The general characteristics of hospitalized patients with the diagnosis of COVID-19, and the relationship between presenting symptoms and clinical course: a single center experience

Objective: In this study, it was aimed to reveal the relationship between the clinical features, presenting symptoms, and prognosis of COVID-19 patients who were hospitalized in our center. Materials and Methods: 499 patients with the diagno-sis of COVID-19 followed in the service and intensive care units of Sakarya University Training and Research Hospital between March 2020 and January 2021 were included in the study. The clinical and demographical data of the patients were obtained from the patient files and hospital automation system. The obtained data were ana-lyzed statistically. Results: Of 499 patients, 171 were followed up in the ward and 328 in the intensive care unit. Follow-up of 230 patients resulted in death, while 269 patients were dis-charged. Comorbid diseases were found to be more fre-quently seen in the mortal group (p< 0.05). Mean leuko-cyte, neutrophil, c-reactive protein (CRP), procalcitonin (PCT), lactate dehydrogenase (LDH), ferritin, d-dimer, and troponin values were higher in the mortal group;whereas mean lymphocyte value was found to be lower (p< 0.05). While fever, cough, and other less common symptoms (diarrhea, nausea, muscle weakness, etc.) were more frequently seen in the non-mortal group (p=0.022, p=0.038, and p=0.000 respectively), shortness of breath was significantly more common in the mortal group (p=0.000). The frequency of symptoms such as sputum, fatigue, sore throat, and the headache were found to be similar in both groups (p >0.05). Conclusion: It was concluded that the clinical course of patients with dyspnea at admission may be more severe and these patients should be followed more closely.

Investigation of long-term follow-up results of COVID-19 disease in kidney transplant patients and the effect of inactive COVID-19 vaccine

Objective: We aimed to evaluate the long-term graft functions of kidney transplant recepients (KTR) who have been cured of the COVID-19 and to investigate the role of inactivated COVID-19 vaccine in the clinical course of the disease. Materials and Methods: KTR who had COVID-19 pneumonia between March 2020 and September 2021 were included in the study.. The clinical course of the disease was evaluated in vaccinated patients and compared with those who were not vaccinated. The laboratory information of the patients at the time of admission to the hospital, 6 months and 12 months after the disease was recorded. Results: Of the 83 patients included, 67.5% were male. COVID-19 disease developed in 20 patients after vaccination. Vaccine;it decreased the development of acute kidney injury (AKI) 5.9 fold and hospitalization in the intensive care unit (ICU) 1.4 times fold (p < 0.05). In the follow-up, 10 patients died at the first admission to the hospital and no late death was recorded in the first year. Dialysis treatment was started in 5 patients due to graft loss. Conclusion: In kidney transplant patients, graft dysfunction may develop after COVID-19 infection. However, the inactivated COVID-19 vaccine;it can reduce the risks of hospitalization, AKI, and ICU admission.

The effect of thrombosis-related laboratory values on mortality in COVID-19 infection.

OBJECTIVE: COVID-19 may cause thrombosis in both venous and arterial systems. Familiarity with the signs and symptoms of thrombosis and its treatment is essential in treating COVID-19 infection and its complications. D-Dimer and mean platelet volume (MPV) are measurements related to the development of thrombosis. This study investigates whether MPV and D-Dimer values could be used to determine the risk of thrombosis and mortality in the COVID-19 early stages. PATIENTS AND METHODS: 424 patients who were COVID-19 positive, according to the World Health Organization (WHO) guidelines, were randomly and retrospectively included in the study. Demographic and clinical characteristics such as age, gender, and length of hospitalization were obtained from the digital records of participants. Participants were divided into living and deceased groups. The patients' biochemical, hormonal, and hematological parameters were analyzed retrospectively. RESULTS: White blood cells (WBC), neutrophils, and monocytes were significantly different in the two groups (p-value <0.001), and their values were lower in the living group than in the deceased group. MPV median values did not differ according to prognosis (p-value = 0.994). While the median value was 9.9 in the survivors, it was 10 in the deceased. Creatinine, procalcitonin, ferritin, and the number of hospitalization days in living patients were significantly lower than in patients who died (p-value <0.001). Median values of D-dimer (mg/L) differ according to prognosis (p-value <0.001). While the median value was 0.63 in the survivors, it was found as 438 in the deceased. CONCLUSIONS: Our results did not show any significant relationship between the mortality of COVID-19 patients and their MPV levels. However, a significant association between D-Dimer and mortality in COVID-19 patients was observed.

