.: ORİJİNAL ARAŞTIRMA
The Frequency of Ocular Surface Inflammation Findings and Relationship with Mortality in Patients Diagnosed with SARS-CoV-2 Infection: A Retrospective Study
SARS-CoV-2 Enfeksiyonu Tanısı Almış Olgularda Oküler Yüzey İnflamasyon Bulgularının Sıklığı ve Mortalite ile İlişkisi: Retrospektif Bir Çalışma
Turkiye Klinikleri J Ophthalmol. 2021;30(4):259-65
doi: 10.5336/ophthal.2021-83243
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: To investigate the frequency of inflammationrelated examination findings of the ocular surface observed in patients with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), levels of inflammation markers and their relationship with mortality. Material and Methods: One hundred ninety-one patients with laboratory- confirmed SARS-CoV-2 infection who received inpatient treatment in the Afyonkarahisar/Sandıklı State Hospital between April 1 and September 30, 2020 were included in the study. The relationship was examined between ocular surface examination findings and white blood cell, neutrophil and leukocyte counts, C-reactive protein, lactate dehydrogenase and, ferritin levels.The relationship between duration of hospital and intensive care unit stay, mortality and ocular surface examination was also evaluated. Results: A statistically significant correlation was determined between an increase in white blood cells and neutrophil count (p=0.011, p=0.008) and C-reactive protein and ferritin levels (p=0.044, p=0.031) with ocular surface examination findings. However, the relationship between the level of lactate dehydrogenase, another inflammatory marker, and ocular surface examination findings was not statistically significant (p=0.338). The relationship between length of stay in hospital, inten sive care unit, mortality and ocular surface examination findings was determined to be statistically significant (p=0.038, p=0,003, p<0.001). Conclusion: The study results showed that a relationship was frequently seen between the ocular surface examination findings and white blood cell and neutrophil counts and C-reactive protein and ferritin levels. Due to increased mortality associated with SARS-CoV-2 infection in cases with pathology observed in the ocular surface examination, it must be considered in the treatment process that there could be a worse prognosis of the clinical course.
Keywords: COVID-19; conjunctivitis; ferritins; lactate dehydrogenases; neutrophils
Objective: To investigate the frequency of inflammationrelated examination findings of the ocular surface observed in patients with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), levels of inflammation markers and their relationship with mortality. Material and Methods: One hundred ninety-one patients with laboratory- confirmed SARS-CoV-2 infection who received inpatient treatment in the Afyonkarahisar/Sandıklı State Hospital between April 1 and September 30, 2020 were included in the study. The relationship was examined between ocular surface examination findings and white blood cell, neutrophil and leukocyte counts, C-reactive protein, lactate dehydrogenase and, ferritin levels.The relationship between duration of hospital and intensive care unit stay, mortality and ocular surface examination was also evaluated. Results: A statistically significant correlation was determined between an increase in white blood cells and neutrophil count (p=0.011, p=0.008) and C-reactive protein and ferritin levels (p=0.044, p=0.031) with ocular surface examination findings. However, the relationship between the level of lactate dehydrogenase, another inflammatory marker, and ocular surface examination findings was not statistically significant (p=0.338). The relationship between length of stay in hospital, inten sive care unit, mortality and ocular surface examination findings was determined to be statistically significant (p=0.038, p=0,003, p<0.001). Conclusion: The study results showed that a relationship was frequently seen between the ocular surface examination findings and white blood cell and neutrophil counts and C-reactive protein and ferritin levels. Due to increased mortality associated with SARS-CoV-2 infection in cases with pathology observed in the ocular surface examination, it must be considered in the treatment process that there could be a worse prognosis of the clinical course.
