Evaluation of pleural complications affecting mortality in COVID-19 patients

INTRODUCTION: This study aimed to retrospectively evaluate pleural complications in patients who were polymerase chain reaction (PCR)-positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and admitted to the hospital with COVID-19 pneumonia. METHODS: A total of 164 patients who applied to our hospital between March 2020 and May 2021 with PCR-positive for SARS-CoV-2 were retrospectively evaluated and were followed up and treated in the service or intensive care unit. Pleural complications were detected during the treatment of COVID-19 pneumonia. In the current study, mortality was taken as the death of the patients in the first 30 days after hospitalization. Pleural complications occurring during treatment were classified into two groups: the pneumothorax (PNX) group and the pneumomediastinum (PMN) group. RESULTS: Of the patients, 69 (52.3%) had isolated PNX and 14 (43.7%) had isolated PMN. PNX and subcutaneous emphysema were determined in 50 (37.9%) patients, PMN and subcutaneous emphysema were determined in 13 (40.6%), PMN, PNX, and subcutaneous emphysema were determined in 3 (9.4%), and PMN and PNX were determined in 2 (6.3%) patients. Hydro-PNX was determined in 12 (9.1%) patients, and PNX and empyema were determined in 1 (0.7%) patient. When the relationship between pleural complications occurring during treatment due to COVID-19 pneumonia and mortality was examined, mortality was observed in 14 (43.8%) of the PMN patients and 104 (78.8%) of the PNX patients (p<0.001). When the relationship between gender and mortality was examined, mortality was observed in 75 (65.8%) of the male patients and in 43 (86%) of the female patients (p=0.008). DISCUSSION AND CONCLUSION: As a result, it was found that PNX after positive pressure ventilation increased mortality more than other pleural complications and worsened the prognosis. We think this issue will contribute to the literature in the COVID-19 pandemic and in pandemic diseases that may occur later and cause pleural involvement.

Effect of omega-3 fatty acid use on sepsis and mortality in patients with Covid-19.

Background: This study aimed to investigate the effects of omega-3 fatty acid use on sepsis and mortality in patients treated for COVID-19 disease in the intensive care unit (ICU) based on clinical and laboratory results. Aim: To determine the effect of omega-3 fatty acid use on sepsis and mortality in patients with COVID-19. Patients and Methods: A total of 80 patients with confirmed COVID-19 infection who were hospitalized in the ICU of Ankara City Hospital, received (n = 40) or did not receive (n = 40) omega-3 fatty acid dietary supplementation, were included in this single-center, retrospective study. The clinical and laboratory data of eligible patients were extracted from the hospital records. Results: The mean age was 65.5 (13.6). The mean length of stay in the intensive care unit was 11.5 (6.3) days. Mortality and sepsis development rates were similar in the groups. The frequency of patients who received pulse steroid therapy was higher in the group of patients who did not receive omega-3 (P < 0.05). Hypertension was more common in the patient group receiving omega-3 supplements (P < 0.05). Mean procalcitonin and interleukin-6 (IL-6) levels were significantly lower in patients who received omega-3 supplements compared to those who did not receive supplements (P < 0.001 and P < 0.05). Mean prothrombin time (PT) was shorter in patients receiving omega-3 supplementation (P < 0.05). Conclusions: Study results obtained in this study indicate that providing omega-3 fatty acid supplements may be beneficial to patients with severe COVID-19, however further research with large-scale randomized controlled trials is necessary.

The influence of financial literacy on financial resilience - New evidence from Europe during the COVID-19 crisis

Purpose This study examines the importance of financial literacy in explaining financial resilience in four continental European countries during the coronavirus disease 2019 (COVID-19) crisis while controlling for a wide set of additional determinants. Design/methodology/approach Variable importance may vary with the technique applied. Therefore, different classification techniques, such as logistic regression, partial proportional odds regression, and conditional random forest, have been employed. The analysis relies on the Survey of Health, Ageing and Retirement in Europe in the context of COVID-19, collecting 4,781 observations from France, Germany, Italy, and Spain. Findings In line with previous studies, financial resilience is found to increase with financial literacy that consistently ranks in the midfield in terms of variable importance among all explanatory variables. Practical implications The findings reveal the most important features that improve financial resilience. Financial literacy is one of the few determinants of financial resilience that can be actively shaped. To increase preparedness for future crises, a policy mix of financial education, regulation, and nudging may help increase financial literacy and, subsequently, financial resilience. Originality/value The better the financial literacy, the more protected individuals are from macroeconomic shocks. However, most previous studies do not rely on data samples that cover such crises. Moreover, most of the previous studies rely on single classification techniques, while this study applied traditional and data-mining techniques to assess feature importance.

Platelet hyperreactivity related with covid- 19 disease severity

Objectives: A hypercoagulability status has been reported in SARS-CoV-2 infection. Beside their traditional roles, platelets are referred to as immune cells. The purpose of the study was to examine platelet activation and aggregation in COVID-19. Materials and Methods: This case-control study comprised 61 patients with SARS-CoV-2 infection and 18 healthy individuals. The patients were separated into groups with respect to the need for treatment in the intensive care unit (ICU). CD41, CD61, CD42a, and CD42b were determined as platelet activation markers, and platelet aggregation tests were analyzed in all groups. Results: Platelet CD41, CD61, CD42a, and CD42b expressions were significantly elevated in ICU patients compared to non-ICU patients and healthy donors. Patients in the ICU group had increased platelet aggregations than those in non-ICU patients and controls. Additionally, platelet activation and platelet function tests correlated with inflammatory and coagulation markers involving C-reactive protein, Interleukin-6, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte to lymphocyte ratio, D-dimer, and fibrinogen concentrations. Conclusion: Enhanced platelet activity and faster platelet aggregation were observed in ICU COVID-19 patients. It is possible that platelet hyperreactivity may contribute to the progression of SARS-CoV-2 infection. The relationships between platelet activation and functions tests with inflammatory and coagulation markers show that systemic inflammation and cytokines may trigger the hypercoagulability in COVID-19 patients in ICU, or hyperactivated platelets could augment the inflammation. © 2021 Ankara Yildirim Beyazit University. All Rights Reserved.