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Introduction: Since the beginning of the pandemic, factors associated with mortality in patients with corona virus infection disease 2019 (COVID-19) have been investigated. Comorbidities and increased age have been frequently reported to be associated with mortality. We aimed to evaluate the factors associated with unfavorable outcome of patients with COVID-19 at an early period of the pandemic. Methodology: This single center, retrospective, observational study was conducted among laboratory confirmed COVID-19 patients hospitalized between March 11 and May 5, 2020, at Umraniye Training and Research Hospital, Istanbul, Turkey. The effects of the severity of illness, comorbidities, symptoms, and laboratory findings on the clinical outcome were evaluated. Factors associated with unfavorable outcome (necessity of mechanical ventilation or death) were examined using Cox proportional hazards models. Results: Out of a total of 728 patients, 53.8% were men and median age 54 years. The 30-day mortality rate was 4.9% among all hospitalized patients. A logistic regression model identified six predictors of unfavorable clinical outcome: age, severity of illness, the numbers of comorbidities, lymphopenia, high levels of C-reactive protein, and procalcitonin. Conclusions: The mortality rate was lower among the patients with COVID-19, hospitalized during the early period of the pandemic. Older age, higher severity score on admission, the numbers of comorbidities, higher levels of C-reactive protein, procalcitonin, and lymphopenia were identified to be associated with unfavorable outcome of the hospitalized patients with COVID-19. Copyright © 2022 Ozel et al.
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Objective: In this study, we aimed to determine the characteristics of patients with COVID-19 pneumonia who were hospitalized in our hospital in the first wave of the pandemic and the factors affecting the need for intensive care.
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Objective: Frontline healthcare workers (HCW) exposed to coronavirus disease-2019 (COVID-19) patients at their work environment are at a higher risk of acquiring the disease. The aim of this study was to research the COVID-19 risks due to the occupational exposure of HCW and the clinical characteristics of the affected. Material and Methods: In this retrospective study, HCW, employed by The Ümraniye Research and Training Hospital, who were diagnosed with COVID-19 between 20th March 2020 to 20th May 2020 were analysed. Results: A total of 128 (3.8%) HCW were diagnosed with COVID-19. Most of the infected HCW were medical staff (34%), nurses (24%), physicians (22%) and staff with no patient contact (20%). Fifty-six percent of the infected HCW were working in COVID-19 wards and out-patient clinics. Twenty-nine percent acquired the infection in hospital from an index patient and 32% of them from an infected HCW. The highest transmission was during the sharing of the same environment (53%) like offices. Thirteen per cent of the HCW took the virus during examination or treatment, 31% of the individuals were unaware of the transmission. The number of the infected HCW was higher during the beginning of the outbreak in Turkey. The symptomatic cases were more (88%) than the asymptomatic cases (12%). A total of 28 (22%) HCW were hospitalised and only 4% of the cases were severe. Conclusion: The asymptomatic COVID-19 carrying HCW are to be considered as the source of the spread of the disease among their colleagues. Stricter measures should be implemented to prevent in-hospital transmission. © 2021 by Türkiye Klinikleri.
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Objective: This study aimed to identify the effect of tocilizumab (TCZ) on clinical outcomes in severe COVID-19 patients. Material and Methods: We included hospitalized COVID-19 patients with an initial WHO scale >= 4. We matched the patients with baseline characteristics by using propensity scores. Then, we selected patients with C-reactive protein levels above 30 and showing an upward trend. We assessed the effect of TCZ in patients on clinical outcomes by using Mann - Whitney U and Chi-square tests. Results: Of 200 patients who had an initial WHO scale >= 4, 42 (21%) were given it? in addition to standard of care (SOC). Twenty-five patients (50%) needed mechanical ventilation (MV) in the TCZ group, compared with 35 (21%) of 158 patients with SOC (p<0.01). Nineteen (45%) and 37 (23%) patients died in 30 days in these groups, respectively (p <0.01). The secondary infection rate was significantly higher in the TCZ group (p=0.004). However, no difference was observed in all these parameters in the propensity score-matched cohort (14 patients in ICZ and 14 in the SOC group) (p=0.45, 0.45, 1.0 respectively). Conclusions: Tocilizumab does not provide a beneficial effect on MV requirement and mortality in severe COVID-19, and it does not increase the risk of secondary bacterial infection.