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BACKGROUND: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes COVID-19. On March 11, 2020, the WHO declared it a pandemic. SARS-CoV-2 indicates that it poses a significant threat to public health and global economy. The aim of the study was to determine (a) patient characteristics, (b) demographic characteristics, (c) comorbidities, diagnostic methods used, treatment, and outcomes, and (d) mortality rates of patients. MATERIALS AND METHODS: This retrospective cohort study included 352 hospitalized adult patients from Baskent University Hospital in Ankara who were confirmed cases of COVID-19 between March 2020 and March 2021. SPSS v. 14.0 was used for statistical analysis. RESULTS: Out of 352 patients, 55 died (males: 37, females: 18), while 297 survived (males: 162, females: 135). The most common comorbidities were hypertension (HT), diabetes mellitus (DM), coronary artery disease (CAD), cancer, Vitamin D deficiency, and chronic obstructive pulmonary disease. Comorbidities associated with mortality rate were obesity (33%) (P = 0.118), Vitamin D deficiency (28%) (P = 0.009), DM (25%) (P = 0.004), CAD (21.2%) (P = 0.142), cancer (20.9%) (P = 0.084), and HT (16.6%) (P = 0.90). Normal ward admission resulted in death in 67.3% and survival in 93.9% (P = 0.001), intensive care unit (ICU) admission resulted in death in 69.1% and survival in 18.5% (P = 0.001), and oxygen therapy was used in 80% death and survival in 39.4% (P = 0.001). CONCLUSIONS: Our study shows that male gender, advanced age, and presence of comorbidities in COVID 19 patients are at higher risk for severe disease, ICU admission, and death. We emphasize that morbidity and mortality can be reduced by early and comprehensive identification of risk factors and the warning systems that will meet the ICU needs of these patients. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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BACKGROUND AND AIMS: There is not enough data on the post-COVID-19 (coronavirus disease 2019) period for peritoneal dialysis (PD) patients affected from COVID-19. We aimed to compare the clinical and laboratory data retrospectively obtained in the follow-up of PD patients after COVID-19 with a control PD group. METHOD: This study, supported by the Turkish Society of Nephrology, is a national multicenter retrospectively case-control study involving adult PD patients with confirmed COVID-19, using data collected from 21 April 2021 to 11 June 2021. A control PD group was also formed from each PD unit, from patients with similar characteristics but who did not have COVID-19. Patients in the active period of COVID-19 were not included. Data at the end of the first month and within the first 90 days, as well as other outcomes, including mortality, were investigated. RESULTS: A total of 223 patients (COVID-19 group: 113, control group: 110) from 28 centers were included. The duration of PD in both groups was similar [median (IQR):3.0 (1.88-6.0) years and 3.0 (2.0-5.6)], but the patient age of the COVID-19 group was lower than the control group [50 (IQR:40-57) years and 56 (IQR:46-64) years, P < 0.001]. PD characteristics and baseline laboratory data were similar in both groups, except serum albumin and hemoglobin levels on Day 28, which were significantly lower in the COVID-19 group. In the COVID-19 group, respiratory symptoms, rehospitalization, lower respiratory tract infection, change in PD modality, UF failure and hypervolemia were significantly higher on the 28th day. There was no significant difference in laboratory parameters at Day 90. Only one (0.9%) patient in the COVID-19 group died within 90 days. There was no death in the control group. Respiratory symptoms, malnutrition and hypervolemia were significantly higher at Day 90 in the COVID-19 group. CONCLUSION: Mortality in the first 90 days after COVID-19 in PD patients with COVID-19 is not different from the control PD group. However, some of these patients continue to experience significant problems, especially respiratory system symptoms, malnutrition, and hypervolemia.
