Clinical and Laboratory Evaluations of Patients Diagnosed as Having Multisystem Inflammatory Syndrome Associated with Coronavirus Disease 2019 in Children: A Single Center Experience from Konya

Objective Multisystem inflammatory syndrome in children (MIS-C), characterized by fever, inflammation, and multiorgan dysfunction, was newly defined after severe acute respiratory syndrome coronavirus 2 infection. The clinical spectrum of MIS-C can be classified as mild, moderate, and severe. We aimed to evaluate demographics, clinical presentations, laboratory findings, and treatment modalities of patients with MIS-C according to clinical severity.Methods We performed a retrospective study of patients who were diagnosed as having MIS-C between September 2020 and October 2021 in the Necmettin Erbakan University Meram Faculty of Medicine, Turkey.Results A total of 48 patients (24 females and 24 males) with a median age at diagnosis of 10.3 years (range: 42 months-17 years) were enrolled, the most common clinical severity of MIS-C was moderate. The common presentations of patients were fever (97%), nonpurulent conjunctivitis (89.6%), rashes (81.3%), fatigue (81.3%), strawberry tongue (79.2%), and myalgia (68.8%). The most common laboratory findings were lymphopenia (81.2%), thrombocytopenia (54.1%), elevated D-dimer levels (89.5%), C-reactive protein (CRP;100%), procalcitonin (97%), erythrocyte sedimentation rate (87.5%), ferritin (95.8%), interleukin 6 (IL-6) (86.1%), and probrain natriuretic peptide (pro-BNP) (97%). High levels of CRP, procalcitonin, pro-BNP, and urea were associated with the severity of MIS-C ( p < 0.05). Fifteen of the patients were found to have pulmonary involvement. Ascites were the most common finding on abdominal ultrasonography (11 patients) and were not seen in a mild form of the disease. During the study period, two patients died.Conclusion It is important to make patient-based decisions and apply a stepwise approach in treating patients with MIS-C due to the increased risk of complications and mortality.

Relationship between Selective IgA Deficiency and COVID-19 Prognosis.

The prevalence and mortality rates of coronavirus disease 2019 (COVID-19) widely vary among populations. Mucosal immunity is the first barrier to the pathogen's entry into the body. Immunoglobulin A (IgA) is the primary antibody responsible for mucosal immunity. We explored the relationship between selective IgA deficiency (SIgAD) and COVID-19 severity. We included 424 patients (203 women) with COVID-19. Eleven patients had SIgAD. Laboratory data of patients with SIgAD and normal IgA levels were compared. The relationship between SIgAD and severe COVID-19 infection was explored using logistic regression analysis. In the univariate logistic regression analysis, the risk of severe COVID-19 disease in patients with SIgAD was approximately 7.7-fold higher than that in other patients (odds ratio [OR], 7.789; 95% confidence interval [CI], 1.665-36.690, P = 0.008), while it was 4-fold (OR, 4.053; 95% CI, 1.182-13.903, P = 0.026) higher in the multivariate logistic regression analysis. Serum IgA levels were positively correlated with total lymphocyte counts and negatively correlated with C-reactive protein levels, which was a risk factor for severe COVID-19. In patients with SIgAD, the number of severe acute respiratory coronaviruses 2 that pass through mucosal membranes may be increased, leading to complications such as cytokine storm syndrome and acute respiratory distress syndrome.

Memory B cells and serum immunoglobulins are associated with disease severity and mortality in patients with COVID-19.

PURPOSE OF THE STUDY: The aim of this study was to investigate the relationship of B cell-mediated immunity with disease severity and mortality in patients with COVID-19. STUDY DESIGN: In this retrospective cohort and single-centre study, 208 patients with laboratory-confirmed COVID-19 were recruited. A COVID-19 severity score, ranging from 0 to 10, was used to evaluate associations between various factors. Serum immunoglobulin levels and the number of cells in B lymphocyte subsets were measured and their association with disease severity and mortality in patients with COVID-19 examined. RESULTS: The median age of the patients was 50 (35-63) years and 88 (42%) were female. The number of deceased patients was 17. The median COVID-19 severity score was 8 (6-8) in deceased patients and 1 (0-2) in survivors. Deceased patients had significantly lower levels of total B lymphocytes, naive B cells, switched memory B cells, and serum IgA, IgG, IgG1 and IgG2 than recovered patients (all p<0.05). In addition, a significant negative correlation was found between the number of these parameters and COVID-19 severity scores. Decrease in the number of total B cells and switched memory B cells as well as lower serum IgA, IgG and IgG1 levels were independent risk factors for mortality in patients with COVID-19. CONCLUSION: In the present study, the prognosis of patients with COVID-19 was shown to be associated with the B cell subset and serum immunoglobulin levels.

