ABSTRACT
Purpose: Remdesivir is an adenosine nucleotide analog antiviral drug recommended in these treatment combinations. While vaccine and drug studies are underway in the treatment of COVID-19, remdesivir is also being studied in terms of efficacy, safety, and potential side effects. Therefore, we aimed to share our experiences of patients who were diagnosed with COVID-19 and treated with remdesivir in our hospital. Material and method: Patients over 18 years of age, who were diagnosed with COVID-19 in our hospital between March 15 and March 30, 2020, based on positive RT-PCR and/or thoracic computed tomography (CT) results studied from nasopharyngeal samples, were screened retrospectively. Those who had received Remdesivir treatment were included in our study. Results: 23 patients were included in our study. Eighteen (79.2%) of the patients were male and 5 (20.8%) were female. Remdesivir initiation time was 8.4±2.6 days from the onset of symptoms and 6±2.6 days from the time of diagnosis. In the follow-up period, we had to hospitalize 18 patients (78.2%) in the intensive care unit (ICU). 14 (60.8%) needed a mechanical ventilator. Post-treatment follow-up showed that 15 (65.2%) recovered, and 8 (34.8%) resulted in mortality. Conclusion: Since inflammation is as critical as the replication of the virus in the pathogenesis of COVID-19 disease, the use of remdesivir in combination with other antiviral and anti-cytokine therapies may increase the effectiveness. We believe that we need new studies in this regard. © 2023, Pamukkale University. All rights reserved.
ABSTRACT
Introduction: It has been reported that short-term and lowdose intravenous corticosteroids prevent the progression of the disease and reduce mortality during the hyperinflammation period caused by the virus in COVID-19 disease. The aim of our study is to evaluate the clinical course, hospital readmission and mortality rates of patients with mild to moderate COVID- 19 pneumonia, who do not need oxygen and for whom we started outpatient corticosteroid treatment. Materials and Methods: Patients over the age of 18 who applied to our hospital with the diagnosis of mild-to-moderate COVID-19 pneumonia and were treated with outpatient oral systemic corticosteroid were included in the study. Inclusion criteria were pneumonia finding consistent with mild to moderate COVID-19 involvement in lung computerized tomography, seven days or more from symptom onset, and oxygen saturation of 93 and above. The patients were given dexamethasone 8 milligrams (mg) methylprednisolone 32 mg, methylprednisolone 40 mg as oral systemic corticosteroid. Results: The mean age of the patients was 49.2 +or- 12, and 60% of them were male. The median steroid duration was 6.76 +or- 2.35 days. Due to ongoing symptoms, 56% of the patients were admitted to the hospital again, 12% were hospitalized due to clinical and laboratory deterioration, the intensive care hospitalization rate was 3% and the mortality rate was 2% (2/100). Conclusion: As a result, the effectiveness of oral corticosteroids on mortality and morbidity has not been demonstrated in mild to moderate COVID-19 pneumonia. Well-designed randomized controlled studies are needed on this subject.
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Background and aim: It is important that the immune system is active and strong in protection from the COVID-19 pandemic. Folic acid and vitamin B12 are involved in the initiation, maintenance and regulation of both innate and adaptive immune reactions of the host against infections. In this study, it was aimed to investigate the relationship between serum folic acid and vitamin B12 levels of COVID-19 patients on the prognosis of the disease. Methods: The sample of the study consists of 529 individuals hospitalized in the Pandemic Chest Diseases Intensive Care Unit. General characteristics of the individuals, biochemical parameters checked routinely (white blood cell (WBC), platelet (PLT), lymphocyte, Neutrophil/Lympho-cyte (N/L) rate, C-reactive protein (CRP), oxygen (O2) saturation at the time of admission), serum vitamin B12 and folic acid levels, length of stay in intensive care units (ICUs) and hospitalization, and mortality were recorded. Results: The mean age of individuals was 62.8 +/- 15.12 years, and 50.9% were men and 49.1% were women. The mean level of serum folic acid in the subjects was 9.1 +/- 4.91 (ng/mL), and 2.4% had folic acid deficiency and 28.4% had folic acid insufficiency. The mean serum vitamin B12 was 295.6 +/- 229.98 (pg/mL), and vitamin B12 deficiency was observed only in 14.4%. The increase in serum folic acid levels reduces the total length of hospitalization and the risk of mortality (p<0.05). On the other hand, no correlation was found between B12 levels and the length of stay in ICU, hospitalization, and mortality. It was shown that WBC and N/L rates decreased as serum folic acid levels increased, and O2 saturation at the first hospital admission was higher. Conclusions: Folate deficiency and insufficiency are common among hospitalized COVID-19 patients and cause progression to severe disease. Therefore, examining COVID-19 patients in terms of nutritional deficiencies is critical in monitoring the clinical outcomes of the disease.
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Objective: The aim of this study is to evaluate the relation of body mass index (BMI) with Coronavirus disease-19 (COVID-19) and its effects on the course of the disease in COVID-19 patients.