Abstract | Cilj istraživanja: Glavni cilj istraživanja je usporediti serumske razine GFAP-a između bolesnika koji su preživjeli teški oblik COVID-19 i bolesnika koji su preminuli od iste za vrijeme boravka u bolnici. Nadalje, dodatni cilj je usporediti značajke hormonskog statusa između skupina. Konačno, cilj je utvrditi postoji li povezanost između serumskih razina GFAP-a te laboratorijskih parametara i zahvaćenosti plućnog parenhima u COVID-19 bolesnika.
Ispitanici i postupci: Istraživanje je provedeno u Kliničkom bolničkom centru Split, u Jedinici intenzivnog liječenja (JIL), u razdoblju od prosinca 2021. do svibnja 2022. godine. U istraživanje je uključeno 50 muškaraca, u dobi od 18-65 godina, koji boluju od teškog oblika bolesti COVID-19. Ispitanici su podijeljeni u dvije skupine. U prvoj skupini su bolesnici bez smrtnog ishoda (n=37), dok u drugoj skupini su oni u kojih je nastupio smrtni ishod (n=13). Određivanje svih laboratorijskih parametara je provedeno prema standardnoj proceduri na Odjelu za laboratorijsku medicinu Kliničkog bolničkog centra Split. Sva uzorkovanja su izvršena na dan prijema u JIL.
Rezultati: Utvrđena je statistički značajno niža razina serumskog GFAP-a u preživjelih u odnosu na ispitanike koji su preminuli tijekom boravka u bolnici (27,5 ± 7,2 pg/mL vs. 34,9 ± 8,3 pg/mL, P=0,028). Usporedbom hormonskog statusa, utvrđena je statistički značajno viša razina vitamina D u preživjelih ispitanika (40,2 ± 18,6 vs 27,4 ± 17,0 nmol/L, P= 0,040). Nije pronađena značajna razlika u razinama spolnih hormona između skupine bolesnika s i bez smrtnog ishoda. Određena je statistički značajna pozitivna korelacija između serumskih koncentracija GFAP i testosterona (r=-0,310, P=0,036). Također, pronađena je pozitivna korelacija između serumske razine GFAP-a i Brixia zbira (r=0,481, P<0,001).
Zaključci: Naše istraživanje je pokazalo da su veće serumske koncentracije GFAP unutar skupine bolesnika u kojih je nastupio smrtni ishod. Nije pronađena značajna razlika u razini spolnih hormona, dok je razina vitamina D značajno niža unutar skupine bolesnika u kojih je nastupio smrtni ishod. Serumska koncentracija GFAP pozitivno korelira s Brixia zbirom te negativno korelira sa serumskom razinom testosterona. |
Abstract (english) | Objectives: The main aim of the study is to compare the serum levels of GFAP between patients with a severe form of COVID-19 in whom the fatal outcome occurred and patients who survived. Also, an additional goal was to determine the characteristics of the hormonal status between the mentioned groups. In addition to the above, the goal was to determine the relationship between serum GFAP levels, laboratory parameters and lung parenchyma involvement with COVID-19.
Subjects and procedures: The research was conducted at the University Hospital of Split, in the Intensive Care Unit (ICU), in the period from December 2021 to May 2022. The study included 50 men, aged 18-65, who suffer from a severe form of COVID-19. The respondents were divided into two groups. The first group includes patients without a fatal outcome (n=37), while the second group includes those with a fatal outcome (n=13). The determination of all laboratory parameters was carried out according to the standard procedure at the Department of Laboratory Medicine of the University Hospital of Split. All samplings were performed on the day of admission to the ICU.
Results: A statistically significantly lower level of serum GFAP was found in survivors compared to subjects who died during hospital stay (27.5 ± 7.2 pg/mL vs. 34.9 ± 8.3 pg/mL, P =0.028). Comparing the hormonal status, a statistically significantly higher level of vitamin D was found in the surviving subjects (40.2 ± 18.6 vs 27.4 ± 17.0 nmol/L, P= 0.040). No significant difference was found in sex hormone levels between the group of patients with and without a fatal outcome. A statistically significant positive correlation was determined between serum concentrations of GFAP and testosterone (r=-0.310, P=0.036). Also, a positive correlation was found between serum GFAP level and Brixia score (r=0.481, P<0.001).
Conclusions: Our research has shown that higher serum concentrations of GFAP were found in the group of patients who had a fatal outcome. No significant difference was found in the level of sex hormones, while the level of vitamin D was significantly lower in the group of patients who died. The serum concentration of GFAP positively correlates with the Brixia score and negatively correlates with the serum level of testosterone. |