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1.
Balkan Med J ; 39(3): 209-217, 2022 05 24.
Article in English | MEDLINE | ID: covidwho-1865616

ABSTRACT

Background: Broad-spectrum empirical antimicrobials are frequently prescribed for patients with coronavirus disease 2019 (COVID-19) despite the lack of evidence for bacterial coinfection. Aims: We aimed to cross-sectionally determine the frequency of antibiotics use, type of antibiotics prescribed, and the factors influencing antibiotics use in hospitalized patients with COVID-19 confirmed by polymerase chain reaction. Study Design: The study was a national, multicenter, retrospective, and single-day point prevalence study. Methods: This was a national, multicenter, retrospective, and single-day point-prevalence study, conducted in the 24-h period between 00:00 and 24:00 on November 18, 2020, during the start of the second COVID-19 peak in Turkey. Results: A total of 1500 patients hospitalized with a diagnosis of COVID-19 were included in the study. The mean age ± standard deviation of the patients was 65.0 ± 15.5, and 56.2% (n = 843) of these patients were men. Of these hospitalized patients, 11.9% (n = 178) were undergoing invasive mechanical ventilation or ECMO. It was observed that 1118 (74.5%) patients were receiving antibiotics, of which 416 (37.2%) were prescribed a combination of antibiotics. In total, 71.2% of the patients had neither a clinical diagnosis nor microbiological evidence for prescribing antibiotics. In the multivariate logistic regression analysis, hospitalization in a state hospital (p < 0.001), requiring any supplemental oxygen (p = 0.005), presence of moderate/diffuse lung involvement (p < 0.001), C-reactive protein > 10 ULT coefficient (p < 0.001), lymphocyte count < 800 (p = 0.007), and clinical diagnosis and/or confirmation by culture (p < 0.001) were found to be independent factors associated with increased antibiotic use. Conclusion: The necessity of empirical antibiotics use in patients with COVID-19 should be reconsidered according to their clinical, imaging, and laboratory findings.


Subject(s)
Anti-Bacterial Agents , COVID-19 , Aged , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , COVID-19/drug therapy , Cross-Sectional Studies , Female , Hospitalization , Humans , Male , Middle Aged , Prevalence , Retrospective Studies , SARS-CoV-2 , Turkey/epidemiology
2.
Curr Med Imaging ; 2021 Jun 03.
Article in English | MEDLINE | ID: covidwho-1862445

ABSTRACT

AIM: Initial chest CT findings of patients were compared by grouping them according to the clinical outcome of the infection and those which could predict clinical outcome, prognosis and mortality were investigated. BACKGROUND: Published studies on chest CT in COVID-19 infection do not go beyond describing the characteristics of the current period. Nevertheless, comparative analysis of chest CT findings on hospital admission among patients in different clinical outcomes is scarce. OBJECTIVE: 198 consecutive symptomatic patients with COVID-19 infection confirmed by positive polymerase chain reaction (PCR) and who had undergone chest CT were enrolled in this retrospective study. METHOD: According to their clinical outcomes, we divided them (n:98) into 3 groups. Group 1 (n: 62) involved patients discharged from the service, group 2 (n: 60) included patients hospitalized in the intensive care unit, and group 3 (n: 76) comprised patients who died despite any treatment. RESULTS: Clinical characteristics involving age, dyspnea, hypertension, and chest CT findings of mediastinal lymphadenopathy, pleural effusion, and pericardial effusion, were determined as poor prognosis and mortality predictors, and halo sign in chest CT finding was a good prognosis predictor in multivariate analysis. CONCLUSION: It was seen that some CT findings were significantly correlated to the patients' endpoints, such as discharge, hospitalization in the intensive care unit, and as a worst consequence, death. These findings support the role of CT imaging for potentially predicting the clinical outcomes of these patients with COVID-19.

3.
J Med Virol ; 94(7): 3176-3183, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1739188

ABSTRACT

The efficacy of the inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine has not been fully elucidated across the whole spectrum of patients on kidney replacement therapy. We aimed to characterize the long-term antibody response of inactivated SARS-CoV-2 vaccine administered in kidney transplant recipients (KTRs) and hemodialysis (HD) patients. We performed this prospective observational study in 50 HD, 64 KTR, and 41 healthy control groups (HG) given two doses of CoronaVac. We measured anti-Spike antibodies after 28 days of every vaccine dose, 3rd and 6th months after the first dose, and compared them between cohorts. After two doses, an anti-spike immunoglobulin G of ≥50 AU/ml was present in HD, KTR, and HG as 44%, 7.2%, and 58.5%, respectively (p < 0.001). Furthermore, the proportion of antibody titers peaked at 86.5%, 23%, and 97.6% (p < 0.001) at the 3rd month and decreased significantly at the 6th month in most HD and HG participants, whereas this effect was not observed in KTRs from basal until the 6th month (p < 0.001). During the follow-up, the incidence of coronavirus disease 2019 disease was higher (p < 0.003) in KTRs compared to the other groups, but there was no requirement for an intensive care unit and no death was recorded. We found a negative correlation between antibody seroconversion and age (p < 0.016). The antibody response following inactivated vaccine in dialysis patients is almost comparable to controls for 6 months. In contrast, kidney transplant patients have a poor response. These findings reinforce the need to discuss the vaccination strategy in immunocompromised patients, including the third dose with homologous or heterologous vaccines.