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BACKGROUND AND AIMS: Although existing data suggest an increased mortality rate, data about the course of coronavirus disease 2019 (COVID-19) in peritoneal dialysis (PD) patients, its short-and long-term effects on the patient and technique survival are limited. Moreover, specific factors associated with increased risk of death have not been clearly defined yet. Therefore, we aimed to study the characteristics of PD patients with COVID-19, determine the short-term mortality and other medical complications, and delineate the factors associated with COVID-19 outcome. METHOD: This national multicenter study included all PD patients who had confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection based on positive reverse transcriptase-polymerase chain reaction testing of a nasopharyngeal swab recorded in this database from the attending 27 PD centers. The demographic data, comorbidities, medications used, PD-related data were recorded as well as clinical, laboratory and radiological findings of COVID-19 and outcomes at the end of the first month were recorded. RESULTS: We enrolled 142 COVID-19 patients (median age: 52 years). A total of 58.2% of patients had mild disease at diagnosis, lung involvement was detected in 60.8% of patients. A total of 83 (58.4%) patients were hospitalized, 31 (21.8%) patients were admitted to intensive care unit and 24 needed mechanical ventilation. A total of 15 (10.5%) patients were switched to hemodialysis and hemodiafiltration was performed for 4 (2.8%) patients. Persisting pulmonary symptoms (n = 27), lower respiratory system infection (n = 12), rehospitalization for any reason (n = 24), malnutrition (n = 6), hypervolemia (n = 13), peritonitis (n = 7), ultrafiltration failure (n = 7) and in PD modality change (n = 8) were reported in survivors. During the 1 month from the diagnosis of COVID-19, 26 patients (18.31%) died. The non-survivor group was older and comorbidities were more prevalent. Fever, dyspnea, cough, serious-vital disease at presentation, bilateral pulmonary involvement and pleural effusion were more frequent among non-survivors. Age (OR:1.102;95% CI: 1.032- 1.117;P:0.004), moderate-severe clinical disease at presentation (OR:26.825;95% CI: 4.578-157.172;P < 0.001) and CRP levels (OR:1.008;95% CI;1.000-1.016;P:0.040) were associated with increased first-month mortality in multivariate analysis. CONCLUSION: Early mortality rate and medical complications are quite high in PD patients with COVID-19. Age, clinical severity of COVID-19 and baseline CRP level are the independent parameters associated with mortality.
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The aim of this study was to investigate the anxiety of catching a new type of coranavirus (Covid-19) in professional soccer players. soccer players 188 including 42 professional soccer players from the Turkish Super League, 32 players from the TFF 1st League, 41 players from the 2nd League, and 73 players from the 3rd League were voluntarily participated in this study . Average age of the players is 25.04 +or- 4.831 years;average height of the players is 180.11 +or- 6.246 cm;average body weight of the players is 75.23 +or- 6.118 kg,;average sports age of the players is 12.82 +or- 4.256 years. In this study evaluating the anxiety of professional soccer players about catching Covid-19, the level of anxiety of soccer players about getting Covid-19 was compared according to the status of being caught and not caught, the leagues they played and their game positions. No significant difference was found in the cases of the soccer players catching or not getting Covid-19. The change between the leagues in which the players play does not make any sense. When the anxiety of catching Covid-19 was examined according to the playing positions, a statistical significance was found in the comparison of the social anxiety scores according to the positions played by the players. In conclusion, while there was no significant relationship between the soccer players catching and not getting Covid-19, and their anxiety about catching Covid-19 for the leagues they played, the anxiety levels of catching Covid-19 were statistically significant to the game positions.
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COVID-19 is a viral disease that is recognized now as a pandemic by the World Health Organization. It is known that some viral infections may trigger autoimmune diseases. It has been revealed that COVID-19 may also lead to the pathogenesis of some autoimmune diseases, including Type 1 DM (T1DM) and autoimmune thyroid diseases. Here, we aimed to present a young female patient with COVID-19, who we followed up in our clinic, who presented with diabetic ketoacidosis (DKA), and developed Hashimoto’s disease during the treatment process. In order to emphasize that COVID-19 may trigger the emergence of T1DM, that it may mask nonspecific DKA symptoms like nausea and vomiting, that it may cause delay in diagnosis of DKA, and also to emphasize the importance of evaluating other autoimmune diseases accompanying COVID-19, we found it appropriate to present this case.
