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1.
Biomark Insights ; 17: 11772719221135443, 2022.
Article in English | MEDLINE | ID: covidwho-2138764

ABSTRACT

Background: Biomarkers of lung injury and interstitial fibrosis give insight about the extent of involvement and prognosis in well-known interstitial lung diseases (ILD). Serum Krebs von den Lungen-6 (KL-6) reflects direct alveolar injury and, transforming growth factor-beta1 (TGF-ß1) and fibroblast growth factor-2 (FGF-2) are principal mediators of fibrosis in ILD and in almost all fibrotic diseases. In this sense, we aimed to assess associations of these biomarkers with traditional inflammatory markers and clinical course of COVID-19. Methods: Patients with COVID-19 who had confirmed diagnosis with SARS-CoV-2 nucleic acid RT-PCR were enrolled and followed up prospectively with a standardized approach one month after diagnosis. Patients were divided into severe and non-severe groups according to National Institutes of Health criteria. Outcome was assessed for the requirement of intensive care unit (ICU) admission, long term respiratory support and death. Blood samples were collected at enrollment and serum levels of KL-6, TGF-ß1, FGF-2 were determined by ELISA. Association between these markers with other prognostic markers and prognosis were analyzed. Results: Overall 31 severe and 28 non-severe COVID-19 patients were enrolled and were compared with healthy control subjects (n = 30). Serum KL-6 levels in COVID-19 patients were significantly higher (median [IQR]; 11.54 [4.86] vs 8.54 [3.98] ng/mL, P = .001] and FGF-2 levels were lower (median [IQR]; 76.84 [98.2] vs 101.62 [210.6] pg/mL) compared to healthy control group. A significant correlation was found between KL-6 values and CRP, fibrinogen, d-dimer and lymphocyte counts. However, we did not find an association between these markers and subsequent severity of COVID-19, mortality and long-term prognosis. Conclusions: Serum KL-6 levels were significantly elevated at the diagnosis of COVID-19 and correlated well with the other traditional prognostic inflammatory markers. Serum levels of principal fibrosis mediators, TGF-ß1, FGF-2, were not elevated at diagnosis of COVID-19, therefore did not help to anticipate long term prognosis.

2.
Mod Rheumatol ; 2022 Jul 21.
Article in English | MEDLINE | ID: covidwho-1948387

ABSTRACT

OBJECTIVE: Aim of the study is to evaluate the impact of Familial Mediterranean Fever (FMF) features on clinical course and outcomes of Coronavirus disease-19 (COVID-19) and clinical course of FMF after COVID-19. METHODS: Consecutive FMF patients with COVID-19 were enrolled from three referral hospitals. Clinical features of FMF and detailed COVID-19 information were obtained from patient interviews and medical records. RESULTS: Seventy-three FMF patients were included in the study. Sixty-nine patients had clinical symptoms of COVID-19, and 90.4% of patients received COVID-19 specific treatment. We found 24.7% hospitalization, %12.3 respiratory support, 4.1% ICU admission, 6.8% complication, and 1.4 % mortality rate in patients. Male gender and older age were significantly frequent in inpatients compared to outpatients (male gender 77.8 % vs 25.8%, p<0.001; median age 39.5 vs 32 years, p:0.043). FMF features were similar in both groups. The risk factors of hospitalization for respiratory support were male gender (OR: 7.167 (95% CI:1.368-37.535)), greater age (OR:1.067 (95% CI:1.016-1.121)) and non-adherence to colchicine treatment before the infection (OR:7.5 (95% CI: 1.348-41.722)). One-third of patients (33.3%) had reported attacks after COVID-19. The patterns of triggered attacks were fever, peritonitis, pleuritis, transient arthritis, chronic knee mono-arthritis, and protracted febrile myalgia. CONCLUSION: FMF characteristics were not associated with worse outcomes of COVID-19. Colchicine non-adherence was the risk factor of hospitalization for oxygen support. The rate of FMF attacks after COVID-19 is prominently increased with some of them be protracted and destructive.

