Short and mid-term SARS-CoV-2 antibody response after inactivated COVID-19 vaccine in hemodialysis and kidney transplant patients.

The efficacy of the inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine has not been fully elucidated across the whole spectrum of patients on kidney replacement therapy. We aimed to characterize the long-term antibody response of inactivated SARS-CoV-2 vaccine administered in kidney transplant recipients (KTRs) and hemodialysis (HD) patients. We performed this prospective observational study in 50 HD, 64 KTR, and 41 healthy control groups (HG) given two doses of CoronaVac. We measured anti-Spike antibodies after 28 days of every vaccine dose, 3rd and 6th months after the first dose, and compared them between cohorts. After two doses, an anti-spike immunoglobulin G of ≥50 AU/ml was present in HD, KTR, and HG as 44%, 7.2%, and 58.5%, respectively (p < 0.001). Furthermore, the proportion of antibody titers peaked at 86.5%, 23%, and 97.6% (p < 0.001) at the 3rd month and decreased significantly at the 6th month in most HD and HG participants, whereas this effect was not observed in KTRs from basal until the 6th month (p < 0.001). During the follow-up, the incidence of coronavirus disease 2019 disease was higher (p < 0.003) in KTRs compared to the other groups, but there was no requirement for an intensive care unit and no death was recorded. We found a negative correlation between antibody seroconversion and age (p < 0.016). The antibody response following inactivated vaccine in dialysis patients is almost comparable to controls for 6 months. In contrast, kidney transplant patients have a poor response. These findings reinforce the need to discuss the vaccination strategy in immunocompromised patients, including the third dose with homologous or heterologous vaccines.

Association of mortality and endothelial dysfunction with serum ADMA level in COVID-19 patients.

Objectives: To investigate the role of asymmetric dimethylarginine (ADMA) level in predicting intensive care and mortality in patients affected with coronavirus disease 2019 (COVID-19). Methods: This retrospective, cross-sectional study was conducted at Sakarya University Training and Research Hospital (Sakarya, Turkey) between April and August of 2020. We enrolled patients who were diagnosed with COVID-19 via real-time reverse-transcription polymerase chain reaction and admitted to the intensive care (Severe COVID-19; S-COVID) or non intensive care (Moderate COVID-19; M-COVID). We then analyzed the relationship of the ADMA level with various parameters between S-COVID and M-COVID groups. Results: This study included 87 patients, comprising 43 females and 44 males, with a mean age of 61 and 71.50 years, respectively. The male/female distribution was 22/25 (46.8%/53.2%) in the M-COVID group and 22/18 (55%/45%) in the S-COVID group. The hospitalization time, white blood cell count, neutrophil count, lymphocyte-to-albumin ratio, international normalization ratio, D-dimer, troponin, ferritin, lactate dehydrogenase, C-reactive protein, procalcitonin, erythrocyte sedimentation rate, fibrinogen, lactate, ADMA, and mortality rate were significantly higher (p < 0.05). In contrast, lymphocyte, total cholesterol, high-density lipoprotein, calcium, and albumin values were lower (p < 0.05) in the S-COVID group than in the M-COVID group. While the mortality rate was 55% in S-COVID patients, no mortality was detected in M-COVID patients (p < 0.05). Moreover, ADMA level was 6618 ± 3000 (6400) in S-COVID patients and 5365 ± 3571 (3130) in M-COVID patients, indicating a statistically significant difference (p = 0.012). Conclusion: The asymmetric dimethylarginine level increases in severe outcomes; hence, it can potentially predict severity in patients with COVID-19.

Effects on mortality of early vs late administration of convalescent plasma in the treatment of Covid-19.

The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first seen in the city of Wuhan, China, in December 2019 and then spread worldwide. On 24 March 2020, the U.S. Food and Drug Administration reported that the use of convalescent plasma (CP) containing antibodies against COVID-19 could be effective against infection. The aim of this study is to retrospectively investigate whether early CP transfusion treatment has an effect on recovery of clinical and laboratory parameters in patients diagnosed with severe COVID-19 who were admitted to the intensive care unit (ICU). The study included 141 consecutive patients who had laboratory confirmation of COVID-19 and were admitted to the ICU between 1 May and 30 September 2020. Of the 141 patients, 84 received CP in the first five days of hospitalization in the ICU (early group), and 57 received CP after the fifth day of hospitalization in the ICU (late group). There were no significant differences between the two groups in terms of age, gender, comorbidities and the severity of the disease (according to the evaluation of lung tomography). There was no difference between the two groups in terms of mechanical ventilator needed, inotrope support, and tracheostomy procedure during the ICU admission (p = 0.962, p = 0.680, and p = 0.927, respectively). Despite these limitations, the overriding result of our study is that it suggests that administration of CP either early or late in the treatment of COVID-19, had no effect on mortality.

