Effects of Hydroxychloroquine Plus Favipiravir Treatment on the Clinical Course and Biomarkers in Hospitalized Covid-19 Patients with Pneumonia

Background: The novel coronavirus disease 2019 (COVID-19) has a broad spectrum of clinical manifestations, the most common serious clinical manifestation of the coronavirus infection being pneumo-nia. Unfortunately, the optimal treatment approach is still uncertain. However, many studies have been conducted on the effectiveness of several medications in the treatment of COVID-19 infection. The aim of this study was to evaluate the effectiveness of the hydroxychloroquine (HCQ) + favipiravir (FAV) treatment regimen and HCQ alone by comparing the patient's clinical response and laboratory results on the fifth day of treatment in patients hospitalized due to COVID-19 infection. Patients and Methods: This retrospective cohort study was conducted in Malatya Training and Research Hospital between March 2020 and July 2020. The study included 69 patients with confirmed COVID-19 with pneumonia. The patients were divided into 2 groups, those receiving HCQ alone and those receiving the HCQ + FAV combination. Result(s): A total of 69 patients were included in the study, and the mean age was 60.09+/-15.56 years. A statistically significant decrease was observed in C-reactive protein (CRP) levels, at the end of the fifth day, in patients who received HCQ + FAV treatment (p=0.002), whereas there was no decrease in CRP levels in patients who received HCQ treatment alone. In addition, an increase in lymphocyte count and a better fever response was observed at the end of the fifth day in patients who received HCQ + FAV (p=0.008). However, there was no statistical difference between both treatment regimens in terms of hospital stay and treatment results (p=0.008, p=0.744, p=0.517). Conclusion(s): Although the combination of HCQ + FAV treatment was observed to be effective on CRP levels and fever response in patients with COVID-19 pneumonia, there was no difference in terms of hospital stay and discharge.Copyright © 2022, Dr. Mladen Stojanovic University Hospital. All rights reserved.

Can Pneumothorax Developing in COVID-19 Patients be a Mortality Marker?

Objectives: The purpose of this study is to investigate the effects of pneumothorax (PX), a rare complication of COVID-19, on mortality. Method(s): All patients admitted to our hospital with the diagnosis of COVID-19 were screened, and patients who developed PX were included in the study. Patient demographics data, number of days of hospitalization for comorbidities, day and duration of thorax tube insertion, and laboratory findings during hospitalization were recorded by scanning the hospital automation system and patient records. Result(s): For our study, 7485 patients hospitalized with the diagnosis of COVID-19 were screened in intensive care unit. PX was detected in 32 (0.296%) of the patients. About 59.4% of these patients included in the study were male. DM was the most common comorbid condition at 56.3%. In these patients, the mortality rate was found to be 90.6%. Conclusion(s): The data obtained indicate that PX, a COVID-19 complication, leads to a serious increase in mortality. We believe that using protective ventilation methods to avoid the development of pneumotarax will help to reduce mortality.© Copyright 2022 by The Cardiovascular Thoracic Anaesthesia and Intensive Care - Available online at www.gkdaybd.org.

Causes of COVID-19's Mortality and Prognostic Effect of Neutrophile-Lymphocyte Ratio

Objectives: In this study, we aimed to investigate the prognostic value of the neutrophile-lymphocyte ratio and the effects of age, gender, and comorbidities on mortality. Method(s): In our study, 100 patients who had a ground-glass opacification on computed thorax tomography and who had a positive polymerase chain reaction test were included in our study. Demographic data, laboratory data and comorbidities of the patients were recorded. Result(s): Sixty-five (65%) of the patients participating in the study were male. The mean age of the patients was 66 (21.5). The mortality rate was found to be 27% (n=27) High neutrophile-lymphocyte ratio, low lymphocyte count, high urea, and creatin levels were significant in terms of mortality. In addition, advanced age, diabetes mellitus, and hypertension are other factors that have an impact on mortality. Conclusion(s): The neutrophile-lymphocyte ratio can solely be used as a prognostic marker because it is simple and economical.©Copyright 2022 by The Cardiovascular Thoracic Anaesthesia and Intensive Care.

