학술논문
Potential Biomarkers in the Diagnosis of Hemophagocytic Syndrome in COVID-19 Patients/COVID-19 hastalarinda Hemofagositik Sendrom Tanisinda Potansiyel Biyobelirtecler
ORIGINAL INVESTIGATION/OZGUN ARASTIRMA
ORIGINAL INVESTIGATION/OZGUN ARASTIRMA
Document Type
Report
Source
Istanbul Kanuni Sultan Suleyman Medical Journal (Istanbul Kanuni Sultan Suleyman Tıp Dergisi). January 2022, Vol. 14 Issue 1, p43, 9 p.
Subject
Language
English
ISSN
2148-273X
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) has rapidly affected the whole world after the first case appeared in Wuhan, China, in December 2019. It is an infectious disease, which is caused [...]
Objective: Hemophagocytic syndrome (HPS) is one of the very severe immunologic complications a COVID-19 patient may exhibit. HPS can cause cytokine storm syndrome and acute respiratory distress syndrome both of which can be fatal. The aim of this study was to determine the immunologic differences caused by HPS in COVID-19 patients early on so that appropriate treatment of immunologic complications can be provided. Method: This study was a planned prospective study. Thirty patients who initially did not have HPS hospitalized for COVID-19 were included in the study. These patients were later separated into two groups based on having HPS or not. Both groups were examined according to CD subgroups, NK, and HLA parameters at the time of admission. Results: The mean age and gender distribution of the HFS- and HFS+ patient groups were not statistically significant between them. Statistically significant results were obtained in the markers AST, LDH, albumin, CD3 (%), CD19 (%), and CD21 MFI (mean fluorescence intensity). In the univariate statistical analysis performed with CD21, correlations were found with age, lymphocyte count, CD3, and CD19 values. In linear regression analysis performed with these four parameters, which were found to be correlated, a negative relationship with age was confirmed. When the NK cells and NK cell subgroups (CD56bright/CD16CD56dim/CD16+) were examined, no statistically significant difference was found between the groups. Conclusion: More frequently used laboratory markers such as CD3, CD19, and CD21 may be beneficial in the early diagnosis and management of treatment for HPS patients with COVID-19. Keywords: CD3, CD19, CD21, COVID-19, hemophagocytic syndrome, peripheral lymphocyte subsets Amac: Hemofagositik Sendrom (HPS), bir COVID-19 hastasinin sergileyebilecegi cok ciddi immunolojik komplikasyonlardan biridir. HPS, her ikisi de olumcul olabilen sitokin firtinasi sendromuna ve akut solunum sikintisi sendromuna neden olabilir. Bu calismanin amaci, COVID- 19 hastalarinda HPS'nin neden oldugu immunolojik farkliliklari erken donemde belirleyerek immunolojik komplikasyonlarin uygun tedavisinin saglanabilmesidir. Yontem: Bu calisma prospektif arastirma olarak planlandi. Baslangicta COVID-19 nedeniyle hastaneye yatirilan HPS'si olmayan 30 hasta calismaya dahil edildi. Bu hastalar daha sonra HPS olup olmamasina gore iki gruba ayrildi. Her iki grup, basvuru sirasindaki CD alt gruplari, NK ve HLA parametreler acisindan incelendi. Bulgular: HFS- ve HFS+ hasta gruplarinin yas ortalamasi ve cinsiyet dagilimlari acisindan aralarinda istatistiksel olarak anlamli degildi. AST, LDH, albumin, CD3 (%), CD19 (%) ve CD21 (MFI--ortalama floresan yogunlugu) belirteclerinde istatistiksel olarak anlamli sonuclar elde edildi. CD21 ile yapilan tek degiskenli istatistiksel analizde yas, lenfosit sayisi, CD3 ve CD19 degerleri ile korelasyonlar bulundu. Iliskili oldugu tespit edilen bu 4 parametre ile yapilan lineer regresyon analizinde yas ile negatif bir iliski dogrulandi. NK hucreleri ve NK hucre alt gruplari (CD56bright/CD16-, CD56dim/CD16+) incelendiginde gruplar arasinda istatistiksel olarak anlamli bir fark bulunmadi. Sonuc: CD3, CD19 ve CD21 gibi rutin laboratuvarlarda daha sik kullanilan belirtecler, COVID-19'lu HPS hastalarinin erken tanisinda ve tedavisinin yonetiminde faydali olabilir. Anahtar kelimeler: CD3, CD19, CD21, COVID-19, hemofagositik sendrom, periferik lenfosit alt gruplari
