The association between QT interval changes and the treatment protocols of COVID-19 patients.

OBJECTIVE: This study aimed to investigate the QT, QTc, and QTc dispersion changes that may occur with the use of hydroxychloroquine (HCQ), favipiravir, and moxifloxacin in combination or alone in COVID 19 patients. METHODS: This study was retrospectively conducted on 193 inpatients diagnosed with COVID-19. We divided the patients into four separate groups due to their medications as, group-1: favipiravir, group-2: favipiravir + HCQ, group-3: favipiravir + moxifloxacin, and group-4: favipiravir + moxifloxacin + HCQ. We recorded their pre and post-treatment QT parameters of each group and evaluated the changes of these parameters with the SPSS statistical program. RESULTS: The mean age of the patients was 63.1±17.7. In group 1 and 2, although there were slight changes in QT parameters, these results were not statistically significant. In group 3, significant increases in QT and QTc dispersion occurred (p=0.005 and p=0.018). In the 4th group where the triple therapy was applied, there was a significant increase only in the QTc values (p=0.027). When we compared the changes of QT parameters for each group, a significant difference was found in ΔQTc dispersion, and post hoc analysis showed that it was due to changes in the third group (p=0.047). CONCLUSION: We thought that, if there is a COVID-19 infection with an additional bacterial infection, and if there is a need of using moxifloxacin alone or together with HCQ, additional risk factors that may cause QT interval prolongation should be reviewed and ECG monitoring of the patients should be performed during the treatment period.

Mean Platelet Volume as an Early Predictor for The Complication of Coronavirus Disease 19

INTRODUCTION: Although several studies have been conducted on the association of mean platelet volume (MPV) with the diagnosis, morbidity, and mortality of coronavirus disease 19 (COVID-19) patients, the results were contradictory. We aimed to investigate the effects of MPV on hospitalization and mortality with a significant number of patients. METHODS: This multicenter study was carried out retrospectively on 9.487 patients. The demographic information and laboratory parameters of the patients were obtained from their medical records in the hospital. Analyses were performed using Statistical Package for the Social Sciences (SPSS) version 22.0 for Windows. RESULTS: In total, there were 806 intensive care unit (ICU) patients, in addition to 8.681 non-ICU patients. The mean age of patients in ICU was significantly higher than non-ICU (71.25±13.42 vs. 56.17±16.59;p<0.001). MPV values at admission and max MPV values during the period of hospitalization were significantly higher in patients followed in the ICU (p<0.05). MPVfirst, MPVlast, ΔMPVlast-first, and ΔMPV% values were significantly higher in non-survivor group than the survived patients. As a result of receiver-operating characteristic analysis, the risk of mortality was determined to be 5.15 fold greater in people with MPVlast ≥10.05 fl. (ODDS ratio: 5.15 95% CI: 4.374–6.067). The patient has a 4.62 fold risk of death after a 2.18% increase of arrival MPV value (ODDS ratio: 4.62, 95% CI: 3.455-6.203). DISCUSSION AND CONCLUSION: We thought that MPV and MPV changes during hospitalization may be a powerful predictor of mortality in patients with COVID-19.Alternate abstract: GÍRÍŞ ve AMAÇ: COVID-19 hastanın teşhisi, morbidite ve mortalitesi ile MPV ilişkisi üzerine yürütülmüş çalışmalar olmasına rağmen, sonuçlar çelişkilidir. Bu çalışmada belirgin sayıda hasta ile MPV'nin hastanede yatış süresi ve mortalite üzerindeki etkilerini araştırmayı amaçladık. YÖNTEM ve GEREÇLER: Bu çok merkezli çalışma, 9.487 hasta üzerinde retrospektif olarak gerçekleştirildi. Hastaların demografik bilgileri ve laboratuvar parametreleri hastanedeki tıbbi kayıtlarından elde edildi. Analizler, Windows (SPSS) 22.0 sürümü kullanılarak yapıldı. BULGULAR: Çalışmaya, 8.681 yoğun bakım ünitesi (YBÜ) dışında takip edilen hastaya ek olarak 806 yoğun bakım hastası dâhil edildi. YBÜ'de takip edilen hastaların yaş ortalaması (YBÜ) dışında takip edilen hastalara göre anlamlı derecede yüksekti (71,25 ± 13,42'ye karşı 56,17 ± 16,59;p <0,001). Başvuru anındaki ortalama trombosit hacmi (Mean Platelet Volume: MPV) değerleri ve yatış süresindeki maksimum MPV değerleri yoğun bakım ünitesinde takip edilen hastalarda anlamlı olarak yüksekti (p <0.05). Hayatını kaybeden grupta MPVilk, MPVson, ΔMPVson-ilk ve ΔMPV% değerleri sağ kalan hastalara göre anlamlı olarak daha yüksekti. ROC analizi sonucunda MPVson ≥ 10.05 fl olan kişilerde ölüm riskinin 5.15 kat daha fazla olduğu belirlendi (ODDS oranı: 5.15 %95 CI: 4.374-6.067). Hastanın, hastaneye ilk geliş MPV değerinde %2.18'in üzerindeki artışlarda ölüm riskinin 4.62 kat arttığı görüldü (ODDS oranı: 4.62,%95 CI: 3.455-6.203). TARTIŞMA ve SONUÇ: Sonuç olarak, hastanede yatış sırasındaki MPV ve MPV değişikliklerinin COVID-19 hastalarında mortalitenin güçlü bir belirleyicisi olabileceği düşünüldü.

Association of blood groups on the risk of COVID-19 infection, morbidity, and mortality.

OBJECTIVE: We aimed to compare the effects of blood groups and Rh factor on the development of coronavirus-19 disease (COVID-19) with all aspects such as clinical course, inflammatory parameters, and organ-specific biochemical parameters with a significant number of patients. METHODS: This multicenter study was carried out retrospectively on 3551 patients hospitalized with the diagnosis of COVID-19 and whose blood groups were recorded during the time of hospitalization. As control groups, 22133 individuals' medical data who were admitted to the blood bank affiliated with our hospitals during the last year was used. The differences between the blood groups and clinical characteristics were analyzed. RESULTS: Of the 3551 patients, A Rh (+) blood group was found to be in a higher ratio in the case group than controls, with increased risk to be infected (case: 41.3% vs. control: 38.8%), (OR 1.113; 95% CI: 1.036-1.197; p=0.003). Meanwhile O Rh (+) blood group ratios were significantly lower in the case group than in the control group (case: 26% vs. control: 28.3%) (OR 0.862; 95% CI: 0.823-0.966; p=0.005). There was no significant difference between blood groups in terms of admission to the intensive care units and mortality, it was observed that patients with AB Rh (+) blood group have a greater risk for intubation than others (OR: 1.467; 95% CI: 1.040-2.071; p=0.028). CONCLUSION: We demonstrated that people with blood group A Rh (+) more susceptible to COVID-19, whereas blood group 0 Rh (+) have a protective effect against the infection. Once a person has been infected with severe acute respiratory syndrome coronavirus 2, we should be mindful that patients with blood group AB Rh (+) would be prone to intubation more than other blood groups.