3.
Curr Med Imaging ; 18(6): 658-665, 2022.
Article in English | MEDLINE | ID: covidwho-1862445

ABSTRACT

AIM: This study aimed to investigate whether initial chest Computed Tomography (CT) findings of COVID-19 patients could predict clinical outcomes, prognoses, and mortality rates associated with the infection. BACKGROUND: Published studies on chest CT in COVID-19 infection do not go beyond describing the characteristics of the current period. Comparative analysis of chest CT findings upon hospital admission among patients with different clinical outcomes is scarce. OBJECTIVE: We sought to retrospectively evaluate and compare clinical outcomes, prognoses, and mortality rates based upon the initial chest CT findings of 198 consecutive symptomatic patients with COVID-19 confirmed by Polymerase Chain Reaction (PCR). METHODS: Patients (N = 198) were divided into three groups according to their clinical outcomes as follows: group 1 (n = 62) included patients discharged from the service, group 2 (n= 60) included patients hospitalized in the intensive care unit, and group 3 (n = 76) included patients who died despite treatment. RESULTS: Predictors of poor prognosis and mortality with regard to chest CT findings included mediastinal lymphadenopathy, pleural effusion, and pericardial effusion, and clinical characteristics of age, dyspnea, and hypertension. The halo sign on chest CT was a good prognosis predictor in multivariate analysis. CONCLUSION: Some CT findings, such as discharge, intensive care unit hospitalization, and death as the worst consequence, significantly correlated with endpoints. These findings support the role of CT imaging for potentially predicting clinical outcomes of patients with COVID-19.


Subject(s)
COVID-19 , COVID-19/diagnostic imaging , Hospitalization , Humans , Prognosis , Retrospective Studies , SARS-CoV-2 , Tomography, X-Ray Computed/methods
4.
Turkish Journal of Intensive Care ; 20:49-50, 2022.
Article in Turkish | Academic Search Complete | ID: covidwho-1755963

ABSTRACT

Amaç: Yoğun bakım ünitesine (YBÜ) yatış gerektiren COVID-19 hastalarında gelişen spontan pnömotoraks (SPX) ve spontan pnömomediastinum (SPM) olgularını vurgulamak ve olası predispozan risk faktörlerini araştırmaktır. Gereç ve Yöntem: 20 Mart-17Aralık 2020 tarihleri arasında YBÜ’ye kabul edilen COVID-19 hastalarının verileri hastane kayıtlarından retrospektif olarak tarandı. Çalışmaya tanısı laboratuvar olarak doğrulanmış ve SPX, SPM gelişen COVID-19 hastaları dahil edildi. Hastaların demografik verileri, radyolojik görüntülemeleri, laboratuvar incelemeleri, klinik yönetimleri, kültür sonuçları ve mortalite oranları araştırıldı Bulgular: Çalışmaya dahil edilen 305 hastanın 30’un da SPX ve SPM tespit edildi. Olguların medyan yaşı 70 (IQR, 62-78) olarak bulundu. Erkek hasta sayısı 20 (%66,7, medyan yaş, 66,7) ve kadın hasta sayısı 10 (%33,3) olarak tespit edildi. Hastalarda en çok görülen komorbiditeler ise sırasıyla hipertansiyon 16 (%53,3), diabetes mellitus 10 (%33,3) ve kronik obstrüktif akciğer hastalığı 5’dir (%16). Olguların COVID-19 açısından BT değerlendirmeleri, tipik 25 (%83,3), atipik 3 (%10) ve belirsiz 1 (%3,3) olarak değerlendirilmiştir. Trakeal aspirat kültürlerinde ise, Acinetobacter baumannii 10 (%43,3), Klebsiella pneumoniae 5 (%16,7) ve Pseudomanas auroginosa 2 (%6,7) üremesi olmuştur. Hastaların 25’inde (%83,3) septik şok tespit edilmiştir. Vasopressör ihtiyacı 25 (%83,3) hastada gelişmiştir. Hastalardan 26’sının (%86,7) entübe edilip invaziv mekanik ventilasyonla takip edildiği, entübasyon öncesi 12’sine (%40) yüksek akımlı nasal kanülle ve 22’sine de (%20) non-invaziv mekanik ventilasyonla tedavi uygulandığı tespit edildi. Ortalama YBÜ yatış süresi 12±7 ve ortalama hastanede yatış süresi ise 16±12 gün olarak bulunmuştur. Takip edilen hastaların 28 günlük mortalitesi %86,7 olarak tespit edilmiştir. Sonuç: COVID-19 hastalarında yüksek barotravma oranları, invaziv ve non-invaziv mekanik SPX ve SPM için risk faktörüdür. Her iki klinik durum da mortalite için bir risk faktörüdür. Barotravma risk faktörlerinin iyi bilinmesi ve akciğer koruyucu ventilasyon paremetrelerinin geliştirilmesi bu klinik durumu yönetmeyi kolaylaştırabilir. SPX ve SPM, için klinisyenlerin farkındalığını artıracak, tahmin ettirici risk faktörlerini ve laboratuvar verilerini öngören daha ileri çalışmalara ihtiyaç vardır. (Turkish) [ FROM AUTHOR] Copyright of Turkish Journal of Intensive Care is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

