COVID-19 in elderly: Correlations of viral load, clinical course, laboratory parameters, among patients vaccinated with CoronaVac.

SARS-CoV-2 virus was initially identified in Wuhan, China, in December 2019 and a global pandemic was declared in March 2020 by World Health Organization. COVID-19 disease is characterized with severe pneumonia and hypoxemia, especially in the elderly population. The elderly population was primarily vaccinated with CoronaVac, which is a whole virion inactivated vaccine (Sinovac Biotech, China) in Turkey. This study aimed to investigate the association of viral load and laboratory parameters with the severity of the disease and vaccination status in elderly (older than 60 years old) COVID-19 patients. The age range of the patients was 61-97 years old with a mean of 71.80. Vaccinated patients had a lower viral load (P = 0.253) in nasopharyngeal swabs during breakthrough COVID-19 infection compared to unvaccinated ones and were hospitalized for a shorter period of time in hospital wards (P = 0.035). A lower number of patients were vaccinated in both moderate (n = 33, 29.20%) and severe/critical group (n = 46, 34.07%) (P = 0.412). Only 17 (32.08%) vaccinated patients were hospitalized in an intensive care unit (ICU), whereas 36 (67.92%) of the ICU patients were unvaccinated (P = 0.931). Severe/critical patients had higher c-reactive protein (CRP), platelet-to-lymphocyte ratio (PLR), fibrinogen, ferritin, and lactate dehydrogenase (LDH) levels compared to the moderate group on the admission day (P < 0.05). Our study suggested that elderly patients vaccinated with CoronaVac had a shorter stay in hospitals and according to our results CRP, PLR, fibrinogen, ferritin, and LDH levels could be used to determine the severity of the infections.

Examination of the specific clinical symptoms and laboratory findings of Crimean-Congo hemorrhagic fever.

BACKGROUND & OBJECTIVES: Crimean-Congo hemorrhagic fever (CCHF) is a fatal disease, caused by a tick-borne virus (Nairovirus), having a high mortality rate. The study was aimed to evaluate the risk factors, the presenting symptoms and findings of the patients with prediagnosis of CCHF disease, and to compare these variables between the CCHF-positive and CCHF-negative patients. It was also aimed to develop a scoring formula for the diagnosis of CCHF. METHODS: In total, 281 patients who were admitted to the Sabuncuoglu Serafeddin Training and Research Hospital, Amasya, Turkey between 2011 and 2015 and were prediagnosed with CCHF based on the clinical symptoms, laboratory findings and risk factors were included in the study. The definitive laboratory diagnosis of patients with prediagnosis of CCHF was ensured via molecular and serological methods. In addition, a mathematical diagnostic scoring formula was developed for enhancing the laboratory results of CCHF. RESULTS: The ratio of certain clinical symptoms such as fever (p<0.001), headache (p<0.001), widespread body pain (p<0.001), fatigue (p = 0.001), nausea and vomiting (p = 0.013) in CCHF-positive patients were found to be significantly higher compared to the ratio in CCHF-negative patients. In terms of laboratory findings such as presence of leucopenia (p<0.001), creatine kinase (CK) elevation (p<0.001), thrombocytopenia (p<0.001), aspartate aminotransferase/alanine aminotransferase (AST/ALT) elevation (p<0.001), lactate dehydrogenase (LDH) levels (p = 0.002), absence of abnormal findings on chest radiograph (p = 0.042), and the absence of anaemia (p = 0.007), the CCHF-positive patients had higher rates in comparison to CCHF-negative ones. INTERPRETATION & CONCLUSION: It was inferred that certain clinical symptoms and laboratory findings such as fever, headache, widespread body pain, fatigue, leucopenia, nausea, vomiting, high CK levels, thrombocytopenia, AST/ ALT elevation and elevated LDH levels are highly specific and are required to be considered in the definitive diagnosis of CCHF, particularly in regions where this infection is observed as endemic.