ABSTRACT
Introduction: In this study, it was aimed to retrospectively evaluate the clinical course, laboratory findings and radiological features of patients with severe Coronavirus disease-2019 (COVID-19) pneumonia in a 200-bed secondary state hospital. Materials and Methods: Male and non-pregnant female patients older than 18 years who were hospitalized with the diagnosis of COVID-19 pneumonia between 01.04.2020-01.07.2020 were included in our study. Severe pneumonia was defined as the presence of tachypnea (>30 breaths/ min) and/or hypoxia (SpO2 <90% room air) and/or bilateral diffuse ground-glass infiltrations. Conformity of continuous data to normal distribution was evaluated with Kolmogorov-Smirnov and Shapiro-Wilk tests. In the analysis of the relationship between laboratory parameters and mortality, independent groups t-test was used for parametric data and Mann-Whitney U test was used for non-parametric data. Results: Sixty two (60.8%) of the patients were male, with a mean age of 60.2±16.1 years (n=102). Of the study group 76.5% had at least one or more comorbid diseases. The most common comorbidities were hypertension (60.3%), diabetes mellitus (42.3%) and coronary artery disease (26.9%). The most common symptoms observed in patients at the time of admission were cough (n=63, 61.8%), dyspnea (n=57, 55.9%), fever (n=33, 32.4%) and malaise (n=22, 21.6%). Severe acute respiratory syndrome-Coronavirus-2 polymerase chain reaction test was positive in 68% (n=70) of the patients. Blood culture was taken from 42.3% of the patients who were admitted with the complaint of fever and there was no detected culture growth. During the hospitalization period, the rate of patients who received any of the antibiotic treatments including azithromycin, clarithromycin, moxifloxacin was 90.2% and 66.7% (n=68) of them were treated with azithromycin. Of the patients 42.2% (n=43) required treatment in the intensive care unit. A favorable clinical response was observed in 74.5% (n=77) of the patients and nine of these patients were discharged with partial recovery and recommendation for home oxygen support therapy. The mortality rate was 24.5% (n=25). The mean of lactate dehydrogenase level and the mean urea level were higher in the group with mortality (p.0.001). Conclusion: Despite the low rates of bacterial coinfection and/or secondary bacterial infection in COVID-19, frequently given antibiotic treatments contribute to the problem of antimicrobial resistance, creating a serious public health problem and causing an economic burden. Large-scale randomized controlled trials are required for treatment protocols of which potential benefits have not yet been proven. Copyright © 2021 by the Infectious Diseases and Clinical Microbiology Specialty Society of Turkey.
ABSTRACT
Background. We aimed to explore a novel risk score to predict mortality in hospitalised patients with COVID-19 pneumonia. In additoon, we compared the accuracy of the novel risk score with CURB-65, qSOFA and NEWS2 scores. Methods. The study was conducted in hospitalised patients with laboratory and radiologically confirmed COVID-19 pneumonia between November 1, 2020 and November 30, 2020. In this retrospective multicenter study. independent predictors were identified using multivariate logistic regression analysis. A receiver operating characteristics (ROC) analysis with area under the curve (AUC) was used to evaluate the performance of the novel score. The optimal cut-off points of the candidate variables were calculated by the Youden's index of ROC curve. Mortality was defined as all cause in-hospital death. Results. A total of 1013 patients with COVID-19 were included. The mean age was 60,5 ±14,4 years, and 581 (57,4%) patients were male. In-hospital death was occured in 124 (12,2%) patients. Multivariate analysis revealed that peripheral capillary oxygen saturation (SpO2), albumin, D-dimer, and age were independent predictors for mortality (Table). A novel scoring model was named as SAD-60 (SpO2, Albumin, D-dimer, ≥60 years old). SAD-60 score (0,776) had the highest AUC compared to CURB-65 (0,753), NEWS2 (0,686), and qSOFA (0,628) scores (Figure). Conclusion. We demonstrated that SAD-60 score had a promising predictive capacity for mortality in hospitalised patients with COVID-19. Univariate and multivariate analysis of factors predicting mortality Comparison of CURB-65, qSOFA, NEWS-2 and SAD-60 for predicting pneumonia mortality in hospitalised patients with COVID-19 by ROC analysis.
ABSTRACT
NTRODUCTION: Anticoagulant treatment approach in patients with COVID-19 is not well studied and not standardized. We aimed to compare the effects of standard prophylactic and pre-emptive therapeutic Low-Molecular-weight Heparin (LMWH) treatment approaches on mortality in patients with COVID-19. PATIENTS AND METHODS: This retrospective and single-centre study includes patients aged ≥ 18 years, who were diagnosed with COVID-19 and treated with LMWH during the hospital stay. Therapeutic dose of LMWH was defined as 1 mg/kg subcutaneously twice daily and prophylactic dose of LMWH was defined as 40 mg subcutaneously once daily. RESULTS: Among the 336 patients diagnosed with COVID-19 pneumonia, 115 patients, who received LMWH were included in the study. The mean age was 58.6 ± 13.3 and 58 (50.4 %) of the patients were male. Sixty-nine (60 %) of the patients were treated with prophylactic and 46 (40 %) therapeutic LMWH.In-hospital mortality was not different between patients treated therapeutic LMWH and prophylactic LMWH by the multivariate regression analysis (OR=2.187, 95% CI 0.484-9.880, p=0.309) and the propensity score modelling (OR=1.586, 95% CI 0.400-6.289, p=0.512.)CONCLUSION: Clinicians should consider the potential risks and benefits of standard prophylactic and pre-emptive therapeutic LMWH. Therefore, anticoagulant therapy should be individualized in patients with COVID-19 (Tab. 3, Ref. 28).