Subject(s)
COVID-19 , Kidney Transplantation , Antibodies, Viral , Antibody Formation , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Renal Dialysis , SARS-CoV-2
4.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-318249

ABSTRACT

Background: In this study, it is aimed to investigate the specific risk factors for the transmission of novel coronavirus (SARS-CoV-2) among healthcare workers in different campuses of a university hospital and to reveal the risk factors for antibody positivity. Methods In this cross-sectional study, 2988 (82%) of 3620 healthcare workers in a university hospital participated. The Coronavirus Disease (COVID-19) antibody was investigated by taking serum to the healthcare workers who accepted for the COVID-19 antibody test. The antibody test results of the participants were evaluated according to the campus they work, their profession and their workplace. Statistical significance level was accepted as p < 0.05 in all analyzes. Results Of the antibody test results of the participants in this study, 108 (3.6%) were positive and 2880 (96.4%) were negative. Antibody positivity were higher in nurses than in other healthcare workers (p < 0.001). When examined according to work places, antibody positivity was higher in those working in intensive care compared to those working in other places (p < 0.001). Conclusions Healthcare workers are at the highest risk of being infected with COVID-19. Those who have a higher risk of infection among healthcare workers and those working in high-risk areas should be vaccinated early and take care to work with personal protective equipment during the pandemic period. Trial Registration: Retrospective permission was obtained from both the local ethics committee and the Turkish Ministry of Health for this study. (IRB No:71522473/050.01.04/370, Date: 05.20.2020

5.
Rev. Assoc. Med. Bras. (1992) ; 67(9): 1299-1304, Sept. 2021. tab, graf
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-1533481

ABSTRACT

SUMMARY OBJECTIVE: This study aimed to investigate the effectiveness of dexamethasone in dialysis patients with COVID-19 and whether it predicts mortality. METHODS: This is a comparative cross-sectional study of 113 consecutive patients with COVID-19 with severe pneumonia signs. The patients were divided into two groups according to the use of dexamethasone treatment: group 1 (n=45) included patients who were treated with dexamethasone and group 2 (n=68) who did not receive dexamethasone. RESULTS: The mean age of both groups was 67.0±10.6 and 67.2±13.0 years, respectively (p=0.947). With respect to demographic and laboratory findings, there were no significant differences between the two groups (p>0.05). The hospitalization time of patients in group 1 was longer than that in group 2 (11 [7-17] days vs. 8 [5.3-14] days, p=0.093]. The 28-day survival rate was 54.2% in the group receiving dexamethasone treatment and 79.5% in the group not receiving dexamethasone treatment (p=0.440). CONCLUSION: Dexamethasone did not reduce mortality rates and the requirement for intensive care unit in dialysis patients with COVID-19. Larger prospective randomized clinical trials are required to associate personalized medicine with the corticosteroid treatment to select suitable patients who are more likely to show a benefit.


Subject(s)
Humans , Aged , COVID-19/drug therapy , Prognosis , Dexamethasone/therapeutic use , Cross-Sectional Studies , Prospective Studies , Renal Dialysis , SARS-CoV-2 , Middle Aged
7.
Rev. Assoc. Med. Bras. (1992) ; 67(supl.1): 80-85, 2021. tab, graf
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-1362148

ABSTRACT

SUMMARY OBJECTIVE: The present study compares the cardiac parameters of the survivor and nonsurvivor patients with COVID-19 infection. METHODS: This study was conducted in 379 patients diagnosed with COVID-19 disease. Information of 21 nonsurvivor and 358 survivor patients with COVID-19 was obtained from the hospital information management system and analyzed retrospectively. Relationship between cardiac parameters in patients categorized into the mortal and immortal groups was investigated. RESULTS: Of the total 379 patients involved in this study, 155 (40.9%) were females and 224 (59.1%) were males. No statistically significant difference in mortality was found between females and males (p=0.249). The total median age was 70, the median age in the nonsurvivor group was 74 (35-89), and it was 69.5 (18-96) in the survivor group (p=0.249). The median values of high-sensitivity troponin (hs-Tn), creatine kinase MB form, and especially myoglobin in the survivor and nonsurvivor groups were 25/64.9 (p=0.028), 18/23 (p=0.02), and 105.5/322.4 (p<0.001), and the difference was statistically significant. Comparing mortality, while there was 1 (0.7%) nonsurvivor out of 134 patients in the service unit, there were 20 (8.2%) nonsurvivors out of 245 patients in the intensive care unit. This difference was statistically significant (p=0.003). The cutoff value of myoglobin, which may pose a risk of mortality, was found to be 191.4 µg/L, while it was 45.7 ng/l for hs-Tn and 60.1 U/L for creatine kinase MB. CONCLUSIONS: Advanced age and increased levels of high-sensitivity troponin, creatine kinase MB, and myoglobin were found to be associated with mortality.