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Objective: COVID-19 is a disease with high mortality, and risk factors for worse clinical outcome have not been well-defined yet. The aim of this study is to delineate the prognostic importance of presence of concomitant cardiac injury on admission in patients with COVID-19. Methods: For this multi-center retrospective study, data of consecutive patients who were treated for COVID-19 between March 20 - April 20 2020 were collected. Clinical characteristics, laboratory findings and outcomes data were obtained from electronic medical records. In-hospital clinical outcome was compared between patients with and without cardiac injury. Results: A total of 607 hospitalized patients with COVID-19 were included in the study;the median age was 62.5±14.3 years, and 334 (55%) were male. Cardiac injury was detected in 150 (24.7%) of patients included in the study. Mortality rate was higher in patients with cardiac injury (42% vs. 8%;p<0.01). The frequency of patients who required intensive care unit (ICU) (72% vs.19%), who developed acute kidney injury (AKI) (14% vs. 1%) and acute respiratory distress syndrome (ARDS) (71% vs. 18%) were also higher in patients with cardiac injury. In multivariate analysis, age, coronary artery disease (CAD), elevated CRP levels, and presence of cardiac injury (OR: 10.58, 95% CI: 2.42-46.27;p<0.001) were found to be independent predictors of mortality. In subgroup analysis, including patients free of history of CAD, presence of cardiac injury on admission also predicted mortality (OR: 2.52, 95% CI: 1.17-5.45;p=0.018). Conclusion: Cardiac injury on admission is associated with worse clinical outcome and higher mortality risk in COVID-19 patients including patients free of previous CAD diagnosis.
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BACKGROUND AND AIMS: Acute kidney injury (AKI) is common in coronavirus disease-2019 (COVID-19) and the severity of AKI is linked to adverse outcomes. In this study, we investigated the factors associated with in-hospital outcomes among hospitalized patients with COVID-19 and AKI. METHOD: In this multicenter retrospective observational study, we evaluated the characteristics and in-hospital renal and patient outcomes of 578 patients with confirmed COVID-19 and AKI. Data were collected from 34 hospitals in Turkey from March 11 to June 30, 2020. AKI definition and staging were based on the Kidney Disease Improving Global Outcomes criteria. Patients with end-stage kidney disease or with a kidney transplant were excluded. Renal outcomes were identified only in discharged patients. RESULTS: The median age of the patients was 69 years, and 60.9% were males. The most frequent comorbid conditions were hypertension (70.5%), diabetes mellitus (43.8%), and chronic kidney disease (41.5%). The proportions of AKI stages 1, 2, and 3 were 54.0%, 24.7%, and 21.3%, respectively. 291 patients (50.3%) were admitted to the intensive care unit. Renal improvement was complete in 80.7% and partial in 17% of the patients who were discharged. Renal outcomes were worse in patients with AKI stage 3 or baseline CKD. The overall in-hospital mortality in patients with AKI was 38.9%. By multivariate Cox regression analysis, age (hazard ratio [HR] [95% confidence interval (95%CI)]: 1.01 [1.0-1.03], p = 0.035], male gender (HR [95%CI]: 1.47 [1.04-2.09], p = 0.029), diabetes mellitus (HR [95%CI]: 1.51 [1.06-2.17], p = 0.022) and cerebrovascular disease (HR [95%CI]: 1.82 [1.08-3.07], p = 0.023), serum lactate dehydrogenase (greater than two-fold increase) (HR [95%CI]: 1.55 [1.05-2.30], p = 0.027) and AKI stage 2 (HR [95%CI]: 1.98 [1.25-3.14], p = 0.003) and stage 3 (HR [95%CI]: 2.25 [1.44-3.51], p = 0.0001) were independent predictors of in-hospital mortality. The in-hospital mortality rates across AKI stages by age, gender, and diabetes mellitus were shown in the Figure. CONCLUSION: Advanced-stage AKI is associated with extremely high mortality among hospitalized COVID-19 patients. Age, male gender, comorbidities, which are risk factors for mortality in patients with COVID-19 in the general population, are also related to in-hospital mortality in patients with AKI. Renal problems continue in a significant portion of the patients who were discharged.