The significance of a novel inflammatory biomarker, presepsin, in predicting disease prognosis in patients with COVID-19.

OBJECTIVE: This study aims at determining the significance of a novel inflammatory biomarker, presepsin, in predicting disease prognosis in patients with COVID-19. PATIENTS AND METHODS: This retrospective study was concluded at the University Hospital between April and August 2020. The study involved 88 COVID-19 patients (48 men and 40 women). The patients were categorized into two groups: the patients admitted to the COVID-19 clinic, described as the moderate COVID-19 patients (Group-1; n=44), and those admitted to the internal medicine outpatient clinic, who were the mild COVID-19 patients (Group-2; n=44). The groups were compared using inflammatory markers: presepsin, C-Reactive Protein to Albumin Ratio, Neutrophil to Lymphocyte Ratio, and procalcitonin. RESULTS: Serum presepsin levels (195.29 vs. 52.12 pg/ml) were significantly higher in the Group-1 compared to the Group-2 (p=0.001). The gender distribution and average age were similar in both groups (p > 0.05). While ferritin, lactate dehydrogenase, D-Dimer, platelet lymphocyte ratio, C-Reactive Protein to Albumin Ratio (p=0.001), erythrocyte sedimentation ratio, C-Reactive Protein and presepsin were significantly higher in the Group-1 compared to Group-2 (p<0.05), while hemoglobin and lymphocyte were significantly lower in the Group-1 than in Group-2 (p<0.05). CONCLUSIONS: Serum presepsin levels were found to be significantly higher in moderate clinical group COVID-19 patients compared to mild group. Presepsin, a new inflammatory biomarker, may be useful in predicting the prognosis and early treatment of COVID-19 infection.

Prealbumin: a new biomarker for predicting prognosis in patients with severe COVID-19

Objective: To analyse whether prealbumin could be a new biomarker for predicting mortality in severe COVID-19 patients. Study Design: An observation study. Place and Duration of Study: Intensive care units (ICU) of Sakarya University Training and Research Hospital, Sakarya, Turkey, from October 2020 to December 2020. Methodology: The data of 149 patients, who were admitted to the ICU were collected and analysed retrospectively. Routine blood samples were collected from all patients at the time of admission to the ICU;and 102 patients with the mortal course and 47 patients with the non-mortal course were included in the study. The data obtained from these patients were analyzed in the biostatistics programme.

URIC ACID AND MORTALITY RELATIONSHIP IN COVID-19

Aim: The present study aims to investigate and compare the uric acid of the recovered/deceased and ICU/ward COVID-19 patients. Method: The study was conducted with 397 patients with COVID-19 diagnosis. Information about 157 deceased and 240 recovered COVID-19 patients was analyzed retrospectively. Relationship between serum uric acid, Na, K, urea, and creatinine was investigated between patients in the mortal/non-mortal and ICU/ward group. Result: Of the total 397 patients in the study, 158 (39,8%) were female and 239 (60,2%) were male. Statistically significant difference in mortality was found between males and females in order (107-239, 44.8%/50-158,31, 7%;p=0.009). Total mean age (std deviation), was 63.77±16,1, the mean age in the deceased group was 71,41±11, 39, and it was 58.78±16,8 in the survived group and that is statistically significant too (p=0.001). The mean values of Uric acid with order survivor and deceased group ((4,867±1,81 (n=222)- 7, 086±3,24(n=148), P=0,000). Mean age in ICU group 69.53±12,52, in the ward group 56.24±17,1 and this age differentiation between two groups is statistically significant (p=0,001), There is a statistically significant difference in ICU care or ward was found between males and females in order (107-239, 44.8%/50-158,31,7%;p=0.009). The mean values of Uric acid with order ICU care and ward group ((6,52 ±3,1(n=217) -4,66±1,46 (n=153), P=0,000)). Serum K+ (Potassium) (4,164±0,5 (n=239)) - 4,357±0,7 (n=157), P=0,002)) levels are higher in deceased groups. The cutoff value of uric acid, which may pose a risk of mortality, was found to be 5,15 mg/dl. And the cutoff value of creatinine, which may pose a risk of mortality, was found to be 0,9 mg/dl. Conclusion: The cutoff value of uric acid, which may pose a risk of mortality, was found to be 5,15 mg/dl and the cutoff value of creatinine, which may pose a risk of mortality, was found to be 0,9 mg/dl. Advanced age, uric acid, creatinine, and potassium increase were found to be associated with mortality. © 2022 A. CARBONE Editore. All rights reserved.

