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Introduction and aim. We aimed to investigate whether systemic immune inflammatory index (SII) and prognostic nutritional index (PNI) were associated with short-term mortality in geriatric patients with SARS-CoV-2. Material and methods. Our study was designed retrospectively. The data of patients that presented to a single center. The primary outcome of the study was the diagnostic value of SII and PNI in predicting 28-day mortality in geriatric patients with SARS-CoV-2 pneumonia. Results. 272 geriatric patients with SARS-CoV-2 included. The median PNI was 42.5, and the median SII was 687.6 (430–1404.2). In univariant analysis, PNI and SII has a significant relationship with mortality (p<0.001 and p=0.008, Mann-Whitney U test). PNI had an area under the curve (AUC) value of 0.680, which was significantly higher than that of SII (AUC: 0.6). The odds ratio of PNI (>40.1) and SII (<1.267) for 30-day mortality were determined as 1.12, and 1. Conclusion. In conclusion, the blood tests used to calculate PNI and SII are routinely included in complete blood count and biochemistry tests that can be performed in every hospital. According to the results of the current study, the mortality group had significantly higher SII values and significantly lower. © 2022 Publishing Office of the University of Rzeszow. All Rights Reserved.
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This study aimed to evaluate COVID-19 reinfection in patients that presented to the emergency department with similar or different COVID-19 symptoms after recovery from the disease. This retrospective study included patients aged over 18 years presenting to the emergency department between January 1, 2021 and July 1, 2021, who had been previously diagnosed with COVID-19 and received treatment for the disease. Statistical analysis was performed using SPSS version 22.0.A total of 199 patients, 54.3% female, were included in the study. PCR positivity was present in 2.5% of the patients, and it was statistically significantly low(p<0.001). The most common symptom was fatigue (46.2%), and the least common symptom was loss of taste (3.0%). However, there was a statistically significant correlation between the loss of taste and smell and PCR positivity (p=0.024 and p=0.043, respectively). The logistic regression analysis revealed that the loss of taste and loss of smell alone did not have an effect on PCR positivity (p=0.848, 95% confidence interval: 0.005-71.83 and p=0.287, 95% confidence interval: 0.001-9.369). In the Covid-19 management and treatment guide, it is necessary to make changes in terms of symptoms for people who have had Covid-19 disease. Copyright © 2022 Ondokuz Mayis Universitesi. All rights reserved.
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This case report aimed to report two patients admitted to the emergency department with a preliminary diagnosis of carbon monoxide intoxication and was diagnosed with COVID-19 during their follow-up. A 73-year-old female patient presented with weakness and shortness of breath complaints to the emergency department. Carboxyhemoglobin (COhgb) reached 36.2 %. Atypical pneumonic infiltration with peripheral and central patchy consolidations in the zones in hemothorax images from computerized tomography. The patient was tested positive for COVID-19 after a PCR test. The COhgb values of the patient reached 16 % after 3 h. Then, it dropped to 3.0 % after 8 h. A 77-year-old male patient presented with shortness of breath and nausea complaints to the emergency department. COhgb (carboxyhemoglobin) reached 30%. Emphysematous changes in the lung parenchyma and increased peribronchial densities in the lobes were shown in computed tomography. The patient was tested positive for COVID-19 after a PCR test. The COhgb values of the patient reached 13 after 3 h. It dropped to 2.4 after 8 h. Carbon monoxide intoxication is a significant public health problem with a high probability of death. Detailed studies and meta-analyses are needed to affect the prognosis of COVID-19 disease.
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This study aimed to determine whether the PSI, CURB-65, CALL and BCRSS had any superiority over each other as a prognostic determinant in patients with COVID-19. This prospective cohort study included patients over 18 years of age that presented to the emergency department between May 12 and August 12, 2020 and had a positive COVID-19 polymerase chain reaction (PCR) test. The PSI, CURB-65, CALL and BCRS scores were calculated. SPSS version 22 was used for all statistical analyses. A total of 213 patients with a positive COVID-19 PCR result were included in the study. The total 30-day mortality rate was determined as 14.08%. PSI, CURB-65, CALL and BCRSS had a statistically significant relationship with mortality (p<0.001). The best parameter in predicting mortality was determined as PSI (area under the curve: 0.900;95% CI: 0.972-0.828). A positive correlation was found between each scoring system, both with the length of hospital stay (PSI, CURB-65, CALL and BCRSS: r=0.696, p=0;r=0.621, p=0;r=0.75, p=0;and r=0.666, p=0, respectively). Scoring systems, which include comorbidity, vital signs as well as laboratory, imaging findings, will be more effective than other scoring systems in determining the mortality in patients with covid-19.
