吸衰竭甚至死亡。本研究旨在了解临床和实验室特征对调查死亡的影响。诊断基于胸部计算机断层扫描(CT)的典型结果和实时逆转录酶聚合酶链式反应(RT-PCR)严重急性呼吸系统综合征冠状病毒2型的阳性结果。回顾性收集接受治疗的新冠肺炎患者的人口学特征、伴随的合并症和实验室标准(血淋巴细胞计数、C反应蛋白(CRP)、D-二聚体、白细胞介素6(IL-6)、血中性粒细胞计数/淋巴细胞计数)。结果显示,121例中,66例(54.54%)为男性,55例(45.46%)为女性,平均年龄为±Std(Min-Max),59.63±17.4(22-91)。在有致命病程的患者中,中性粒细胞百分比(p=0.027)、中性粒细胞/淋巴细胞比率(NE/LE)(p=0.028)、CRP(p=0.001)、PCT(p=0.004)、D二聚体(p=0.021)和IL-6(p=0.047)的值高于康复者。血淋巴细胞计数(p=0.001)和百分比(p<0.001)较低。有严重临床表现的患者的血白球数量(p=0.010)、血中性粒细胞计数(p=0.001)和百分比(p<0.001)、NE/LE(p0.001)、CRP(p<0.001)、PCT(p=0.003)和IL-6(p<0.0001)水平高于轻症患者。病例死亡率为9%。新冠肺炎患者应考虑血液中性粒细胞百分比、血淋巴细胞计数、血淋巴细胞百分比、NE/LE、CRP、D二聚体和IL 6值作为预后的早期预警。需要更多的经验来评估免疫血浆、tocilizumab、IVIG治疗和最近引入治疗方案的瑞德西韦治疗的益处。
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审稿时长
20 weeks
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