Prealbumin: A New Biomarker for Predicting Prognosis in Patients with Severe COVID-19

Objective: To analyse whether prealbumin could be a new biomarker for predicting mortality in severe COVID-19 patients. Study Design: An observation study. Place and Duration of Study: Intensive care units (ICU) of Sakarya University Training and Research Hospital, Sakarya, Turkey, from October 2020 to December 2020. Methodology: The data of 149 patients, who were admitted to the ICU were collected and analysed retrospectively. Routine blood samples were collected from all patients at the time of admission to the ICU;and 102 patients with the mortal course and 47 patients with the non-mortal course were included in the study. The data obtained from these patients were analyzed in the biostatistics programme. Results: The median age of all patients was 68 years;while 94 of them were males (63.1%) and 55 of them were females (36.9%). Median levels of potassium (K) (p=0.04), uric acid (p=0.001), C-reactive protein (CRP) (p=0.004), and procalcitonin (PCT) (p<0.001) were significantly higher and median level of prealbumin (p=0.002) was significantly lower in the deceased group. The cut-off level of prealbumin for mortality was found as 0.085 gIL (p=0.002). Further analysis revealed that the risk of mortality was found as 2.193 times more in patients with prealbumin levels of <0.085 g/L (Odds Ratio (OR): 2.193, 95% CI: 1.084-4.434). Conclusion: As a result of this study, it was found that patients with lower levels of prealbumin at the time of admission to the ICU have a higher risk for mortality. It was showed that prealbumin can be a useful biomarker for predicting mortality in patients with severe COVID-19.

Super levels and covid-19: Is there a relationship between supar levels and prognosis of covid-19 infection?

Objective: SuPAR is known as a marker for inflammation. In this study, we aimed to analyse suPAR levels and its correlation with disease prognosis in COVID-19 patients. Method: Demographical, clinical and laboratory data of the 36 patients were recorded. Existence of suPAR levels and other parameters along with prognosis was studied. Result: Of 36 patients included in this study, 15 were female (42%) and 21 were male (58%). The median age of the patients with mortality was 73 (min-max ,IR;49-88, 25), and the median age of the patients with no mortality was 72 (min-max ,IR;47- 83, 21) revealing a statistically non-significant difference (p=0,596). Among lab tests, hemoglobin (p=0,044), urea (p=0,011), troponin(p=0,033), LDH (p=0,005), and procalcitonin (p=0,036) were significantly associated with mortality. Median suPAR level was 102 (min-max, IR;29-540, 274) for the patients with no mortality whereas, median suPAR level was 61 (min-max, IR;29-540, 355) for the patients with mortality, and the difference was statistically non-significant (p=0,607). Conclusion: SuPAR levels seem to be ineffective to predict disease severity and prognosis of COVID-19. More randomised controlled trials with larger groups are needed to clarify the association of suPAR levels and COVID-19. © 2021 A. CARBONE Editore. All rights reserved.

Mediating role of self-disclosure in the relationship between attitudes towards online counselling and perception of social stigma due to receiving psychological help

People have needed mental health services more and more during Coronavirus disease (COVID-19) pandemic. Due to the contagious nature of the COVID-19 virus, online counseling has been preferred more during the COVID-19 pandemic. Those who need such mental health services might take actions to seek help by demanding psychological assistance from psychological counselors or mental health institutions. However, these people might avoid seeking and receiving such help when they think that they have a weak personality or they somehow will be criticized by the society or experience social stigma because they seek psychological help. This study aims to examine the mediating role of self-disclosure between attitudes towards online counselling and perception of social stigma due to receiving psychological help. Participants of the study consist of 519 adults who live in Turkey and are older than 18 years old. The data for the study were collected through “Distress Disclosure Index”, “Online Counseling Attitudes Scale (OCAS)”, “Stigma Scale for Receiving Psychological Help (SSRPH)” and “Personal Information Form”. The hypothetical model developed in order to determine whether self-disclosure mediates in the relationship between perception of social stigma due to receiving psychological help and online psychological counselling attitudes was tested through SEM (Structural Equation Modeling). The results of the study revealed that self-disclosure play partial mediating role between perception of social stigma and value of online counselling and discomfort with online counselling. © 2021 The Author(s). Open Access - This article is under the CC BY license (https://creativecommons.org/licenses/by/4.0/).