5.
Turkish Journal of Intensive Care ; 20:29-30, 2022.
Article in Turkish | Academic Search Complete | ID: covidwho-1755962

ABSTRACT

Amaç: Yoğun Bakım Ünitesi’nde COVID-19’a bağlı akut respiratuvar distress sendromu tanısı ile spontan solunumda takip edilen hastaların, supin ve prone pozisyonunda yüksek akımlı nasal kanülle (HFNC) tedavisinin, AC ventilasyonu ve homojenitesinde ki etkilerini elektrik impedans tomografi (EIT) aracılığı ile değerlendirmek amaçlanmıştır. EIT, akciğerlerin durumunu dinamik olarak görselleştirilmesini ve tedavinin etkisinin eş-zamanlı olarak değerlendirilmesini sağlayan non-invaziv, radyasyonsuz ve yatak başı bir yöntemdir. COVID-19 pandemisi sırasında bulaş riski nedeniyle klasik yöntemlere göre tercih sebebi olmuştur. Gereç ve Yöntem: Tanısı laboratuvar, klinik ve radyolojik olarak doğrulanan COVID-19 hastalarının demografik verileri, hemodinamik ve solunum paremetreleri, pozisyon bilgileri, HFNC’de uygulanan akım değerleri ve EIT görüntüleri retrospektif olarak hastane kayıtlarından elde edildi. EIT ölçümleri kiniğimizde rutin bakımın bir parçası olan Pulmovista 500 cihazı (Dräger Medical, Lübeck, Almanya) yapıldı. EIT ile elde edilen verilerde, AC bölgeleri 4 ilgi alanına (ROI) bölünmüştür. Supin pozisyonda zamanlar HFNC 30L/dk (T1), HFNC 50L/dk (T2) olarak kayıt edilirken, prone pozisyonundaki zamanlar HFNC 30L/dk (T3), HFNC 50L/dk (T4) olarak kayıt edildi. ROI oranı (ROI ratio) ise, ventral AC alanları (ROI 1 ve 2) ortalama değerlerinin toplamının ile dorsal AC alanlarının (ROI 3 ve 4) ortalama değerlerinin toplamının oranı olarak AC ventilasyonunun homojenliğinin bir oransal değeridir. ROI rationun 1’e yakın olması ventilasyonun homojen dağıldığının bir göstergesi olarak kabul edildi. Bulgular: Çalışmaya dahil edilme kriterlerini karşılayan 10 hasta, 7 erkek ve 3 kadın hastadan oluşuyordu. Hastaların tanımlayıcı bilgileri ve klinik özellikleri Tablo 1’de özetlenmiştir. Çalışmamızda 4 ROI bölgesinde iki farklı HFNC akım ve iki farklı pozisyonda ki değerleri istatiksel olarak anlamlı bulunmuştur (Tablo 2). Sonuç: Çalışmamızda ROI ratio değerinin, prone pozisyonunda 1 değerine daha çok yaklaşması, ventilasyonun homojenitesinin prone pozisyonunda arttığını göstermiştir. Akciğerin HFNC’deki akım hızlarıyla ne oranda değiştiği, atelektazi ve overdistansiyon bölgeleri yatak-başı tanımlanabileceği kanıtlabileceği gösterilmiştir. (Turkish) [ FROM AUTHOR] Copyright of Turkish Journal of Intensive Care is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

