ABSTRACT
Aim: Clinical presentation of COVID-19 ranges from asymptomatic to fatal cases. Therefore, predictability of prognosis gains importance in managing the disease. The aim of this study is to investigate the relation between RT-PCR cycle threshold (Ct) values and the clinical severity of COVID-19 infection. Material(s) and Method(s): A retrospective study was conducted among 1224 COVID-19 patients. A scoring system, which is designed by the World Health Organization was used to classify patients by means of their clinical status. Result(s): The cut-off for Ct value in ROC curves was 21.52 at the point, when the COVID-19 patient clinic is shifting from ambulatory to hospitalized (79.7% sensitivity, 69% specificity). A significant weak positive correlation was found between age and WHO Score (r= .238 p<0.01) and a significant weak negative correlation was found between Ct value and WHO Score (r=-.068 p<0.05) in COVID-19 patients. Discussion(s): Patients with lower RT-PCR Ct values were more likely to go through the disease more severely due to higher virulence. Reporting of numerical Ct values may help clinicians in terms of prognosis.Copyright © 2022, Derman Medical Publishing. All rights reserved.
ABSTRACT
Introduction: This study was aimed to assess the clinical features and electrophysiological subtypes of patients with Guillain-Barre syndrome (GBS) in Istanbul, as well as to analyze the probably different characteristics of COVID-associated GBS. Method(s): From the patients who were admitted to the major hospitals in Istanbul between April 2019 and November 2021, those aged over 18 years and diagnosed as having GBS within the 21 days after the initial symptoms were selected for the study. Electrophysiologic examinations were performed twice within the first 6 weeks along with close clinical observation throughout the acute illness. The patients were divided into groups as those admitted in the pre-pandemic and pandemic periods. The characteristics of the patients who developed GBS after COVID infection (C-GBS) were also evaluated separately. Axonal and demyelinating subtypes were determined according to the previously described electrophysiologic criteria. Result(s): From 12 centers, 134 patients were included in the study. The number of patients diagnosed in the pre-pandemic and pandemic periods were 61 and 73, respectively. Eighteen patients developed C-GBS in the pandemic era. According to Uncini's criteria, 33.6% of the patients were classified as axonal GBS (29/45 patients had reversible conduction failure) and electrophysiological distinction could not be made in 8.2% of the patients. In the second electrophysiological examination performed in 116 patients, the subtype diagnosis was changed in 29 who had been classified according to the Hadden's criteria in the first examination and in 17 who had been categorized by using Rajabally's criteria. Sensory symptoms were found in all C-GBS patients and in only 67.9% of all patients diagnosed during the pandemic (p = 0.006). The frequency of demyelinating subtype was 83.3% in the C-GBS group, and this rate was 47.8% in the patients without recent COVID infection (p = 0.026). While MRC sum score, Hughes score, and modified Erasmus outcome score were not found to be different in the pre-pandemic and post-pandemic groups, C-GBS had lower Hughes score (<3) than the other patients diagnosed during the pandemic (p = 0.040). Conclusion(s): The frequency of axonal GBS in Istanbul, a large metropole inhabiting people from every region of Turkey, seems to be placed in between the values reported from high and low incidence countries. The second electrophysiologic examination is important for precise determination of the subtypes. C-GBS seems to cause more frequent sensory symptoms, demyelinating electrophysiologic characteristics, and moderate clinical features. Copyright © 2022
ABSTRACT
Aim: Clinical presentation of COVID-19 ranges from asymptomatic to fatal cases. Therefore, predictability of prognosis gains importance in managing the disease. The aim of this study is to investigate the relation between RT-PCR cycle threshold (Ct) values and the clinical severity of COVID-19 infection. Material and Methods: A retrospective study was conducted among 1224 COVID-19 patients. A scoring system, which is designed by the World Health Organization was used to classify patients by means of their clinical status. Results: The cut-off for Ct value in ROC curves was 21.52 at the point, when the COVID-19 patient clinic is shifting from ambulatory to hospitalized (79.7% sensitivity, 69% specificity). A significant weak positive correlation was found between age and WHO Score (r= .238 p<0.01) and a significant weak negative correlation was found between Ct value and WHO Score (r=-.068 p<0.05) in COVID-19 patients. Discussion: Patients with lower RT-PCR Ct values were more likely to go through the disease more severely due to higher virulence. Reporting of numerical Ct values may help clinicians in terms of prognosis.
ABSTRACT
BACKGROUND AND AIM: SARS-CoV-2 has caused a pandemic and COVID-19 challenged both human and public health over the world. Different types of COVID-19 vaccines were developed against the disease virus with various techniques. In this research, it was aimed to evaluate the antibody responses induced by mRNA vaccines and inactivated vaccines or SARS-CoV-2 infection. METHODS: Between January and August 2021, 651 patients tested for immunoglobulin G antibody levels against the spike protien of SARS-CoV-2. Antibody levels(AU/mL) were detected by Chemiluminescence-Microparticle-Immunoassay, detection was carried on Abbott-Architect ci8200-Autoanalyzer. RESULTS: Among 651 patients 298 of them were vaccinated without previous COVID-19 history (77 mRNA, 221 inactivated), 123 were infected with SARSCoV-2 and not vaccinated, 58 were vaccinated after the infection (19 mRNA, 39 inactivated) while 172 of all did not have previous infection or vaccination history. of 172 patients 29 of them tested positive for anti-Spike antibody levels with a median value of 223.9. Inactivated vaccine induced antibody responses were significantly lower than mRNA vaccine induced levels (p=0.000, median:304.5, 7530.8 respectively). In previously infected population who were not vaccinated;higher antibody levels were observed than inactivated vaccine administred patients (p=0.000, median:737.1, 304.5 respectively), when compared to the patients who received mRNA vaccine antibody levels were found to be lower (p=0.000, median:737.1, 7530.8). Among the patients who were vaccinated after the infection;latterly mRNA vaccine administred patients were found to have higher antibody levels than patients who received inactivated vaccine after the infection (p=0.000, median:12070.4, 1183.9 respectively). CONCLUSIONS: Higher levels of antibody response were observed in patients who received mRNA vaccine when compared to those who received inactived vaccine or were infected with SARS-CoV-2. The highest levels were observed among patients who were infected then also received mRNA vaccine. This study whose preliminary data were examined should be supported by larger sample groups and longer follow-up with further studies.