The Relationship Between Functional Status and Fatigue After COVID-19 Infection

Introduction: After COVID-19 infection, symptoms last for weeks or months. In this study, it was aimed to examine the relationship between functional status and fatigue and the associated factors in patients with COVID-19. Method(s): Patients with COVID-19 infection who applied to 13 centers were included into the study according to the inclusion criteria. Age, gender, height, body weight, body mass index (BMI), marital status, smoking status and amount, presence, duration of chronic disease, Charlson comorbidity index, regular exercise habit, time of diagnosis with COVID-19, presence of hospitalization,length of hospital stay, intubation status, home oxygen therapy need, participation in PR program, presence of dyspnea, cough, sputum, mMRC score, post-COVID functional status scale, fatigue severity scale, EQ-5D-5L Questionnaire scores were recorded. Result(s): Of the 1095 patients, 603 (55%) were male and 492 (45%) were female. Their mean age was 50+/-14 years. The most common chronic lung disease was COPD (11%), while 266 patients (29%) had non-pulmonary systemic disease. The median time of COVID-19 diagonosis was 5 months ago with 47% hospitalization rate. The median value of post-COVID functional status scale was 1 (0:4), and fatigue severity scale score was 4.4 (1:7). There was a significant correlation between post-COVID functional status and fatigue severity scale (r=0.43, p <0.01). Conclusion(s): Functional status and fatigue were found to be related primarily to quality of life and then patients' age, BMI, presence of chronic and systemic lung disease, regular exercise habits before COVID-19, hospitalization and its duration, home oxygen therapy and symptoms.

Gastrointestinal Symptoms in Patients with COVID-19: A Single-Center Experience

Objective: Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus, the first cases of which were reported in Wuhan, China in December 2019. The disease often presents with major respiratory symptoms. In addition, gastrointestinal (GI) symptoms are observed. They may be the first or even the only symptoms of the disease. The aim of this study is to demonstrate the presentation of GI symptoms and their relationship to other symptoms, the clinical course and prognosis of patients with COVID-19. Methods: Included in this study were patients over 18 years of age who had been hospitalised for treatment in clinics and intensive care units due to COVID-19 between March and June 2020. The symptoms reported by the patients at the time of admission and the data collected as a result of the clinical follow-up were evaluated. Results: Out of the 1,045 patients with COVID-19, 140 patients (13.4%) had GI symptoms. The complaints of these 140 patients were nausea (53.6%), vomiting (32.1%), abdominal pain (11.4%), diarrhea (45.7%), anorexia (43.6%) and loss of taste (5.6%). In 3.2% of the patients, only GI symptoms were present, without any respiratory symptoms. Conclusion: Gastrointestinal symptoms were present at the time of admission in 13.4% of the patients with COVID-19. The most common GI symptom in the patients was nausea. Length of stay in hospital and mortality rate were higher in patients with only GI symptoms. Therefore, GI symptoms should be considered in patients with suspected COVID-19.

Effects of high dose vitamin C administration in COVID-19 patients

Aim: There is currently no pharmacotherapy with for the treatment of COVID-19. We aimed to investigate the effects of early and high-dose vitamin C (VC) therapy in hospitalized patients with COVID-19. Materials and Methods: We included patients (n=139) who received high-dose VC supplement to the standard treatment protocol into group 1 (n=58), and only those who received a standard treatment protocol into group 2 (n=81). The patients' requirement for supplemental oxygen therapy, requirement for intensive care treatment and survival rates was investigated retrospectively. Furthermore, the changes in white blood cell, C-reactive protein (CRP), procalcitonin, D-Dimer, renal function tests, ferritin, and interleukin 6 values during hospitalization were evaluated.

A Tertiary Care Hospital Experience During the COVID-19 Pandemic

Introduction: Early detection of the severity of COVID-19 disease is important for patient prognosis and effective use of hospital capac- ity. Early detection of critical patients and providing supportive treatment is the main goal of disease management. In this study, we evaluated demographic, clinical, laboratory and radiological findings in COVID-19 patients and aimed to find risk factors associated with poor prognosis. Materials and Methods: A total of 579 cases hospitalized with the diagnosis of COVID-19 were evaluated retrospectively. The diagnosis of COVID-19 was confirmed by polymerase chain reaction (PCR) positivity or typical clinical, laboratory and radiological findings. The study population was divided into groups according to the World Health Organization (WHO) COVID-19 disease severity classification. Significant risk factors associated with severe disease and mortality were investigated by comparing the demographic, clinical, labora- tory and radiological data of these groups. Results: Mean age of the 579 cases was 54 +/- 18.25, and 321 of them (55.4%) were male. Severe disease was detected in 131 (22.6%) patients and mortality rate was %8.29. The most common comorbidities were hypertension (31.8%), diabetes mellitus (18.5%) and coronary artery disease (17.8%), respectively. The most common symptoms at the time of admission to the hospital were cough (40.7%), fever (38 degrees C;33.6%) and shortness of breath (26.3%). Age, coronary artery disease and shortness of breath, neutrophil count, urea, CRP, ferritin, Pro-BNP, fibronogen, IL-6 values were found to be predictive variables for severe disease. Age, presence of shortness of breath, urea, ferritin and Pro-BNP values were found to be independent predictive variables for severe disease, and the cut-off points were calculated for these variables (age 59.5, urea 33.5 mg/dL, ferritin 50.8 mu g/L and Pro-BNP 881 pg/mL). Conclusion: Some predictive factors were demonstrated to detect severe disease in COVID-19 patients. It is important to predict poor prognosis based on these factors. It provides early detection of critical patients and it will be a guide for reducing mortality rates in these patients with effective treatment.

