Evaluation of the relationship between TAFI level and prognosis in COVID-19 patients.

OBJECTIVE: Serum thrombin-activated fibrinolysis inhibitor (TAFI) levels were measured in coronavirus disease 2019 (COVID-19) patients requiring intensive care, clinical hospitalization, and outpatient follow-up. The relationships between serum TAFI levels and prognosis were determined. PATIENTS AND METHODS: Ninety patients who had positive COVID-19 PCR test results were randomly selected and included in the study. Subgroups were formed according to the clinical characteristics of the patients as follows: mild, moderate, and severe. Venous blood samples were taken from all patients, and serum C-reactive protein (CRP), lactate dehydrogenase (LDH), fibrinogen, D-dimer, ferritin, and TAFI levels were measured. The results were evaluated by comparing each group. RESULTS: The one-way ANOVA test to determine differences between subgroups resulted in p-values lower than 0.05 for all biochemical analytes (CRP, LDH, fibrinogen, D-dimer, ferritin, and TAFI). Regarding serum TAFI levels, there were significant differences in the severe group (853.04 ± 338.58 ng/mL) compared to the mild group (548.33 ± 264.17 ng/mL). ROC curve analysis to predict mortality revealed that TAFI levels were able to detect 85% of deaths. In addition, ROC analysis revealed that serum TAFI levels could detect 86% of intubated cases. CONCLUSIONS: The disease progression is more severe in patients with high TAFI levels, and high TAFI levels are associated with mortality and intubation rates. Further studies are needed to determine serum TAFI levels as a biomarker of prognosis in COVID-19 patients.

Interleukin-28 as a Promising Marker for Predicting Invasive Mechanical Ventilation Requirement and Mortality in COVID-19 Patients

OBJECTIVE: The study aimed to evaluate serum interleukin-28 levels in COVID-19 patients and correlate the results with disease severity. MATERIAL AND METHODS: This study included 90 patients who presented to the COVID-19 outpatient clinics, hospital wards, and intensive care units. Serum interleukin-28, C-reactive protein, lactate dehydrogenase, fibrinogen, d-dimer, and ferritin levels were mea-sured. Patients were divided into 3 groups based on clinical severity to mild, moderate, and severe groups (each group consisted of 30 patients). RESULT(S): There were significant differences in serum C-reactive protein, lactate dehydrogenase, fibrinogen, d-dimer, ferritin, and inter-leukin-28 levels between all groups. The mean serum interleukin-28 levels of all patients were 383.74 +/- 63.58 ng/L. The mean serum interleukin-28 levels were 335.52 +/- 42.12 ng/L in the mild group, 366.88 +/- 41.27 ng/L in the moderate group, and 453.46 +/- 36.78 ng/L in the severe group. CONCLUSION(S): There were significant differences in comparisons of all pairs (P < .05). Interleukin-28 may be a promising biomarker for detecting disease severity in COVID-19 patients.Copyright © 2023, AVES. All rights reserved.

Spontaneous pneumothorax in COVID-19: a single center experience.

OBJECTIVE: The effect of pulmonary complications of COVID-19, such as pneumothorax, pneumomediastinum, and subcutaneous emphysema, is still unclear. This study aimed at investigating the relationship between COVID-19 and spontaneous pneumothorax. PATIENTS AND METHODS: This study was conducted as a single-center retrospective study. Groups were assigned as study and control groups. The study group (n=120) included patients who were followed up in ICU and developed pneumothorax during their follow-up. The control group (n=120) included patients who did not develop a pneumothorax in ICU and who had been randomly selected using hospital records. Demographic findings, laboratory parameters, radiological findings, clinical management, patients' follow-up patterns, and survival status of the patients were recorded. RESULTS: There was a significant relationship between gender, outcome, last hospitalization, general condition, first follow-up, intubation, uptake tomography, uptake rate, CO-RADS, and involvement variables between groups (p<0.05). In the survival analysis performed in the control and study groups, a significant difference was obtained between the averages of the two groups (LogRank=3.944, p<0.05). Intubation and mortality rates of the patients who developed pneumothorax during the patient follow-ups were significantly higher than the control group. CONCLUSIONS: We found that patients diagnosed with COVID-19 who developed pneumothorax during intensive care follow-up had a higher hospital stay and intubation rate. The pneumothorax rate was also higher in follow-up methods such as noninvasive/HFO providing PEEP to the patients. The data in our study may help reducing mortality by shedding light on the early prevention and recognition of pneumothorax in critically ill patients diagnosed with COVID-19.

The relationship between COVID-19 and the complement system: mannose-binding lectin.

OBJECTIVE: Mannose-binding lectin (MBL) is one of the important parts of the complement system. In our study, we aimed to determine serum MBL levels and their relationship with intensive care hospitalization. PATIENTS AND METHODS: Ninety COVID-19-positive patients from outpatient clinics and clinics were included in this study. The patients were evaluated in three groups as mild, moderate, and severe groups. Each group consisted of 30 patients. A venous blood sample was taken once from each patient. Serum MBL, C-reactive protein (CRP), lactate dehydrogenase (LDH), fibrinogen, D-dimer, and ferritin levels were measured. RESULTS: The mean serum MBL levels of all patients were 695.46±324.42 ng/mL. One-way ANOVA test resulted in significant differences in serum CRP, LDH, fibrinogen, D-dimer, ferritin, and MBL levels between groups (p<0.05 for all comparisons). Post-hoc Tukey analysis showed significant differences in serum MBL levels between mild and severe groups and moderate and severe groups. CONCLUSIONS: MBL may be used as a prognostic biomarker in COVID-19 patients. Further studies are needed to determine MBL in treatment strategies.