ABSTRACT
Introduction: There is no known specific treatment for Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2). Our retrospective study evaluates the effectiveness of steroid treatment and the factors affecting treatment in patients with severe Coronavirus disease-2019 (COVID-19) pneumonia that received favipiravir treatment. Materials and Methods: This study included patients older than 18 years with severe COVID-19 pneumonia who received favipiravir treatment in a training and research hospital between March 1 and May 31, 2020. It retrospectively evaluated respiratory rate <30/min and/or severe respiratory distress and oxygen saturation > 90 and typical thoracic computerized tomography findings: Bilateral lobular, peripheral lesions, and the presence of ground-glass opacities were determined as the criteria for severe pneumonia. For 82 cases of SARS-CoV-2 polymerase chain reaction positive, age, gender, symptoms, comorbidities, steroid use, and mortality rates were examined. Results: Eighty-two patients with confirmed COVID-19 diagnosed with severe pneumonia were included in the study. Of these cases, 63% were males. The median patient age was 64±16.98 (21-97, minimum-maximum) years. The mortality in women was 23%, and the mortality in men was 30%. The correlation between gender and mortality was statistically significant (p=0.04). Advanced age, chronic renal failure, and confusion on hospital admission were associated with mortality (p=0.04, p=0.02, p=0.02, respectively). Methylprednisolone was given to 12 patients as an additional treatment. The mortality of the patients who received steroid treatment was significantly lower than those who did not (p=0.017). There was no bacterial infection in these 12 patients, who received steroid treatment and the procalcitonin level was not high. Conclusion: In confirmed COVID-19 patients without concomitant bacterial infections, steroid treatment can lower mortality and long-term morbidities. Similar to prospective randomized studies, our study showed that steroid use reduces mortality in patients with severe COVID-19 pneumonia.
ABSTRACT
Introduction: There is no known specific treatment for Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2). Our retrospective study evaluates the effectiveness of steroid treatment and the factors affecting treatment in patients with severe Coronavirus disease-2019 (COVID-19) pneumonia that received favipiravir treatment. Materials and Methods: This study included patients older than 18 years with severe COVID-19 pneumonia who received favipiravir treatment in a training and research hospital between March 1 and May 31, 2020. It retrospectively evaluated respiratory rate >30/min and/or severe respiratory distress and oxygen saturation <90 and typical thoracic computerized tomography findings: Bilateral lobular, peripheral lesions, and the presence of ground-glass opacities were determined as the criteria for severe pneumonia. For 82 cases of SARS-CoV-2 polymerase chain reaction positive, age, gender, symptoms, comorbidities, steroid use, and mortality rates were examined.
ABSTRACT
Avibacterium paragallinarum is an important pathogen affecting the respiratory tract of chickens. There is a paucity of information on the molecular characteristics and pathology of A. paragallinarum in Turkish poultry flocks. In the present study, broiler and layer flocks (n = 2) suspected of viral infections with serious respiratory signs and significant mortality were visited. Chickens showed various disease signs and necropsy lesions, including purulent nasal discharge, respiratory distress, facial edema, sticky eyes, mucoid tracheitis, hemorrhagic inflammation of the infraorbital sinuses along with fibrinous mass and conjunctivitis. Histopathological lesions included loss of cilia along with necrosis and exfoliation of the superficial mucosal epithelium of the trachea, facial cellulitis, dermatitis, fibrinous plasmatic edema and infiltration of inflammatory cells, especially heterophils. A. paragallinarum was detected in tissue samples by species-specific polymerase chain reaction (PCR). The sequencing and phylogenetic analysis of the core region of the hemagglutinin (HA) gene revealed that Turkish strains detected here belonged to serotype A (serovar A1). They were related to strains reported from India (VRDC), the United States (0083), and Japan (0221), which are representatives of serovar A1. A homology of 88-90% was found between Indian strains and the Turkish strains detected in this study. Surprisingly, only vaccine strains of infectious bronchitis virus (IBV) were detected as a co-infecting agent in all samples positive for A. paragallinarum. Our findings suggest that A. paragallinarum may be an emerging pathogen in Turkish poultry flocks, and direct PCR may facilitate rapid diagnosis of infectious coryza. These results will also help to develop control strategies for A. paragallinarum..