ABSTRACT
Aim: Fibrinogen and albumin are proteins that play a role in inflammation. In this study, it was aimed to investigate the role of fibrinogen, albumin, and fibrinogen/albumin ratio (FAR) levels as markers of disease severity and prognosis in coronavirus disease 2019 (COVID-19) patients. Material and Methods: Seventy-one patients aged between 19 and 84 years diagnosed with COVID-19 who were hospitalized in Sakarya University Training and Research Hospital, Neurology Department between March and May 2020 were analyzed retrospectively. Fibrinogen, albumin, FAR, D-dimer, platelet, and C-reactive protein (CRP) levels of the patients were compared according to the length of hospitalization duration, survival, and clinical severity of COVID-19. Results: Twenty-eight (%39.4) of the patients were male and 43 (%60.6) were female, and the mean age was 55.7±20.7 years. There was a significant difference between the groups of COVID-19 clinical severity in terms of age, fibrinogen, albumin, FAR, D-dimer, and CRP values (all p values were <0.001). Also, significantly higher fibrinogen, FAR, D-dimer, and CRP values were found in patients hospitalized longer, while the albumin level was lower in these patients (all p values were <0.001). FAR values were higher and albumin values were lower in non-surviving patients compared to surviving patients (p=0.025 and p<0.001, respectively). Conclusion: FAR levels may be useful in predicting mortality risk in COVID-19 patients. In addition, it may be helpful and useful in determining the prognosis since it has higher levels as the severity of the disease and the length of hospital stay increase.
ABSTRACT
Aim: The aim of this study is to identify the frequency of stroke among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases in Sakarya city, to find out the clinical characteristics of patients diagnosed with stroke and to contribute to the national database. Material and Methods: This retrospective study was carried out with 783 cases diagnosed with SARS-CoV-2 between April-June 2020 at the pandemic hospital in Sakarya city. Patients were compared in terms of age, National Institute of Health Stroke Scale (NIHSS), risk factors, radiological findings, inpatient treatment, intubation, and mortality rates. Results: Out of 26 cases of ischemic stroke, 11 (42.3%) were male and 15 (57.7%) were female. In terms of infarction localization, the cause was medial cerebral artery (MCA) in 4 (15.4%) patients, top of the basilar in 2 (7.7%) patients, basilar artery in 1 (3.8%) patient, lacunar in 9 (34.6%) patients and anterior system in 10 (38.5%) patients. There was no significant difference in terms of D-dimer and C-reactive protein (CRP) levels according to disease severity (both p=0.262). Three (0.38%) patients presented with stroke findings and were diagnosed with SARS-CoV-2. Cryptogenic stroke was detected in 8 (30.8%) of the SARS-CoV-2 cases. Stroke frequency was calculated as 3.3% among the SARS-CoV-2 cases in Sakarya city. Conclusion: This is the first study to identify the frequency of stroke among SARS-CoV-2 patients in Sakarya city and Turkey. Our study is important as it shows that preventing or treating ischemic stroke in SARS-CoV-2 cases contributes greatly to the reduction of mortality. © 2020, Duzce University Medical School. All rights reserved.
ABSTRACT
Aim: Many studies have showed that myalgia is a common onset symptom in coronavirus disease 2019 (COVID-19). This study aimed to determine the frequency of muscle pain in patients followed with COVID-19 diagnosis, and to investigate the relationship between muscle pain and creatine kinase (CK), pH, lactate and lactate dehydrogenase (LDH) levels. Material and Methods: One hundred ten patients diagnosed with COVID-19 in our hospital were included retrospectively in this study. Presence of myalgia at the time of admission and on the 14th day of control were investigated. The first admission laboratory findings, 3rd day CK values and 14th day control CK values of all patients were recorded retrospectively from their files. Results: The study included 110 patients diagnosed with COVID-19. Fifty patients (45.5%) had muscle pain at the time of admission, and it was one of the most common musculoskeletal complaints. High CK results were obtained in 48 (43.6%) of the 110 patients at the time of admission. Thirty-two (66.7%) of 48 patients with high CK had muscle pain (p<0.001). In the patients with muscle pain, the CK levels observed on 1st, 3rd, and 14th day of the disease were found to be significantly higher than in those without muscle pain (p<0.001, p=0.003, p=0.029). No significant relationship was found between complaints of muscle pain and lactate, pH, and LDH values. Conclusion: Since some patients may only present with musculoskeletal symptoms such as myalgia, it is important that clinicians consider COVID-19 in patients presenting with myalgia and high CK levels. © 2020, Duzce University Medical School. All rights reserved.
ABSTRACT
The coronavirus invades the nervous system with the spread we call neuroinvasion, and "cytokine storm" becomes an important factor affecting the course of the disease. Serious damage occurs in the brain and other organs as a result of cytokine storm. Evidence is accumulating that the coronavirus, which infects millions of people all over the world, affects both the central and peripheral nervous system and muscles as well as the respiratory tract. Increasing evidence has revealed neurological involvement in 36-54% of the patients, which corresponds to almost one in every 2 or 3 patients. In severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients, we frequently encounter neurological symptoms such as smell and taste disturbances, fatigue and muscle pain, headache, nausea, vomiting, impaired consciousness, numbness in hands and feet. To a lesser extent, we encounter neurological handicaps such as dizziness, inflammation of the meninges, loss of myelin in nerve tissue, muscle inflammation, and severe rhabdomyolysis. Some of the nervous system diseases accompanying SARS-CoV-2 disease recover with complete or partial sequelae. Observation of permanent dysfunction in patients with neurological findings draws attention to the importance of a detailed neurological evaluation in the examination of these cases.