New prognostic markers in acute cholangitis patients with COVID-19

Abstract

Introduction: COVID-19 is the cause of a pandemic with high mortality rates that affect the entire world. In the present study, the importance of blood parameters was investigated in predicting the severity of the disease in patients diagnosed with both covid19 and acute cholangitis simultaneously. Methods: A total of 37 patient groups (n=37) who were diagnosed with both COVID-19 and acute cholangitis, a total of 38 patients in the control group (n=38) infected with Covid 19 and with no comorbidity, and 68 completely healthy control group (n) =68) were included in the study retrospectively and simultaneously. Those who had positive RT-PCR (Real-Time Polymerized Chain Reaction) test results were included in the study. The results of routine biochemistry, serology, hormone, and blood gas tests of the patients were compared with those of the control group. The Tokyo 2018 Criteria (TG18) were used in the diagnosis of acute cholangitis and disease severity grading. Results: The WBC(white blood cell), CRP(c-reactive protein), N/L Ratio(- neutrophile/lynfosite ratio), AST(Aspartat Aminotransferaz), ALT(Alanin Aminotransferaz), LDH(Laktate dehidrogenaz), GGT(Gama glutamil transferaz), ALP(alkalen fosfataz) total bilirubin, and direct bilirubin levels were higher in the patient group at statistically significant levels than in the control group (p<0.001). The albumin levels were lower than in the control group (p<0.001). Total bilirubin/lymphocyte, GGT/lymphocyte, ALP/lymphocyte ratios, and D-dimer parameters had the highest AUC (Area Under the Curve) values in ROC analysis (0.984, 0.924, 0.923, and 0.897, respectively). Conclusion: Total bilirubin/lymphocyte, GGT/lymphocyte, and ALP/lymphocyte ratios may be useful in predicting the severity of the disease in acute cholangitis cases developing with COVID-19 simultaneously.