Predictive role of FAR ratio in COVID-19 patients.

OBJECTIVE: No effective treatment has yet been found for SARS-Cov-2, which caused a pandemic outbreak in 2019. It is crucial to detect the progression of COVID-19 in patients as early as possible. Fibrinogen to albumin ratio (FAR) has been used as a new inflammatory marker. We aimed to find out whether the use of the FAR as a predictor of mortality in COVID-19 patients provides clinical benefit. MATERIALS AND METHODS: Data from 590 patients with COVID-19 from March 15, 2020 to January 15, 2021 in medicine wards and intensive care units (ICU) were retrospectively analysed. Demographic data and other laboratory markers were collected from the electronic medical records. Relationship between FAR was investigated between patients in the survivor/non-survivor patients. FINDINGS: The mean FAR levels in patients who were non-survivor was 24.44 ± 30.3 (n = 272 and 11.29 ± 6.29 (n = 275) (P = .000) in patients survivor COVID-19 infection. In ROC curve for FAR, the threshold FAR that may pose a risk for mortality was determined as 13.84 ((AUC: 0.808 (0.771-0.844)); 74.9% sensitivity, 74.6% specificity; P = .000)). RESULT: As a result of this study, increased FAR were found to be important markers in determining the mortality levels in COVID-19 patients.

Observational study of the effects of Favipiravir vs Lopinavir/Ritonavir on clinical outcomes in critically Ill patients with COVID-19.

WHAT IS KNOWN AND OBJECTIVES: In November 2019, several patients were diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, China. So far, there are no specific treatments with proven high efficacy in patients with SARS-CoV-2. Presently, several drugs, such as hydroxychloroquine, ribavirin, favipiravir (FVP), lopinavir/ritonavir (LPV/r), remdesivir and oseltamivir, have been suggested as effective treatments for SARS-CoV-2. The aim of this study was to describe the clinical experience with FPV and LPV/r in critically ill patients with COVID-19 at Sakarya University Education and Research Hospital. METHODS: The study included 107 consecutive patients who had a laboratory confirmation of COVID-19 and were admitted to the intensive care unit (ICU) between 19 March and 19 May 2020. Follow-up continued through 30 May 2020 when the last observed patients were discharged. RESULTS AND DISCUSSION: Of the 107 patients, 65 received FPV (Group FPV) and 42 received LPV/r (Group LPV/r). The two groups were similar in terms of demographic data and clinical findings. 43 (66.2%) of the 65 patients in the FPV group and 23 (54.8%) of the 42 patients in the LPV/r group died (p = 0.237). The median ICU stay was 6.6 (IQR, 3-10) days in the FPV group and 9 (IQR, 6-16) days in the LPV/r group, which was a statistically significant difference (p = 0.010). WHAT IS NEW AND CONCLUSION: The length of hospital stay was significantly lower in the FVP group compared to the LPV/r group among patients who were discharged from the ICU. Although the analysis was done with a limited number of patients and the observed difference in mortality rate is of some concern, FVP treatment may be more beneficial than LPV/r in terms of effective use in the ICU.