Subject(s)
Humans , Male , Female , Adult , Aged , Aged, 80 and over , COVID-19 , Biomarkers , Retrospective Studies , Survivors , Creatine Kinase , SARS-CoV-2 , Middle Aged
8.
Rev. Assoc. Med. Bras. (1992) ; 67(supl.1): 74-79, 2021. tab, graf
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-1362144

ABSTRACT

SUMMARY OBJECTIVE: This study aims to investigate and compare the coagulation parameters of coronavirus disease 2019 (COVID-19) patients with mortal and nonmortal conditions. METHODS: In this study, 511 patients diagnosed with COVID-19 were included. Information about 31 deceased and 480 recovered COVID-19 patients was obtained from the hospital information management system and analyzed retrospectively. Whether there was a correlation between coagulation parameters between the mortal and nonmortal patients was analyzed. Descriptive analyses on general characteristics of the study population were performed. Visual (probability plots and histograms) and analytical methods (Kolmogorov-Smirnov and Shapiro-Wilk test) were used to test the normal distribution. Analyses were performed using the SPSS statistical software package. RESULTS: Out of 511 patients, 219 (42.9%) were females and 292 (57.1%) were males. There was no statistically significant difference between males and females in terms of mortality (p=0.521). In total, the median age was 67 (22). The median age was 74 (13) in the nonsurvivor group and 67 (22) in the survivor group, and the difference was statistically significant (p=0.007). The D-dimer, prothrombin time, international normalized ratio, neutrophil, and lymphocyte median age values with p-values, in the recovered and deceased patient groups were: 1070 (2129), 1990 (7513) μg FEU/L, p=0.005; 12.6 (2.10), 13.3 (2.1), p=0.014; 1.17 (0.21), 1.22 (0.19), p=0.028; 5.51 (6.15), 8.54 (7.05), p=0.001; and 0.99 (0.96), 0.64 (0.84), p=0.037, respectively, with statistically significant differences. CONCLUSIONS: As a result of this study, D-dimer, prothrombin time, and international normalized ratio increase were found to be associated with mortality. These parameters need to be closely monitored during the patient follow-up.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , COVID-19 , Blood , Blood Coagulation , Retrospective Studies , Survivors , SARS-CoV-2 , Middle Aged
9.
Rev. Assoc. Med. Bras. (1992) ; 67(supl.1): 51-56, 2021. tab, graf
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-1362134

ABSTRACT

SUMMARY The purpose of this study was to investigate the relation between venous blood gas and chest computerized tomography findings and the clinical conditions of COVID-19 pneumonia. METHODS: A total of 309 patients admitted to the emergency department and subsequently confirmed COVID-19 cases was examined. Patients with pneumonia symptoms, chest computerized tomography scan, venous blood gas findings, and confirmed COVID-19 on reverse transcription-polymerase chain reaction (PCR) were consecutively enrolled. Multiple linear regression was used to predict computerized tomography and blood gas findings by clinical/laboratory data. RESULTS: The median age of patients was 51 (interquartile range 39-66), and 51.5% were male. The mortality rate at the end of follow-up was 18.8%. With respect to survival status of patients pCO2 and HCO3 levels and total computerized tomography score values were found to be higher in the surviving patients (p<0.001 and p=0.003, respectively), whereas pH and lactate levels were higher in patients who died (p=0.022 and p=0.001, respectively). With logistic regression analysis, total tomography score was found to be significantly effective on mortality (p<0.001). The diffuse and random involvement of the lungs had a significant effect on mortality (p<0.001, 95%CI 3.853-38.769, OR 12.222 and p=0.027; 95%CI 1.155-11.640, OR 3.667, respectively). With linear regression analysis, the effect of pH and lactate results were found to have a positive effect on total tomography score (p=0.003 and p<0.001, respectively), whereas pCO2 was found to have a negative effect (p=0.029). CONCLUSION: There was correlation between venous blood gas indices and radiologic scores in COVID-19 patients. Venous blood gas taken in emergency department can be a fast, applicable, minor-invasive, and complementary test in terms of diagnosing COVID-19 pneumonia and predicting the prognosis of disease.


