ABSTRACT
Objective The havoc caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic could not have been predicted, with children being affected worldwide. Testing for SARS-CoV-2 infection helped to define the interventions against the spread of the disease. A polymerase chain reaction (PCR) test has been the mainstay of diagnostic testing. Cycle threshold (Ct) is a semiquantitative value that indicates approximately how much viral genetic material was in the sample. The aim of this study was to evaluate the impact of Ct values among children with SARS-CoV-2 infection. Methods Between May 3, 2020 and August 3, 2020, clinical laboratory input and the data of patients with positive SARS-CoV-2 PCR tests were retrospectively studied. Results There was no statistical significance between Ct values and the patient's status, symptoms other than fever, or other laboratory findings. However, the Ct value of patients who had symptoms at the time of admission to the hospital was significantly lower. Conclusion In this study, symptomatic patients had lower Ct than asymptomatic patients that reflected higher viral loads. In evidence-based medicine applications, it might be useful to correlate the clinical history with laboratory test results. Even symptomatic patients with high Ct value coinfections, or an alternative acute infection, should be considered. © 2022. Thieme. All rights reserved.
ABSTRACT
Objective: This study aims to investigate the relationship between prothrombin time (PT), activated partial thromboplastin time (aPTT), INR (International Normalized Ratio), and D-dimer levels, platelet (PLT) levels at hospital admission, and positivity or negativity of Polymerase Chain Reaction (PCR) test results in patients with suspected coronavirus disease-19 (COVID-19) followed at COVID-19 services. Methods: This study was performed on 238 patients with the prediagnosis of COVID-19, all patients are hospitalised in Samsun city at our hospital between 11 March 2020-30 May 2020. According to COVID-19 PCR test results, PCR test negative 119 individua and PCR test positive 119 patients were included in the study. PT, aPTT, D-dimer, INR, and PLT levels were examined. Results: While PCR test negative individuals had a mean PT value of 11.46 +/- 0.86 sec, PCR test positive patients had a mean PT value of 12.97 +/- 3.65 sec (p<0.001). There was no significant difference in mean aPTT values of PCR test positive and negative patients. Whereas INR, D-dimer increased significantly in PCR test positive patients. PLT value decreased from a mean value of 266.75 +/- 71.36*10(9)/L in PCR test negative patients to 241.18 +/- 96.64*10(9)/L in PCR test positive patients (p=0.002). Conclusions: In our study, it was found that in patients who were admitted to hospital with COVID-19 suspicion and followed up in COVID-19 services, PT, D-dimer, INR, PLT values were important in detecting coagulopathy and thrombocytopenia in the group who were PCR positivity.
ABSTRACT
Objective In this article, we aimed to evaluate the clinical, laboratory, and radiological findings and outcomes of patients treated with corticosteroids and intravenous immunoglobulin (IVIG) with the multisystem inflammatory syndrome in children (MIS-C) in two centers in Bursa, Turkey. Methods We retrospectively collected the clinical characteristics, laboratory results, and treatment outcomes of MIS-C cases treated in two centers from April 2020 to February 2021. Patients were compared both according to their clinical categorization and the place they were hospitalized in, as well as with studies published in the literature. Results Fifty-six patients were included. Thirty-six (64.3%) were male with a mean age of 67.95 ± 50.87 months. Thirty patients (53.5%) were categorized as Kawasaki-like disease, 17 (30.3%) sepsis-like disease, and 9 (16%) were toxic shock syndrome (TSS). Admission symptoms were fever (100%), rash (71.4%), myalgia (69.6%), and abdominal pain (62.5%). Seventeen (30.3%) patients were hospitalized in pediatric intensive care unit. Elevated C-reactive protein levels, procalcitonin, erythrocyte sedimentation rate, D-dimer, and troponin were found in 100, 77, 84, 84, and 23.2% of the patients, respectively. Of all, 55 (98.2%) received IVIG, 54 (96.4%) corticosteroids, 56 (100%) antibiotic therapy, 22 (40%) albumin infusion, and 13 (23.2%) inotropic support. Fifty patients (89.3%) received low-molecular-weight heparin: enoxaparin, followed by acetylsalicylic acid treatment. Only one patient who was resistant to both IVIG and steroid treatment received Anakinra. One patient (1.7%) with TSS died within 1 hour of hospitalization. Conclusion Combined use of IVIG and corticosteroids is an effective way of treatment in MIS-C patients resulting in low mortality.