Outcomes of High-Dose Vitamin C Therapy on Patients Diagnosed with COVID-19 Associated ARDS in Intensive Care Units: Multi-Center Retrospective Study

Background and Aim: The new type of Severe Acute Respiratory Syndrome Coronavirus 2 (Coronavirus 2019-COVID-19) infection is the largest pandemic in the last decade. Acute respiratory distress syndrome is the complication with the highest mortality rate of this infection and there is no adequate treatment with proven efficacy to reduce mortality. This multi-center, retrospective study aimed to determine the effect of high-dose vitamin C on survival and other endpoints in invasively ventilated ARDS patients. Method(s): This multi-center, observational retrospective cohort study was performed at five ICU centers between March 2020 and July 2020. Patients with ARDS due to COVID-19 who required IMV were included. High-dose vitamin C group was defined as patients who were treated with vitamin C over 200 mg/kg for four days. Patients who were not given vitamin C treatment were defined as the control group by using propensity score match analysis, as well. The groups were compared about the effects of high-dose vitamin C treatment on ICU mortality. Result(s): A total of 86 patients with a mean age of 67.85 +/- 10.38 were included in the study. 72.1% of the patients were male. Forty-two (49%) patients were in the high dose vitamin C group, and 44 (51%) were in the control group. The mean PaO2/FiO2 at the time of admission to the ICU was 128.27+/-58.69 mmHg (133.63+/-56.51 mmHg in the control group, 122.36+/-61.18 mmHg in the study group, p=0.389). The mortality rate of high dose vitamin C group was lower than the control group (73.8% vs. 90.9%, p = 0.037,respectively). Conclusion(s): As an adjunctive therapy in invasively ventilated patients with COVID-19-associated ARDS, high doses of vitamin C may reduce mortality and development of organ damage. Prospective, randomized controlled studies with larger numbers of patients are needed to confirm these findings.Copyright © 2023, Society of Turkish Intensivists. All rights reserved.

Cutaneous findings of COVID-19 infection related with length of hospital stay: a prospective, multicenter study

Objective: Coronavirus disease-2019 (COVID-19) was declared a pandemic in March 2020. As the number of cases increased, the infection emerged as a multi-systemic disease. Respiratory, cardiac, hepatic, urinary, circulatory, gastrointestinal systems and finally skin may be the target organs of COVID-19. The aim of this study was to evaluate the cutaneous signs of COVID-19 and their effect on the patients' prognosis. Material and Methods: A total of 192 hospitalized COVID-19 cases, between May 2021 to July 2021 were included in the study. The length of stay (LoS) of the patients were recorded. Hospitalization and discharge decisions and all treatments of the patients were determined at the discretion of the treating physician according to the pandemic guidelines of the Ministry of Health. Fever, fatigue, cough, dyspnea, myalgia, anosmia, and headache were considered COVID-19 symptoms.

The Future of Organizations in the Age of Digital Transformation – A Critical Discussion Beyond Marketing and Buzzword

The need for preparing for the digital transformation has been a recurrent theme in public and academic debates, and the COVID-19 pandemic has contributed considerably to actions as well. © 2021, Management Revue. All Rights Reserved.

Analysis of ACE2 gene coding variants by direct whole exome sequencing in the Turkish Population

Objective: Due to the rapid spread of a novel coronavirus (SARS-CoV-2) globally, the WHO declared the situation as a pandemic. ACE2 is crucial for SARS-CoV-2 attachment onto the host cells. The expression levels and variations of ACE2 may facilitate or slow down the entrance of the SARS-CoV-2 virus into host cells. This might explain the variability of infection through individuals and populations. Materials-Methods: In this study, a retrospective comparative WES analysis of the ACE2 variants was conducted to 584 individuals around Turkey. Allele frequencies of all variants were calculated and filtered to remove variants with allele frequencies lower than 0.003. Results: The variants that showed a susceptibility to SARS-CoV-2 transmission in the literature were compared with our data. The most frequent variant, ACE2 N720D, and the second most frequent variant, ACE2 K26R that alters ACE2 protein and enhances its affinity for SARS-CoV-2 are not frequent in the Turkish population. Conclusion: The main ACE variants that has susceptibility effect to SARS-CoV-2 were not determined. It shows that the Turkish genetic makeup lacks any ACE2 variant that increases susceptibility for SARS-CoV-2 infection. Overall, this study will contribute to the formation of a national variation database and may also contribute to further studies of SARS-CoV-2 infection.

Blood purification treatments in COVID-19

Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) emerged for the first time in Wuhan, China, in December 2019. These viruses mainly cause respiratory and intestinal infections and induce a variety of clinical manifestations (1, 2). High virus titer and the subsequent strong inflammatory cytokine and chemokine responses are related to the high morbidity and mortality observed during the pathogenic HCoV infection. Blood purification system including plasma exchange, adsorption, perfusion, blood/plasma filtration, etc., can remove inflammatory factors, block the "cytokine storm", to reduce the damage of inflammatory response to the body. This therapy can be used for severe and critical patients in the early and middle stages of the disease (3). We recommend not using Extracorporeal treatments based on cytokine and / or endotoxin removal routinely in patients infected with COVID-19 due to insufficient studies (4).