Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Erzincan Binali Yıldırım University, Erzincan 24100, Turkey.
Medicina (Kaunas). 2024 Aug 29;60(9):1414. doi: 10.3390/medicina60091414.
Disease-2019 (COVID-19) has posed formidable challenges to healthcare systems. Exploring novel biomarkers that can provide valuable prognostic insights, particularly in critically ill patients, has a significant importance. Against this backdrop, our study aims to elucidate the associations between serum chloride levels and clinical outcomes. A total of 499 patients were enrolled into the study. The serum chloride levels of patients upon hospital admission were recorded and then categorized into three groups (hypochloremia, normochloremia, and hyperchloremia) for the evaluation of clinical outcomes. Additionally, serum C-reactive protein, procalcitonin, and D-dimer measurements were recorded for further evaluation. A total of 390 (78.1%) patients tested positive for COVID-19 via polymerase chain reaction testing. Non-contrast thorax computed tomography scans were indicative of COVID-19 compatibility for all patients. A total of 210 (42%) patients were female and 289 (58%) were male. A total of 214 (42.8%) patients necessitated tocilizumab intervention; 250 (50.1%) were at an intensive care unit (ICU), with 166 (66.4%) of them receiving tocilizumab. A total of 65 (13%) patients died, 40 (61.5%) of whom received tocilizumab; 41 (63%) were in the ICU. Serum chloride levels upon admission were markedly lower and elevated D-dimer levels were apparent in tocilizumab users, patients requiring ICU care, and patients who died. our findings provide robust evidence supporting the value of serum chloride levels as a prognostic biomarker in critically ill COVID-19 patients.
疾病-2019（COVID-19）对医疗系统构成了巨大挑战。探索新的生物标志物，特别是在重症患者中，能够提供有价值的预后见解，具有重要意义。在此背景下，我们的研究旨在阐明血清氯水平与临床结局之间的关系。
共纳入 499 例患者。记录患者入院时的血清氯水平，并将其分为三组（低氯血症、正常氯血症和高氯血症），以评估临床结局。此外，还记录了血清 C 反应蛋白、降钙素原和 D-二聚体的测量值，以进行进一步评估。
共有 390 例（78.1%）患者通过聚合酶链反应检测 COVID-19 检测呈阳性。所有患者的非对比性胸部 CT 扫描均提示符合 COVID-19 标准。共有 210 例（42%）患者为女性，289 例（58%）为男性。共有 214 例（42.8%）患者需要托珠单抗干预；250 例（50.1%）在重症监护病房（ICU），其中 166 例（66.4%）接受了托珠单抗治疗。共有 65 例（13%）患者死亡，其中 40 例（61.5%）接受了托珠单抗治疗；41 例（63%）在 ICU。托珠单抗使用者、需要 ICU 护理的患者和死亡患者入院时的血清氯水平明显较低，D-二聚体水平升高。
我们的研究结果提供了有力的证据，支持血清氯水平作为重症 COVID-19 患者预后生物标志物的价值。