Subject(s)
Humans , Male , Female , COVID-19 , Tomography, X-Ray Computed , Retrospective Studies , Emergency Service, Hospital , SARS-CoV-2 , Hospitalization
10.
Turk J Med Sci ; 51(3): 929-938, 2021 06 28.
Article in English | MEDLINE | ID: covidwho-1289062

ABSTRACT

Background/aim: There is no study in the literature in which only chest computed tomography (CT) findings of deceased cases obtained at admission were examined, and the relationship between these findings and mortality was evaluated. Materials and methods: In this retrospective study, a total of 117 deceased patients with COVID-19 infection confirmed by positive polymerase chain reaction and undergone chest CT were enrolled. We evaluated initial chest CT findings and their relationship, location, prevalence, and the frequency with mortality. Results: The mean age of patients was 73 ±18 years; 71 of all patients were male and 46 were female. The predominant feature was pure ground-glass opacity (GGO) lesion (82.0%), and 59.8% of cases had pure consolidation. There was no cavitation or architectural distorsion. Pericardial effusion was found in 9.4% the patients, and pleural effusions were found in 15.3% of them. Mediastinal lymphadenopathy was only 11.9% in total. Conclusion: In deceased patients, on admission CTs, pure consolidation, pleural and pericardial effusion, mediastinal LAP were more common than ordinary cases. It was these findings that should also raise the concern when they were seen on chest CT; therefore, these radiologic features have the potential to represent prognostic imaging markers in patients with COVID-19 pneumonia.


Subject(s)
COVID-19/diagnosis , Lung/diagnostic imaging , Tomography, X-Ray Computed/methods , Aged , COVID-19/epidemiology , Female , Humans , Male , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2
11.
Int Dent J ; 72(2): 211-215, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1230512

ABSTRACT

AIMS: The objective of the present study was to investigate the presence of SARS-CoV-2 in aerosol and COVID-19 contamination distance asssociated with ultrasonic scaling and tooth preparation. METHODS: Twenty-four patients with COVID-19 were included in this study. Removal of supragingival plaque with ultrasonic instruments for 10 minutes and high-speed air-turbine using for the simulation of cutting the maxillary right canine tooth with a round diamond bur for 5 minutes were performed. Patients were randomly assigned to 2 groups: In group A, medium-volume suction was used during treatment. In group B, high-volume suction with an aerosol cannula was added to medium-volume suction. Prior to treatment, 5 glass petri dishes containing viral transport medium were placed in the operating room. After treatment, petri dishes were immediately delivered to a microbiology laboratory for real-time polymerase chain reaction (RT-PCR) analysis. RESULTS: RT-PCR test results were negative for all specimens in group B. However, 5 positive test results for COVID-19 were detected in group A specimens. CONCLUSIONS: Suction with an aerosol cannula is very important to prevent COVID-19 viral contamination via aerosol. In addition, a high-volume suction capacity (air volume) of 150 mm Hg or 325 L/min is sufficient for elimination of viral contamination. Thus, high-volume suction should be used during dental treatments in COVID-19 patients.


Subject(s)
COVID-19 , SARS-CoV-2 , Aerosols , Dental Care , Humans , Suction
12.
Turk J Med Sci ; 51(2): 421-427, 2021 04 30.
Article in English | MEDLINE | ID: covidwho-1211944

ABSTRACT

Background/aim: The COVID-19 infection, which started in Wuhan City, China, in December 2019, turned into a pandemic in a very short time, affecting mainly the elderly and those with serious chronic illnesses. COVID-19 infections have been observed to have a high mortality rate, especially in patients undergoing maintenance hemodialysis. Materials and methods: Forty-two patients over 18 years of age who underwent a maintenance hemodialysis program at our unit, who tested positive for COVID-19 by PCR from nasopharyngeal swabs, and/or who were observed to have disease-related signs in their CTs were included in the study. Results: In this study, 23 of 42 patients receiving hemodialysis support in our clinic were included. The median age was 67 years old (min: 35; max: 91 years), and all of our patients had primary hypertension and other comorbidities. Their clinical evaluation showed that dry cough (47.8%) and shortness of breath (47.8%) were the most common symptoms. Fever was less pronounced (30.4%). The median time from the onset of symptoms to hospitalization was 1 day (min: 0; max:), and the time from hospitalization to death was 18 days (min: 1; max: 22). Transfer from the inpatient ward to the ICU took a median of 7 days (min: 1; max: 13). Among the 23 patients, 3 died during follow-up, and 20 were discharged with full recovery. Baseline ferritin, procalcitonin levels, and CRP/albumin rates were higher, and neutrophil/lymphocyte levels were lower in patients who eventually died. In these patients, despite being nonsignificant, there were more diabetic patients, and the D-dimer levels were higher than 1000 ugFEU/L. Conclusion: The COVID-19 infection is associated with increased mortality in chronic kidney diseases patients. Despite being nonsignificant, there was a trend towards increased mortality in patient with diabetes, D-dimer levels >1000 ugFEU/L, higher ferritin and prokalsitonin levels, an increased CRP/albumin ratio, and a lower neutrophil/lymphocyte ratio.


