Dímero D y otros biomarcadores asociados con la letalidad en pacientes con COVID-19
Abstract
La COVID-19, en principio con cuadro fisiopatológico desconocido; llevó a una alta tasa de mortalidad. Los biomarcadores se tornaron valiosos para el pronóstico; identificando la gravedad y mortalidad de la enfermedad en pacientes hospitalizados. Según la fisiopatología, pacientes en estado crítico por COVID 19 padecen de hipercoagulabilidad; determinado por exámenes complementarios de laboratorio que señalan aumento de Dímero D, disminución de recuento de plaquetas y linfocitos; dichos cambios forman parte de la génesis del fallo multiorgánico convirtiéndose en un factor de riesgo de mortalidad. La metodología utilizada fue la revisión sistemática con base en directrices PRISMA, recopilando 2107 estudios, de los cuales se seleccionaron 12, de acuerdo a criterios de inclusión y exclusión. Las plataformas de búsqueda fueron PubMed, Scopus, WoS, Science direct. La revisión se basó en los conocimientos actuales de biomarcadores utilizados asociados a mortalidad en pacientes con COVID-19. De los 12 estudios, se registraron 2525 pacientes positivos a SARS-CoV2. Los resultados mostraron que la edad de los pacientes osciló entre 16 a 75 años, y su mortalidad fue en promedio entre 0 a 28.2%. Esta revisión concluye que el aumento del dímero D se asocia a complicaciones graves o mortalidad en pacientes con COVID-19; por lo tanto, pueden usarse como biomarcador predictivo, además sugiere que los análisis hematológicos de laboratorio contribuyen a identificar a los pacientes infectados por COVID-19 en grupos de riesgo, fundamental en el ámbito clínico y manejo terapéutico.
COVID-19, initially with unknown pathophysiological picture; led to a high mortality rate. Biomarkers became valuable for prognosis; identifying the severity and mortality of the disease in hospitalized patients. According to the pathophysiology, patients in critical condition due to COVID 19 suffer from hypercoagulability; determined by complementary laboratory tests that show increased D-Dimer, decreased platelet and lymphocyte counts; these changes are part of the genesis of multiorgan failure becoming a risk factor for mortality. The methodology used was a systematic review based on PRISMA guidelines, compiling 2107 studies, of which 12 were selected according to inclusion and exclusion criteria. The search platforms were PubMed, Scopus, WoS, Science direct. The review was based on current knowledge of biomarkers used associated with mortality in patients with COVID-19. From the 12 studies, 2525 SARS-CoV2 positive patients were registered. The results showed that the age of the patients ranged from 16 to 75 years, and their mortality averaged from 0 to 28.2%. This review concludes that increased D-dimer is associated with severe complications or mortality in patients with COVID-19; therefore, it can be used as a predictive biomarker and suggests that hematological laboratory tests contribute to identify COVID-19 infected patients in risk groups, which is essential in the clinical setting and therapeutic management.
COVID-19, initially with unknown pathophysiological picture; led to a high mortality rate. Biomarkers became valuable for prognosis; identifying the severity and mortality of the disease in hospitalized patients. According to the pathophysiology, patients in critical condition due to COVID 19 suffer from hypercoagulability; determined by complementary laboratory tests that show increased D-Dimer, decreased platelet and lymphocyte counts; these changes are part of the genesis of multiorgan failure becoming a risk factor for mortality. The methodology used was a systematic review based on PRISMA guidelines, compiling 2107 studies, of which 12 were selected according to inclusion and exclusion criteria. The search platforms were PubMed, Scopus, WoS, Science direct. The review was based on current knowledge of biomarkers used associated with mortality in patients with COVID-19. From the 12 studies, 2525 SARS-CoV2 positive patients were registered. The results showed that the age of the patients ranged from 16 to 75 years, and their mortality averaged from 0 to 28.2%. This review concludes that increased D-dimer is associated with severe complications or mortality in patients with COVID-19; therefore, it can be used as a predictive biomarker and suggests that hematological laboratory tests contribute to identify COVID-19 infected patients in risk groups, which is essential in the clinical setting and therapeutic management.
Description
Vol. 5, No. 14