Risk Factors and Predictors of 1-year Overall Mortality in Patients with COVID-19

Aim: To date, limited data exists on 1-year mortality and associated factors in patients with coronavirus diseases-2019 (COVID-19). We determined risk factors and predictors of 1-year mortality. Method(s): In this retrospective and single-center study, hospitalized patients with COVID-19 were enrolled between March 11 and March 11, 2020. The primary outcome was 1-year all-cause mortality after discharge from the hospital. Secondary outcomes were the risk factors and predictors of 1-year mortality. A comparative analysis was applied to patients who died after recovering from acute COVID-19 and patients who survived. Result(s): A total of 567 patients were analyzed. The 1-year mortality occurred in 18 (3.2%) patients. Older age (p=0.001), chronic obstructive pulmonary disease (p=0.001), chronic artery disease (p=0.001), chronic renal failure (p=0.001), presence of pleural fluid (p=0.001), high levels of leukocyte (p=0.001), neutrophil (p=0.001), monocyte (p=0.026), C-reactive protein (p=0.042), procalcitonin (p=0.004), urea (p=0.001), creatinine (p=0.001), troponin (p=0.001), lactate dehydrogenase (p=0.019), potassium (p=0.003), and a low level of alanine aminotransferase (p=0.001) at the first admission were associated with increased long-term mortality. Additionally, the need for intensive care unit (ICU) admission (p=0.007) and invasive ventilation (p=0.019) during the hospital stay for COVID-19 were associated with increased 1-year mortality. Conclusion(s): This study suggests that age, underlying diseases, pleural fluid, certain laboratory parameters, and ICU care are somewhat associated with 1-year mortality. Copyright © 2022 by The Medical Bulletin of Istanbul Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayinevi.

Development a Novel Score (SAD-60) for Predicting Mortality in Hospitalised Patients with COVID-19 Pneumonia: A Multicenter Retrospective Study of 1013 Patients

Background. We aimed to explore a novel risk score to predict mortality in hospitalised patients with COVID-19 pneumonia. In additoon, we compared the accuracy of the novel risk score with CURB-65, qSOFA and NEWS2 scores. Methods. The study was conducted in hospitalised patients with laboratory and radiologically confirmed COVID-19 pneumonia between November 1, 2020 and November 30, 2020. In this retrospective multicenter study. independent predictors were identified using multivariate logistic regression analysis. A receiver operating characteristics (ROC) analysis with area under the curve (AUC) was used to evaluate the performance of the novel score. The optimal cut-off points of the candidate variables were calculated by the Youden's index of ROC curve. Mortality was defined as all cause in-hospital death. Results. A total of 1013 patients with COVID-19 were included. The mean age was 60,5 ±14,4 years, and 581 (57,4%) patients were male. In-hospital death was occured in 124 (12,2%) patients. Multivariate analysis revealed that peripheral capillary oxygen saturation (SpO2), albumin, D-dimer, and age were independent predictors for mortality (Table). A novel scoring model was named as SAD-60 (SpO2, Albumin, D-dimer, ≥60 years old). SAD-60 score (0,776) had the highest AUC compared to CURB-65 (0,753), NEWS2 (0,686), and qSOFA (0,628) scores (Figure). Conclusion. We demonstrated that SAD-60 score had a promising predictive capacity for mortality in hospitalised patients with COVID-19. Univariate and multivariate analysis of factors predicting mortality Comparison of CURB-65, qSOFA, NEWS-2 and SAD-60 for predicting pneumonia mortality in hospitalised patients with COVID-19 by ROC analysis.

Comparison of standard prophylactic and preemptive therapeutic low molecular weight heparin treatments in hospitalized patients with COVID-19.

NTRODUCTION: Anticoagulant treatment approach in patients with COVID-19 is not well studied and not standardized. We aimed to compare the effects of standard prophylactic and pre-emptive therapeutic Low-Molecular-weight Heparin (LMWH) treatment approaches on mortality in patients with COVID-19. PATIENTS AND METHODS: This retrospective and single-centre study includes patients aged ≥ 18 years, who were diagnosed with COVID-19 and treated with LMWH during the hospital stay. Therapeutic dose of LMWH was defined as 1 mg/kg subcutaneously twice daily and prophylactic dose of LMWH was defined as 40 mg subcutaneously once daily. RESULTS: Among the 336 patients diagnosed with COVID-19 pneumonia, 115 patients, who received LMWH were included in the study. The mean age was 58.6 ± 13.3 and 58 (50.4 %) of the patients were male. Sixty-nine (60 %) of the patients were treated with prophylactic and 46 (40 %) therapeutic LMWH.In-hospital mortality was not different between patients treated therapeutic LMWH and prophylactic LMWH by the multivariate regression analysis (OR=2.187, 95% CI 0.484-9.880, p=0.309) and the propensity score modelling (OR=1.586, 95% CI 0.400-6.289, p=0.512.)CONCLUSION: Clinicians should consider the potential risks and benefits of standard prophylactic and pre-emptive therapeutic LMWH. Therefore, anticoagulant therapy should be individualized in patients with COVID-19 (Tab. 3, Ref. 28).

The Effect of the Covid-19 Pandemic on the Psychological Status of Hospital Workers

Background: The aim of this study was to determine the levels of disaster related depression, anxiety and stress symptoms and the affecting factors for hospital workers. Methods: This cross-sectional survey study was conducted in a pandemic hospital between April 8, 2020 and April 14, 2020 in Turkey. The survey included demographics, 18 situations containing seven main themes (health status, vulnerability, work, isolation, income, knowledge, and media) and the Depression Anxiety Stress-21 scale (DASS-21). A multiple regression model was constructed to define the factors associated with the presence of any level depression, anxiety, and stress symptoms. Results: In total, 1129 participants completed the survey. Of all participants, 22.5% had various levels of depression, 23.6% had anxiety, and 20.3% had stress. Female gender, previous diagnosed psychiatric disease, and request for psychological support were common factors associated with the presence of depression, anxiety, and stress. Health status, vulnerability, income, and media as the main themes were also common factors related to the three psychological conditions of hospital workers. Conclusions: The study results demonstrated that one in every five hospital workers struggle with depression, anxiety, and stress symptoms at any level, and there was a significant relationship between certain factors and these psychological conditions.