The predictive and diagnostic accuracy of long pentraxin-3 in COVID-19 pneumonia

Background/aim: The purpose of this study is to evaluate serum pentraxin-3 (PTX-3) levels in Sars-CoV-2 virus infection (COVID-19) patients and to investigate whether PTX-3 predicts the disease prognosis. Materials and methods: This study was conducted on 88 confirmed COVID-19 patients who were hospitalized due to symptomatic pneumonia between April 15 and August 15, 2020. The patients were divided into two groups as survived patients and non-survived patients. Both groups were compared according to demographic features, comorbid conditions and measurement of the PTX-3 and other laboratory parameters of the patients. Results: Of 88 patients with COVID-19, 59 (67%) were discharged with complete cure and 29 (33%) resulted in death. 46 (52.3%) of the patients were men. PTX-3 median value (IQR) was 3.66 ng/mL (0.9­27.9) in all patients, 3.3 ng/mL (0.9­27.9) in survivors and 3.91 ng/mL (1.9­23.2) in nonsurvivors which was significantly higher (P = 0.045). As a receiver operating characteristic curve analysis the cut-off value of PTX-3 for predicting mortality in patients was 3.73 with 65% sensitivity and 65% specificity (AUC: 0.646, 95% CI: 0.525­ 0.767, P = 0.045). Also, we found significant cut-off values with respect to D-dimer, D-dimer/PTX-3, high-sensitivity troponin, high- sensitivity troponin/PTX-3, lymphocyte, PTX-3/lymphocyte, procalcitonin, procalcitonin/PTX-3, CRP, and CRP/PTX-3 (P < 0.05). Conclusion: In this study, as far as we know, for the first time, we have shown PTX-3 as the new mortality biomarker for COVID-19 disease.

The relationship of extent of initial radiological involvement with the need of intensive care, mortality rates, and laboratory parameters in Covid-19

Background/aim: It is very important for the efficient use of limited capacity and the success of treatment to predict patients who may need ICU with high mortality rate in the Covid-19 outbreak. In our study, it was aimed to investigate the value of the radiological involvement on initial CT in demonstrating the ICU transfer and mortality rate of patients. Materials and methods: All PCR-positive patients were included in the study, whose CT, PCR, and laboratory values were obtained simultaneously at the time of first admission. Patients were divided into 4 groups in terms of the extent of radiological lesions. These groups were compared in terms of intensive care transfer needs and Covid-related mortality rates. Results: A total of 477 patients were included in the study. Ninety of them were group 0 (no lung involvement), 162 were group 1 (mild lesion), 89 were group 2 (moderate lesion), and 136 were group 3 (severe lung involvement). A significant relationship was found between the extensiveness of the radiological lesion on CT and admission to intensive care and mortality rate. As the initial radiological involvement amounts increased, the rate of ICU transfer and mortality increased. The mortality rates of the groups were 0%, 3%, 12.3%, and 12.5%, respectively, and the difference was significant (p < 0.001). Similarly, the ICU transfer rates of the groups were 2.2%, 5.6%, 13.5%, and 17.7%, respectively, and the difference was significant (p < 0.001). Conclusion: In conclusion, in our study, the strong relationship between the initial radiological extent assessment and the need for intensive care and mortality rates has been demonstrated, and we believe that our results will make a significant contribution to increase the success of the health system in predicting patients who may progress, helping clinicians and managing pandemics.

Characteristics and outcomes of critically ill patients with covid-19 in Sakarya, Turkey: a single centre cohort study

Background/aim: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Turkey on March 10, 2020 and the number of the patients are increasing day by day. Coronavirus disease 2019 (Covid-19) has high mortality rates in intensive care units (ICUs). We aimed to describe the demographic characteristics, comorbidities, treatment protocols, and clinical outcomes among the critically ill patients admitted to the ICU of our hospital. Materials and methods: This cohort study included 103 consecutive patients who had laboratory confirmed Covid-19 and admitted to ICU of Sakarya University Training and Research Hospital between March 19 and April 13, 2020. The final date of the follow-up was April 18. Results: The mean age of the patients was 69.6 ± 14.1 years. Most of the patients had increased CRP (99%), serum ferritin (73.8%), d-dimer (82.5%), and hs-troponin levels (38.8%). 34 patients (33%) had lymphocytopenia, 24 patients (23.3%) had thrombocytopenia. 63 patients (61.2%) developed acute respiratory distress syndrome (ARDS), 31 patients (30.1%) had acute kidney injury, and 52 patients (50.5%) had multiple organ dysfunction syndrome (MODS) during follow-up. Sixty-two patients (60.2%) received mechanical ventilation. As of April 18, of the 103 patients, 52 (50.5%) had died, 30 (29.1%) had been discharged from the ICU, 21 (20.4%) were still in the ICU. Conclusions: Covid-19 has high mortality rates in ICU. Patients with elevated procalcitonin, hs-troponin, d-dimer, and CRP levels and lower platelet count at admission have higher mortality.

