DIFFERENCES IN INFLAMMATORY MARKERS IN COVID-19 MORTALITY IN PATIENTS AGED 18-65, 65-80 AND 80 YEARS AND OLDER
Background: Since its emergence, coronavirus disease 2019 (COVID-19) has been a challenge to manage and has resulted in high mortality rates.
Aim: This study aimed to reveal the differences in the parameters at the time during the first admission, according to age groups in patients who applied due to Covid-19 and died in the hospital.
Methods: This was a retrospective, cross-sectional, and descriptive study covering the period from March 16 to May 9, 2021. The study population (1169 patients) included patients with COVID-19 who presented to the emergency department and died in the hospital. The data required for this study were obtained from the electronic medical records of the patients in the information system of our hospital. The patients were divided into three groups and analyzed.
Results: It was determined that the highest mortality rate was 547 (46.8%) in the 65-80 age group. In terms of comorbidities, there was a statistically significant difference between the three groups only in the incidence of asthma (p = 0.037). When the laboratory parameters and patient age groups were compared; a statistically significant difference was found in D-dimer, ferritin, WBC, platelet, and neutrophil values (respectively: p=0.001, p=0.020, p=0.005, p=0.029, p=0.037).
Conclusion: The highest death rate in Covid 19 patients is seen in the 65-80 age group. In patients over 80 years of age, the presence of asthma and the increase in D-dimer and ferritin levels among laboratory parameters can be used to predict mortality.
World Health Organization. Coronavirus disease (COVID-19). [accessed 20 Dec 2021]. Available from: https://covid19.who.int/
Fredi M, Cavazzana I, Moschetti L, Andreoli L, Franceschini F; Brescia Rheumatology COVID-19 Study Group.Rheumatology COVİD-19 Study Group. COVID-19 in patients with rheumatic diseases in northern Italy: a single-center observational and case-control study. Lancet Rheumatol. 2020;2(9):e549–56. doi: 10.1016/S2665-9913(20)30169-7
World Health Organization. Guidance on COVID-19 for the care of older people and people living in long-term care facilities, other nonacute care facilities, and home care. [accessed 23 July 2020] Available from: https://apps.who.int/iris/handle/10665/331913
Güneysu F, Guner NG, Erdem AF, Durmus E, Durgun Y, Yurumez Y. Can COVID-19 mortality be predicted in the Emergency room? J Coll Physicians Surg Pak. 2020;30(9):928–32. doi:10.29271/jcpsp.2020.09.928
Parra-Medina R, Herrera S, Mejia J.Systematic review of microthrombi in COVID-19 autopsies. Acta Haematol. 2021;144(5):476–83. doi:10.1159/000515104
T.C. Sağlık BakanlığıCOVID-19 Bilgilendirme Platformu.Covid-19 Rehberi. 2020. [accessed 3 Sept 2020] Available from: https://covid19bilgi.saglik.gov.tr/depo/rehberler/COVID-19_Rehberi.pdf
Robert G. Newcombe DGA. In: Altman D, Machin D, Bryant T GM, Ed. Statistics with Confidence: Confidence Intervals and Statistical Guidelines. 2nd Edition. London: Wiley; 2000. p. 45–7.
Mesas AE, Cavero-Redondo I, Álvarez-Bueno C, Sarriá Cabrera MA, Maffei de Andrade S, Sequí-Dominguez I, et al. Predictors of in-hospital COVID-19 mortality: A comprehensive systematic review and meta-analysis exploring differences by age, sex and health conditions. Plos One. 2020;15(11):e0241742. doi:10.1371/journal.pone.0241742
Jin J-M, Bai P, He W, Wu F, Liu XF, Han DM, et al. Gender Differences in patients with COVID-19: focus on severity and mortality. Front Public Health 2020; 8: 152. doi:10.3389/fpubh.2020.0015
Qiu S, Cai X, Jia L, Sun Z, Wu T, Wendt J, et al. Does objectively measured light-intensity physical activity reduce the risk of cardiovascular mortality? A meta-analysis. Eur Heart J Qual Care Clin Outcomes. 2021;7(5):496-504. doi: 10.1093/ehjqcco/qcaa051.
Asselta R, Paraboschi EM, Mantovani A, Duga S. ACE2 and TMPRSS2 variants and expression as candidates to sex and country differences in COVID-19 severity in Italy. Aging (Albany NY). 2020;12(11):10087-98. doi:10.18632/aging.103415
Ma Q, Hao ZW, Wang YF. The effect of estrogen in coronavirus disease 2019 (COVID-19). Am J Physiol Lung Cell Mol Physiol. 2021;321(1): 219-27. doi:10.1152/ajplung.00332.2020
Wang B, Li R, Lu Z, Huang Y. Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis. Aging (Albany NY). 2020;12(7):6049–57. doi:10.18632/aging.103000
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J,, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061–9. doi:10.1001/jama.2020.1585.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet.2020;395(10229):1054-62. doi:10.1016/S0140-6736(20)30566-3.
Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, 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;180(7):934–43. doi:10.1001/jamainternmed.2020.0994.
Klok FA, Kruip MJHA, van der Meer NJM, Arbous MS, Gommers DAMPJ, Kant KM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020;191:145-7. doi:10.1016/j.thromres.2020.04.013.
Penaloza A, Roy P-M, Kline J, Verschuren F, LE Gal G, Quentin-Georget S, et al. Performance of age-adjusted D-dimer cut-off to rule out pulmonary embolism. J Thromb Haemost.2012;10(7):1291-6. doi:10.1111/j.1538-7836.2012.04769.x
Zhang L, Yan X, Fan Q, Liu H, Liu X, Liu Z, et al. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost. 2020;18(6):1324-9. doi:10.1111/jth.14859.
Chilimuri S, Sun H, Alemam A, Mantri N, Shehi E, Tejada J, et al. Predictors of ,ortality in adults admitted with COVID-19:retrospective cohort study from New York City. West J Emerg Med. 2020;21(4):779-84. doi:10.5811/westjem.2020.6.47919
Vargas-Vargas M, Cortés-Rojo C. Ferritin levels and COVID-19. Rev Panam Salud Pública. 2020;44:e72. doi:10.26633/RPSP.2020.72.
Ahmed S, Ansar Ahmed Z, Siddiqui I, Haroon Rashid N, Mansoor M, Jafri L. Evaluation of serum ferritin for prediction of severity and mortality in COVID-19- A cross-sectional study. Ann Med Surg. 2021;63:102163. doi:10.1016/j.amsu.2021.02.009
Onur ST, Altın S, Sokucu SN, Fikri Bİ, Barça T, Bolat E, et al. Could ferritin level be an indicator of COVID-19 disease mortality? J Med Virol. 2021;93(3):1672-7. doi:10.1002/jmv.26543.
Usul E, Şan İ, Bekgöz B, Sahin A. Role of hematological parameters in COVID-19 patients in the emergency room. Biomark Med. 2020;14(13):1207-15. doi:10.2217/bmm-2020-0317
Feng X, Li S, Sun Q, Zhu J, Chen B, Xiong M, et al. Immune-inflammatory parameters in COVID-19 cases: a systematic review and meta-analysis. Front Med (Lausanne). 2020; 7: 301. doi: 10.3389/fmed.2020.00301. eCollection 2020.
Li X, Liu C, Mao Z, Xiao M, Wang L, Qi S, et al. Predictive values of neutrophil-to-lymphocyte ratio on disease severity and mortality in COVID-19 patients: a systematic review and meta-analysis. Crit Care. 2020;24(1):647. doi:10.1186/s13054-020-03374-8
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