COVID-19 ve persistent inflamasyon, immünsüpresyon ve katabolizma sendromu

Abstract

Purpose: Multiple organ failure (MOF) is a disease group that necessitates intensive care monitoring and carries a significant mortality rate. If these individuals are not dead as a result of early MOF, they will either quickly restore immunological balance or their immunological dysfunction may persist, resulting in chronic critical illness (CCI). Some of these patients have CCI, which is characterized by chronic inflammation, immunosuppression, and the syndrome of catabolism (PICS). With this study, we aimed to evaluate PICS cases in our intensive care unit, their effects on mortality, and their biomarkers. Materials and Methods: This is a retrospective, observational study involving 190 patients diagnosed with acute respiratory distress syndrome (ARDS) due to SARS-CoV-2 and followed up in the ICU. Patients' laboratory data and body mass index (BMI) were compared between the first and twenty-first days of ICU admission. In addition, the patients were evaluated according to PICS utilizing the number of days they spent in the ICU, CRP, albumin, prealbumin, lymphocytes, and BMI data. Results: The laboratory values of the patients on the 21st day were as follows, and the results obtained were statistically significant when compared with the values on the 1st day. Albumin 2.56±0.57 g/L, prealbumin 9±15 g/L, d-dimer 4.41±4.70 (interquartile range (IQR): 2.53-4.76) µgFEU/mL, fibrinogen 497±189,35 mg/dl, hemoglobin 10.15±1.82 g/dL, leukocytes 13.94±8.12 (IQR: 12.34-7.69) 109/L, immature granulocyte 1.16±2.13 (IQR: 0.46-1)109/L and BMI of 26.92±3.27 (IQR: 26.7-4.8). Again in these patients, lymphocyte values were 0.92±0.80 (IQR: 0.71-0.74)109/L, CRP was 101.42±99,96 mg/L, and platelet values were 214.24±128.08 109/L. Conclusion: PICS is a significant condition affecting mortality and morbidity in critical care patients. In this group of patients, immature granulocytes may also serve as a useful biomarker. Due to the lack of studies regarding PICS, we are in the premature phase of understanding the pathogenesis and management of PICS and therefore need more comprehensive research regarding the topic.