ABSTRACT
OBJECTIVE: The impact of COVID-19 infection still continues all over the world and is an important cause of mortality. The mortality rate due to infection varies between 1-5%. The mortality rate is higher in those with cardiovascular risk factors, especially in cases with hypertension. Some studies have shown that blood urea nitrogen (BUN) and albumin levels are associated with worse prognosis in patients with COVID-19. In our study, we aimed to investigate whether the BUN/albumin (BAR) ratio has an effect on in-hospital mortality in hypertensive COVID-19 patients. PATIENTS AND METHODS: A total of 800 hypertensive COVID-19 patients, (618 of whom were alive and 182 died) were included in our study. Patients with a history of heart failure, malignancy, acute coronary syndrome, and myocarditis were excluded. RESULTS: The median age of the study population was 69 (60-77 IQR) years, and 305 (38%) of these patients were men. There was no statistically significant difference between the patients who died during follow-up and cases that remained alive in terms of comorbidities except chronic obstructive pulmonary disease (COPD) which was significantly lower in surviving group (p=0.014). Multivariable logistic regression analysis revealed that age [OR: 1.04, CI (1.01-1.06); p=0.002], male gender [OR: 1.85, CI (1.13-3.02); p=0.010], lymphocyte count [OR: 0.63, CI (0.40-0.98); p=0.038], SaO2 [OR: 0.82, CI (0.79-0.85); p<0.001] and BAR level [OR: 1.09, CI (1.04-1.16); p=0.001] were independent predictors of in-hospital mortality. ROC analysis yielded that BAR is a better predictor of in-hospital mortality compared to albumin and BUN alone. CONCLUSIONS: BUN, albumin, and BAR levels were found to be reliable predictors of in-hospital mortality in COVID-19 patients, and BAR was also found to be a more reliable predictor than BUN and albumin levels. Hypertension is one of the major risk factors for morbidity and mortality in COVID-19 and, BAR presents additional prognostic data in hypertensive COVID-19 patients that may direct physicians for treatment intensification.
Subject(s)
COVID-19 , Hypertension , Humans , Male , Female , Blood Urea Nitrogen , Hospital Mortality , Biomarkers , Prognosis , Albumins , Retrospective StudiesABSTRACT
Background and Aim: Malignant ventricular arrhythmia is an important cause of mortality in COVID-19 patients (1-3). In our study, we aimed to investigate the cardiac electrophysiological balance index (ICEB), which predicts the risk of malignant ventricular arrhythmia in patients with COVID-19 who developed SIRS (systemic inflammatory response syndrome). Method(s): After exclusion criteria (atrial fibrillation, left bundle branch block, pre-excitation), a total of 533 COVID-19 patients, of whom 197 (37%) were SIRS, were included in the study. Result(s): The average age in the study population was 62 (49-72), and the gender distribution was 49% (261) female, 51% (272) male. The patients were divided into two groups as the control group with SIRS and the control group without SIRS. The clinical, laboratory and demographic characteristics of the patients were compared in Table 1. The QTc/QRS ratio (ICEBc) in the SIRS group was 5.1 (4.64-5.1) and was significantly higher than 4.98 (4.5-5.45) in the control group (p=0.004). The QTc interval was 450 (422-474) and 427 (407-447) significantly longer in the SIRS group than the control group (p=0.001). As a result of multivariable linear regression analysis, a significant correlation was found between ICEBc and SIRS, age, gender and CRP. Conclusion(s): Malign ventricular arrhythmias developing in COVID-19 patients are an important cause of mortality. ICEBc and QTc were significantly higher in the SIRS group than in the control group. It was thought that ICEBc could be used to predict malignant ventricular arrhythmias in the patient group developing SIRS.
ABSTRACT
Maintaining the dynamism of the work scheduling of the nurses without causing them to lose their work motivation provides the sustainability of the effectiveness of health services. Thus, there is a need to develop patient-centred operational research approach applied to health services against new Covid19 waves or new pandemics. In this context, the aim of this study is to develop a novel simulation-based two-stage optimization approach to determine the required number of nurses and schedule the shifts of the nurse working in the Covid19 inpatient service in a Turkish State Hospital. We develop our model in three stages: 1) A simulation model is developed to specify the weekly required number of nurses and run for the scenarios based on demand increases and patient activity, 2) The first mathematical model is used to determine the weekly number of shifts, and 3) The second mathematical model is applied to prepare a fair nurse shift schedule in the pandemic service. This paper suggests a crucial study that will provide managers of healthcare services to plan ahead for personnel needs problems that may take place in the next waves of the Covid19 pandemic in advance. [ FROM AUTHOR]
ABSTRACT
There are several vaccines developed against COVID-19 infection. Inactivated viral vaccines are usually well tolerated. We aimed to present a relapsing immune thrombocytopenia case following inactive COVID-19 vaccine. Here we report a case of relapsing immune thrombocytopenia following inactivated viral vaccine against COVID-19 in a 60-year-old woman with a history of immune thrombocytopenia. The patient responded well to dexamethasone treatment and was discharged from the hospital with full recovery. We suggest that physicians seek the history of a recent inactivate COVID-19 vaccine shot in patients with immune thrombocytopenia.