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Aim: This study aimed to determine the analysis of the laboratory parameters in patients infected with SARS-CoV-2 during the early pandemic period in Turkey. Material and Methods : This retrospective descriptive study was conducted at a pandemic hospital. All hospitalized patients and outpatients with a positive RT-PCR assay for SARS-CoV-2 were included In the study. Demographics, clinical characteristics, vital parameters on admission, laboratory findings, and drugs used for SARS-CoV-2 infection were obtained from the computer-based patient data system of the hospital and analyzed. The primary outcome of the study was the laboratory parameters of patients with COVID-19. The secondary outcome was 30-day all-cause mortality following emergency department admission. Results: A total of 2,012 patients were included in study. The rates of hospitalization and 30-day mortality were 24% and 2%, respectively. The most common symptom was cough, and the most common comorbidity was hypertension. The neutrophil count, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio values were elevated in the non-survivor group compared to the survivor group (P = 0.001, P < 0.001, and P = 0.020, respectively). The lymphocyte and platelet counts were elevated in the survivor group compared to the non-survivor group (P = 0.001 and P < 0.001, respectively). As predictors of mortality, the cut-off value for the neutrophil, lymphocyte and platelet counts, and the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios were 5.68, 1.42, 195, 3.09, and 141.8, respectively, and the AUC was determined as 0.704, 0.714, 0.727, 0.745, and 0.610, respectively (P < 0.001, P < 0.001, P < 0.001, P < 0.001, and P = 0.023, respectively). Discussion: The results of the study demonstrated that the neutrophil count, lymphocyte count, platelet count, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are useful in determining prognosis in SARS-CoV-2 Infection.
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Aim: The riskiest working group in pandemics is healthcare workers. This study sought to determine the effect of the coronavirus 2019 pandemic on the mental health of healthcare workers. Material and Methods: The study, designed as a case-control, clinical observation study, was conducted on healthcare workers working in pandemic clinics during the pandemic period. One hundred fifty-three healthcare workers included. The study form included demographic data, marital status, working hours, job, Insomnia Severity Index, Patient Health Questionnaire-9 and Beck's Depression Inventory, and clinical questions. Turkish-adapted versions of all scales were applied. Results: In our clinical observation study, 26.2% of healthcare professionals working in pandemic clinics during the pandemic period were depressed (according to Beck's Depression Inventory), 39.8% had moderate and severe depression (according to the Patient Health Questionnaire-9), and 58.6% had insomnia (according to the Insomnia Severity Index). However, there was no significant difference between the subgroups of health workers in terms of depression and insomnia. Discussion: All medical and non-medical healthcare workers working in COVID 19 clinics during the pandemic have been widely adversely affected by the process.
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Aim: This study aimed to determine the analysis of the laboratory parameters in patients infected with SARS-CoV-2 during the early pandemic period in Turkey. Material and Methods: This retrospective descriptive study was conducted at a pandemic hospital. All hospitalized patients and outpatients with a positive RT-PCR assay for SARS-CoV-2 were included in the study. Demographics, clinical characteristics, vital parameters on admission, laboratory findings, and drugs used for SARS-CoV-2 infection were obtained from the computer-based patient data system of the hospital and analyzed. The primary outcome of the study was the laboratory parameters of patients with COVID-19. The secondary outcome was 30-day all-cause mortality following emergency department admis-sion. Results: A total of 2,012 patients were included in study. The rates of hospitalization and 30-day mortality were 24% and 2%, respectively. The most common symptom was cough, and the most common comorbidity was hypertension. The neutrophil count, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio values were elevated in the non-survivor group compared to the survivor group (P = 0.001, P < 0.001, and P = 0.020, respectively). The lymphocyte and platelet counts were elevated in the survivor group compared to the non-survivor group (P = 0.001 and P < 0.001, respectively). As predictors of mortality, the cut-off value for the neutrophil, lymphocyte and platelet counts, and the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios were 5.68, 1.42, 195, 3.09, and 141.8, respectively, and the AUC was determined as 0.704, 0.714, 0.727, 0.745, and 0.610, respectively (P < 0.001, P < 0.001, P < 0.001, P < 0.001, and P = 0.023, respectively). Discussion: The results of the study demonstrated that the neutrophil count, lymphocyte count, platelet count, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are useful in determining prognosis in SARS-CoV-2 infection.
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Objective: We investigated the effectiveness of the Rapid Emergency Medicine Score and the Rapid Acute Physiology Score in identifying critical patients among those presenting to the emergency department with COVID-19 symptoms. Material and methods: This prospective, observational, cohort study included patients with COVID-19 symptoms presenting to the emergency department over a two-month period. Demographics, clinical characteristics, and the data of all-cause mortality within 30 days after admission were noted, and the Rapid Emergency Medicine Score and the Rapid Acute Physiology Score were calculated by the researchers. The receiver operating characteristic curve analysis was performed to determine the discriminative ability of the scores. Results: A total of 555 patients with a mean of age of 49.4 +/- 16.8 years were included in the study. The rate of 30-day mortality was 3.9% for the whole study cohort, 7.2% for the patients with a positive rt-PCR test result for SARS-CoV-2, and 1.2% for those with a negative rt-PCR test result for SARS-CoV-2. In the group of patients with COVID-19 symptoms, according to the best Youden's index, the cut-off value for the Rapid Emergency Medicine Score was determined as 3.5 (sensitivity: 81.82%, specificity: 73.08%), and the area under curve (AUC) value was 0.840 (95% confidence interval 0.768-0.913). In the same group, according to the best Youden's index, the cut-off value for the Rapid Acute Physiology Score was 2.5 (sensitivity: 90.9%, specificity: 97.38%), and the AUC value was 0.519 (95% confidence interval 0.393-0.646). Conclusion: REMS is able to predict patients with COVID-19-like symptoms without positive rt-PCR for SARS-CoV-2 that are at a high-risk of 30-day mortality. Prospective multicenter cohort studies are needed to provide best scoring system for triage in pandemic clinics. (C) 2021 Elsevier Inc. All rights reserved.