DOES THE USE OF DEXMEDETOMIDINE AFFECT THE OUTCOMES IN PATIENTS WITH SEVERE COVID-19? (preprint)

Objective: Dexmedetomidine (DEX) is a highly selective α2-adrenoceptor agonist that is increasingly used in the daily practice of intensive care units (ICUs) with its sedative, analgesic, anxiolytic, and immunoprotective effects. In this study, we aimed to analyze whether Dexmedetomidine improves the outcomes in patients treated in ICU. Design: A retrospective study Place and Duration of Study: Intensive care units (ICU) of Sakarya University Training and Research Hospital, Sakarya, Turkey, from October 2020 to February 2021 Methodology: The medical records of the patients were analyzed retrospectively. We included 134 patients in the study, in 45 of whom the treatment regimen included dexmedetomidine and 89 of whom were not treated with dexmedetomidine. Patients treated with DEX were defined as the “patient group”, whereas patients not treated with DEX were defined as “control group” and the parameters were compared between these groups. Obtained data were analyzed in the biostatistical program. Results: The median age of all patients was 64 and 62.7% of them were male. No significant difference was found between the groups in terms of median ages (p>0.05). The patients with diabetes mellitus (DM), congestive heart failure (CHF), and undergoing insulin treatment were significantly less treated with DEX (p=0.04, p=0.03, and p=0.016 respectively) whereas intravenous immunoglobulin (IVIG) therapy was found to be more frequently applied to the patient group (p=0.043). The median duration between ICU admission and the time of intubation was 4 days for the control group whereas it was 1 day for the patient group and the difference was strongly significant (p=0.000, p<0.001). The other analyses concerning lab parameters, mortality rates, intubation rates and durations, applied treatments, and comorbidities revealed no significant difference between the groups. Conclusion: Our study revealed that DEX therapy can help us to gain time before intubation however can not reduce mortality rates in severe COVID-19.

IS THERE ASSOCIATION BETWEEN MIDKINE LEVELS AND PROGNOSIS OF COVID-19 DİSEASE? (preprint)

Aim: The aim of this study was to measure plasma midkine levels in patients with COVID-19 and to assess its clinical significance. Material and Method: 88 patients followed in our hospital with a diagnosis of COVID-19 were included in the study. Demographic characteristics, clinical and laboratory data of the patients were recorded, and the relationship between midkine level and prognosis and other parameters were investigated. Results: Of the 88 patients included in the study, 43 (48.9%) were female and 45 (51.1%) were male. 24 (27%) of our cases were died. The mean age of non-survivals was 70 ± 12.3 and the survivals were 61.9 ± 18.2 years. Mortality predictors due to COVID-19 in group 2 patients were significantly higher than those in group 2 (p <0.05). The median (IR) value of the MK level was 152.5±125 pg/ml in all patients, 143±149 pg/ml in survivors and 165.5±76 pg/ml in those who died (p= 0.546). The difference between these two groups compared according to mortality was not statistically significant The area under the ROC curve was found to be 0.542 (95% CI 0.423-0.661, p= 0.546). Conclusion: MK is not a biomarker that can reinforce known predictors of mortality in COVID-19 patients and can provide better predictions of mortality.