Güven Bülent Barış, Özçelik Fatih, Tanoglu Alpaslan
Department of Anesthesiology and Reanimation, Sultan 2. Abdulhamidhan Training and Research Hospital, Istanbul, Turkey.
Department of Medical Biochemistry, Sultan 2. Abdulhamid Han Training and Research Hospital, University of Health Sciences, Turkey.
Cent Eur J Immunol. 2022;47(1):73-83. doi: 10.5114/ceji.2022.115091. Epub 2022 Mar 30.
Predicting which patients will need the intensive care unit (ICU) due to severe COVID-19 is critical in terms of disease treatment. In this study, the use of the derived isohemagglutinin (dIH) parameter calculated from isohemagglutinin (IH) values and neutrophil to lymphocyte ratios for prediction of clinical care (CLC), ICU admission and mortality status was investigated for the morbidity and mortality of COVID-19. The data of approximately 21,500 patients admitted to the hospital with the suspicion of COVID-19 were scanned retrospectively. A total of 352 patients with IH results were divided into three groups according to CLC, ICU admission and mortality. Isohemagglutinin, hemogram and biochemistry test results, demographic characteristics, chronic diseases, length of stay, treatments, ICU admission and mortality records were reviewed for all patients. The relationship between test results, demographic characteristics, clinical status and mortality was investigated using statistical methods. The dIH values of patients with ICU admission and mortality were much lower than those of CLC patients [median (min-max): 3.34 (0.14-95.8) and 0.82 (0.05-42.3) vs. 0.18 (0.01-20.6) titers, p < 0.01, respectively]. In the ROC analysis for the power of dIH to discriminate ICU admission, the cutoff was ≤ 0.68 with sensitivity 88.9%, and specificity 79.6%. It was determined that a 1-unit increase in dIH values decreased the need for ICU by 2.09 times and the mortality of those receiving ICU treatment by 2.02 times. dIH values calculated in the early stages of the disease in patients with COVID-19 can be used to estimate the clinical progression associated with ICU admission and mortality.
对于严重新型冠状病毒肺炎（COVID-19）患者，预测哪些患者需要入住重症监护病房（ICU）对于疾病治疗至关重要。在本研究中，我们研究了根据同种血凝素（IH）值和中性粒细胞与淋巴细胞比率计算得出的衍生同种血凝素（dIH）参数在预测COVID-19的发病率和死亡率方面对临床护理（CLC）、ICU入住率和死亡率状况的应用。我们回顾性扫描了约21500例因疑似COVID-19入院患者的数据。共有352例有IH结果的患者根据CLC、ICU入住率和死亡率分为三组。对所有患者的同种血凝素、血常规和生化检查结果、人口统计学特征、慢性病、住院时间、治疗情况、ICU入住率和死亡率记录进行了审查。我们使用统计方法研究了检查结果、人口统计学特征、临床状况与死亡率之间的关系。入住ICU和死亡患者的dIH值远低于CLC患者[中位数（最小值-最大值）：3.34（0.14-95.8）和0.82（0.05-42.3）与0.18（0.01-20.6）滴度，p均<0.01]。在dIH区分ICU入住能力的ROC分析中，临界值≤0.68，敏感性为88.9%，特异性为79.6%。研究确定，dIH值每增加1个单位，ICU需求降低2.09倍，接受ICU治疗患者的死亡率降低2.02倍。COVID-19患者在疾病早期计算出的dIH值可用于估计与ICU入住和死亡率相关的临床进展。
