Prognostic role of intermountain risk score (IMRS) in intensive care unit patients with a diagnosis of COVID-19.

OBJECTIVE: In this study, we aimed to assess the predictive value of Intermountain Risk Score (IMRS) in intensive care unit (ICU) patients with COVID-19. PATIENTS AND METHODS: Our retrospective study included the data of 194 patients who were admitted to the COVID-19 ICU of a tertiary care center. COVID-19 diagnoses were made by a positive result from a real-time reverse-transcriptase (RT) polymerase chain reaction (PCR) assay of nasal and pharyngeal swab specimens. Patients who had negative RT-PCR results or who were not admitted to ICU and patients under 18 years old were excluded from the study. Complete blood count, biochemistry panel, and blood gas analysis results were gathered and compiled. RESULTS: 194 ICU patients with COVID-19 (PCR positive) were included in the study. The patients were divided into two groups according to IMRS (if IMRS was <15 in women and <17 in men, patients were included in the non-high-risk group, while patients with IMRS ≥15 in women and ≥17 in men were defined as a high-risk group). Multivariate regression analysis was performed to predict in-hospital mortality. The IMRS [OR: 1.17 (1.08-1.27) p<0.001)] was found to predict in-hospital mortality. CONCLUSIONS: In this study, we showed that the IMRS score at admission can predict in-hospital mortality in intensive care unit patients with a diagnosis of COVID-19.

Frontal QRS-T angle in patients with the suspicion of Coronavirus disease 2019 (COVID-19): could it be used as a predictive gravity sign even before the diagnosis by PCR?

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has been an ongoing global public health concern, causing serious challenges in diagnosing the disease timely. We investigated the value of the frontal QRS-T (fQRS-T) angle in patients visiting the emergency department with the suspicion of COVID-19. PATIENTS AND METHODS: A hundred and thirty-seven patients with the complaint of dyspnea were evaluated retrospectively. The patients with a history of coronary artery disease, heart failure, pulmonary disease, hypertension, diabetes mellitus, or using any medication such as heart rate controllers or antiarrhythmic drugs were excluded from the study. The angle between frontal QRS- and T-wave axis was defined as the fQRS-T angle, and the patients were divided into two groups based on the fQRS-T angle (group 1, <90° and group 2, ≥90°). Demographic, clinical, electrocardiographic data and rRT-PCR results were compared between the groups. RESULTS: The mean value of the fQRS-T angle of all participants was 45.26°. There was no significant difference between the groups according to the demographic and clinical data. Subjects with wider fQRS-T angle (group 2) had higher heart rates (p = 0.018), higher corrected QT values (p = 0.017), and higher QRS axis (p = 0.001). The patients in group 2 had a higher number of positive COVID-19 rRT-PCR test results compared to subjects with the normal fQRS-T angle (p = 0.002). In multivariate regression analysis, fQRS-T angle (p = 0.027, OR: 1.013, 95% CI: 1.001-1.024) was found as an independent variable affecting the PCR test results. CONCLUSIONS: Prompt diagnosis, initiating preventive and protective measures in an early stage of COVID-19 are crucial. In suspected COVID-19 infection, the use of faster-resulting tests and diagnostic tools for COVID-19 allows patients to be diagnosed and treated in a timely manner for recovery, thereby optimizing patient management. Therefore, the fQRS-T angle can be used in patients with dyspnea as a part of diagnostic scores of COVID-19, even before the rRT-PCR test results and overt disease.

Bronchogenic cyst invading right atrium in a 5-year-old.

Primary bronchogenic cysts of cardiac origin or extension are rare. We report here on a 5-year-old girl with a bronchogenic cyst with a diameter of 5.0 x 4.5 x 4.5 cm extending to the right atrial wall. Tumor enucleation and resection of the cyst together with the invaded right atrial wall was performed through a right posterolateral thoracotomy and an opening in the lateral pericardium. Resection of intrapericardial bronchogenic cysts is possible, although extensive invasion of cardiac structures may necessitate the use of cardiopulmonary bypass through a sternotomy.