2022, Cilt 20, Sayı 1, Sayfa(lar) 037-045 |
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The Importance of Acute Phase Proteins in the Evaluation of Critical COVID-19 Patient Prognosis |
Rasime Derya Güleç1, Fatma Demet Arslan2, Taner Çalışkan3, Nimet Şenoğlu4 Nisel Yılmaz5 |
1Sağlık Bakanlığı Tepecik Eğitim Ve Araştırma Hastanesi, Doku Tipleme, İzmir, Türkiye 2Bakırçay Üniversitesi Çiğli Eğitim Ve Araştırma Hastanesi, Biyokimya, İzmir, Türkiye 3Sağlık Bakanlığı Tepecik Eğitim Ve Araştırma Hastanesi, Anestezi Ve Reanimasyon, İzmir, Türkiye 4Bakırçay Üniversitesi Çiğli Eğitim Ve Araştırma Hastanesi, Anestezi Ve Reanimasyon, İzmir, Türkiye 5Sağlık Bakanlığı Tepecik Eğitim Ve Araştırma Hastanesi, Tıbbi Mikrobiyoloji, İzmir, Türkiye |
Keywords: Acute-phase proteins; COVID-19; mechanical ventilation; mortality |
Objectives: Identifying COVID-19 patients with risk of adverse outcomes at first admission to the
intensive care unit has several diagnostic challenges. The concentration of acute phase proteins
synthesized by the liver increases or decreases markedly in the serum following inflammation and
infection. This study aimed to investigate the predictive value of acute phase proteins in critically ill
COVID-19 patients and to evaluate the efficacy of inflammatory markers in predicting mortality risk in
the intensive care unit.
Methods: A retrospective study was conducted in critically ill COVID-19 patients treated in the intensive
care unit. Overall, 123 patients with ARDS and/or multi-organ dysfunction were included in the first 24
hours of admission to intensive care unit. After 28 days, groups of survived (n=54) and dead patient
(n=69) or groups of patient with (n=83) and without (n=40) invasive mechanical ventilation were
formed. Serum amyloid A, C-reactive protein, albumin, and prealbumin values considered as acute
phase proteins within the first 24 hours of admission to the intensive care unit were compared between
groups.
Results: Albumin and prealbumin levels significantly decreased in dead patients (p=0.011, p<0.001,
respectively) and were mechanically ventilated patients (p=0.010, p=0.006, respectively). The Serum
amyloid A levels in mechanically ventilated patients significantly increased (p=0.022).
Conclusion: Low prealbumin and albumin levels and high serum amyloid A levels during admission to
ICU can be used as a prognostic marker of disease severity and mortality.
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