Asociación entre pruebas de laboratorio y mal pronóstico en pacientes infectados por el nuevo coronavirus.

Autores/as

• Deysianne Ferreira da Silva Faculdades Nova Esperança
• Keylla Talitha Fernandes Barbosa Universidade Federal da Paraíba
• Fabiana Maria Rodrigues Lopes de Oliveira
• Maria Hellena Ferreira Brasil
• Yanne Jannine Gomes Araujo Morais

DOI:

https://doi.org/10.36704/cipraxis.v19i34.7314

Palabras clave:

Coronavirus, Covid-19, Diagnóstico laboratorial, Enfermería

Resumen

Introducción: La enfermedad causada por el nuevo coronavirus, covid-19, responsable de desencadenar un síndrome agudo del sistema respiratorio, fue detectada inicialmente en la provincia de Wuhan, China. La enfermedad puede ocurrir de diferentes maneras entre los individuos, desde casos asintomáticos hasta casos graves.
Objetivo: El objetivo fue investigar la asociación entre los resultados de las pruebas de laboratorio y el mal pronóstico en pacientes infectados con el nuevo coronavirus.
Métodos: Se trata de un estudio documental retrospectivo, transversal, desarrollado en unidades de atención de emergencia de la ciudad de João Pessoa, Paraíba. La muestra estuvo compuesta por 187 pacientes. La recolección de datos se realizó entre junio y agosto de 2020, apoyado en un instrumento estructurado que contiene información sobre datos sociodemográficos, pruebas de laboratorio, resultados de salud y el instrumento News-FAST-COVID. Los datos se analizaron mediante estadística descriptiva univariada para todas las variables. También se realizó análisis inferencial mediante la prueba exacta de Fischer, T-Student y correlación de Spearman.
Resultados: Se observó asociación estadísticamente significativa entre la muerte y las siguientes variables: acidosis metabólica (p = 0,004); SDRA moderado (p = 0,017); hipocapnia (p = 0,002); bicarbonato bajo (p = 0,034); leucocitosis (p = 0,029); aumento de urea (p = 0,003) y creatinina (p = 0,042); lactato (p< 0,001); y proteína C reactiva (p = 0,002). En relación a los valores obtenidos en News-FAST-COVID, se observó correlación estadística positiva con las variables: leucocitos, proteína c reactiva, dímero D, urea, creatinina, sodio, troponina y CKMB. Por otro lado, hubo una correlación negativa entre la puntuación News-FAST-COVID y el pH, la relación P/F y las plaquetas.
Conclusión: Se concluye que los resultados de las pruebas de laboratorio y los síntomas clínicos estudiados están relacionados con la infección por el nuevo coronavirus. Por lo tanto, se destaca que conocer estos factores ayuda en la identificación temprana de un mal pronóstico, además de apoyar la toma de decisiones clínicas por parte de los profesionales de la salud involucrados en la atención.

Citas

AKHAVIZADEGAN, H. et al. Can laboratory tests at the time of admission guide us to the prognosis of patients with COVID-19? Journal of Preventive Medicine and Hygiene, v. 62, n.2, p. 321-325, 2021.

BARBOSA, D. A. et al. Alterações bioquímicas de pacientes com COVID-19. Acta Paul Enferm., v. 36, p. 1-10, 2023. DOI: https://doi.org/10.37689/acta-ape/2023AO01112

BHATRAJU, P. K. et al. Covid-19 in Critically Ill Patients in the Seattle Region: Case Series. The New England Journal of Medicine, v. 382, n. 21, p. 2012-2022, 2020. DOI: https://doi.org/10.1056/NEJMoa2004500

BRASIL. Governo do Estado da Paraíba. Protocolo clínico: Centro Estadual de Disseminação de Evidências em Saúde do COVID-19 da SES-PB. João Pessoa, 2020.

BRASIL. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Informática do SUS. Painel Coronavírus. Brasília, 2020.