Epidemiological characteristics of patients with Covid-19 suspicion applying to a university hospital: The first eighty days in a pandemic

Aim: The first COVID-19 case in Turkey was detected on March 11, 2020 during the COVID-19 pandemic process. Epidemiological studies are needed to be prepared for other outbreaks and to be effective in the disease management process. Based on this reason, in this study it was aimed to determine the epidemiological characteristics of Covid 19 possible and definite cases who applied to the university hospital during the pandemic process. Materials and Methods: This retrospective epidemiological study was carried out by analyzing the data of Covid 19 possible and definite cases, who applied to the university hospital operating as a pandemic hospital between 11 March / 01 June 2020. The data were summarized with descriptive statistics, tables and graphs. Results: Of the 1,383 patients, who applied with the suspicion of COVID-19, 55.5% were men and 84.5% were adults. The median age of children is 4.0 (1.5-10) years old;adults were 52.0 (36.0-67.0) years old. The median time between the outset of complaints and the date of admission to the hospital was 2 (1-3) days. 87.4% of adults and 87.9% of children had symptoms that supported COVID-19 infection. Among cases 7.8% were health care workers. The median age of the fatal cases was 71 (64-82) years old, 79.5% were male, 77.7% were retired. The most common comorbide diseases in these cases were hypertension (28.2%) and malignancy (28.2%). The case fatality rate was found as 2.8% in all patients and 48.4% in patients hospitalized in the intensive care unit. Conclusions: As a result, Covid-19 affects all age groups. Hypertension and malignancy were the most common additional diseases in fatal cases. The risk of illness is higher in healthcare workers who have direct contact with the patients. According to our observations, preventive measures, rapid diagnosis and supportive treatment are valuable. [ABSTRACT FROM AUTHOR] Copyright of Annals of Medical of Research is the property of Annals of Medical Research 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 abstract 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 abstract. (Copyright applies to all Abstracts.)

Emerging technologies for the diagnosis of viral infections and SARS-CoV-2

Coronavirus disease 2019 (COVID-19) is a newly emerging infection caused by Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2). Based on the rapid increase in the rate of human infection, the World Health Organization (WHO) has classified the COVID-19 outbreak as a pandemic. Considering that there is no specific drug or vaccine yet for COVID-19, effective rapid diagnosis of viruses has become very important in terms of early detection and control of the outbreak. The routine difficulties of isolating the virus necessitated the diagnosis to be made with more serological tests for many years. However, in recent years, molecular tests that provide fast and high-quality viral diagnosis information have started to take their place in laboratories. Syndrome-based PCR tests after PCR and multiplex PCR tests are also approaches that question the direct factor and accelerate the diagnosis and treatment. LAMP PCR technology has also developed rapidly, and the diagnosis time has been shortened in the field or at the bedside with very small portable devices. As a new technology, CRISPR diagnostic methods and portable DNA sequencing devices will be very useful in the diagnosis of viral infections in the clinic for rapid results per patient. With immunoprecipitation systems using luciferase-labeled antigens, virus identification, quantitation, antiviral efficacy can be monitored. COVID-19 outbreak management increased the need for very fast and reliable tests and triggered the laboratory biotechnology industry. The entire world is experiencing a dynamic pandemic process in which the benefits of new, highly sensitive, accessible and portable identification methods will be tested. The presence of a large number of applications in the approval process for these methods provides strong evidence that SARS-CoV-2 diagnostic algorithms will have richer and productive solutions in the near future. Experiences will be guiding in better understanding of other viral infections, establishing bedside diagnostic solutions, providing more effective treatments.