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This study was performed to evaluate whether the use of drugs in the treatment of osteoporosis in women is associated with COVID-19 outcomes. The results showed that the risk of hospitalization, intensive care unit admission, and mortality was not altered in individuals taking anti-osteoporosis drugs, suggesting no safety issues during a COVID-19 infection. INTRODUCTION: Whether patients with COVID-19 receiving anti-osteoporosis drugs have lower risk of worse outcomes has not been reported yet. The aim of this study was to evaluate the association of anti-osteoporosis drug use with COVID-19 outcomes in women. METHODS: Data obtained from a nationwide, multicenter, retrospective cohort of patients diagnosed with COVID-19 from March 11th to May 30th, 2020 was retrieved from the Turkish Ministry of Health Database. Women 50 years or older with confirmed COVID-19 who were receiving anti-osteoporosis drugs were compared with a 1:1 propensity score-matched COVID-19 positive women who were not receiving these drugs. The primary outcomes were hospitalization, ICU (intensive care unit) admission, and mortality. RESULTS: A total of 1997 women on anti-osteoporosis drugs and 1997 control patients were analyzed. In the treatment group, 1787 (89.5%) women were receiving bisphosphonates, 197 (9.9%) denosumab, and 17 (0.9%) teriparatide for the last 12 months. Hospitalization and mortality rates were similar between the treatment and control groups. ICU admission rate was lower in the treatment group (23.0% vs 27.0%, p = 0.013). However, multivariate analysis showed that anti-osteoporosis drug use was not an independent associate of any outcome. Hospitalization, ICU admission, and mortality rates were similar among bisphosphonate, denosumab, or teriparatide users. CONCLUSION: Results of this nationwide study showed that preexisting use of anti-osteoporosis drugs in women did not alter the COVID-19-related risk of hospitalization, ICU admission, and mortality. These results do not suggest discontinuation of these drugs during a COVID-19 infection.
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COVID-19 , Osteoporosis , Pharmaceutical Preparations , Cohort Studies , Female , Humans , Osteoporosis/drug therapy , Osteoporosis/epidemiology , Retrospective Studies , SARS-CoV-2ABSTRACT
OBJECTIVE: The primary objective of this study was to evaluate the frequency and impact of acute myocardial injury on prognosis in hospitalized COVID-19 patients. PATIENTS AND METHODS: This was a retrospective study that included consecutive hospitalized patients with COVID-19. Clinic-demographic characteristics, laboratory values, and high-sensitivity troponin I were extracted from the electronic database. Mortality and other clinical complications, including respiratory failure requiring invasive mechanical ventilation and acute kidney injury were recorded. Myocardial injury was defined as having a serum troponin I value >19.8 ng/mL. We performed Kaplan-Meier survival analysis and Cox regression to determine survival times and independent predictors of mortality. RESULTS: A total of 324 patients were included. Seventy-seven patients (23.8%) had acute myocardial injury. The primary outcome measure, namely death, occurred in 54.5% and 3.2% of the patients with and without myocardial injury, respectively. Notably, 75.3% of the patients with myocardial injury and 6.5% of the patients without myocardial injury developed ARDS. Overall, 50 out of 324 patients (15.4%) died during the study period. The mortality rate was 54.5% in patients with myocardial injury and 3.2% in patients without myocardial injury. Mean survival times were significantly different between the groups (15.1±0.9 days in patients with myocardial injury and 24.4±0.7 days in patients without myocardial injury, log-rank test p-value <0.001). CONCLUSIONS: The presence of chronic kidney disease and application of invasive mechanical ventilation were found to be independent predictors of in-hospital mortality. The presence of acute myocardial injury was common but not independently associated with mortality among hospitalized COVID-19 patients.
Subject(s)
COVID-19/complications , COVID-19/mortality , Heart Injuries/mortality , Adult , Aged , Aged, 80 and over , COVID-19/diagnosis , Female , Heart Injuries/diagnosis , Hospital Mortality , Hospitalization , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , SARS-CoV-2 , Survival Rate , Troponin I/bloodABSTRACT
Shortly after the first cases were reported in late 2019 in Wuhan Province of China, SARS CoV 2 spread all over the world and was declared a pandemic by the World Health Organization on March 12, 2020. In Turkey the first case was in March 10, 2020 and March 25, 2020 in Duzce. Duzce University Faculty of Medicine, Department of Medical Microbiology, PCR laboratory was declared to be "T.C. Ministry of Health Duzce authorized Covid 19 PCR laboratory " in 28.03.2020. Samples are sent to our laboratory from all provincial and district hospitals, private hospitals and public health institutions in Duzce. This is the only Covid 19 center in our city and it works for 7 days a week. In our laboratory, Covid 19 antibody tests are carried out with card tests and ELISA methods. A total of 8500 COVID 19 PCR tests and 2200 anti Covid19 ELISA total antibody tests were studied in our laboratory within three months. Although covid 19 patients are not followed in our hospital, pandemic process continues in our laboratory. In addition, all PCR studies and IFA studies of the hospital are carried out in this laboratory.