CRP AND PROCALCITONIN, INFLAMMATORY MARKERS IN COVID-19 DISEASED PATIENTS

Uloga laboratorijske dijagnostike je ključna u suzbijanju i praćenju bolesti COVID-19 upotrebom već dobro poznatih laboratorijskih parametara kao vrlo važnih u praćenju liječenja pacijenata, osobito za rano prepoznavanje komplikacija bolesti COVID-19. Tu je potrebno posebno navesti upalne parametre koji su ključni u praćenju razvoja bolesti poput CRP-a, feritina i PCT-a. CRP je osjetljiv sistemski pokazatelj akutne upale, infekcije i oštećenja tkiva. Serumska koncentracija proporcionalna je jačini upalnog odgovora, pa praćenje porasta tijekom razvoja bolesti predstavlja značajan pokazatelj težine bolesti i razvoja komplikacija. Prokalcitonin ima ulogu u razlikovanju bakterijskih od virusnih uzročnika infekcije jer je u virusnim infekcijama suprimirano otpuštanje prokalcitonina i vrijednosti su mu ispod graničnih. U teškom obliku bolesti COVID-19, zbog lošeg općeg stanja, vrijednosti su mu povišene i koristi se prvenstveno za isključivanje bakterijske koinfekcije. Zabilježeno je da su rutinski biokemijski i hematološki testovi korisni u stratifikaciji i prognozi pacijenata s dijagnosticiranom koronavirusnom bolešću (COVID-19), u korelaciji s lošim ishodima kao što su potreba za mehaničkom ventilacijom ili intenzivnom njegom, napredovanje do višesustavnih organa neuspjeh i/ili smrt. Iako su ovi testovi već dobro uspostavljeni u većini kliničkih laboratorija, još uvijek postoji rasprava o njihovoj kliničkoj vrijednosti u liječenju COVID-19, kao i o vrijednosti ocjena kliničkog rizika u predviđanju bolesti COVID-19.The role of laboratory diagnostics is crucial in the control and monitoring of COVID-19 disease using already well-known laboratory parameters as very important in monitoring the treatment of patients, especially for early detection of complications of COVID-19 disease. Here it is necessary to specify the inflammatory parameters that are crucial in monitoring the development of diseases such as CRP, ferritin and PCT. CRP is a sensitive systemic indicator of acute inflammation, infection, and tissue damage. Serum concentration is proportional to the strength of the inflammatory response, so monitoring the increase during disease development is a significant indicator of disease severity and the development of complications. Procalcitonin has a role in distinguishing bacterial from viral causes of infection because in viral infections the release of procalcitonin is suppressed and its values are below the limit. In the severe form of the disease COVID-19, due to its poor general condition, its values are elevated and it is used primarily to exclude bacterial coinfection. Routine biochemical and hematological tests have been reported to be useful in stratification and prognosis of patients diagnosed with coronavirus disease (COVID-19), correlated with poor outcomes such as the need for mechanical ventilation or intensive care, progression to multisystem organs, failure and / or death. Although these tests are already well established in most clinical laboratories, there is still debate about their clinical value in the treatment of COVID-19, as well as the value of clinical risk assessments in predicting COVID-19 disease