6.
Turk J Med Sci ; 51(SI-1): 3328-3339, 2021 12 17.
Article in English | MEDLINE | ID: covidwho-1726147

ABSTRACT

Background/aim: Available information on the radiological findings of the 2019 novel coronavirus disease (COVID-19) is constantly updated. Ground glass opacities (GGOs) and consolidation with bilateral and peripheral distribution have been reported as the most common CT findings, but less typical features can also be identified. According to the reported studies, SARS-CoV-2 infection is not limited to the respiratory system, and it can also affect other organs. Renal dysfunction, gastrointestinal complications, liver dysfunction, cardiac manifestations, and neurological abnormalities are among the reported extrapulmonary features. This review aims to provide updated information for radiologists and all clinicians to better understand the radiological manifestations of COVID-19. Materials and methods: Radiological findings observed in SARS-CoV-2 virus infections were explored in detail in PubMed and Google Scholar databases. Results: The typical pulmonary manifestations of COVID-19 pneumonia were determined as GGOs and accompanying consolidations that primarily involve the periphery of the bilateral lower lobes. The most common extrapulmonary findings were increased resistance to flow in the kidneys, thickening of vascular walls, fatty liver, pancreas, and heart inflammation findings. However, these findings were not specific and significantly overlapped those caused by other viral diseases, and therefore alternative diagnoses should be considered in patients with negative diagnostic tests. Conclusion: Radiological imaging plays a supportive role in the care of patients with COVID-19. Both clinicians and radiologists need to know associated pulmonary and extrapulmonary findings and imaging features to help diagnose and manage the possible complications of the disease at an early stage. They should also be familiar with CT findings in patients with COVID-19 since the disease can be incidentally detected during imaging performed with other indications.


Subject(s)
COVID-19/diagnostic imaging , Tomography, X-Ray Computed/methods , Humans , SARS-CoV-2
7.
Bartin &Uuml ; niversitesi Egitim Fakültesi Dergisi; 10(3):526-540, 2021.
Article in English | ProQuest Central | ID: covidwho-1471192

ABSTRACT

Bu araştırmanın amacı özel eǧitim öǧretmenlerinin pandemi sürecindeki uzaktan eǧitimle ilgili deneyimleri ve ihtiyaçlarının belirlenmesidir. Çalışmada betimsel araştırma yöntemlerinden tarama modeli ve elverişli örnekleme tekniǧi kullanılmıştır. Katılımcılar, 2019-2020 eǧitim ve öǧretim yılında görev yapan, Ízmir ilinden 191 özel eǧitim öǧretmenidir. Veri toplama aracı olarak araştırmacılar tarafından geliştirilen Özel Eǧitim Öǧretmeni Íhtiyaç Analizi Formu kullanılmıştır. Verilerin analizinde Orange ve SPSS programları kullanılmıştır. Bulgular yüzde ve frekans şeklinde tablolaştırılarak sunulmuştur. Çalışmanın sonuçlarına göre öǧretmenlerin hemen hepsi teknoloji okuryazarı olduklarını belirtmişlerdir. Öǧretmenlerin neredeyse hiçbiri uzaktan eǧitim konusunda eǧitim almamıştır. Öǧretmenlerin çoǧu ödevler, BEP (bireyselleştirilmiş eǧitim planı), bilgisayar/web destekli materyaller, eǧitsel mobil uygulamalar, basılı materyaller, eǧitsel video uygulamalarından en az birini geliştirmiştir. Öǧretmenlerin sadece dörtte biri canlı ders yapmıştır. Öǧretmenlerin çevrimiçi eǧitimde çoǧunlukla kısmen dönüt verebildiǧi ve kısmen etkileşim saǧlayabildiǧi, kısmen bireyselleştirme saǧladıǧı, meslektaşlarıyla kısmen işbirliǧi yaptıǧı görülmüştür. Öǧretmenler bu ortamda kendilerine destek olacak e-mentor olsa hazır hissedeceklerini belirtmişlerdir. Ayrıca en fazla karşılaşılan güçlük öǧrencilerin teknoloji kullanımıdır. Bulgular, öǧretmenlerin öǧrencilerin bireysel ihtiyaçlarını dikkate alarak öǧretim yapması, sık geri bildirim vermesi, aile ile iletişimi güçlü tutması ve uzaktan eǧitim konusunda öǧretmenlerin hizmet içi eǧitim alması gerektiǧini göstermektedir.Alternate abstract:This study was conducted to determine the experiences and needs of special education teachers regarding distance education during the COVID-19 pandemic. Screening model and convenient sampling technique were used. Participants were 191 active special education teachers from Ízmir, Turkey in the academic year of 2019-2020. Special Education Teacher Needs Analysis Form developed by the researchers was used as data collection tool. Orange and SPSS programs were used for analyzing. Results indicate that most of the teachers stated they are technology literate and few had been trained in distance education. Most of them have developed at least one of the homework, IEP (individualized education plan), computer/web supported materials, educational mobile applications, materials, educational video applications. Only a quarter of teachers taught live lessons. They mostly provide feedback and interact partially, individualize lessons partially, cooperate with their colleagues partially in distance education. They stated that if there was an e-mentor to support them in this environment, they would feel ready. Moreover, the most encountered difficulty is their students' use of technology. These findings indicate that teachers should customize for individual students' needs, provide frequent feedback, keep the teacher family communication strong and receive in-service training on distance education.

