Gharib Atoosa, Nematollahi Zahra, Kazeminejad Behrang, Najafi Ghazal, Pashapour Hadi, Javadi Abdolreza, Mollasharifi Tahmineh
Department of Pathology and Laboratory Medicine, Clinical Research Development Center, Shahid Modarres Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Tanaffos. 2023 Apr;22(4):389-394.
The role of activation of inflammatory processes in the exacerbation of COVID-19 disease has been fully confirmed. In addition, the occurrence of thromboembolic events in patients with COVID-19 is expected even long after recovery from the disease. However, which factors are essentially prognostic for this disease is still not theoretically agreed upon. What we did in the present study was to evaluate the prognostic role of some inflammatory and coagulation factors in predicting the severity of COVID-19 disease. In this study, the need for ICU admission was considered as a symbol of disease severity.
Forty-six cases were studied in this cross-sectional study. Patients over 18 years of age with a definitive diagnosis of COVID-19 were assessed in terms of coagulation profiles and inflammatory and cytokine markers. Regarding laboratory data, serum levels of D-dimer, protein S, protein C, FDP, and fibrinogen were measured using an automated coagulation analyzer, and serum levels of interleukin-6 were measured using the ELISA technique.
In total, 21 patients (45.7%) were admitted to the ICU due to the severity of the disease. In comparing inflammatory and coagulation factors between the two groups of patients, with and without ICU admission, a significant difference was revealed between fibrinogen (P=0.023), D-dimer (P=0.047), protein C (P=0.001), and protein S level (P=0.014). The decrease in protein C level had the highest value for predicting the severity of the disease and therefore the need for ICU admission.
Among various inflammatory and coagulation factors, the role of fibrinogen, D-dimer, protein C, and protein S in predicting the severe form of COVID-19 and the patient's need for ICU admission was confirmed.
炎症过程激活在新型冠状病毒肺炎（COVID-19）病情加重中的作用已得到充分证实。此外，COVID-19患者即使在疾病康复后很长时间仍可能发生血栓栓塞事件。然而，关于哪些因素对该疾病具有本质上的预后价值，在理论上仍未达成共识。我们在本研究中所做的是评估一些炎症和凝血因子在预测COVID-19疾病严重程度方面的预后作用。在本研究中，入住重症监护病房（ICU）的需求被视为疾病严重程度的标志。
在这项横断面研究中对46例病例进行了研究。对年龄超过18岁且确诊为COVID-19的患者进行了凝血指标以及炎症和细胞因子标志物的评估。关于实验室数据，使用自动凝血分析仪测量D-二聚体、蛋白S、蛋白C、纤维蛋白降解产物（FDP）和纤维蛋白原的血清水平，并使用酶联免疫吸附测定（ELISA）技术测量白细胞介素-6的血清水平。
总共有21例患者（45.7%）因病情严重入住ICU。在比较入住ICU和未入住ICU的两组患者的炎症和凝血因子时，发现纤维蛋白原（P = 0.023）、D-二聚体（P = 0.047）、蛋白C（P = 0.001）和蛋白S水平（P = 0.014）之间存在显著差异。蛋白C水平降低对预测疾病严重程度以及因此入住ICU的需求具有最高价值。
在各种炎症和凝血因子中，纤维蛋白原、D-二聚体、蛋白C和蛋白S在预测COVID-19的严重形式以及患者入住ICU的需求方面的作用得到了证实。
