What Is the Place of Intermediate Care Unit in Patients with COVID-19? A Single Center Experience.

Introduction: COVID-19 pandemic has led to an increased rate of intensive care unit (ICU) stays. Intermediate care units (IMCUs) are a useful resource for the management of patients with severe COVID-19 that do not require ICU admission. In this research, we aimed to determine survival outcomes and parameters predicting mortality in patients who have been admitted to IMCU. Materials and Methods: Patients who were admitted to IMCU between April 2019 and January 2021 were analyzed retrospectively. Sociodemographics, clinical characteristics, and blood parameters on admission were compared between the patients who died in IMCU and the others. Blood parameters at discharge were compared between survived and deceased individuals. Survival analysis was performed via Kaplan-Meier analysis. Blood parameters predicting mortality were determined by univariate and multivariate Cox regression analysis. Results: A total of 140 patients were included within the scope of this study. The median age was 72.5 years, and 77 (55%) of them were male and 63 (45%) of them were female. A total of 37 (26.4%) patients deceased in IMCU, and 40 patients (28.5%) were transferred to ICU. Higher platelet count (HR 3.454; 95% CI 1.383-8.625; p=0.008), procalcitonin levels (HR 3.083; 95% CI 1.158-8.206; p=0.024), and lower oxygen saturation (HR 4.121; 95% CI 2.018-8.414; p < 0.001) were associated with an increased risk of mortality in IMCU. At discharge from IMCU, higher procalcitonin levels (HR 2.809; 95% CI 1.216-6.487; p=0.016), lower platelet count (HR 2.269; 95% CI 1.012-5.085; p=0.047), and noninvasive mechanic ventilation requirement (HR 2.363; 95% CI 1.201-4.651; p=0.013) were associated with an increased risk of mortality. Median OS was found as 41 days. The overall survival rate was found 40% while the IMCU survival rate was 73.6%. Conclusions: IMCU seems to have a positive effect on survival in patients with severe COVID-19 infection. Close monitoring of these parameters and early intervention may improve survival rates and outcomes.

Spontaneous remission of chronic lymphocytic leucemia in a patient with SARS-CoV2.

Although novel therapies have improved the treatment outcome of patients, chronic lymphocytic leukaemia (CLL) is still considered incurable. Recently, a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), causing coronavirus disease 2019 (Covid 19), emerged in late 2019, and it has posed a global health threat. In a limited number of cases, it has been shown that some lymphoma types spontaneously regress after SARS-CoV2 infection suggesting that the infection can trigger de immune system against the tumour cell. Cross-reactivity of pathogen-specific T cells with tumour antigens and natural killer cell activation can be the possible mechanism of this hypothesis.

COVID-19 Pnömonisiyle Yoğun Bakım Ünitesine Başvuran Hastalarda Mortaliteyi Öngörmede Prealbüminin Prognostik Değeri

Amaç: Bu çalışmanın amacı, yoğun bakım ünitesinde (YBÜ) yatan hastalarda 28 günlük mortaliteyi öngörmede prealbümin prognostik değerini araştırmaktır. Gereç ve Yöntem: YBÜ’ye yatırılan 264 hastanın verileri geriye dönük olarak toplandı ve analiz edildi. Hastalar hayatta kalanlar ve ilk 28 gün içinde ölenler olarak iki gruba ayrıldı. Yatışta ve birinci haftanın sonunda alınan prealbümin ve rutin kan örnekleri iki grupta incelendi. Eğri altındaki alan (AUC) değerleri %95 güven aralığı (%95 GA) ile rapor edilmiştir. P<0,05 olan bir p değeri istatistiksel olarak anlamlı kabul edildi. Bulgular: Çalışmaya 236 hasta dahil edildi. Tüm hastaların yaş ortalaması 66,3±14 yıl olarak bulundu;139’u erkek (%59) ve 97’si (%41) kadındı. Tüm hastaların 28 günlük mortalite oranı %56 (n=134) idi. Başvuru anında ve birinci haftanın sonunda düşük prealbümin (p<0,001) ve lenfosit (p<0,001) düzeyleri ile daha yüksek laktat dehidrojenaz (LDH) (p<0,01), C-reaktif protein (CRP) (p<0,001), prokalsitonin (PCT) (yatışta, p=0,003 ve birinci hafta sonunda, p<0,001) daha yüksek ve D-dimer (başvuru sırasında, p=0,02 ve birinci haftanın sonunda p=0,002) daha kötü sonuçlarla ilişkili bulundu. Prealbüminin mortalite için eşik değeri 0,09 g/L olarak bulundu (p<0,001) (Tablo 1, 2). Sonuç: Yoğun bakım ünitesine kabul sırasında ve/veya birinci haftanın sonunda daha düşük prealbümin seviyeleri olan hastalarda 28 günlük mortalite oranı daha yüksektir. Bununla birlikte, 0,09’luk bir eşik değeri olan prealbümin daha düşük prediktif değere sahiptir. (Turkish) [ FROM AUTHOR] Copyright of Turkish Journal of Intensive Care is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)