Is anemia a risk factor in pneumonia progression in covid-19-infected patients?

Background Determining the factors contributing to the development of severe coronavirus 2019 disease (COVID-19) disease is of great importance for health guidance. In this study, the authors aimed to investigate whether there is a relationship between anemia and progression of COVID-19 pneumonia. Patients and methods Records of 201 patients whose RT-PCR positivity for COVID-19 was confirmed between August 2020 and October 2020, when admissions and hospitalizations were at their peak, were retrospectively reviewed. The scoring system based on visual evaluation was used for evaluating the severity of the disease on each computed tomography (CT). To determine the progression status of pneumonia, the score difference was calculated by the difference between two CT scores. The patients were divided into two groups according to their hemoglobin levels as anemic and nonanemic patients. Results A significant difference was reported between the CT score difference groups in terms of mean age (P < 0.001). The mean age of the group that did not show progression was significantly lower than the other groups. Although the mean hemoglobin level of the group that did not show progression was higher than the other groups, no significant difference was reported between the groups (P=0.768). There was no significant difference between the CT score difference groups in terms of the presence or absence of anemia (P=0.791). Conclusion No significant relationship was found between hemoglobin levels, anemia, and pneumonia progression in COVID-19-infected patients.

Can evaluating adrenal glands in computed tomography contribute to predicting the prognosis of hospitalized COVID-19 patients?

OBJECTIVE: The novel coronavirus disease 2019 (COVID-19) may affect the adrenal glands. Therefore, it is important to evaluate the morphologic appearance of the adrenal glands by thorax computed tomography (CT). On CT scans, stranding in peripheral fatty tissue with enlarged adrenal glands may indicate signs of adrenal infarction (SAI). The present study aimed to evaluate the incidence of SAI and determine whether this finding may contribute to predictions of the prognosis of COVID-19. PATIENTS AND METHODS: A total of 343 patients who had been hospitalized at Malatya Training and Research Hospital between September 1 and 30, 2020, with a diagnosis of COVID-19 were enrolled in this study. All patients underwent thorax CT scans that included their adrenal glands. RESULTS: Of the enrolled patients, 16.0% had SAI. Moreover, 41.8% of patients with SAI and 15.3% of patients without SAI were treated in the Intensive Care Unit (ICU). Patients with SAI had a significantly higher rate of ICU admission (p < 0.001). Mortality rates were also significantly higher among patients with SAI than those without p < 0.001). CONCLUSIONS: In this study, it was found that COVID-19 patients with SAI may have a poorer prognosis. More comprehensive studies are needed on this subject, but the present study may provide helpful preliminary information in terms of prognosis.

The evaluation of the trachea as a new parameter in determining the prognosis of COVID-19: first pilot study.

OBJECTIVE: Coronavirus disease-2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) follows a biphasic disease model consisting of an early viral response phase and an inflammation phase. SARS-CoV-2 has a high affinity for the upper respiratory tract and conjunctiva; hence, it can infect the upper respiratory tract and facilitate airway inflammation. COVID-19 also affects the tracheal epithelial cells. We hypothesized that the size of the trachea increases depending on the severity of the disease, and this increase is an indicator of poor prognosis. There are no studies on this subject in literature, to the best of our knowledge. For this purpose, in this study, the tracheas of 326 patients who reported to the radiology clinic were examined by evaluating the thoracic computed tomography (CT) images. PATIENTS AND METHODS: The patients who were admitted to the Malatya Training and Research Hospital between September and December 2020, had a positive SARS-CoV-2 nasopharyngeal reverse transcription-polymerase chain reaction result, and had undergone thoracic CT, were included in the study. The thoracic CT scans without respiratory artifacts were evaluated, and anteroposterior (AP) and transverse diameters of the trachea were measured at the thyroid and bifurcation levels. RESULTS: We believe that a tracheal AP diameter of >20 mm at the thyroid level and a tracheal AP diameter of 18 mm at the thyroid bifurcation level (according to Group 3 and Group 4) may be indicators of poor prognosis. In terms of survival, a tracheal AP diameter of >18 mm at the bifurcation level can be considered as a poor prognostic factor. CONCLUSIONS: The tracheal diameter may increase in proportion to the severity of inflammation, indicating or accompanying a poor prognosis. Patients with extensive involvement should be monitored closely for the development of tracheal stenosis.