Association of hematological indices with neurological symptoms in COVID 19 patients

Purpose: The aim of this study was to compare the neurological involvement in Coronavirus 19 (COVID-19) patients with laboratory findings with these cost-free, practical tests. Materials and Methods: Of the 170 patients diagnosed COVID-19, 103 patients could be reached by phone, and neurological symptoms were recorded as three categories. Laboratory tests of the patients and 103 controls whose real-time polymerase chain reaction (RT-PCR) test negative without any chronic disease history and drug use were obtained from the hospital software. Results: White blood cell, neutrophil, lymphocyte, eosinophil, basophil, platelet were lower, monocyte to lymphocyte ratio and platelet to lymphocyte ratio higher in patients than controls. In the group with central nervous system findings, red blood cell and hematocrit counts, in the group with peripheral nervous system findings, lymphocyte and platelet counts and with sleep disturbances and muscle pain group eosinophil counts were lower in patients than those without. Conclusion: COVID-19 patients with neurological symptoms have some hematological abnormalities. The presence of certain hematological findings may be a clue to the emergence of neurological symptoms, and early detection and correction of these hematological abnormalities may be the solution to prevent the development of neurological symptoms in COVID-19.

Type 1 Brugada Type-ECG Pattern Provoked by Fever in a Patient with COVID-19

The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) related coronavirus disease 2019 (COVID-19) has been declared as a global pandemic by the World Health Organization. Brugada Syndrome (BrS) has been shown to occur spontaneously in patients with a viral infection, and the fever is the culprit trigger in the underlying mechanism. Herein, we described a patient who presented with syncope and Brugada-type electrocardiogram (ECG) pattern and diagnosed with COVID-19 pneumonia. The patient was taken to the intensive care unit for continuous ECG recording and monitoring. Favipiravir, low molecular weight heparin, high flow oxygen therapy, and antipyretic therapy were initiated. Brugada-type ECG pattern was disappeared with a resolution of fever. ECG findings of BrS may occur during fever and may lead to life-threatening arrhythmic events in unknown subjects. This clinical condition may require a subcutaneous implantable cardioverter-defibrillator in some patients. ECG should be a part of clinical evaluation in patients with COVID-19 even though without syncope.

Corticosteroid therapy in COVID-19 disease

Corticosteroid therapy has been used for many years and is still controversial in use. In the Coronovirus disease 2019 (COVID-19) outbreak, it is very important to find reliable treatment information for clinicians and patients. Low dose corticosteroids are also used in patients with septic shock, relative adrenal insufficiency and acute respiratory distress syndrome (ARDS). There is not enough evidence for its use in COVID-19. However, low dose use is recommended in the case of ARDS and septic shock in COVID-19 patients. Caution should be exercised until further evidence emerges surrounding the use of corticosteroids in COVID-19 patients.