CAVALLI, G. et al. Interleukin-1 blockade with high-dose anakinra in patients with COVID-19, acute respiratory distress syndrome, and hyperinflammation: a retrospective cohort study. The Lancet, v. 2, n. 6, p. 325-331, 2020. DOI: https://doi.org/10.1016/S2665-9913(20)30127-2

CAPELA, R. C. et al. Avaliação das classificações de gravidade na síndrome do desconforto respiratório agudo na infância pelo Consenso de Berlim e pelo Pediatric Acute Lung Injury Consensus Conference. Critical Care Science, v. 36, p. 1-8, 2024. DOI: https://doi.org/10.62675/2965-2774.20240229-pt

CHAOCHAO, T. et al. C‐reactive protein correlates with computed tomographic findings and predicts severe COVID‐19 early. Journal of Medical Virology, v. 92, n. 7, p. 856-862, 2020. DOI: https://doi.org/10.1002/jmv.25871

CHENG, Y. et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney International, v. 97, n. 5, p. 829-838, 2020. DOI: https://doi.org/10.1016/j.kint.2020.03.005

CHI, Z. et al. A Novel Scoring System for Prediction of Disease Severity in COVID-19. Frontiers in Cellular and Infection Microbiology, v. 10, p. 318, 2020. DOI: https://doi.org/10.3389/fcimb.2020.00318

COSTA, A. C. O. et al. Knowledge of the graduants of the Nursing course in the interpretation of blood gasometry in a university center of the interior of Pernambuco. Research, Society and Development, v. 9, n. 8, p. 1-19, 2020.

FERNANDES, E. S. et al. Ventilação protetora na síndrome do desconforto respiratório agudo causada pela COVID-19: o manejo do fisioterapeuta. J. Health Biol Sci, v. 11, n. 1, p. 1-7, 2023. DOI: https://doi.org/10.12662/2317-3076jhbs.v11i1.4463.p1-7.2023

FERRARI, D. et al. Routine blood tests as a potential diagnostic tool for COVID-19. Clinical Chemistry and Laboratory Medicine, v. 58, n. 7, p. 1095-1099, 2020. DOI: https://doi.org/10.1515/cclm-2020-0398

FERREIRA, R. F. A. et al. Análise do perfil de pacientes na segunda onda de COVID-19 em uma Unidade de Terapia Intensiva respiratória. Cadernos Escola de Saúde Pública, v. 17, p. 1-6, 2023. DOI: https://doi.org/10.54620/cadesp.v17i1.1410

GAMSIZKAN, Z. et al. The Use of Predictive Laboratory Tests in Rapid Triage of COVID-19 Pandemic Outpatient Clinic Patients. Clin Lab., v. 1, n. 68, 2022. DOI: https://doi.org/10.7754/Clin.Lab.2021.210521

GORBALENYA, A. E. et al. Severe acute respiratory syndrome-related coronavirus: The species and its viruses–a statement of the Coronavirus Study Group. Nature Microbiology, v. 5, p. 536-544, 2020. DOI: https://doi.org/10.1038/s41564-020-0695-z

GRASSELLI, G. et al. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA, v. 323, n. 16, p. 1574-1581, 2020. DOI: https://doi.org/10.1001/jama.2020.4031

GROTO, A. D. et al. Avaliação de exames laboratoriais e sintomatologia de pacientes com diagnóstico molecular positivo (RT-qPCR) para COVID-19 internados em Unidade de Terapia Intensiva em um município do Oeste do Paraná. Research, Society and Development, v. 10, n. 9, p. 1-8, 2021. DOI: https://doi.org/10.33448/rsd-v10i9.17477

GUADIANA-ROMUALDO, L. G. et al. Characteristics and laboratory findings on admission to the emergency department among 2873 hospitalized patients with COVID-19: the impact of adjusted laboratory tests in multicenter studies. A multicenter study in Spain (BIOCOVID-Spain study). Scandinavian Journal Of Clinical And Laboratory Investigation, v. 81, p. 1-7, 2021. DOI: https://doi.org/10.1080/00365513.2021.1881997

GUAN, W. J. et al. Clinical characteristics of coronavirus disease 2019 in China. New England Journal of Medicine, v. 382, n. 18, p. 1708-1720, 2020.

HUANG, C. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet, v. 395, n. 10223, p. 497-506, 2020. DOI: https://doi.org/10.1016/S0140-6736(20)30183-5

LEON, S. J.; TANGRI, N. Metabolic acidosis in patients with kidney disease. Brazilian Journal of Nephrology, v. 42, n. 1, p. 266-267, 2020. DOI: https://doi.org/10.1590/2175-8239-jbn-2020-0139

LIPPI, G.; PLEBANI, M.; HENRY, B. M. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis. Clinica Chimica Acta, v. 506, n.1, p. 145-148, 2020. DOI: https://doi.org/10.1016/j.cca.2020.03.022

