Važnost dodatnih hematoloških parametara u dijagnozi infekcije COVID-19 i sepse

postgraduate specialist thesis

• Author: Tina Brenčić
• Mentor: Dunja Rogić (mentor)
• Committee member: Jozsef Petrik (predsjednik povjerenstva)
• Committee member: Dunja Rogić (član povjerenstva)
• Committee member: Sandra Šupraha-Goreta (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of medical biochemistry and haematology); Zagreb
• Defense date and country: 2024, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Medical Biochemistry

Abstract

Cilj istraživanja: Suvremeni hematološki analizatori imaju mogućnost precizne
klasifikacije i kvantifikacije stanica koje se javljaju uslijed upalnih stanja, pri čemu se
mjere brojni dodatni hematološki parametri. Cilj istraživanja bio je utvrditi utječe li
imunološki odgovor na koronavirusnu infekciju uzrokovanu SARS-CoV-2 (COVID-19)
i sepsu na dostupne hematološke parametre te mogu li oni imati dodanu vrijednost u
ranoj dijagnostici tih stanja.
Ispitanici i metode: U istraživanje je... More uključeno 200 bolesnika podijeljenih u tri
skupine; kontrolna skupina, bolesnici s COVID-19 i sepsom. Parametri koji su
predmet ovog istraživanja su broj leukocita, neutrofilnih granulocita (NEUT), limfocita
(LYMPH), monocita (MONO) i nezrelih granulocita (IG), parametri aktivacije neutrofila
(NEUT-RI, NEUT-GI), reaktivni limfociti (RE-LYMP), limfociti koji sintetiziraju antitijela
(AS-LYMP), reaktivni monociti (RE-MONO) te računski omjeri navedenog (NLR, MLR
i IGLR). Ispitano je postoji li statistički značajna razlika u navedenim parametrima
između različitih skupina te su izračunate mjere dijagnostičke točnosti.
Rezultati: Postoji statistički značajna razlika u NEUT %, LYMPH, RE-LYMP, CRP-u
te računskim omjerima između COVID-19 bolesnika i kontrolne skupine (P<0,001) uz
dobru dijagnostičku točnost za navedene parametre (AUC>0,7). U ranoj dijagnostici
bolesnika sa sepsom korisni pokazatelji su NEUT>78,1 %, LYMPH<16,8 %, IG>0,6
%, NEUT-RI>52,7 FI, NLR>4,13, IGLR>0,06 i CRP>120 mg/L te postoji statistički
značajna razlika u ovim parametrima između kontrolne skupine i bolesnika sa
sepsom (P<0,001). Pojava RE-MONO pokazuje visoku specifičnost u ovoj skupini
bolesnika.
Zaključak: COVID-19 dovodi do neutrofilije i limfopenije te porasta računskih omjera.
Sepsa dovodi do značajne promjene gotovo svih parametara leukocitnih
subpopulacija uz porast NEUT-RI i pojavu RE-MONO kao ranih dijagnostičkih
pokazatelja aktivacije imunološkog sustava. Less

Abstract (english)

Objectives: Modern hematology analyzers offer a series of clinical parameters that
provide precise classification and quantification of cells found in inflammatory
conditions. The aim of this study was to determine whether the immune response to
coronavirus infection caused by SARS-CoV-2 virus (COVID-19) and sepsis affects
these hematological parameters and if they have added value in the early diagnosis
of these conditions.
Patients and Methods: Two hundred patients divided into... More three groups; the control
group, patients with COVID-19 and those with sepsis were included in this study. The
following parameters of interest were evaluated: the number of leukocytes, neutrophil
granulocytes (NEUT), lymphocytes (LYMPH), monocytes (MONO) and immature
granulocytes (IG), parameters of neutrophil activation (NEUT-RI, NEUT-GI), reactive
(RE-LYMP), antibody synthesizing lymphocytes (AS-LYMP), reactive monocytes
(RE-MONO) and calculated ratios (NLR, MLR, IGLR). The difference in the evaluated
parameters between different groups and their diagnostic accuracy has been
assessed.
Results: There is statistically significant difference in NEUT %, LYMPH, RE-LYMP,
CRP and calculated ratios between COVID-19 and control group (P<0.001) with good
diagnostic accuracy for these parameters (AUC>0.7). In early diagnosis of sepsis,
useful indicators are NEUT>78.1 %, LYMPH<16.8 %, IG>0.6 %, NEUT-RI>52.7 FI,
NLR>4.13, IGLR>0.06 and CRP>120 mg/L with significant difference in these
parameters between control group and sepsis (P<0.001). The appearance of REMONO
indicates high specificity in this group of patients.
Conclusion: COVID-19 is characterised with neutrophilia, lymphopenia and
increased calculated ratios. Sepsis leads to a significant change of almost all tested
parameters with an increase of NEUT-RI and RE-MONO as early indicators of
immune system activation. Less

• Keywords: hematološki analizatori; hematološki parametri; koronavirusna infekcija; korona virus; SARS-CoV-2; COVID-19; sepsa
• Keywords (english): hematology analyzers; hematological parameters; coronavirus infection; corona virus; SARS-CoV-2; COVID-19; sepsis
• Language: croatian
• URN:NBN: urn:nbn:hr:163:988687
• Study programme: Title: Medical biochemistry and laboratory medicine - specialistic study - university study; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni specijalist medicinske biokemije i laboratorijske medicine (sveučilišni specijalist medicinske biokemije i laboratorijske medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-12-03 12:05:13