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.

Evaluation of covid-19 lung involvement effect on exercise capacity in the 3rd and 6th months

Objective: Since Covid-19 was detected in December 2019, it has become evident that it causes different clinical courses. However, the long-term effect of acute severity of disease on systems is still unclear, particularly on exercise capacity. The aim of this study is to evaluate the effect of covid-19 lung involvement on the patients' exercise capacity with cardiopulmonary exercise test (CPET) in the post-covid 3rd and 6th months. Material-Methods: This is a prospective observational study. Between March 2021 and october 2021 76 patients,39 of these with covid-19 lung involvement, who are directed our exercise test laboratory enrolled to the study. All patients underwent pulmonary function and diffusion tests, 6-minute walking test and cpet. Result(s): A total of 76 patients, 31 females and 45 males, were evaluated. While Covid-19 patients with lung involvement were older than without lung involvement (49+/-14 vs 33+/-10, respectively, p=0.0001), body mass index was high in without lung involvement (26+/-4 vs 28+/-4, respectively, p=0.02). D-dimer and fibrinojen were high in lung involvement group (351+/-59 vs 134+/-21, 323+/-75 vs 230+/-43, p=0.002, p=0.0001, respectively). In third and sixth monts there was no differrence peak oygen consumption (VO2) between the groups (p=0.08). Of note, the results of the CPET revealed that lung-involvement group had low ventilatory efficiency (low breathing reserve (BR), and high physiological dead space/tidal volume ratio, VD/VT) (p=0.002, p=0.009, respectively) Conclusion(s): Our study showed that the effect of covid-19 lung involvement to restrict exercise capacity continues at 6 months.

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.

Post-discharge mortality in the first wave of COVID-19 in Turkey

Objective: To determine post-discharge mortality and associated factors of the first-wave multicenter Turkish Thoracic Society (TTD)-TURCOVID study.

Prognostic Factors of COVID-19 Infection in Older Patients

Introduction: COVID-19 can cause acute respiratory failure, metabolic acidosis, coagulopathy, septic shock, and death in older adults. The timely identification of at-risk patients will facilitate early intensive care intervention. Therefore, this study aimed to investigate the prognostic factors of COVID-19 in geriatric patients, a group shown to have higher mortality risk. Materials and Methods: A total of 61 patients over 65 years of age with presumed COVID-19 were included in the study. Patients' demographic characteristics, chest computed tomography findings at admission, biomarkers such as neutrophil/lymphocyte ratio (NLR), hemoglobin (g/dL), platelet count (109/L), alanine aminotransferase (ALT) (U/L), aspartate aminotransferase (AST) (U/L), total bilirubin (mg/dL), direct bilirubin (mg/dL), lactate dehydrogenase (LDH) (U/L), creatine kinase (CK) (U/L), blood urea nitrogen (BUN) (mg/dL), creatinine (mg/dL), albumin (mg/dL), D-dimer (ng/mL), ferritin (ng/mL), troponin (ng/mL), C-reactive protein (CRP) (mg/L), and procalcitonin (PCT) (ng/mL), complications during follow-up, and treatments received were recorded retrospectively from patient files and electronic records. Results: Mean age was 71.13 +/- 7.68 years, and 32 (52.5%) of the patients were males. During hospitalization, 18 patients (29.5%) were admitted to the intensive care unit and 10 (16.4%) died. Non-surviving patients were significantly older. Mean admitting NLR, LDH, CK, BUN, creatinine, troponin, D-dimer, CRP, and procalcitonin values were higher and mean albumin level was lower among the non-surviving patients. A Cox regression model based on variables associated with significantly prolonged hospital length of stay showed that highest NLR during follow-up was an independent risk factor for mortality and increased the risk of death by 10.67 times (95% Confidence Interval: 1.183-96.309) (p= 0.035). Conclusion: Highest NLR was found to be an independent risk factor for mortality and was associated with a 10-fold higher risk of death. Close monitoring and comprehensive treatment are required to reduce mortality in these patients.

Same virus, different course: The relationship between monocyte chemoattractant protein-1 and surfactant protein-a levels and clinical course and prognosis of COVID-19

Introduction: To date, over 165 million people have been infected in the COVID-19 pandemic caused by the novel coronavirus SARS-CoV-2 which emerged in Wuhan, China in December 2019. This study examined the relation between serum monocyte chemoattractant protein-1 and surfactant protein-A levels and the clinical course and prognosis of COVID-19. Materials and Methods: The study included a total of 108 subjects. Those in the patient group (n= 88) were diagnosed with COVID-19 using real-time PCR analysis of nasopharyngeal swab samples and treated in the Pulmonary Diseases Intensive Care Unit and the Infectious Diseases Department between March 24 and May 20. The control group (n= 20) included asymptomatic healthcare workers whose real-time PCR results during routine COVID-19 screening in our hospital were negative. Results: The COVID-19 patient group had significantly higher monocyte chemoattractant protein-1 and SP-A levels compared to the control group (p= 0.001, p= 0.001). Patients who developed macrophage activation syndrome had significantly higher monocyte chemoattractant protein-1 and surfactant protein-A levels than those who did not both at admission (p= 0.001, p= 0.001) and on day 5 of treatment (p= 0.05, p= 0.04). Similarly, monocyte chemoattractant protein-1 and surfactant protein-A levels were significantly higher in patients who developed acute respiratory distress syndrome compared to those who did not at both time points (p= 0.001 for all). Both parameters were significantly higher in non-surviving COVID-19 patients compared to survivors (p= 0.001 for both). Conclusion: Monocyte chemoattractant protein-1 and surfactant protein-A are on opposing sides of the inflammatory balance, and SP-A may be a pneumoprotein of importance in the presentation, course, prognosis, and possibly the treatment of COVID-19 in the future.