Prognostic Value of Chest-Computed Tomography in Patients with COVID-19.

BACKGROUND: The diagnostic value for chest CT has been widely established in patients with COVID-19. However, there is a lack of satisfactory data about the prognostic value of chest CTs. This study investigated the prognostic value of chest CTs in COVID-19 patients. MATERIALS AND METHODS: A total of 521 symptomatic patients hospitalized with COVID-19 were included retrospectively. Clinical, laboratory, and chest CT characteristics were compared between survivors and non-survivors. Concerning chest CT, for each subject, a semi-quantitative CT severity scoring system was applied. RESULTS: Most patients showed typical CT features based on the likelihood of COVID-19. The global CT score was significantly higher in non-survivors (median (IQR), 1 (0-6) vs. 10 (5-13), p < 0.001). A cut-off value of 5.5 for the global CT score predicted in-hospital mortality with 74% sensitivity and 73% specificity. Global CT score, age, C-reactive protein, and diabetes were independent predictors of in-hospital mortality. The global CT score was significantly correlated with the C-reactive protein, D-dimer, pro-brain natriuretic peptide, and procalcitonin levels. CONCLUSION: The global CT score could provide valuable prognostic data in symptomatic patients with COVID-19.

Assessment of COVID-19 deaths from cardiological perspective.

BACKGROUND: COVID-19 can cause a variety of cardiac complications and a range of electrocardiographic abnormalities. We analysed cardiological parameters including ECG and high-sensitivity troponin T (hs-TnT) level and their association with mortality in hospitalised patients with COVID-19. METHODS: We retrospectively analysed the demographics, comorbidities, laboratory findings and electrocardiographic parameters of 453 consecutive patients, whose outcome was clear, died or discharged. Findings were compared between survivors and non-survivors. Also, the same comparison was made between cardiac injury and no-cardiac injury subgroups. RESULTS: The cardiac injury group had significantly higher in-hospital mortality than the no-cardiac injury group. Also, frequencies of atrial fibrillation, axis change, ST-segment/T-wave change, fragmented QRS, premature atrial/ventricular contraction was found to be higher in the cardiac injury group. Moreover, non-survivors had longer QRS intervals, more frequent ST-segment/T-wave changes and isolated S1Q3T3 pattern than surviving patients. Laboratory results showed median values of hs-TnT at the admission of 4.95 ng/L (IQR, 3-12.35) with concentrations markedly higher in the non-surviving patients vs survivors. Hs-TnT value along with age and respiratory rate was found to be an independent predictor of in-hospital mortality in hospitalised patients with COVID-19. Comorbidities were more frequently reported in non-surviving and cardiac injury groups than those surviving and without cardiac injury. CONCLUSIONS: In COVID-19 patients, both elevated hs-TnT and ECG abnormalities, suggesting cardiac involvement, on admission portends an ominous prognosis and indicates at higher risk of in-hospital mortality. Prioritised treatment and more aggressive therapeutic strategies could be planned to avoid the occurrence of death in these patients.

A Case Series of Patients with COVID-19 Infection Admitted to a Secondary Care Center in Turkey

Introduction: COVID-19 is a zoonotic viral infection that first emerged in Wuhan, China, the source of which is thought to be a seafood market, and then spread rapidly from China to the world. Objective: The aim of this observational study was to analyze cases with COVID-19 admitted to a single secondary care center in Turkey. Methods: This is a descriptive study performed during the period from March 22 to 30, 2020, in Kars Harakani State Hospital, Kars, Turkey. We evaluated all patients with reverse transcription polymerase chain reaction (RT-PCR) to confirm COVID-19. Demographic characteristics, clinical signs and symptoms, comorbidities, blood tests results, chest computed tomography (CT) scan findings and outcomes including hospitalization, intensive care unit (ICU) admission and survival of the patients were recorded. Results: During the one week study period, we took 435 nasopharyngeal swabs from suspicious cases and found 22 patients (4 females, 18 males) whose COVID-19 infection was confirmed via RT-PCR. Their ages ranged from 18 to 86 years, with an average of 45.59 +/- 25.02. Ten (45%) of the cases were current smokers. The body temperature of the cases ranged from 36.1 to 38.4 degrees C, with an average of 36.78 +/- 0.65. Four cases were asymptomatic and the most common complaint was cough (82%). Hypertension (23%) and chronic obstructive pulmonary disease (COPD) (23%) were the most common coexisting diseases. In chest CT scan, ground glass densities were detected in 7 (32%) patients and infiltration was observed in 8 (36.3%). The mortality rate of the cases was 9% (n=2). Conclusion: The most common complaint of patients was cough. Hypertension and COPD were the most prevalent comorbidities among patients.