Subject(s)
COVID-19/physiopathology , Kidney Failure, Chronic/therapy , Adult , Aged , Aged, 80 and over , C-Reactive Protein/metabolism , COVID-19/complications , COVID-19/metabolism , COVID-19/mortality , Cough/physiopathology , Cross-Sectional Studies , Dyspnea/physiopathology , Female , Ferritins/metabolism , Fever/physiopathology , Hospital Mortality , Humans , Kidney Failure, Chronic/complications , Length of Stay , Leukocyte Count , Lymphocyte Count , Male , Middle Aged , Neutrophils , Procalcitonin/metabolism , Prognosis , Renal Dialysis , SARS-CoV-2 , Serum Albumin/metabolism , Time Factors
13.
Turk J Med Sci ; 51(2): 440-447, 2021 04 30.
Article in English | MEDLINE | ID: covidwho-1211943

ABSTRACT

Background/aim: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Turkey on March 10, 2020 and the number of the patients are increasing day by day. Coronavirus disease 2019 (Covid-19) has high mortality rates in intensive care units (ICUs). We aimed to describe the demographic characteristics, comorbidities, treatment protocols, and clinical outcomes among the critically ill patients admitted to the ICU of our hospital. Materials and methods: This cohort study included 103 consecutive patients who had laboratory confirmed Covid-19 and admitted to ICU of Sakarya University Training and Research Hospital between March 19 and April 13, 2020. The final date of the follow-up was April 18. Results: The mean age of the patients was 69.6 ± 14.1 years. Most of the patients had increased CRP (99%), serum ferritin (73.8%), d-dimer (82.5%), and hs-troponin levels (38.8%). 34 patients (33%) had lymphocytopenia, 24 patients (23.3%) had thrombocytopenia. 63 patients (61.2%) developed acute respiratory distress syndrome (ARDS), 31 patients (30.1%) had acute kidney injury, and 52 patients (50.5%) had multiple organ dysfunction syndrome (MODS) during follow-up. Sixty-two patients (60.2%) received mechanical ventilation. As of April 18, of the 103 patients, 52 (50.5%) had died, 30 (29.1%) had been discharged from the ICU, 21 (20.4%) were still in the ICU. Conclusions: Covid-19 has high mortality rates in ICU. Patients with elevated procalcitonin, hs-troponin, d-dimer, and CRP levels and lower platelet count at admission have higher mortality.


Subject(s)
Acute Kidney Injury/physiopathology , COVID-19/physiopathology , Multiple Organ Failure/physiopathology , Respiratory Distress Syndrome/physiopathology , Respiratory Insufficiency/physiopathology , Age Factors , Aged , Aged, 80 and over , Antiviral Agents/therapeutic use , C-Reactive Protein/metabolism , COVID-19/metabolism , COVID-19/mortality , COVID-19/therapy , Cohort Studies , Continuous Renal Replacement Therapy , Critical Illness , Female , Ferritins/metabolism , Fibrin Fibrinogen Degradation Products/metabolism , Glucocorticoids/therapeutic use , Hospital Mortality , Humans , Intensive Care Units , Length of Stay , Lymphopenia/blood , Male , Middle Aged , Oxygen Inhalation Therapy , Platelet Count , Procalcitonin/metabolism , Prognosis , Respiration, Artificial , Respiratory Insufficiency/therapy , SARS-CoV-2 , Severity of Illness Index , Thrombocytopenia/blood , Troponin/metabolism , Turkey
14.
Ann Clin Microbiol Antimicrob ; 20(1): 31, 2021 Apr 27.
Article in English | MEDLINE | ID: covidwho-1204080

ABSTRACT

BACKGROUND: This study aimed to investigate the specific risk factors for the transmission of novel coronavirus (SARS-CoV-2) among healthcare workers in different campuses of a university hospital and to reveal the risk factors for antibody positivity. METHODS: In this retrospective cross-sectional study, 2988 (82%) of 3620 healthcare workers in a university hospital participated. The coronavirus disease 2019 (COVID-19) antibody was investigated using serum from healthcare workers who underwent COVID-19 antibody testing. The antibody test results of the participants were evaluated based on their work campus, their profession and their workplace. The statistical significance level was p < 0.05 in all analyses. RESULTS: Of the participants in this study, 108 (3.6%) were antibody positive, and 2880 (96.4%) were negative. Antibody positivity rates were greater in nurses compared with other healthcare workers (p < 0.001). Regarding workplace, antibody positivity was greater in those working in intensive care compared to those working in other locations (p < 0.001). CONCLUSIONS: Healthcare workers are at the highest risk of being infected with COVID-19. Those who have a higher risk of infection among healthcare workers and those working in high-risk areas should be vaccinated early and use personal protective equipment during the pandemic. TRIAL REGISTRATION: Retrospective permission was obtained from both the local ethics committee and the Turkish Ministry of Health for this study (IRB No:71522473/050.01.04/370, Date: 05.20.2020).