Clinical course of COVID-19 disease in immunosuppressed renal transplant patients

Background/aim: We aimed to identify clinical settings of renal transplant patients with COVID-19. Materials and methods: In this retrospective study, we included kidney transplant inpatients with laboratory confirmed COVID-19 who had been discharged or had died by October 1st, 2020. Characteristics of the patients, including basal and last outpatient biochemical parameters were recorded. Discontinuation or dosage reduction of immunosuppressives and other treatment information was documented. Results: Twenty patients were included in this study, of whom 18 were discharged and 2 died in hospital. The mean duration of hospitalization and follow-up were 9.7 ± 6.4 days and 4.5 ± 2.0 months, respectively. Fourteen patients (70%) were male and mean age was 48.0 ± 10.3 years. At admission, all had immunosuppression withdrawn and were started on methylprednisolone 16 mg/ day (50%) or dexamethasone (50%). Tacrolimus/m-TOR inhibitors were reduced by 50% and all antimetabolites were discontinued. Hemodialysis was needed for 10% of patients. Acute kidney injury was detected in 25% of the patients. With respect to hospitalization time and complications, there was no significant difference between patients who used dexamethasone and those who did not (P > 0.05). The discontinued immunosuppressives were resumed within 2 to 4 weeks after discharge according to the severity of disease. No rehospitalization or acute rejection was detected during the follow-up of the patients. Conclusion: Renal transplant patients are considered a high risk group for COVID-19. It can be said that discontinuation or reducing dosages of immunosuppressives may be effective and safe in kidney transplant patients.

Frequency and types of headaches in patients with metabolic syndrome.

BACKGROUND AND PURPOSE: Metabolic Syndrome (MetS) and headaches are common public health problems in whole world. The relationship between headaches and the MetS isn't understood clearly. Purpose - The aim of this study is to determine the prevalence and types of headaches, and evaluate the relationship between headache characteristics and clinical and laboratory parameters analyzed in patients diagnosed with MetS. METHODS: Of the patients diagnosed with MetS in Endocrinology outpatient clinics between July 2011 and July 2012, 202 patients were included in the study. Hemoglobin, fasting blood glucose (FBG), total cholesterol, triglyceride, HDL and LDL cholesterol, thyroid function tests and HbA1c values of all patients were recorded. Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were applied to all patients. The headache severity was assessed by Visual Analog Scale (VAS). RESULTS: The prevalence of headache in patients with MetS was found to be 61.4%. The incidence of headache was higher in female patients (F: 86.4%, M: 13.6%). The distribution of the subtypes of headaches was as follows: Episodic Tension-Type Headaches (ETTH) 24.8%, Episodic Migraine 14.4%, Chronic Tension-Type Headaches (CTTH) 11.3%, Episodic Tension-Type Headaches (ETTH) and Episodic Migraine 7.9%, and other types of headaches (Cervicogenic Headache and Cluster Headache) 3%. No statistically significant relationship was found between headache and non-headache groups in terms of body mass index, waist circumference, and the laboratory parameters (p>0.05). The mean BDI and BAI scores were higher in the headache group (p<0.001 and p<0.001). No significant difference was found between the mean MIDAS scores in the subtypes of headaches (p=0.35). In the headache group, there was a significant relationship only between triglyceride levels and attack frequency, duration and severity. CONCLUSION: Prevalence of headache in patients with MetS was 61.4%. The incidence of subtypes of headaches was similar to those in the general population. A relationship was found between triglyceride levels and attack frequency and severity. The result may be important to draw attention to the evaluation of triglyceride levels for reducing the frequency and severity of attacks in patients with headaches.

Leptospirosis during the COVID-19 pandemic: a case report.

Since SARS-CoV-2 disease (COVID-19) has been labeled as a pandemic, it took the spotlight in the differential diagnosis for patients presenting with acute respiratory and systemic symptoms. Leptospirosis is one of the most common zoonoses in the world, yet it is mainly a disease of differential diagnosis for places that do not have it as an endemic. Due to the high burden of COVID-19 on the healthcare field, patients suffering from other infections may have been inadvertently neglected. COVID-19 infection can mimic other infectious diseases and can confuse physicians in their search for a confirmatory diagnosis. Nonetheless, it is very crucial to broaden the differential diagnosis and keep diseases like leptospirosis within the differential diagnosis despite its rarity, especially in patients presenting with unexplained systemic infectious symptoms. This is a unique case of a patient who presented with dyspnea, jaundice and change in urine color who was suspected to be COVID-19 positive. After a detailed investigation, the patient was diagnosed with leptospirosis instead of COVID-19 and was treated with plasmapheresis and antibiotics accordingly.

