Characteristics of our hypoxemic COVID-19 pneumonia patients receiving corticosteroids and mortality-associated factors.

BACKGROUND: COVID-19 is a disease associated with diffuse lung injury that has no proven effective treatment yet. It is thought that glucocorticoids may reduce inflammation-mediated lung injury, disease progression, and mortality. We aimed to evaluate our patient's characteristics and treatment outcomes who received corticosteroids for COVID-19 pneumonia. METHODS: We conducted a multicenter retrospective study and reviewed 517 patients admitted due to COVID-19 pneumonia who were hypoxemic and administered steroids regarding demographic, laboratory, and radiological characteristics, treatment response, and mortality-associated factors. RESULTS: Of our 517 patients with COVID-19 pneumonia who were hypoxemic and received corticosteroids, the mortality rate was 24.4% (n = 126). The evaluation of mortality-associated factors revealed that age, comorbidities, a CURB-65 score of ≥ 2, higher SOFA scores, presence of MAS, high doses of steroids, type of steroids, COVID-19 treatment, stay in the intensive care unit, high levels of d-dimer, CRP, ferritin, and troponin, and renal dysfunction were associated with mortality. CONCLUSION: Due to high starting and average steroid doses are more associated with mortality, high-dose steroid administration should be avoided. We believe that knowing the factors associated with mortality in these cases is essential for close follow-up. The use of CURB-65 and SOFA scores can predict prognosis in COVID-19 pneumonia.

Characteristics of hospitalised COVID-19 patients and parameters associated with severe pneumonia.

BACKGROUND: After the first case of coronavirus disease 2019 (COVID-19) was reported in China in December 2019, it caused a global pandemic, including Turkey. OBJECTIVES: The aim of this study was to analyse the characteristics of hospitalised COVID-19 patients and assess the parameters related to severe pneumonia. METHODS: Included in the study were hospitalised COVID-19 patients with positive naso-oropharyngeal swabs. Patients' demographics, admission symptoms, laboratory and radiological findings were recorded retrospectively. RESULTS: Of 1013 patients, 583 were males (57.6%) and 430 were females (42.4%), with a mean age of 53.7 ± 17.9. More than half of the patients had at least one comorbidities, the most common of which were hypertension and diabetes mellitus. Cough (59.8%), fatigue (49.5%) and fever (41.2%) were the most common presenting symptoms. Of the hospitalised COVID-19 patients, 84.9% had pneumonia and 83.5% had typical radiological COVID-19 appearances (94.5%: ground-glass areas). The most common laboratory findings were high C-reactive protein (CRP) (73.6%) and lactate dehydrogenase (LDH) (46.2%) levels, as well as lymphopenia (30.1%). Severe pneumonia was present in 28.1% of COVID-19 patients. Multivariate logistic regression analysis indicated that advanced age, hypotension, anaemia and elevated CRP and LDH serum levels were independent risk factors for the severity of COVID-19 pneumonia (P = .011, .006, .017, .003 and .001, respectively). CONCLUSION: This study, as one of the first multicentre studies about characteristics of COVID-19 in Turkey, may guide about disease-related parameters and severity of pneumonia. Age, blood pressure, complete blood count and routine biochemical tests (including CRP and LDH) would appear to be important parameters for the evaluation of the severity of COVID-19 pneumonia.

Clinical characteristics and outcomes of hospitalized COVID-19 patients with COPD.

BACKGROUND: Although COPD is not one of the most common comorbidities in COVID-19 patients, it can be more fatal in this group. This study aimed to investigate the characteristics and prognosis of COPD patients among the population with COVID-19. RESEARCH DESIGN AND METHODS: Patients diagnosed with positive PCR test were included in our multicentered, retrospective study. Patients with airway obstruction (previous spirometry) were included in 'COPD group'. RESULTS: The prevalence of COPD in COVID-19 patients was 4.96%(53/1069). There was a significant difference between COPD and non-COPD COVID-19 patients in terms of gender, mean age, presence of dyspnea, tachypnea, tachycardia, hypoxemia and presence of pneumonia. The mortality rate was 13.2% in COPD, 7% in non-COPD patients(p = 0.092). The significant predictors of mortality were higher age, lymphopenia (p < 0.001), hypoxemia (p = 0.028), high D-dimer level (p = 0.011), and presence of pneumonia (p = 0.043) in COVID-19 patients. CONCLUSIONS: Our research is one of the first studies investigating characteristics of COPD patients with COVID-19 in Turkey. Although COPD patients had some poor prognostic features, there was no statistical difference between overall survival rates of two groups. Age, status of oxygenization, serum D-dimer level, lymphocyte count and pneumonia were significantly associated parameters with mortality in COVID-19.