Predictive value of early warning scores for clinical deterioration and mortality in hospitalized COVID-19 pneumonia patients

BACKGROUND AND AIM: The most important step in inpatient management to prevent mortality in COVID-19 patients is to diagnose clinical deterioration early and quickly. Early warning score (EWS) systems evaluate vital signs to detect early deterioration in a patient's clinical status. The aim of this study was to see how accurate the EWS is at predicting the need for a transfer to the intensive care unit (ICU) and the mortality in COVID-19 pneumonia patients who are hospitalized. METHODS: A total of 471 confirmed COVID-19 pneumonia patients treated in our COVID-19 wards were included in the present study. RESULTS: ICU admission occurred in 95 (20.1%) of the cases during hospitalization, with a death rate of 11.9%. Compared with patients who were not admitted to the ICU, those who were admitted had higher National Early Warning Score (NEWS), NEWS2, Modified Early Warning Score (MEWS), and Quick Sequential Organ Failure Assessment (qSOFA) score (p<0.001). NEWS was found to be superior to NEWS2, MEWS, and qSOFA in predicting patient clinical deterioration (p<0.001). NEWS outperformed NEWS2, MEWS, and the qSOFA score in predicting overall hospital mortality (p<0.05). ICU admission was substantially associated with high NEWS (>= 7) and NEWS2 (>= 7) (p=0.001, p=0.0028). CONCLUSIONS: NEWS and NEWS2 could be used routinely in pandemic wards to detect clinical worsening in COVID-19 pneumonia patients who are hospitalized.

Clinical features and predisposing factors of delirium due to COVID-19 pneumonia in intensive care units.

OBJECTIVE: Delirium is an acute disorder in which attention, perception, memory, thought, mood, psychomotor activity and sleep-wake cycles change rapidly. Delirium is also a common clinical syndrome in patients hospitalized in intensive care units due to COVID-19 pneumonia. We reviewed clinical features and predisposing factors of delirium according to psychomotor subtype in patients hospitalized in the intensive care units due to COVID-19 pneumonia. PATIENTS AND METHODS: 64 patients who were hospitalized in the intensive care units due to COVID-19 pneumonia were included. Delirium status and psychomotor subtype were determined by applying the Confusion Assessment Method for the Intensive Care Unit scale to the patients daily. The gender, age, comorbidity, treatments, intubation, and mortality rates of the patients were recorded. Multivariate analyses were performed by examining predisposing factors, arterial blood gases, hemograms, biochemistry, and brain magnetic resonance imaging. RESULTS: There were 64 patients in delirium clinic, 65.6% (n=42) of them were male. Hypokinetic delirium was more common in 60.9% (n=39). 79.4% of the patients who received ventilator support were male (p=0.013).When mortality was analyzed in this group, hypoactive delirium was found to be significantly higher (p=0.035). In addition, leukocyte levels were higher in patients with hypokinetic delirium (p=0.029). Ferritin and fibrinogen levels were higher in patients with hyperkinetic delirium (p=0.039, p=0.008, respectively). CONCLUSIONS: The presence of additional diseases such as advanced age, male gender, hypertension, coronary artery disease, dementia, and hypoxia were factors that increased the frequency of delirium. In addition, the mortality rate was higher in patients with hypokinetic delirium.

COVID-19: risk factors, drugs used in treatment and mortality rate

Objective: The disease caused by Coronavirus 19 is a pandemic disease that emerged at the end of 2019 and has spread worldwide. Although it progresses as a classical upper respiratory tract infection in mild cases, it causes death by causing pneumonia and respiratory distress in severe cases. Although various drugs have been tried, there is still no specific drug treatment. The aim of this study is to investigate the demographic characte-ristics, risk factors, drugs used and the effects of these drugs on mortality of patients who were infected with Coronavirus 19. Materials and Methods: A total of 71 patients hospitalized in Malatya Training and Research Hospital with the diagnosis of COVID-19 due to positive test results between March 2020 and May 2020 were retrospectively re-viewed and recorded from the hospital's database and the Public Health Management System. The demog-raphic characteristics of these patients, the service they were hospitalized, the duration of hospitalization, additional diseases, survival status, and the drugs they used were recorded. statistical analyses were performed by using SPSS (IBM SPSS for Windows, ver.24) and Minitab (Statistical Software for Windows, ver.17) statisti-cal package programs.