How did covid-19 pandemic affect the older patients? Comparison of clinical features in older versus younger patients

Íntroduction: COVID-19 infection may be atypically presented in the older adults with a poor prognosis. In this study, we aimed to investigate the clinical and laboratory differences of COVID-19 course in older patients. Materials and Method: The demographic, clinical, laboratory and radiological data of the patients hospitalized with COVID-19 infection were compiled retrospectively. A randomized control group was created from younger patients. Chest tomography of the patients were examined and scored. Results: Data of 100 older and 127 younger patients with COVID-19 infection, and 80 non-COVID older patients were evaluated retrospectively. While the mean CRP, fibrinogen, procalcitonin, urea, LDH, INR, PT, Troponin-I, CK-MB and total radiological lung score were significantly higher in older patients;the mean hemoglobin, hematocrit and d-dimer were significantly higher in younger patients. Lymphopeniawasmore common and themortality ratewas higher in the older adults. Lymphopenia, presence of comorbidity, being over the age of 75, and radiological lung involvement were identified as mortality risk factors in older patients. The cut-off values for mortality were as follows;age≥77 years, lymphocyte#≤ 700x103 cells/µL, CRP≥108.71 mg/L, d-dimer≥2.25 mg/L, fibrinogen≥383 mg/L, INR≥1.05, PT ≥12.5 seconds, aPTT≥31 seconds, Troponin-I≥19.1 pg/mL, total lung score≥6 points. COVID-19 did not increase mortality much more than other hospital-requiring clinical events in older adults (17% vs 26.25%). Conclusion: The older adults require special attention in COVID-19 pandemic. Those with comorbidities, lymphopenia, high d-dimer levels, and extensive lung involvement in the initial tomography should be followed-up closely.

A new COVID-19 prediction scoring model for in-hospital mortality: experiences from Turkey, single center retrospective cohort analysis.

OBJECTIVE: Although many studies reported prognostic factors proceeding to severity of COVID-19 patients, in none of the article a prediction scoring model has been proposed. In this article a new prediction tool is presented in combination of Turkish experience during pandemic. MATERIALS AND METHODS: Laboratory and clinical data of 397 over 798 confirmed COVID-19 patients from Gülhane Training and Research Hospital electronic medical record system were included into this retrospective cohort study between the dates of 23 March to 18 May 2020. Patient demographics, peripheral venous blood parameters, symptoms at admission, in hospital mortality data were collected. Non-survivor and survivor patients were compared to find out a prediction scoring model for mortality. RESULTS: There was 34 [8.56% (95% CI:0.06-0.11)] mortality during study period. Mean age of patients was 57.1±16.7 years. Older age, comorbid diseases, symptoms, such as fever, dyspnea, fatigue and gastrointestinal and WBC, neutrophil, lymphocyte count, C-reactive protein, neutrophil-to-lymphocyte ratio of patients in non-survivors were significantly higher. Univariate analysis demonstrated that OR for prognostic nutritional index (PNI) tertile 1 was 18.57 (95% CI: 4.39-78.65, p<0.05) compared to tertile 2. Performance statistics of prediction scoring method showed 98% positive predictive value for criteria 1. CONCLUSIONS: It is crucial to constitute prognostic clinical and laboratory parameters for faster delineation of patients who are prone to worse prognosis. Suggested prediction scoring method may guide healthcare professional to discriminate severe COVID-19 patients and provide prompt intensive therapies which is highly important due to rapid progression leading to mortality.

Normal chest ct prevalence in coronavirus disease 2019 (covid-19) patients: A report of 791 cases

Introduction: In this study, we aimed to better understand the role of chest CT as an initial workup tool among all COVID-19 patients admitted to a tertiary hospital. Materials and Methods: We retrospectively evaluated the data of patients that were suspected for COVID-19. All patients who had both noncontrast chest CT scan with RT-PCR test results included in the study. Symptomatic patients were divided into four groups according to time between the onset of symptoms and chest CT;4 days, 5-8 days, 9-13 days, and 14 days. Chest CT findings according to symptom status, duration, and RT-PCR positivity were evaluated. Results: Data for a total of 791 patients were evaluated. The mean patient age was 51.7 19.7 years. 459 (58%) patients were male, and 332 (42%) were female. 55.1% of patients had positive and 44.9% negative RT-PCR tests. Typical, indeterminate, atypical and negative chest CT findings were seen in 241 (30.5%), 131 (16.6%), 154 (19.5%), and 265 (33.5%) patients, respectively. Among 355 patients with negative RT-PCR results, 152 (42.8%) had typical or indeterminate chest CT findings. Asymptomatic patients had a 91.9% of RT-PCR positivity. Only 123 (61.5%) patients had typical or indeterminate CT findings among symptomatic and RT-PCR positive cohort. Conclusion: The greatest value of our study is in demonstrating the value of chest CT in both patients that had symptoms but had negative RT-PCR test results and insignificance of chest CT in asymptomatic but had suspected contact with COVID-19 patients.