ABSTRACT
Background: During COVID 19 pandemic many clinical presentations of respiratory infection were seen. Moreover, many other parts of the body can be involved. More than 75 % of patients were presented as respiratory infection. According to recent published data around 85 % of COVID 19 cases were asymptomatic. Patients with clinical presentation of COVID 19 pneumonia, if they are symptomatic, were presented as widespread pneumonia with appearance of ground glass opacities in most cases. Clinical course of COVID 19, if the predominant is respiratory infection, were divided according to severity, in five groups, as was presented in recent literature. Inflammatory markers rest the corner stone in process of decision making in diagnostic and therapeutic approach. Method(s): Patients treated in COVID Division of Pneumonology department of General hospital Tesanj were analyzed. Standardized diagnostic tools was performed for all patients, and separate other ones, if needs, as follow: Chest x-ray on admission, third, seventh hospitalization day and the day before discharge were performed. Chest CT scan was performed for patients if needs. IL-6, procalcitonin were performed so and LAB analyses including blood cells account, SE, CRP, LDH, CK, ALaAT, AspAT, total amount of proteins, albumins, globulins, lipids, creatinine, blood gas analyses, deep dimer, and other analyses if needs. Result(s): Out of all we analyzed 196, among them 93 female (47.45 %) and 103 (52.55 male, average age 53,2 (+/- 6.6) years. Measurement of IL-6 and procalcitonin were performed for those patients with substantial presentation of ground glass opacities in chest x-ray. Substantial variability was found in IL-6 level in relative short time frame, no more than 24 hours, in 38 patients. Variability of IL-6 was from 2.22 pg/ml as the lowest level and 2600 pg/ml as the highest measured level. Due to the large variability in the concentration of Il-6 in the blood, the calculation of the average value is not informative. Conclusion(s): We concluded that the level of IL-6 is very variable, with no constant close correlation with other inflammatory markers, like CRP.
ABSTRACT
Background: It is known that a lot of global consequences after COVID 19 infection were seen. In symptomatic cases, after discharge from hospital, global psychological and physical status was changed in approximately 75% of patients, as was reported in recent literature. We follow up recovery of chest x-ray changes and disappearance of lung function sequels six months after discharge. Aim and objectives: To analyze what was the time frame for recovery of function of alveolo-capillary membrane, assessed by measurement of transfer factor for carbon monoxid (DLco) across the alveolo-capillary membrane. Method(s): Patients treated for COVID 19 in General hospital Tesanj were analyzed. Measurement of DLco was performed three months after discharge from hospital. Patients with severe disease, according to classification adopted for assessment of COVID 19 infection, were included in the study. Result(s): We analyzed 60 patients, 30 of them with therapy by metil prednisolone and 30 without. Therapy with metil prednisolone was 8 mg BID (two times a day) 10 days after discharge, then 4 mg BID in next 10 days. Average DLco was 68.45% of predicted value in patients with no steroid treatment, and 76.49 % in treated group. Chest X-ray resolution of sequels of COVID 19 was better in patients with steroid treatment than in those without. Symptoms of cough and fatigation disappeared more effectively in treated group. Conclusion(s): In patients after COVID 19 infection inappropriate DLco was seen, but recovery of function of diffusion of gases across alveolo-capillary membrane, measured by DLco, was better in patients treated with tablets of metal prednisolone than in those without.