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Objectives: Clinical features and risk factors are highly variable for Coronavirus disease-2019 (COVID-19). Researchers investigate for the prediction of people who have high risk of developing severe illness and dying. The aim of this study is to examine the effect of obesity on the course of COVID-19. Materials and Methods: Patients with laboratory confirmed COVID-19 were retrospectively screened between March 11 and April 30. Anthropometric measures including standing height and body weight were measured at admission. Body mass index (BMI) was calculated and patients were classified into three groups as BMI< 25, BMI 25-29.99, and BMI30 according to the guidelines for the diagnosis and treatment of obesity in Turkey.
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Objective: Early diagnosis is important for severe diseases in COVID-19. Monocyte/high dansity lipoprotein ratio (MHR) is a new prognostic marker indicating inflammation. We aimed to investigate the relationship between MHR and diseases severity in COVID-19. Methods: Patients with laboratory confirmed COVID-19, were retrospectively analyzed. Clinical symptoms, signs and laboratory data on the first day of hospitalization were obtained from medical records of hospital. The clinical data of 301 patients were included in study. Cases were diagnosed on the basis of interim guidance of World Health Organization (WHO). Patients were classified into two groups as non-severe COVID-19 and severe COVID-19. MHR were calculated with laboratory data on the first day of hospitalization. The relationship between MHR level and COVID-19 severity was evaluated. Statistical analysis of the data was performed by using SPSS 25 (SPSS Inc., Chicago, IL, USA) package program. Statistical significance level was accepted as p<0.05. Results: One hundred ninety-six patients (65.1 %) had non-severe COVID-19,105 patients (34.9 %) had severe COVID-19. In our study, it was found that the mean age was higher in severe patients and comorbid diseases were more common. Although monocyte count values were not statistically significantly different, MHR was significantly higher in severe COVID-19 than non-severe COVID-19. Conclusions: Monocytes are very important to cytokine storm in COVID-19. Dyslipidemia can occur in viral infection because of inflammation. MHR can be used as an inflammatory marker in COVID-19.
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Aim: To meet the increasing intensive care and mechanical ventilator needs during the COVID-19 pandemic process, parameters that will enable rapid assessment and decision-making at the bedside are required in emergency services. The aim is to provide rational use of intensive care units by determining appropriate parameters that can be used to evaluate the intensive care follow-up indication. Material and Methods: Demographic data,vital signs, and hemogram results were recorded during the consultation in terms of intensive care follow-up requirements of the patients. The qSOFA, shock index, modified shock index, and the neutrophil-lymphocyte ratio were calculated. Results: Three hundred patients were included in the study.The median age was 69.2 years, 88% of the patients had at least one comorbid disease. The neutrophil-lymphocyte ratio was significant in predicting the need for intubation, but is not an independent risk factor. Male gender, qSOFA scores and need for intubation were predictors of intensive care mortality. Discussion: We found out that no scoring system can predict the requirement of intubation, but qSOFA is effective in showing mortality when making intensive care follow-up decisions for COVID-19 patients consulted in emergency departments.
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Objective: The admission rates to intensive care units and mortalities in geriatric patients are higher than the rest of the population with COVID-19 infection. Although the efficacy of hydroxychloroquine sulfate has been recognized, especially when started early during infection, its effectiveness at these early time points in geriatric patients has not been investigated. In this study, our primary aim was to investigate the effects of early treatment of hydroxychloroquine sulfate on COVID-19 positive geriatric patients, according to their clinical symptoms, situation before the intensive care, and patient survival.
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Objectives: The COVID-19 disease can manifest itself with acute respiratory distress syndrome, renal failure. and septic shock in critically ill patients. There are opinions that there is a correlation between high IL-6 levels and disease severity. In our intensive care unit, we evaluated the changes in the laboratory data and radiological involvement severity of our patients who underwent tocilizumab treatment and examined the appropriate laboratory parameter in the treatment follow-up and its effect on survival. Methods: In the critical patient follow-up of COVID-19, 17 of the 23 patients treated with tocilizuniab had a mortal course (Group 1) and the remaining 6 (Group 2) were. The C-reactive protein, lactate dehydrogenase, IL-6, D-dimer. procalcitonin, albumin. and ferritin values, which were routinely screened in our clinic on the day of tocilizumab treatment and the 5th day after, were recorded. Both the change between the two groups and the change between days 1 and 5 were analyzed. Results: A total of 23 patients (55.35 +/- 13.31 years) were included in the study. The computed tomography severity score assessed at the intensive care unit admission was statistically significantly higher in Group 2. The procalcitonin and lactate dehydrogenase values measured on day 5 after tocilizumab were significantly lower in Group 2. On the 5th day after treatment, the levels of C-reactive protein, ferritin, chest X-rays, IL-6 and D-dirner statistically significantly changed compared to the first day of the treatment. In correlation with the decrease in PCT as of the 5th day after tocilizumab administration. an increasing tendency was observed in 28-day survival. Conclusion: This study demonstrated that tocilizumab treatment may positively contribute to the treatment by decreasing cytokine levels. PCT and LDH follow-up before and after treatment in critically ill patients who are receiving tocilizumab treatment can give an idea about survival.
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Background and Aim: Acute coronary syndromes (ACS) are the diseases that requires emergent therapies and if not applicable most of these patients have high morbidity and mortality. Therefore, the management of these syndromes is very well-defined. However, the management of them during an infectious outbreak can be changed to reduce the contamination and thus to protect healthcare providers and other individuals. Nowadays, there is a Coronavirus (COVID-19) pandemic all over the world including Turkey and this pandemic affects lots of people, especially immunocompromised and elderly individuals. We aimed to report an algorithm about the management of ACS patients during COVID-19 pandemic. Methods: According to this algorithm patients who admitted to the emergency department and diagnosed to have ACS divide into two groups within the scope of COVID-19 outbreak. At first group, patients with suspected or confirmed COVID-19 cases are included. At second group unsuspected cases that do not have the signs and symptoms of COVID-19 infection was included.If the patient has STEMI and includes in the first group, thrombolytic therapy (Actilyse 100 and 50 mg) is preferred at first. If the patient has NSTEMI and includes within the first group, the treatment decision is made according to the risk category of the patients. Results: This algorithm was applied on a total of 47 patients who were hospitalized between 12 March 2020 to 31 March 2020 with the diagnosis of ACS. Among 47 ACS patients, 32 had STEMI (16 inferior, 14 anterior and 2 posterior MI, mean age: 52.8±19 years, male/female: 26/6, hypertension (HT) prevalance 53%, diabetes mellitus (DM) prevalance 18%) and 15 had NSTEMI (mean age: 63.0±16 years, male/female: 12/3, HT prevalance 66%, DM prevalance 26%). All STEMI was type I MI. 31 STEMI and 14 NSTEMI patients were included into group 2 patients and treated within our routine procedure protocol. All STEMI patients except one who was referred to cardiovascular surgery due to the LAD rupture were treated with PCI. On the other hand, 14 NSTEMI patients were treated with PCI and one patient was treated with medical therapy. 1 STEMI and 1 NSTEMI patients were included into group 1 because of the suspected COVID-19 infection. Conclusions: The management of ACS patients during pandemics have to be well-planned and organised to protect both of health care workers and other individuals interested with the patients. Thrombolytic therapy is the first option for eligible STEMI patients. However, NSTEMI patients have to be categorised based on their risk and then the management strategy should be determined. CTA is also important for medium and low risk NSTEMI patients to decide the invasive therapy before discharge from the hospital. An isolation catheter room and isolation room in ICU with negative pressure is a requisite for follow-up of these patients and must be included into these management algorithm.