Can Fetuin-A Deficiency Predict the Severity of COVID-19 Disease in Kidney Transplant Recipients?

BACKGROUND: This study aims to investigate whether fetuin A deficiency predicts the prognosis of COVID-19 disease in kidney transplant recipients (KTRs). METHOD: The study was conducted on 35 hospitalized KTRs with COVID-19 pneumonia between November 2020 and June 2021. Serums were collected for fetuin-A measurement at admission and after six months of follow-up. The demographic and laboratory data of the patients were recorded and analyzed with the appropriate statistical method. RESULTS: A total of 35 KTRs, 23 of which (65.7%) were men, were included in the study. The mean age of the patients was 51.6 ± 14.0 years. Seventeen (48.6%) patients had severe disease criteria and required intensive care (ICU) support. Biopsy-proven acute rejection developed in 6 (17.1%) patients in the follow-up. At admission, the median fetuin-A value was 173.5 mcg/mL (143.5-199.25) in the moderate disease group and 126.0 mcg/mL (89.4-165.5) in the severe patient group (p = 0.005). While the Median fetuin-A value at the time of diagnosis was 173.5 mcg/mL (143.5-199.25), and in the 6th month was 208 mcg/mL [184-229] (p<0.001). By ROC analysis, the effect of serum fetuin-A level in predicting the severity of COVID-19 disease was significant (AUC: 0.771, p = 0.006, 95% CI: 0.615-0.927). When serum fetuin-A cut-off value was taken as 138 mcg/mL to determine disease severity, it was shown to have 83.3% sensitivity and 64.7% specificity. CONCLUSIONS: Serum fetuin-A level can predict disease severity in kidney transplant recipients in the presence of active COVID-19 disease.

Demographic, clinical and laboratory characteristics of adult-onset minimal change disease in Turkey: Turkish Society of Nephrology-Glomerular Diseases (TSN-GOLD) Working Group.

PURPOSE: In our study, diagnostic and demographic characteristics of patients diagnosed with minimal change disease (MCD) by biopsy, clinical and laboratory findings in our country were investigated. METHODS: Data were obtained from the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group database. Demographic characteristics, indications for biopsy, diagnosis of the glomerular diseases, comorbidities, laboratory and biopsy findings of all patients were recorded. The data presented are cross-sectional and includes application data for the biopsy period. RESULTS: Of 3875 patients, 233 patients with MCD (median age 35.0 years) were included in the study, which constitutes 6.0% of the total glomerulonephritis database. Renal biopsy was performed in 196 (84.1%) patients due to nephrotic syndrome. Median serum creatinine was 0.7 (0.6-1.0) mg/dl, mean eGFR was 104 ± 33 ml/min/1.73 m2 and median proteinuria 6000 mg/day. The number of patients under the age of 40 years was 139 (59.7%) (Group A), and the number of patients aged 40 years and over was 94 (40.3%) (Group B). Compared to Group A, global sclerotic glomeruli (24 vs. 43, p < 0.001) interstitial inflammation (15 vs. 34, p < 0.001), interstitial fibrosis (20 vs. 31, p = 0.001, vascular changes (10 vs. 25, p < 0.001) and tubular atrophy (18 vs. 30, p < 0.001) were found to be significantly higher in Group B. There was no difference in immunofluorescent staining properties between the two groups. CONCLUSION: Our data are generally compatible with the literature. Chronic histopathological changes were more common in patients aged 40 years and older than younger patients. Studies investigating the effects of these different features on renal survival are needed.

Depression and Anxiety Disorders in COVID-19 Survivors: Role of Inflammatory Predictors.

