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Introduction: Proinflammatory cytokines, produced as an immune response in severe acute respiratory syndrome-coronavirus 2 infection, activate the coagulation cascade as well. In this study, we investigated the difference in the clinical course of patients who had been already using anti-thrombotic therapy before coronavirus disease-2019 (COVID-19) for any reason compared to the group who had not. Methods: In this retrospective, multicenter study;patients who were hospitalized between March 11 and July 1, 2020 were divided into two main groups as who had been on anti-thrombotic therapy for any indication use previously at the time of admission or who had not been on anti-thrombotic therapy at the time of admission, and their selected clinical parameters were compared. Results: After analyzing the study population of 124 patients with a homogeneous distribution in terms of age and gender, the comparison of anti-thrombotic users and non-users showed no significant difference in hospitalization. There was a statistically significant decrease in mechanical ventilation apply rate, intensive care unit duration and mortality rate between the group using anti-thrombotic compared to the group not using it (p<0.05). Conclusion: It has already been shown that COVID-19 patients are more prone to thromboembolic events as it activates the coagulation cascade with the cytokine storm it creates and thus the mortality of COVID-19 infection increases significantly. Parallel to this fact the results of our study demonstrated that using anti-thrombotic therapy for any reason may affect the bad prognosis of the disease positively.
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Reactive nitrogen species (RNS) such as nitric oxide (NO) can be produced by local pulmonary cells and inflammatory cells, and they play a role in the pathogenesis of chronic pulmonary diseases and pulmonary infections. NO is an unstable compound turning to a more stable nitrite and nitrate rapidly. The objective of our study was to investigate the association between plasma nitrate+nitrite, nitrate, and nitrite levels and the severity of coronavirus disease (COVID)-19. Blood plasma samples of mild, moderate, and severe COVID-19 patients were collected from 2 different hospitals. Plasma of healthy subjects, who had never COVID-19 was used as controls (n=20 for each group). Samples were isolated by centrifugation following ultrafiltration prior to the commercial nitrate/nitrite colorimetric assay kit. Plasma nitrate+nitrite and nitrate levels, respectively, were significantly increased in severe patients (medians=34.4muM and 33.4muM), as compared to mild groups (medians=22.3muM and 20.6muM;p<0.05). In contrast, nitrite levels were significantly lower in severe patients (median= 0.8muM) than mild patients (median= 1.6muM;p<0.0001). Patients with severe disease were older (64.9 years) than the mild patients (50.6 years;p<0.05). In severe patients, age was positively correlated with nitrate+nitrite and nitrate levels, respectively (r=0.502, p=0.024;r=0.489, p=0.029). Our findings suggest that RNS may play a role in the pathogenesis of COVID-19 and that it may be considered as a marker of severity.
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Objective: To determine post-discharge mortality and associated factors of the first-wave multicenter Turkish Thoracic Society (TTD)-TURCOVID study.