Long-term follow-up and health-related quality of life in COVID-19 patients treated in hospital.

OBJECTIVE: To evaluate the persistence of symptoms and health-related quality of life of coronavirus disease-2019 patients. METHODS: The cross-sectional study was conducted from April to September 2020 at Health Sciences University, Yedikule Chest Diseases Hospital, Istanbul, Turkey, and comprised patients of either gender who had to be hospitalised and treated for coronavirus disease-2019. Those who had spent <3 months (46-90 days) post-discharge formed Group 1, those having spent 3-6 were in Group 2, while those with >6 months post-discharge were in Group 3. Data was collected over the telephone Using the EuroQol's quality of life scale with 5 dimensions and 5 levels. The variables likely to affect the persistence of symptoms and the quality of life questionnaire scores were analysed using SPSS 16. RESULTS: Of the 225 subjects, 135(60%) were male and 90(40%) were female. The overall mean age was 55.7±19.91 years. There were 85(37.8%) participants in Group 1, 83(36.9%) in Group 2, and 57(25.3%) in Group 3. The age (p=0.09) and gender (p=0.23) distribution across the groups had no significant difference. Patients were called on an average 131.72±58.9 days after discharge (range: 46-279 days). Only 52 (23.1%) patients continued to show symptoms. Anxiety was the domain in which most patients 64(28.4%) reported deterioration. CONCLUSIONS: Most patients who have had coronavirus disease-2019COVID-19 after a long follow-up period did not show any symptoms or had any significant deterioration in their quality of life.

Frequency of alpha-1 antitrypsin deficiency and unexpected results in COPD patients in Turkey; rare variants are common.

BACKGROUND: Alpha-1 antitrypsin (α1-AT) is a protease inhibitor that is largely released from liver cells. It inhibits neutrophil elastase and its deficiency increases the risk of developing chronic obstructive pulmonary disease (COPD). The frequency of α1-AT deficiency has been reported with different prevalence rates in different parts of the world. The most common α1-AT variant causing α1-AT deficiency is the Pi*Z allele. In this study, we aimed to determine the frequency of the α1-AT genotypic variant in COPD patients in our country. METHODS: In this study, 196 consecutive COPD patients admitted to our clinic were included. In addition to recording the demographic data of the volunteers, a dry drop of blood sample was taken from the fingertip for the SERPINA1 genotype study. RESULTS: One hundred and fifty-eight (80.6%) of the patients were male and the mean age was 56.92 ± 9.84 years. A variant in the SERPINA1 gene was detected in a total of 14 (7.1%) COPD patients. Pi*ZZ homozygous variant was detected in only 1 (0.51%) patient, while Pi*MZ was detected in 3 (1.53%) patients. The Pi*S variant was never detected. Various rare heterozygous variants were detected in 9 (4.6%) patients and a single point mutation was found in one (0.51%) patient. Serum α1-AT levels were significantly lower in patients with variants compared to the Pi*MM group (p < 0.001). DISCUSSION: In this study, which investigated the genotypic α1-AT variant frequency in COPD patients for the first time in our country, we found that the percentage of homozygous Pi*ZZ patients was 0.51%, but when heterozygous α1-AT gene variant and single point mutation were included, the frequency was 7.1%. At the same time, while the Pi*S variant was never detected, rare variants were found more frequently than expected.

The comparison of favipiravir and lopinavir/ritonavir combination in COVID-19 treatment

Background/aim: SARS-CoV-2, a ribonucleic acid coronavirus, rapidly spread worldwide within a short timeframe. Although different antiviral, antiinflammatory, and immunomodulatory drugs are used, current evidence is insufficient as to which drug is more efficient. Our study compared favipiravir and lopinavir/ritonavir (LPV/RTV) therapies in inpatient care for coronavirus disease 2019 (COVID-19) pneumonia. Materials and methods: Demographic data, test results, treatments, and latest status of patients receiving inpatient COVID-19 pneumonia therapy were recorded. The initial favipiravir and LPV/RTV receiving groups were compared regarding the need for intensive care units (ICU) and mortality. Logistic regression analysis was performed by including variables showing significant differences as a result of paired comparisons into the model. Results: Of the 204 patients with COVID-19 pneumonia, 59 (28.9%), 131 (64.2%), and 14 were administered LPV/RTV, favipiravir, and favipiravir with LPV/RTV, respectively. No difference was found in age, sex, presence of comorbidity, and tocilizumab, systemic corticosteroid, and plasma therapy use between patients administered with these three different treatment regimens. The mean mortality age of the patients was 71 ± 14.3 years, which was substantially greater than that of the survivors (54.2 ± 15.5 years). Compared with patients administered with LPV/RTV, ICU admission and mortality rates were lower in patients administered with favipiravir. CK-MB, AST, CRP, LDH, and creatinine levels were higher, whereas lymphocyte counts were lower in patients who died. Age, AST, CRP, LDH, and neutrophil counts were higher in patients needing ICU, and eosinophil and lymphocyte counts were significantly lower. Logistic regression analysis showed that favipiravir use independently decreased mortality (p = 0.006). Conclusion: The use of favipiravir was more effective than LPV/RTV in reducing mortality in hospitalized patients with COVID-19.