9.
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
10.
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
11.
Clin Imaging ; 77: 37-42, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1056485

ABSTRACT

PURPOSE: To investigate chest computed tomography (CT) findings in asymptomatic patients tested positive for coronavirus disease (COVID-19) by reverse transcription-polymerase chain reaction (RT-PCR). MATERIAL AND METHODS: The chest CT images of 64 patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who were RT-PCR test-positive but asymptomatic were retrospectively evaluated for the appearance and distribution of abnormal parenchymal findings. RESULTS: Of the 64 patients (mean age 59.4 ± 12; range 23-85), 42 (65%) were female, and 22 (35%) were male, and 16 (25%) of the patients had no abnormal findings on chest CT. Of the remaining 48 patients, lung involvement was bilateral in 32 (67%). Right upper lobe in 26 (54%), right middle lobe in 20 (42%), right lower lobe in 38 (79%), left upper lobe in 27 (56%), and left lower lobe were affected in 34 (71%) patients. The mean number of opacities detected in patients was 7.5 ± 5.7. The opacities were located only peripherally/subpleural in 22 (46%), only centrally/peribronchovascular in 5 (10%), and mixed in 21 (44%) patients. The frequency of pure ground glass opacities (GGO) was 63% GGO with a crazy-paving pattern or consolidation was 33%. Pure consolidation was detected in only two (4%) patients. Parenchymal opacities were only round in 27 (56%), only geographic demarcated in 3 (6%), only patchy in 2 (4%), and mixed in 16 (33%) patients. CONCLUSION: Chest CT was normal in only one-quarter of the asymptomatic patients. CT findings in asymptomatic COVID-19 patients were often peripherally located, mostly round-shaped GGO.


Subject(s)
COVID-19 , SARS-CoV-2 , Aged , Female , Humans , Lung/diagnostic imaging , Male , Middle Aged , Retrospective Studies , Reverse Transcriptase Polymerase Chain Reaction , Tomography, X-Ray Computed
12.
Scand J Clin Lab Invest ; 81(2): 160-165, 2021 04.
Article in English | MEDLINE | ID: covidwho-1039680