Subject(s)
Antibodies, Viral/blood , COVID-19 Serological Testing , Health Personnel , SARS-CoV-2/immunology , COVID-19 , Cross-Sectional Studies , Hospitals, University , Humans , Retrospective Studies
15.
J Infect Dev Ctries ; 15(3): 398-403, 2021 Mar 31.
Article in English | MEDLINE | ID: covidwho-1175616

ABSTRACT

INTRODUCTION: The aim of this study is to investigate whether macrophage migration inhibitory factor (MIF) predicts the prognosis of COVID-19 disease. METHODOLOGY: This descriptive and cross-sectional study was conducted on 87 confirmed COVID-19 patients. The patients were separated into two groups according to the admission in the ICU or in the ward. MIF was determined batchwise in plasma obtained as soon as the patients were admitted. Both groups were compared with respect to demographic characteristics, biochemical parameters and prediction of requirement to ICU admission. RESULTS: Forty seven patients in ICU, and 40 patients in ward were included. With respect to MIF levels and biochemical biomarkers, there was a statistically significant difference between the ICU and ward patients (p< 0.024). In terms of ICU requirement, the cut-off value of MIF was detected as 4.705 (AUC:0.633, 95%CI:0.561-0.79, p= 0.037), D-dimer was 789 (AUC:0.779, 95%CI: 0.681-0.877, p= 0.000), troponin was 8.15 (AUC: 0.820, 95%CI:0.729-0.911, p= 0.000), ferritin was 375 (AUC: 0.774, 95%CI:0.671-0.876, p= 0.000), and lactate dehydrogenase (LDH) was 359.5 (AUC:0.843, 95%CI: 0.753-0.933, p= 0.000). According to the logistic regression analysis; when MIF level > 4.705, the patient's requirement to ICU risk was increased to 8.33 (95%CI: 1.73-44.26, p= 0.009) fold. Similarly, elevation of troponin, ferritin and, LDH was shown to predict disease prognosis (p< 0.05). CONCLUSIONS: Our study showed that MIF may play a role in inflammatory responses to COVID-19 through induction of pulmonary inflammatory cytokines, suggesting that pharmacotherapeutic approaches targeting MIF may hold promise for the treatment of COVID-19 pneumonia.


Subject(s)
COVID-19/diagnosis , COVID-19/immunology , Inflammation/blood , Intensive Care Units/statistics & numerical data , Intramolecular Oxidoreductases/blood , Macrophage Migration-Inhibitory Factors/blood , Adult , Aged , Biomarkers/blood , Comorbidity , Cross-Sectional Studies , Female , Hospitalization/statistics & numerical data , Humans , Inflammation/virology , Male , Middle Aged , Prognosis , Qualitative Research , ROC Curve
16.
Turk J Med Sci ; 51(3): 1012-1020, 2021 06 28.
Article in English | MEDLINE | ID: covidwho-1128077

ABSTRACT

Background/aim: It is very important for the efficient use of limited capacity and the success of treatment to predict patients who may need ICU with high mortality rate in the Covid-19 outbreak. In our study, it was aimed to investigate the value of the radiological involvement on initial CT in demonstrating the ICU transfer and mortality rate of patients. Materials and methods: All PCR-positive patients were included in the study, whose CT, PCR, and laboratory values were obtained simultaneously at the time of first admission. Patients were divided into 4 groups in terms of the extent of radiological lesions. These groups were compared in terms of intensive care transfer needs and Covid-related mortality rates. Results: A total of 477 patients were included in the study. Ninety of them were group 0 (no lung involvement), 162 were group 1 (mild lesion), 89 were group 2 (moderate lesion), and 136 were group 3 (severe lung involvement). A significant relationship was found between the extensiveness of the radiological lesion on CT and admission to intensive care and mortality rate. As the initial radiological involvement amounts increased, the rate of ICU transfer and mortality increased. The mortality rates of the groups were 0%, 3%, 12.3%, and 12.5%, respectively, and the difference was significant (p < 0.001). Similarly, the ICU transfer rates of the groups were 2.2%, 5.6%, 13.5%, and 17.7%, respectively, and the difference was significant (p < 0.001). Conclusion: In conclusion, in our study, the strong relationship between the initial radiological extent assessment and the need for intensive care and mortality rates has been demonstrated, and we believe that our results will make a significant contribution to increase the success of the health system in predicting patients who may progress, helping clinicians and managing pandemics.


