Does the variant positivity and negativity affect the clinical course in COVID-19?: A cohort study.

The primary aim of the current study is to analyze the clinical, laboratory, and demographic data comparing the patients with Coronavirus Disease 2019 (COVID-19) admitted to our intensive care unit before and after the UK variant was first diagnosed in December 2020. The secondary objective was to describe a treatment approach for COVID-19. Between Mar 12, 2020, and Jun 22, 2021, 159 patients with COVID-19 were allocated into 2 groups: the variant negative group (77 patients before December 2020) and the variant positive group (82 patients after December 2020). The statistical analyses included early and late complications, demographic data, symptoms, comorbidities, intubation and mortality rates, and treatment options. Regarding early complications, unilateral pneumonia was more common in the variant (-) group (P = .019), whereas bilateral pneumonia was more common in the variant (+) group (P < .001). Regarding late complications, only cytomegalovirus pneumonia was observed more frequently in the variant (-) group (P = .023), whereas secondary gram (+) infection, pulmonary fibrosis (P = .048), acute respiratory distress syndrome (ARDS) (P = .017), and septic shock (P = .051) were more common in the variant (+) group. The therapeutic approach showed significant differences in the second group such as plasma exchange and extracorporeal membrane oxygenation which is more commonly used in the variant (+) group. Although mortality and intubation rates did not differ between the groups, severe challenging early and late complications were observed mainly in the variant (+) group, necessitating invasive treatment options. We hope that our data from the pandemic will shed light on this field. Regarding the COVID-19 pandemic, it is clear that there is much to be done to deal with future pandemics.

The relationship between lesion density change in chest computed tomography and clinical improvement in COVID-19 patients.

OBJECTIVE: To evaluate the association of changes in chest computed tomography (CT) lesion densities with clinical improvement in COVID-19 patients. METHODS: This was a cross-sectional analysis of hospitalised COVID-19 patients who underwent repeated chest CT. Patients who improved clinically but showed radiological progression were included. Demographic data, presentation complaints and laboratory results were retrieved from the electronic database of the hospital. Lesion density that was measured in Hounsfield units was compred between admission and discharge chest CT scans. RESULTS: Forty patients (21 males, mean age 47.4 ± 15.1 years) were included in the analysis. The median white blood cell count and C-reactive protein significantly decreased, whereas the median lymphocyte count significantly increased at discharge compared with the admission values. The mean density significantly reduced from admission to discharge. CONCLUSION: This is the first study in the literature reporting reduction in chest CT lesion densities correlated with clinical and laboratory improvement in COVID-19 patients.

IONIZING RADIATION EXPOSURE IN PATIENTS WITH COVID-19: MORE THAN NEEDED.

OBJECTIVE: The aim of the study was to evaluate the ionizing radiation exposure in patients with Coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS: This was a retrospective study in which all patients presented with suggestive symptoms of COVID-19 were included. The study was carried out in a university-affiliated private hospital in Istanbul, Turkey. Biological radiation dose exposure (cumulative effective dose: CED) was evaluated in millisievert (mSv) units. RESULTS: A total of 1410 patients were included in the study. Of all study subjects, 804 patients (57%) underwent only one chest computed tomography (CT) procedure. Six hundred and six patients (43%) had two or more chest CT procedures. Median CED was 6.02 (min-max:1.67-16.27) mSv. The number of patients who were exposed to ≤ 5 mSv were 149 (24.6%), whereas 457 patients (75.4%) were exposed to >5 mSv. CONCLUSION: The radiation exposure in COVID-19 patients seems unjustifiably high. Awareness should be increased as to the proper use of chest CT in COVID-19 as per to the society recommendations.

Did COVID-19 area change our urology practice: A retrospective analysis.

OBJECTIVE: This research aimed at evaluating the changing conditions and experiences of urological practice during the COVID-19 pandemic. METHODS: The data of all patients who were admitted to outpatient clinics at Hisar Intercontinental Hospital or the hospital's online patient portal system between March 11th and May 30th, 2020 were analyzed retrospectively. Of all patients, 545 in outpatient clinics and 25 in online portal system, (17%) were hospitalized for medical treatment, and 53 underwent surgery. There were 1032 patients admitted to Urology Clinics and 104 patients who underwent surgery in the same period of 2019. The pre-operative assessment of patients who were candidates of urological surgery included certain criteria for COVID-19. RESULTS: Of patients included in this study, the median age was 41 years (18-90). The mean hospital stay was 1 day (1-12), and the mean duration of operation was 25 min (3-250). Thirty-seven patients (69.8%) underwent general anesthesia, while only 11(20.8%) underwent combined spinal epidural anesthesia. Four patients (7.5%) required local and only one patient (1.9%) underwent sedo-analgesia. Complications were encountered in six patients (11.4%), urosepsis in two, pneumonia in one, and urinary tract infection in three patients. Compared to last year's numbers, the number of patients admitted to the hospital's outpatient clinic and that of hospitalized patients decreased by 47.2% and 49.1%, respectively. CONCLUSION: Emergent surgeries in urological practices can be performed safely under routine preoperative testing for COVID-19 and with the use of adequate protective equipment for both the surgical team and the patient.