ABSTRACT
Nephrotic syndrome progresses with various metabolic disturbances, such as proteinuria over 3.5 grams in 24 hours, hypoalbuminemia, and hypercoagulability. Patients usually complain about diffuse edema throughout the body, which is secondary to hypoalbuminemia. It has many primary and secondary causes. Patients may require a renal biopsy to confirm the diagnosis. Besides, many secondary causes of nephrotic syndrome should be examined and excluded. Although many vaccines were developed due to the COVID-19, many side effects are still reported because of the Pfizer-BioNTech COVID-19 vaccine (COVID-19 mRNA and BNT162b2), which is widely used in Turkey. This study examines a case of nephrotic syndrome with acute renal injury after Pfizer-BioNTech vaccine.
ABSTRACT
Background: We aimed to evaluate the relationship between HATCH score [hypertension, age >75 yr, previous transient ischemic attack (TIA) or stroke (doubled), chronic obstructive pulmonary disease, heart failure (doubled)] and in-hospital mortality in COVID-19 patients. Methods: Overall, 572 COVID-19 patients hospitalized between Mar 15 and Apr 15, 2020, were included in this multicenter retrospective study, in Turkey. The HATCH score of each patient was calculated. Mortality results were followed for 50 days. The patients were divided into 2 groups developing mortality (n=267) and non-mortality (n=305). Clinical outcomes were defined as in-hospital mortality improvement status. Results: HATCH scores in non-survivors of COVID-19 were significantly higher than in survivors (P<0.001). In logistic regression analysis, HATCH score (OR: 1.253, 95% CI: 1.003–1.565;P=0.047), platelet count (OR: 0.995, 95% CI: 0.993–0.998;P<0.001), C-reactive protein level (OR: 1.010, 95% CI: 1.007–1.013, P<0.001) and estimated glomerular filtration ratio (eGFR) level (OR: 0.963, 95% CI: 0.953–0.973;P<0.001) were independent predictors of in-hospital mortality in COVID-19 patients. Conclusion: The HATCH score is useful in predicting in-hospital mortality in patients hospitalized with COVID-19.
ABSTRACT
Introduction: In December 2019, a coronavirus disease 2019 (COVID-19) disease outbreak started in Wuhan, Hubei Province, China, and spread rapidly to other regions of the world. Although diffuse alveolar injury and acute respiratory failure were the most prominent characteristics, further investigation of organ involvement is essential. Aim: In this study, we aim to determine the prevalence of acute kidney injury (AKI) in covid-19 patients and also the relationship between inflammatory markers, the severity of lung involvement, and acute kidney injury in COVID-19 patients. Methods: This was a retrospective analysis of 102 COVID-19 patients presented to a tertiary teaching hospital in Mogadishu during the second wave of Covid-19 2021. Patients' age, gender, comorbidities, hemoglobin, platelet, and white blood cell counts, glucose, urea, creatinine, sodium, potassium, CRP, ferritin, real-time polymerase chain reaction (RT PCR) Covid-19 test and CT scan findings were all collected. Results: The mean age of the patients was 58 (Range 23-91 years), including 64 men and 38 women. The prevalence of acute kidney injury was 12.7%. There was a significant association between acute kidney injury, CRP and ferritin with the p values of P<0.003 and P<0.004, respectively. For severity of lung involvement with computed tomography finding, 35 (34.3%) had mild, 35 (34.3%) had moderate and 32 (31.4%) had severe lung involvement. There was significant association between the lung involvement, Ferritin and CRP levels with P values of P<0.005 and P<0.007 respectively. Conclusion: Our findings indicate that acute kidney injury is common in covid-19 patients and can increase the morbidity and mortality of these patients. As a result, clinicians in low-resource countries such as Somalia should be more vigilant about kidney injury in patients with severe COVID-19.
ABSTRACT
OBJECTIVES: To determine risk factors for death in patients with coronavirus disease 2019 (COVID-19) admitted to the main hospital in Somalia, and identify interventions contributing to improved clinical outcome in a low-resource and fragile setting. METHODS: A survival analysis was conducted of all patients with COVID-19 admitted to the main hospital in Somalia from 30 March to 12 June 2020. RESULTS: Of the 131 patients admitted to the hospital with COVID-19, 52 (40%) died and 79 (60%) survived. The main factors associated with the risk of in-hospital death were age ≥60 years {survival probability on day 21 was 0.789 [95% confidence interval (CI) 0.658-0.874] in patients aged <60 years vs 0.339 (95% CI 0.205-0.478) in patients aged ≥60 years}, cardiovascular disease [survival probability 0.478 (95% CI 0.332-0.610) in patients with cardiovascular disease vs 0.719 (95% CI 0.601-0.807) in patients without cardiovascular disease] and non-invasive ventilation on admission (patients who were not ventilated but received oxygen were significantly more likely to survive than patients who were ventilated; P<0.001). CONCLUSION: Considering the risk factors (age ≥60 years, presence of cardiovascular disease and use of non-invasive ventilation) is critical when managing patients with severe COVID-19, especially in low-resource settings where availability of skilled healthcare workers for critical care units is limited. These findings also highlight the importance of use of medical oxygen for severely ill patients, and the critical aspect of deciding whether or not to ventilate critical patients with COVID-19 in order to improve clinical outcome.