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Background: SARS-CoV-2 infections (COVID-19) first occurred in Wuhan, China, in December 2019 and spread worldwide, causing significant mortality and morbidity. IL-17A may mediate numerous immunopathological effects secondary to cytokine release syndrome during SARS-CoV-2 infection. However, there has not been enough research on its effect on prognosis. Objective(s): This study evaluated the predictive power of serum interleukin (IL)-17A level as a prognostic marker in COVID-19. Method(s): The study included 152 patients diagnosed with COVID-19 by real-time polymerase chain reaction analysis of nasopharyn-geal swab samples in the infectious diseases department and intensive care unit of our hospital between October 1 and December 31, 2020. The control group consisted of 40 asymptomatic healthcare workers who had negative RT-PCR results during routine COVID-19 screening in our hospital. Samples were collected in anticoagulant-free tubes and left at room temperature for 30 minutes. Af-terward, it was centrifuged at 1000 x g for 15 minutes at 4degreeC per the instructions provided with the enzyme-linked immunoassay (ELISA) kit. Serum IL-17A levels were measured using the Human Interleukin 17A ELISA Kit. Result(s): Serum IL-17A levels were significantly higher in COVID-19 patients than in controls (P < 0.001). IL-17A levels increased significantly in association with disease severity in patients with the moderate, severe, and critical disease, with a less pronounced difference between severe and critical patients (moderate vs. severe, P < 0.001;severe vs. critical, P = 0.048). IL-17A levels at hospital admission and day 7 were significantly higher in non-surviving patients (P < 0.001). At a cut-off value of 210.25 ng/L, IL-17A at admission had a predictive power of 0.792 (P < 0.001). Compared to baseline, IL-17A values on day seven were significantly increased in non-survivors (P = 0.004) and decreased in survivors (P = 0.014). An increase of 26.17 ng/L or more on day 7 had a predictive mortality power of 0.634 (P = 0.005). Conclusion(s): The results of this study suggest that IL-17A, an important part of the immune system previously shown to be useful in the treatment and follow-up of COVID-19, may also help predict mortality in COVID-19 patients. Copyright © 2023 Author(s).
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Background: Chronic hepatitis B (CHB) patients who are under the treatment of antiviral agents should be monitored in routine control visits. However, during the COVID-19 pandemic, the visits were interrupted. Objectives: This study aimed to investigate whether these patients were affected regarding clinical, laboratory, and treatment out-comes. Methods: This prospective study consisted of CHB patients aged > 18 who were applied to 3 tertiary centers between 14 February and 30 March 2022. The patients were selected from the ones who regularly applied to outpatient clinics and under the treatment of antiviral agents before the pandemic. The demographic and laboratory values, including serologic, biochemistry, and molecular results, were compared between the 2 groups who came and did not come to control visits. Results: A total number of 220 patients were included. More than half (n = 142, 64.5%) were female. The median age was 44 years (19-73). A hundred and forty-two (64.5%) patients did not come to control visits during the pandemic. The most common reason was anxiety about COVID-19. The tenofovir treatment was replaced with entecavir (ETV) due to osteopenia and with alafenamide due to osteopenia and/or renal failure. The previous agents were re-started in 27 (79.5%) patients who discontinued the treatment. Conclusions: The COVID-19 pandemic negatively impacted the follow-up of CHB patients. In this regard, 15.5% of patients stopped their treatments. The patients who stopped their follow-ups and continued tenofovir disoproxil fumarate (TDF) had proteinuria and decreases in bone mineral density (BMD) and estimated glomerular filtration rate (eGFR) levels. © 2022, Author(s).
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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.
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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.