Comparação dos perfis bioquímicos e hematológicos de pacientes com COVID-19 em seus diferentes desfechos: alta hospitalar e óbito
DOI:
https://doi.org/10.33448/rsd-v11i2.25772Palavras-chave:
SARS-CoV-2; COVID-19; Biomarcadores; Prognóstico.Resumo
Introdução: O vírus causador da COVID-19, SARS-CoV-2, apresenta como principal foco de comprometimento o trato respiratório, ainda hoje com muitos pacientes evoluindo para a forma mais grave. Por isso, deve-se identificar precocemente sinais e sintomas da COVID-19, além de possíveis fatores de risco e sinais de mau prognóstico envolvidos na progressão da doença. Objetivo: Desta forma, o presente trabalho teve por objetivo avaliar exames bioquímicos, hematológicos e de coagulação em pacientes diagnosticados com a COVID-19, a fim de identificar um padrão de prognóstico para os desfechos de alta hospitalar e óbito a partir de um compilado de dados descritivos de um repositório público. Metodologia: dados de pacientes atendidos entre 26 de fevereiro e 27 de junho de 2020 no Hospital Sírio-Libanês, disponibilizado por um repositório público, foram divididos em duas categorias para análises. Foram analisados os dados demográficos (gênero, idade e cidade onde o paciente reside) e dados clínicos/laboratoriais (resultados de exames), incluindo o desfecho (alta ou óbito). Resultados: Idade mais avançada e gênero masculino foram mais associados com o desfecho de óbito. Dímero-D e glicemia foram mais altas no grupo óbito, enquanto a TFG apresentou piora em ambos os grupos e TTPA, bilirrubina total, creatinina sérica, glicemia, dímero-D e PCR aumentaram no desfecho apenas dos pacientes que vieram à óbito, tendo esse último reduzido no grupo “alta hospitalar”. Além disso, houve menores índices de hemoglobina, eritrócitos e hematócrito, plaquetas e linfócitos, assim como aumento de leucócitos, neutrófilos e basófilos no grupo de pacientes que evoluiu para óbito. Conclusão: As variações encontradas nos parâmetros bioquímicos sugerem especialmente que a hiperglicemia está associada a casos mais graves, enquanto a análise de inflamação confirma pela PCR que esta condição foi mais exacerbada nos pacientes que morreram. Na análise de coagulação, o aumento do dímero-D foi associado a quadros mais graves e, nos hematológicos, os resultados refletem maior risco de anemia e resposta inflamatória sistêmica.
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