Introduction: Infection-triggered perturbation of the immune system, which was observed after previous coronavirus outbreaks, could induce psychiatric sequelae. The spreading of the Coronavirus-19 (COVID-19) pandemic could be associated with psychiatric implications. In this study, we aimed to evaluate the association between inflammatory biomarkers and the levels of depression and anxiety in patients who recovered from COVID-19. Methods: We screened 109 COVID-19 survivor adults for psychiatric symptoms on the 15th day of follow-up after discharge from the hospital. The patients were split into two groups, the ones with depression and anxiety, and the ones without depression or anxiety, after the psychiatric interview. Self-rating Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were applied to assess the levels in patients with depression and anxiety. We collected and recorded the sociodemographic information, clinical data, and baseline inflammatory markers. Results: Higher baseline neutrophil/lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) were found in patients with depression and anxiety. Higher levels of depression and anxiety were found in younger and female patients. Besides, a significant correlation was found between BAI and ferritin levels in patients with anxiety, while no association was found between BAI and other inflammatory biomarkers. Moreover, no significant relationship was found between BDI scores and inflammatory biomarkers in patients with depression. Conclusion: COVID-19 primarily affects the respiratory and cardiovascular systems. Nonetheless, psychiatric involvement is not uncommon and can lead to severe problems if not detected and managed at an early stage. It is recommended that clinicians should be vigilant in terms of psychiatric involvement in COVID-19 patients presenting with high inflammatory parameters.

Association of C-reactive Protein/Albumin, Procalcitonin/Albumin, Platelet/Lymphocyte, and Lymphocyte/Monocyte Ratio with Mortality in Hospitalised COVID-19 Patients.

OBJECTIVE: To investigate and compare complete blood count and biochemistry parameters such as c-reactive protein/albumin (CRP/ALB) ratio, procalcitonin/albumin (PRO/ALB) ratio, lymphocyte/monocyte (LYM/MON) ratio, platelet/lymphocyte (PLT/LYM) ratio of the recovered/deceased, and ICU (intensive care unit) /ward patients with COVID-19. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Department of Internal Medicine, Sakarya University Training and Research Hospital, Turkey, from April 2020 to January 2021. METHODOLOGY: The study was conducted with 590 diagnosed patients with COVID-19. The patients were divided into 2 groups as deceased (n = 294) /survivor (n = 296) and those in need of ICU (n= 418) /ward (n = 172). The information was obtained from the hospital information system and analysed retrospectively. The relationships of crp/alb, pro/alb, lym/mon, and PLT/LYM ratios with patient groups were investigated. RESULTS: Of the total 590 patients in the study, 358 (60.6%) were males. The total mean age was 65.63 ±14.9 years. The mean age of survivor and deceased groups was 71.32±10.9 and 59.97±16.2 years, respectively (p.

Serum calprotectin as a novel biomarker for severity of COVID-19 disease.

BACKGROUND: Some biomarkers have been reported to be related to the prognosis of the coronavirus disease 2019 (COVID-19). There are sparse data regarding the prognostic value of serum calprotectin in COVID-19 patients. AIMS: This study aimed to investigate the relationship between serum calprotectin level and clinical severity of COVID-19 disease in hospitalized patients. METHODS: This retrospective cross-sectional cohort study included 80 consecutive hospitalized patients with confirmed diagnosis of COVID-19. The study population was divided into two groups as patients hospitalized in the intensive care unit (ICU) and patients hospitalized but not in the ICU. The serum calprotectin levels, other laboratory, and clinical parameters were compared between groups. RESULTS: The mean age of the patients was 66.5 ± 15.7 years. Of the patients, 42 were in the ICU and 38 were not. Serum calprotectin level and acute-phase reactants such as C-reactive protein, procalcitonin, ferritin, fibrinogen, and white blood cell were significantly higher in ICU patients than in non-ICU patients. ROC curve analysis identified that serum calprotectin level was a predictor for ICU requirement with an area under the curve of 0.641 (p = 0.031). Logistic regression analysis revealed that serum calprotectin was a significant determinant for whether or not patient required the ICU. CONCLUSIONS: These findings demonstrate that serum calprotectin level seems to be a useful biomarker that can predict the severity of COVID-19 disease. Serum calprotectin is a significant predictor of ICU requirement in patients with COVID-19.

Evaluation of Electrocardiographic Parameters and the Presence of Interatrial Block in Patients with Mad Honey Intoxication.

