The effectiveness of dexamethasone on the prognosis of dialysis patients with severe COVID-19

SUMMARY OBJECTIVE: This study aimed to investigate the effectiveness of dexamethasone in dialysis patients with COVID-19 and whether it predicts mortality. METHODS: This is a comparative cross-sectional study of 113 consecutive patients with COVID-19 with severe pneumonia signs. The patients were divided into two groups according to the use of dexamethasone treatment: group 1 (n=45) included patients who were treated with dexamethasone and group 2 (n=68) who did not receive dexamethasone. RESULTS: The mean age of both groups was 67.0±10.6 and 67.2±13.0 years, respectively (p=0.947). With respect to demographic and laboratory findings, there were no significant differences between the two groups (p>0.05). The hospitalization time of patients in group 1 was longer than that in group 2 (11 [7-17] days vs. 8 [5.3-14] days, p=0.093]. The 28-day survival rate was 54.2% in the group receiving dexamethasone treatment and 79.5% in the group not receiving dexamethasone treatment (p=0.440). CONCLUSION: Dexamethasone did not reduce mortality rates and the requirement for intensive care unit in dialysis patients with COVID-19. Larger prospective randomized clinical trials are required to associate personalized medicine with the corticosteroid treatment to select suitable patients who are more likely to show a benefit.

Correlation between venous blood gas indices and radiological involvements of COVID-19 patients at first admission to emergency department

SUMMARY The purpose of this study was to investigate the relation between venous blood gas and chest computerized tomography findings and the clinical conditions of COVID-19 pneumonia. METHODS: A total of 309 patients admitted to the emergency department and subsequently confirmed COVID-19 cases was examined. Patients with pneumonia symptoms, chest computerized tomography scan, venous blood gas findings, and confirmed COVID-19 on reverse transcription-polymerase chain reaction (PCR) were consecutively enrolled. Multiple linear regression was used to predict computerized tomography and blood gas findings by clinical/laboratory data. RESULTS: The median age of patients was 51 (interquartile range 39-66), and 51.5% were male. The mortality rate at the end of follow-up was 18.8%. With respect to survival status of patients pCO2 and HCO3 levels and total computerized tomography score values were found to be higher in the surviving patients (p<0.001 and p=0.003, respectively), whereas pH and lactate levels were higher in patients who died (p=0.022 and p=0.001, respectively). With logistic regression analysis, total tomography score was found to be significantly effective on mortality (p<0.001). The diffuse and random involvement of the lungs had a significant effect on mortality (p<0.001, 95%CI 3.853-38.769, OR 12.222 and p=0.027; 95%CI 1.155-11.640, OR 3.667, respectively). With linear regression analysis, the effect of pH and lactate results were found to have a positive effect on total tomography score (p=0.003 and p<0.001, respectively), whereas pCO2 was found to have a negative effect (p=0.029). CONCLUSION: There was correlation between venous blood gas indices and radiologic scores in COVID-19 patients. Venous blood gas taken in emergency department can be a fast, applicable, minor-invasive, and complementary test in terms of diagnosing COVID-19 pneumonia and predicting the prognosis of disease.

Investigation of the frequency of COVID-19 in patients treated with intravesical BCG

SUMMARY INTRODUCTION In this retrospective study, we aimed to investigate the frequency of COVID-19 in patients with and without BCG application due to bladder tumors. METHODS The presence of COVID-19 was investigated in 167 patients with BCG and 167 without bladder cancer. All patients were compatible with COVID-19 infection. Patients with RT-PCR positive for SARS-CoV-2 and/or Chest CT positive for viral pneumonia between March and May 2020 were included in the study. RESULTS A total of 334 patients were included in the study. The mean age of the 167 patients in the study group was 71.1±14.2 1 (min. 38.0- max. 98.0 years), 141 (84.4%) were male. The mean age of the 167 patients in the control group was 70.5±13.8 years (min. 41.0- max. 96.0 years), and 149 were male (p> 0.05). COVID-19 was detected in 5 patients in the BCG group and in 4 patients in the control group (P> 0.05). CONCLUSION Intravesical BCG administration does not decrease the frequency of COVID-19 infection.

RESUMO INTRODUÇÃO Neste estudo retrospectivo, objetivou-se investigar a frequência de COVID-19 em pacientes com e sem aplicação de BCG por tumor de bexiga. MÉTODOS A presença de COVID-19 foi investigada em 167 pacientes com BCG e 167 sem câncer de bexiga. Todos os pacientes compatíveis para infecção por COVID-19. Resumidamente, os pacientes foram incluídos no estudo com RT-PCR positivo para Sars-CoV-2 e/ou TC de tórax positivo para pneumonia viral entre março e maio de 2020. RESULTADOS Um total de 334 pacientes foi incluído no estudo. A idade média dos 167 pacientes no grupo de estudo foi de 71,1±14,2 1 (min. 38,0 - máx. 98,0 anos), 141 (84,4%) eram do sexo masculino; 167 pacientes do grupo controle tinham idade média de 70,5±13,8 (min. 41,0 - máx. 96,0 anos) e 149 eram do sexo masculino (p>0,05). A COVID-19 foi detectada em cinco pacientes no grupo BCG e em um no grupo controle (p>0,05). CONCLUSÃO A administração intravesical de BCG não diminui a frequência da infecção por COVID-19.