LIU, F. et al. Prognostic value of interleukin-6, C-reactive protein, and procalcitonin in patients with COVID-19. Journal of Clinical Virology, v. 127, p. 1-5, 2020. DOI: https://doi.org/10.1016/j.jcv.2020.104370

LIU, X. et al. Analysis of clinical features and early warning signs in patients with severe COVID-19: A retrospective cohort study. Plos ONE, v.15, n.6, p. 1-12, 2020. DOI: https://doi.org/10.1371/journal.pone.0235459

MCMICHAEL, T. M. et al. Epidemiology of Covid-19 in a Long-Term Care Facility in King County, Washington. New England Journal of Medicine, v. 382, n. 21, p. 2005-2011, 2020. DOI: https://doi.org/10.1056/NEJMoa2005412

MUHAMMED, K. et al. The role of biomarkers in diagnosis of COVID-19 – A systematic review. Life Sciences, v. 254, p. 1-12, 2020. DOI: https://doi.org/10.1016/j.lfs.2020.117788

ORGANIZAÇÃO MUNDIAL DA SAÚDE. Novo Coronavirus (2019-nCoV): relatório de situação, 22. Organização Mundial da Saúde, 2020.

OTTESTAD, W.; SOVIK, S. COVID-19 patients with respiratory failure: what can we learn from aviation medicine?. British Journal of Anaesthesia, v. 125, n. 3, p. 280-281, 2020. DOI: https://doi.org/10.1016/j.bja.2020.04.012

PONCE, P. et al. The COVID-19 Campaign at the Polyvalent Intensive Care Unit of Hospital CUF Infante Santo. Gazeta Médica, v. 7, n. 2, p. 92-100, 2020.

RAFAEL, R. M. R. et al. Epidemiologia, políticas públicas e pandemia de Covid-19: o que esperar no Brasil? Revista Efermagem UERJ, v. 28, p. 1-6, 2020. DOI: https://doi.org/10.12957/reuerj.2020.49570

RODRIGUES, C. M. B. et al. COVID-19: sistema renal e cardíaco. Ulakes Journal of Medicine, v. 1, p. 60-61, 2020.

ROP, L. et al. Accuracy of routine laboratory tests to predict mortality and deterioration to severe or critical COVID‐19 in people with SARS‐CoV‐2. Cochrane Database of Systematic Reviews, v. 8, p. 1-289, 2024. DOI: https://doi.org/10.1002/14651858.CD015050.pub2

SANDOVAL, D. M. Hiperlactatemia por estados de hiperventilación y alcalosis respiratoria: reporte de tres casos y revisión de la literatura. Revista de la Asociación Mexicana de Medicina Critica y Terapia Intensiva, v. 30, n. 3, p. 204-208, 2016. DOI: https://doi.org/10.15581/021.7325

SILVA, G. F. R. et al. Comparação dos perfis bioquímicos e hematológicos de pacientes com COVID-19 em seus diferentes desfechos: alta hospitalar e óbito. Research, Society and Development, v. 11, n. 2, p. 1-18, 2022. DOI: https://doi.org/10.33448/rsd-v11i2.25772

WOLFEL, R. et al. Virological assessment of hospitalized patients with COVID-2019. Nature, v. 581, n. 7809, p. 465-469, 2020. DOI: https://doi.org/10.1038/s41586-020-2196-x

X-AKOGLU, H. User’s guide to correlation coefficients. Turkish Journal of Emergency Medicine, v. 18, n. 3, p. 91-93, 2018. DOI: https://doi.org/10.1016/j.tjem.2018.08.001

XIONG, Y. et al. Clinical and high-resolution CT features of the COVID-19 infection: comparison of the initial and follow-up changes. Investigative Radiology, v. 55, n. 6, p. 332-339, 2020. DOI: https://doi.org/10.1097/RLI.0000000000000674

ZHANG, L. et al. D‐dimer levels on admission to predict in‐hospital mortality in patients with Covid‐19. Journal of Thrombosis and Haemostasis, v. 18, n. 6, p. 1324-1329, 2020. DOI: https://doi.org/10.1111/jth.14859

ZHOU, P. et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature, v. 579, n. 7798, p. 270-273, 2020. DOI: https://doi.org/10.1038/s41586-020-2012-7

ZIEHR, D. R. et al. Respiratory Pathophysiology of Mechanically Ventilated Patients with COVID-19: A Cohort Study. American Journal of Respiratory and Critical Care Medicine, v. 201, n. 12, p. 1560-1564, 2020. DOI: https://doi.org/10.1164/rccm.202004-1163LE

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