Objective: Hemophagocytic syndrome (HPS) is one of the very severe immunologic complications a COVID-19 patient may exhibit. HPS can cause cytokine storm syndrome and acute respiratory distress syndrome both of which can be fatal. The aim of this study was to determine the immunologic differences caused by HPS in COVID-19 patients early on so that appropriate treatment of immunologic complications can be provided. Method: This study was a planned prospective study. Thirty patients who initially did not have HPS hospitalized for COVID-19 were included in the study. These patients were later separated into two groups based on having HPS or not. Both groups were examined according to CD subgroups, NK, and HLA parameters at the time of admission. Results: The mean age and gender distribution of the HFS- and HFS+ patient groups were not statistically significant between them. Statistically significant results were obtained in the markers AST, LDH, albumin, CD3 (%), CD19 (%), and CD21 MFI (mean fluorescence intensity). In the univariate statistical analysis performed with CD21, correlations were found with age, lymphocyte count, CD3, and CD19 values. In linear regression analysis performed with these four parameters, which were found to be correlated, a negative relationship with age was confirmed. When the NK cells and NK cell subgroups (CD56bright/CD16CD56dim/CD16+) were examined, no statistically significant difference was found between the groups. Conclusion: More frequently used laboratory markers such as CD3, CD19, and CD21 may be beneficial in the early diagnosis and management of treatment for HPS patients with COVID-19. Keywords: CD3, CD19, CD21, COVID-19, hemophagocytic syndrome, peripheral lymphocyte subsets Amac: Hemofagositik Sendrom (HPS), bir COVID-19 hastasinin sergileyebilecegi cok ciddi immunolojik komplikasyonlardan biridir. HPS, her ikisi de olumcul olabilen sitokin firtinasi sendromuna ve akut solunum sikintisi sendromuna neden olabilir. Bu calismanin amaci, COVID- 19 hastalarinda HPS'nin neden oldugu immunolojik farkliliklari erken donemde belirleyerek immunolojik komplikasyonlarin uygun tedavisinin saglanabilmesidir. Yontem: Bu calisma prospektif arastirma olarak planlandi. Baslangicta COVID-19 nedeniyle hastaneye yatirilan HPS'si olmayan 30 hasta calismaya dahil edildi. Bu hastalar daha sonra HPS olup olmamasina gore iki gruba ayrildi. Her iki grup, basvuru sirasindaki CD alt gruplari, NK ve HLA parametreler acisindan incelendi. Bulgular: HFS- ve HFS+ hasta gruplarinin yas ortalamasi ve cinsiyet dagilimlari acisindan aralarinda istatistiksel olarak anlamli degildi. AST, LDH, albumin, CD3 (%), CD19 (%) ve CD21 (MFI--ortalama floresan yogunlugu) belirteclerinde istatistiksel olarak anlamli sonuclar elde edildi. CD21 ile yapilan tek degiskenli istatistiksel analizde yas, lenfosit sayisi, CD3 ve CD19 degerleri ile korelasyonlar bulundu. Iliskili oldugu tespit edilen bu 4 parametre ile yapilan lineer regresyon analizinde yas ile negatif bir iliski dogrulandi. NK hucreleri ve NK hucre alt gruplari (CD56bright/CD16-, CD56dim/CD16+) incelendiginde gruplar arasinda istatistiksel olarak anlamli bir fark bulunmadi. Sonuc: CD3, CD19 ve CD21 gibi rutin laboratuvarlarda daha sik kullanilan belirtecler, COVID-19'lu HPS hastalarinin erken tanisinda ve tedavisinin yonetiminde faydali olabilir. Anahtar kelimeler: CD3, CD19, CD21, COVID-19, hemofagositik sendrom, periferik lenfosit alt gruplari