Subject(s)
COVID-19/diagnosis , Intensive Care Units/statistics & numerical data , Pandemics , Radiography/methods , COVID-19/epidemiology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2 , Survival Rate/trends , Turkey/epidemiology
17.
J Coll Physicians Surg Pak ; 30(1): S60-S65, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1112955

ABSTRACT

OBJECTIVE: To determine clinical characteristics, renal replacement therapy (RRT) requirements, and predictors of mortality in critically ill patients with COVID-19 associated AKI. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Sakarya University Education and Training Hospital, Sakarya, Turkey, between April 1 and 30, 2020. METHODOLOGY: The study included 55 patients who were admitted with diagnosis of COVID-19, and whose illnesses showed a critical course that leads to AKI. The variables were studied as per objective. RESULTS: During the follow-up, 43 out of 55 patients (78.2%) died and 12 (21.8%) were discharged with recovery. The mortality was higher in patients at stage 3 (88.9% mortality) compared to stage 2 (53.8% mortality) (p=0.014). In the nonsurvivor group, RDW (red cell distribution width) and albumin levels were lower at admission; whereas, the LDH levels and CRP/albumin ratios were higher. On regression analysis, low albumin level (OR: 12.793, p = 0.010), high LDH level (OR: 8.454, p = 0.026), and presence of stage 3 AKI (OR: 10.268, p = 0.020) were found as independent risk factors for mortality in COVID-19 patients, who developed AKI. CONCLUSION: In critically ill patients with COVID-19 pneumonia, who developed AKI, it was seen that the presence of low albumin, high LDH, and stage 3 AKI at the time of admission could be used as predictors of mortality. Moreover,, it was shown for the first time that in these patients, the high CRP/albumin ratio and low RDW could be associated with mortality. Key Words: Acute kidney injury, Mortality, COVID-19.


Subject(s)
Acute Kidney Injury/mortality , COVID-19/complications , Critical Illness/mortality , Acute Kidney Injury/etiology , Aged , Aged, 80 and over , COVID-19/epidemiology , Female , Follow-Up Studies , Hospital Mortality , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2 , Survival Rate/trends , Turkey/epidemiology
18.
J Coll Physicians Surg Pak ; 30(10): 147-152, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-1034258

ABSTRACT

OBJECTIVE: To evaluate the laboratory confirmed COVID-19 pneumonia and correlate the findings obtained by thorax ultrasound (USG) and thorax computed tomography (CT). STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Departments of Infection Disease, Internal Medicine and Radiology, Sakarya Training and Research Hospital, Sakarya, Turkey, between March and May 2020. METHODOLOGY: This study was consisted of 100 adult patients having rRT-PCR positive COVID-19 pneumonia diagnossed by thorax CT. The clinical features, thorax USG and CT findings of these patients were recorded and expressed. USG and thorax CT findings were scored using a method described before. Continuous variables were expressed as mean (±SD) values. The Kolmogorov-Smirnov test was used for the normal distribution test, and continuous variables were compared using the Mann-Whitney U test.  USG and CT performed at time of admission to the hospital. Descriptive statistics were conducted based on the structures of variable. RESULTS: A total of 100 patients (54 men and 46 women; mean age, 59.88±13.03 years; range, 28-91years) with COVID-19 pneumonia were evaluated. Involvement areas on the lower posterior of the right side were detected as 70% by ultrasound and 74% by CT. Positively correlation was detected in lung scans assessed by USG and CT (p<0.001, r=0.705). CONCLUSION: Ultrasound has several advantages including no ionizing radiation exposure for health care workers, being a safe, fast and non-invasive diagnostic technique with bedside usage. Hence, ultrasound is an efficient alternative to diagnosis and monitor of patients with COVID-19 pneumonia. Key Words: COVID-19, Lung ultrasound, Pneumonia, RRT-PCR.


Subject(s)
COVID-19/diagnosis , Lung/diagnostic imaging , Pandemics , Pneumonia, Viral/diagnosis , SARS-CoV-2 , Tomography, X-Ray Computed/methods , Ultrasonography/methods , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Female , Humans , Male , Middle Aged , Reproducibility of Results , Retrospective Studies
19.
Wien Klin Wochenschr ; 133(7-8): 298-302, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-996404

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) is an acute inflammatory respiratory disease. Osteopontin (OPN) is a glycoprotein expressed in various cell types, such as bone, immune, smooth muscle, epithelial and endothelial cells. It also acts as a regulator of immune response. The aim of the present study was to reveal the place of serum osteopontin levels in predicting severity among patients with COVID-19. METHODS: This study included 84 patients, 43 female and 45 male. Patients were divided into 2 groups, group 1 non-severe group (n: 48), group 2 severe (n: 40). Demographic data, neutrophil, lymphocyte, platelet, white blood cell counts, albumin, procalcitonin, C­reactive protein (CRP) and OPN levels were recorded. The OPN levels and these inflammatory parameters of the two groups were compared. RESULTS: There were no significant differences in terms of gender (female/male 25/23 vs. 18/22) and platelet count (178 K/µL vs. 191 K/µL) between the groups (p > 0.05). Ages (57.7 ± 17.0 years vs. 71.4 ± 12.8 years), procalcitonin (0.07 vs. 0.24 ng/mL), CRP (17 vs 158 mg/l), neutrophil count (3.7 vs 5.64 K/µL), WBC counts (5.38 vs 7.85 K/µL) and number of deaths (0 vs 26) (p < 0.001). The OPN levels (98.5 vs 13.75 ng/mL, p = 0.002) were found to be statistically higher, in group 2 than group 1. CONCLUSION: The present study showed that OPN can be used to predict the severity in patients with COVID-19.