Mad honey intoxication (MHI) is a food-induced clinical condition that usually presents with cardiovascular symptoms and can lead to life-threatening arrhythmias if not diagnosed and treated early. No data exist in the literature on the presence of interatrial block (IAB) after food intoxication. In our study, we sought to investigate atrioventricular electrocardiography (ECG) parameters and determine the frequency of IAB in patients with MHI. In total, 76 patients diagnosed with MHI were included in our retrospective study. Twelve-lead ECGs were performed and participants were divided into two groups according to the presence of IAB in the reference ECG. The P maximum (Pmax), P minimum (Pmin), P dispersion (Pdisp), T peak to T end (Tp-Te) interval and QT dispersion (QTdisp) values were compared between the two groups. IAB was detected in 28 (35.5%) of 76 MHI patients included in the final analysis. Pmax duration (122 ± 8; p < 0.001) and PD (69 ± 11; p < 0.001) were significantly higher in the IAB ( +) group. During regression analysis, Pmax [odds ratio (OR) 1.158, 95% confidence interval (CI) 1.036-1.294; p = 0.010] and Pd (OR 1.086, 95% CI 1.001-1.017; p = 0.046) were independently associated with IAB. Pmax and Pd area under the receiver operating characteristic curve values for IAB prediction were 0.926 (95% CI 0.841-1,000; p < 0.001) and 0.872 (95% CI 0.765-0.974; p < 0.001), respectively. ECG changes are common in patients presenting with MHI. These patients need to be followed up clinically in terms of progression to arrhythmic events that may occur in the future.

Prealbumin: A New Biomarker for Predicting Prognosis in Patients with Severe COVID-19.

OBJECTIVE: To analyse whether prealbumin could be a new biomarker for predicting mortality in severe COVID-19 patients. STUDY DESIGN: An observation study. PLACE AND DURATION OF STUDY: Intensive care units (ICU) of Sakarya University Training and Research Hospital, Sakarya, Turkey, from October 2020 to December 2020. METHODOLOGY: The data of 149 patients, who were admitted to the ICU were collected and analysed retrospectively. Routine blood samples were collected from all patients at the time of admission to the ICU; and 102 patients with the mortal course and 47 patients with the non-mortal course were included in the study. The data obtained from these patients were analyzed in the biostatistics programme.  Results: The median age of all patients was 68 years; while 94 of them were males (63.1%) and 55 of them were females (36.9%). Median levels of potassium (K) (p=0.04), uric acid (p=0.001), C-reactive protein (CRP) (p=0.004), and procalcitonin (PCT) (p<0.001) were significantly higher and median level of prealbumin (p=0.002) was significantly lower in the deceased group. The cut-off level of prealbumin for mortality was found as 0.085 g/L (p=0.002). Further analysis revealed that the risk of mortality was found as 2.193 times more in patients with prealbumin levels of <0.085 g/L (Odds Ratio (OR): 2.193, 95% CI: 1.084-4.434). CONCLUSION: As a result of this study, it was found that patients with lower levels of prealbumin at the time of admission to the ICU have a higher risk for mortality. It was showed that prealbumin can be a useful biomarker for predicting mortality in patients with severe COVID-19. Key Words: Prealbumin, COVID-19, Mortality, Prognostic biomarkers, Severe disease.

Association of ABO blood group and age with COVID-19 positive test.

OBJECTIVE: The aim of this study is to evaluate the relation between the coronavirus (SARS-CoV-2) disease (COVID-19) and blood groups and the Rh factor. METHOD: A total of 313 patients hospitalized in the Internal Medicine clinic, at the intensive care unit (ICU) were included in the study. The cases were divided into two groups: those who were COVID-19 positive and those negative, detected with real-time reverse transcription polymerase chain reaction testing. The demographic, clinical, ABO blood groups, and Rh factor data of the cases were obtained from the hospital records retrospectively. RESULTS: The mean age of COVID-19 positive (+) cases was 57.74±16 years and of COVID-19 negative (-) cases, 66.41±15 years. The difference was significant (p<0.001); there was no difference between the two groups in terms of sex (p=0.634). When age was categorically separated in COVID-19 (+) cases, χ2 was extremely significant. Among the ABO blood groups of COVID-19 (+) and (-) cases, χ2 was 4.975 (p=0.174). In the logistic regression, it was 4.1 (p=0.011) in the O blood group. COVID-19 positive test was determined as 13, 4, and 4 times higher in the 31-40, 41-50, and 51-60 age groups, respectively (p=0.001, p=0.010, p=0.003). CONCLUSION: The incidence of COVID-19 has increased in the younger population and in the O blood group. Our findings support that, in this population, the ABO blood groups can contribute to the early detection of COVID-19.