ABSTRACT

Angiotensin-converting enzyme (ACE)/Angiotensin (Ang) II pathway has crucial regulatory effects on circulatory hemostasis and immune responses. This pathway has a major role in the development of acute lung injury and acute respiratory distress syndrome (ARDS), which is a devastating complication of SARS-CoV-2 infection. The aim of this study is to investigate the serum ACE activity and its correlation with clinical features and the disease severity in patients with COVID-19. Patients with confirmed COVID-19 by detecting SARS-CoV-2 nucleic acid RT-PCR were included in the study. Demographic data, clinical features, laboratory and radiologic investigations were recorded. Patients were classified by disease severity; asymptomatic, mild, and severe pneumonia. The serum ACE activity was evaluated with an autoanalyzer based on a spectrophotometric method. Fifty-five patients (50.9% female) and 18 healthy subjects (33.3 % female) were enrolled in the study. The median age of patients was 40 years, ranging from 22 to 81 years. Eighteen healthy subjects were served as the control group. The baseline characteristics were comparable between groups. The median serum ACE activity of patients and controls (38.00 [IQR 21] U/L and 32.00 [IQR 24] U/L, respectively) and of between patients grouped by disease severity (38.5 [IQR 19], 36 [IQR 25], and 38 [IQR 22] U/L, asymptomatic, mild and severe pneumonia group, respectively) were similar. There was no correlation between the serum ACE activity and conventional inflammatory markers. In this study, we did not find an association between serum ACE activity and COVID-19 and serum ACE activity on admission did not reflect disease severity.


Subject(s)
COVID-19/enzymology , COVID-19/physiopathology , Peptidyl-Dipeptidase A/blood , SARS-CoV-2 , Severity of Illness Index , Adult , Aged , Aged, 80 and over , Angiotensin II/metabolism , Biomarkers/blood , Comorbidity , Female , Humans , Inflammation/blood , Male , Middle Aged
13.
Cytokine ; 137: 155302, 2021 01.
Article in English | MEDLINE | ID: covidwho-1023524

ABSTRACT

BACKGROUND: The effectual immune response is crucial to defeat viral infections. However, exuberant immune response with features of macrophage activation syndrome (MAS) lead detrimental consequences in COVID-19 patients. Interleukin (IL)-18 is one of the leading cytokines in MAS which has not been studied in COVID-19. OBJECTIVE: To investigate the association of IL-18 with the other inflammatory markers and disease severity in COVID-19 for predicting disease prognosis. METHODS: Patients with COVID-19 who had confirmed diagnosis with SARS-CoV-2 nucleic acid RT-PCR were enrolled into the study. Data on demographic and clinical characteristics, and laboratory values of CRP, ferritin, d-dimer and procalcitonin were measured on admission. Patients were followed up prospectively with a standardized approach until hospital discharge or death. Individuals were classified as asymptomatic, mild and severe pneumonia according to their clinical, laboratory and radiological characteristics. Worse outcome was defined as requirement of intensive care unit (ICU) admission or death. Blood samples were collected at enrollment and serum levels of IL-6 and IL-18 were determined by ELISA. Association between IL-18 and other inflammatory markers and prognosis were analyzed. RESULTS: There were 58 COVID-19 patients (50% male) with a median age of 43 (min 22-max 81) years. Twenty age and sex matched healthy subjects were served as control group. The study population was divided into three groups according to disease severity: asymptomatic (n = 20), mild pneumonia group (n = 27) and a severe group (n = 11). During follow up nine (15.5%) patients required ICU admission and three of them were died eventually. Serum IL-18 were correlated with other inflammatory markers and biochemical markers of organ injury; creatinine, liver enzymes and troponin. Serum IL-18 levels were remarkably higher in COVID-19 patients compared to healthy subjects with being highest in severe pneumonia group (p < 0.001). IL-18 serum concentrations were almost four-fold higher in patients with worse outcome compared to good outcome (p < 0.001). Serum IL-18 above the cut off value of 576 pg/mL on admission was associated with 11.7 fold increased risk of ICU admission. CONCLUSIONS: The serum concentrations of IL-18 correlate with other inflammatory markers and reflect disease severity. Results of the present study shed light on role of IL-18 on COVID-19 pathogenesis and might provide an evidence for the clinical trials on IL-18 antagonists for the treatment of severe COVID-19 patients.