Subject(s)
COVID-19 , Osteopontin , Adult , Aged , Endothelial Cells , Female , Humans , Leukocyte Count , Male , Middle Aged , SARS-CoV-2
20.
Rev Assoc Med Bras (1992) ; 66(Suppl 2):71-76, 2020.
Article in English | LILACS (Americas), Grey literature | ID: grc-742450

ABSTRACT

SUMMARY OBJECTIVE Coronavirus disease 2019 (COVID-19) is an emerging health threat caused by a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). Previous studies have noted hypertension is associated with increased mortality due to COVID-19;however, it is not clear whether the increased risk is due to hypertension itself or antihypertensive agents. We aimed to evaluate the impact of antihypertensive agents on the clinical outcomes of hypertensive patients with COVID-19. METHODS Our study included 169 consecutive hypertensive patients hospitalized due to COVID-19 between March 20 and April 10, 2020. The demographic characteristics, clinical data, and type of antihypertensive agents being used were reviewed. RESULTS The mean age of patients was 65.8±11.7 years.30 patients(17.7%) died during hospitalization. A total of 142 patients(84%) were using angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs), 91 (53.8%) were using diuretics, 69 (40.8%) were using calcium channel blockers (CCBs), 66 (39.1%) were using beta-blockers, 12 (7.1%) were using alpha-blockers, and 5 (2.9%) were using mineralocorticoid receptor antagonists (MRAs). There was no significant difference between survivors and non-survivors based on the type of antihypertensive agents being used. Binary logistic regression analysis showed that the type of the antihypertensive agent being used had no effect on mortality [OR=0.527 (0.130-2.138), p=0.370 for ACEIs/ARBs;OR=0.731 (0.296-1.808), p=0.498 for CCBs;OR=0.673 (0.254-1.782), p=0.425 for diuretics;OR=1.846 (0.688-4.950), p=0.223 for beta-blockers;OR=0.389 (0.089-1.695), p=0.208 for alpha-blockers;and OR=1.372 (0.107-17.639), p=0.808 for MRAs]. CONCLUSION The type of antihypertensive agent being used had no effect on the clinical course and mortality in hypertensive patients with COVID-19. The use of these agents should be maintained for the treatment of hypertension during hospitalization. RESUMO OBJETIVO A doença de coronavírus 2019 (COVID-19) é uma ameaça emergente à saúde causada por um novo coronavírus denominado síndrome respiratória aguda grave coronavírus 2 (Sars-COV-2). Estudos anteriores observaram que a hipertensão está associada a um aumento da mortalidade devido ao COVID-19, no entanto, não está claro se o aumento do risco pertence à própria hipertensão ou a agentes anti-hipertensivos. Nosso objetivo foi avaliar o impacto de agentes anti-hipertensivos nos resultados clínicos em pacientes hipertensos com COVID-19. MÉTODOS Nosso estudo incluiu 169 hipertensos consecutivos internados por COVID-19 entre 20 de março e 10 de abril de 2020. As características demográficas, dados clínicos e o tipo de anti-hipertensivos em uso foram revistos. RESULTADOS A idade média dos pacientes foi de 65,8±11,7 anos. Trinta pacientes (17,7%) faleceram durante a internação. Cento e quarenta e dois pacientes (84%) usavam inibidores da enzima de conversão da angiotensina (ACEIs) ou bloqueadores dos receptores da angiotensina II (ARBs), 91 (53,8%) usavam diuréticos, 69 (40,8%) usavam bloqueadores dos canais de cálcio (CCBs), 66 (39,1%) usavam betabloqueadores, 12 (7,1%) usavam bloqueadores alpha e cinco (2,9%) usavam antagonistas dos receptores de mineralocorticoides (MRAs). Não houve diferença significativa entre sobreviventes e não sobreviventes com base no tipo de agentes anti-hipertensivos em uso. A análise de regressão logística binária mostrou que o tipo de agente anti-hipertensivo utilizado não teve efeito na mortalidade (OR=0,527 (0,130-2,138), p=0,370 para ACEIs/ARB;OR=0,731 (0,296-1,808), p=0,498 para CCBs;OR=0,673 (0,254-1,782), p=0,425 para diuréticos;OR=1,846 (0,688-4,950), p=0,223 para bloqueadores beta;OR=0,389 (0,089-1,695), p=0,208 para bloqueadores alpha e OR=1,372 (0,107-17,639), p=0,808 para MRAs). CONCLUSÃO O tipo de agente anti-hipertensivo utilizado não teve efeito no curso clínico e na mortalidade em pacientes hipertensos com COVID-19. O uso desses agentes deve ser mantido no tratamento da hipertensão durante a hospitalização.

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