Keywords: COVID-19; conjunctivitis; ferritins; lactate dehydrogenases; neutrophils
ÖZET
Amaç: Şiddetli akut solunum sendromu-koronavirüs-2 [severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)] tanısı almış olgularda izlenen oküler yüzeyin inflamasyonla ilişkili muayene bulgularının sıklığını, inflamasyon belirteçleri düzeyleri ve bunların mortalite ile ilişkisini araştırmaktır. Gereç ve Yöntemler: 1 Nisan 2020 ve 30 Eylül 2020 tarihleri arasında Afyonkarahisar/Sandıklı Devlet Hastanesi'nde laboratuvar olarak doğrulanmış SARS-CoV-2 enfeksiyonu nedeniyle yatışı yapılarak takip edilen 191 olgu çalışmaya alındı. Olguların beyaz küre, nötrofil, lenfosit sayısı ile C-reaktif protein, laktat dehidrojenaz ve ferritin düzeyleri ile oküler yüzey muayenesi bulguları arasındaki ilişki araştırıldı. Ayrıca hastanede ve yoğun bakımda kalış süresi, mortalite ile oküler yüzey muayenesi bulgularının varlığı arasındaki bağlantı değerlendirildi. Bulgular: Beyaz küre hücresinin ve nötrofil sayısının artışı (p=0,011 ve p=0,008) ile C-reaktif protein ve ferritin düzeylerinin (p=0,044 ve p=0,031) oküler yüzey muayenesi bulguları ile ilişkisi istatistiksel olarak anlamlıdır. Ancak bir diğer inflamasyon belirleyicisi olan laktat dehidrojenaz düzeyi ile oküler yüzey muayene bulguları arasındaki ilişki anlamsızdır (p=0,338). Hastanede ve yoğun bakımda kalış süresi ve mortalite ile oküler yüzey muayene bulguları arasındaki ilişki istatistiksel olarak anlamlı izlendi (p=0,038, p=0,003, p<0,001). Sonuç: Oküler yüzey muayene bulgularının artmış beyaz küre hücresi, nötrofil sayısı, C-reaktif protein ve ferritin düzeyi ile ilişkili olarak daha sık görüldüğü tespit edilmiştir. Oküler yüzey muayenesinde patoloji izlenen olgularda, SARS-CoV-2 enfeksiyonuna bağlı artmış mortalite gözlenmesi nedeniyle klinik seyrin daha kötü prognozlu olabileceği, tedavi sürecinde göz önünde bulundurulmalıdır.
Anahtar Kelimeler: COVID-19; konjonktivit; ferritinler; laktat dehidrogenaz; nötrofiller
Amaç: Şiddetli akut solunum sendromu-koronavirüs-2 [severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)] tanısı almış olgularda izlenen oküler yüzeyin inflamasyonla ilişkili muayene bulgularının sıklığını, inflamasyon belirteçleri düzeyleri ve bunların mortalite ile ilişkisini araştırmaktır. Gereç ve Yöntemler: 1 Nisan 2020 ve 30 Eylül 2020 tarihleri arasında Afyonkarahisar/Sandıklı Devlet Hastanesi'nde laboratuvar olarak doğrulanmış SARS-CoV-2 enfeksiyonu nedeniyle yatışı yapılarak takip edilen 191 olgu çalışmaya alındı. Olguların beyaz küre, nötrofil, lenfosit sayısı ile C-reaktif protein, laktat dehidrojenaz ve ferritin düzeyleri ile oküler yüzey muayenesi bulguları arasındaki ilişki araştırıldı. Ayrıca hastanede ve yoğun bakımda kalış süresi, mortalite ile oküler yüzey muayenesi bulgularının varlığı arasındaki bağlantı değerlendirildi. Bulgular: Beyaz küre hücresinin ve nötrofil sayısının artışı (p=0,011 ve p=0,008) ile C-reaktif protein ve ferritin düzeylerinin (p=0,044 ve p=0,031) oküler yüzey muayenesi bulguları ile ilişkisi istatistiksel olarak anlamlıdır. Ancak bir diğer inflamasyon belirleyicisi olan laktat dehidrojenaz düzeyi ile oküler yüzey muayene bulguları arasındaki ilişki anlamsızdır (p=0,338). Hastanede ve yoğun bakımda kalış süresi ve mortalite ile oküler yüzey muayene bulguları arasındaki ilişki istatistiksel olarak anlamlı izlendi (p=0,038, p=0,003, p<0,001). Sonuç: Oküler yüzey muayene bulgularının artmış beyaz küre hücresi, nötrofil sayısı, C-reaktif protein ve ferritin düzeyi ile ilişkili olarak daha sık görüldüğü tespit edilmiştir. Oküler yüzey muayenesinde patoloji izlenen olgularda, SARS-CoV-2 enfeksiyonuna bağlı artmış mortalite gözlenmesi nedeniyle klinik seyrin daha kötü prognozlu olabileceği, tedavi sürecinde göz önünde bulundurulmalıdır.
Anahtar Kelimeler: COVID-19; konjonktivit; ferritinler; laktat dehidrogenaz; nötrofiller
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