Subject(s)
COVID-19/blood , COVID-19/diagnosis , Interleukin-18/blood , Adult , Aged , Aged, 80 and over , Biomarkers/blood , COVID-19/mortality , COVID-19/physiopathology , Female , Humans , Inflammation/blood , Interleukin-6/blood , Male , Middle Aged , Prognosis , Severity of Illness Index
14.
Turk J Med Sci ; 51(3)2021 06 28.
Article in English | MEDLINE | ID: covidwho-972465

ABSTRACT

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) outbreak poses a major global threat to the public health worldwide. The infectious disease caused by the virus that affected the entire world was named as the Coronavirus disease-2019 (COVID-19). The knowledge regarding the wide clinico-biological aspects of the COVID-19 continues to evolve very rapidly, given the growing data from all over the world. During this complicated process, healthcare professionals have benefited from each other's experiences in combatting against the COVID-19 syndrome. COVID-19 related studies have been performed by a wide variety of research groups in Turkey as well as the rest of the world. The aim of this paper is to outline Turkish COVID-19 research indexed in the LitCovid system. LitCovid is a curated literature hub for tracking up-to-date scientific data about the SARS-CoV-2. COVID-19's first case was detected in Turkey, on March 11th, 2020. Six months after the first case was observed, the total number of COVID-19 patients was reported to be as 286,455, and the total number of deaths due to SARS-CoV-2 was 6895. The genetic sequence of the novel coronavirus showed significant identity to SARS-CoV and MERS-CoV. Numerous drugs including lopinavir/ritonavir, favipiravir, neuraminidase inhibitors, remdesivir, umifenovir, azithromycin, and chloroquine have been suggested for the management of COVID-19 although the exact treatment is yet to be determined.


Subject(s)
Biomedical Research , COVID-19/epidemiology , Pandemics , Periodicals as Topic , Humans , SARS-CoV-2 , Turkey
15.
Gazi Med. J. ; 2(31):266-270, 2020.
Article in English | ELSEVIER | ID: covidwho-682154

ABSTRACT

The novel coronaviruses disease, namely COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread worldwide and resulted in a crucial global health problem. Various studies and meta-analyses have demonstrated that chronic disease, including diabetes mellitus, hypertension, cardiovascular diseases, and chronic obstructive pulmonary disease, are considered as risk factors for the disease severity, poor prognosis, and mortality in COVID-19. Although the exact reasons for the association between these comorbidities and disease severity and mortality risk of COVID-19 have not clarified, immune dysregulation and hyperinflammation in these chronic diseases might be contributing factors to the progression of the COVID-19. Furthermore, most of the patients with chronic inflammatory rheumatologic disease have the impairment of immune system and inflammatory response due to underlying pathogenesis of their diseases, and thus they might be prone to SARS-CoV-2 infection. We have focused the attention on most common chronic diseases frequently observed in COVID-19 and rheumatologic diseases which may be related to infection and their association with course of COVID-19.

16.
Turk J Med Sci ; 50(4): 684-686, 2020 06 23.
Article in English | MEDLINE | ID: covidwho-679242

ABSTRACT

COVID-19 infection, a highly contagious disease caused by the SARS-CoV virus, and the World Health Organization declared this increasingly spreading disease as a global public health emergency (pandemic). In the diagnosis of COVID-19, the polymerase chain reaction (RT-PCR) is considered as the reference standard test. In the early stages, thorax CT findings could be present even before the onset of symptoms, thorax CT has quite high sensitivity in COVID-19 patients with false negative RT-PCR results, and it has a great importance not only in diagnosis but also in follow up. We think that it might be beneficial for our radiologist colleagues in the early diagnosis of the imaging features of this disease, by sharing the experiences we have gained by evaluating the typical and relatively atypical CT findings regarding the natural course of the tomographic findings of COVID-19 and when to control CT.


Subject(s)
COVID-19/diagnostic imaging , Lung/diagnostic imaging , Lymphadenopathy/diagnostic imaging , Pericardial Effusion/diagnostic imaging , Pleural Effusion/diagnostic imaging , Thorax/diagnostic imaging , COVID-19/diagnosis , COVID-19 Nucleic Acid Testing , Disease Progression , Early Diagnosis , Humans , Prognosis , SARS-CoV-2 , Sensitivity and Specificity , Tomography, X-Ray Computed
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