ABSTRACT
BACKGROUND: This study aimed to investigate pregnancy frequency and evaluate the factors affecting live births in hemodialysis (HD) patients. METHODS: Female HD patients whose pregnancy was retrospectively reported between January 1, 2014, and December 31, 2019. The duration of HD, primary disease, and the information on whether the pregnancy resulted in abortion, stillbirth, or live birth, whether the HD duration was prolonged after diagnosing the pregnancy and whether it accompanied preeclampsia were recorded. RESULTS: In this study, we reached 9038 HD female patients' data in the study. A total of 235 pregnancies were detected in 145 patients. The mean age was 35.42 (35 ± 7.4) years. The mean age at first gestation was 30.8 ± 6.5 years. The average birth week was 32 (28 -36) weeks. A total of 53.8% (no = 78) of the patients had live birth, 51.7% (no = 70) had at least one abortion in the first 20 weeks, and 13.1% (no = 19) had at least one stillbirth after 20 weeks. The rate of patients' increased numbers of dialysis sessions during pregnancy was 71.7%. The abortion rate was 22.4% in those with increased HD sessions, whereas 79.3% in those not increased HD sessions (p < 0.001). Live birth frequency was 67.2% in the increased HD sessions group and 3.4% in those who did not differ in HD sessions (p < 0.001). DISCUSSION: For the first time, we reported pregnancy outcomes in HD female patients, covering all regions of Turkey. It has been observed that;increasing the number of HD sessions in dialysis patients will decrease fetal and maternal complications and increase live birth rates.
ABSTRACT
Objectives: A hypercoagulability status has been reported in SARS-CoV-2 infection. Beside their traditional roles, platelets are referred to as immune cells. The purpose of the study was to examine platelet activation and aggregation in COVID-19. Materials and Methods: This case-control study comprised 61 patients with SARS-CoV-2 infection and 18 healthy individuals. The patients were separated into groups with respect to the need for treatment in the intensive care unit (ICU). CD41, CD61, CD42a, and CD42b were determined as platelet activation markers, and platelet aggregation tests were analyzed in all groups. Results: Platelet CD41, CD61, CD42a, and CD42b expressions were significantly elevated in ICU patients compared to non-ICU patients and healthy donors. Patients in the ICU group had increased platelet aggregations than those in non-ICU patients and controls. Additionally, platelet activation and platelet function tests correlated with inflammatory and coagulation markers involving C-reactive protein, Interleukin-6, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte to lymphocyte ratio, D-dimer, and fibrinogen concentrations. Conclusion: Enhanced platelet activity and faster platelet aggregation were observed in ICU COVID-19 patients. It is possible that platelet hyperreactivity may contribute to the progression of SARS-CoV-2 infection. The relationships between platelet activation and functions tests with inflammatory and coagulation markers show that systemic inflammation and cytokines may trigger the hypercoagulability in COVID-19 patients in ICU, or hyperactivated platelets could augment the inflammation. © 2021 Ankara Yildirim Beyazit University. All Rights Reserved.
ABSTRACT
Background: Vitamin D is recognized to be an immune regulator. Also, it is known to have antiviral effects by several mechanisms, including reducing inflammatory cytokines. Objectives: To examine the 25-hydroxyvitamin D (25(OH) D) status for assessing the severity of COVID-19. Methods: This study consisted of 596 patients confirmed as SARS-CoV-2 infection and 59 healthy individuals. The cases separated into non-severe group, severe survival, and severe non-survival group. 25(OH)D and other laboratory parameters were evaluated retrospectively. Results: In all COVID-19 groups 25(OH)D levels were low compared to controls (p<0.05). 25(OH)D concentrations were lowest in patients in severe non-survival groups than those in other SARS-CoV-2 infection groups (p<0.05). Multivariate regression analysis exhibited that decreasing 25(OH)D was associated with an increased likelihood of non-severe, severe survival and severe non-survival disease. There were significant associations between 25(OH)D and certain inflammatory and hemostatic parameters (p<0.05, for all). Conclusions: 25(OH)D deficiency was observed among patients with COVID-19. Declined steadily 25(OH)D levels make a huge contribution to the scale of the progression of the disease. Correlations support that 25(OH)D may be a substantial tool for utilizing the severity of the disease and estimating the survival. Also, supplementation of 25(OH)D might slow down the course of the COVID-19.