Evaluation of inflammatory and hematological parameters in patients diagnosed with COVID-19.

INTRODUCTION: This study aims to research the effects of hematological and inflammatory parameters on the prognosis of COVID-19 disease and hospitalization duration. METHODOLOGY: One hundred and eighty-six patients with COVID-19 and a control group consisting of 187 healthy individuals were included in the study. Hematological variables and inflammatory parameters of the patients were recorded on the first and the fifth days of hospitalization. RESULTS: White blood cell count, lymphocyte count, and platelet count were statistically lower, and mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) levels were higher in the patient group compared to the control group. It was observed that the neutrophil count and MPV level were lower, and the platelet count and ferritin level were statistically higher on the fifth day of follow-up compared to the admission day. In contrast, there was a significantly positive correlation between the duration of hospitalization and the fifth day D-dimer (r = 0.546, p < 0.001) and ferritin (r = 0.568, p < 0.001); in addition, there was a negative correlation between the duration of hospitalization and admission day lymphocyte count and the fifth-day lymphocyte count. CONCLUSIONS: Increased levels of ferritin and D-dimer, and decreased count of lymphocytes are among the important factors affecting the duration of hospitalization for COVID-19 patients. Furthermore, we think that neutrophil count and MPV levels are low, and platelet count and ferritin levels are high during the disease. Therefore, these parameters can be used as prognostic indicators of the disease.

Which COVID-19 Patients Die in Intensive Care Unit (ICU) in Turkey

A comparison of deceased and surviving patients showed that being female, older than 62, and a smoker and having diabetes mellitus, hypertension, and/or coronary artery disease significantly increased mortality. Information about the patients' age, gender, comorbidities, duration of hospitalization, COVID-19-related lung tomography findings, hemogram parameters (white blood cell (WBC), neutrophil, lymphocyte, and platelet counts, haemoglobin level, neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte ratios (PLR), biochemical parameters, and ventilatory support [mechanical ventilation, non-invasive mechanical ventilation (NIMV), high-flow oxygen (HFNO)] were retrospectively accessed in the hospital records. Since the first COVID-19 case was admitted on 15 March, 2020, a total of 618 patients have been diagnosed with COVID-19 in our hospital. The comparison of the deceased and surviving patients also displayed that smoking (p=0.004), diabetes mellitus (p=0.007), hypertension (p=0.042), and coronary artery disease (p=0.049) statistically increased mortality. In our study, the comparison of the laboratory parameters of the deceased and surviving patients showed that the platelet (p=0.006), white blood cell (p=0.048), and neutrophil counts (p=0.033), and NLR (p=0.010) and PLR (p=0.033) were significantly higher in the deceased group compared to the surviving group.

COVID-19 ve Yoğun Bakım Süreci

The patient with acute respiratory failure and hemodynamic instability, dyspnea and respiratory distress, respiratory rate >28/minute, oxygen saturation <93% despite nasal oxygen support of 5 liters/minute and above, partial oxygen pressure < 60 mmHg despite nasal oxygen support of 5 liters/minute and above, and PaO2/FiO2 < 300 are critically ill with Covid-19 pneumonia and should be treated and followed up in the intensive care unit. After these patients are admitted to the intensive care unit, they should be evaluated in detail in terms of clinical, laboratory and imaging findings. First of all, traditional oxygen support treatments (nasal cannula, face mask, mask with reservoir] should be started, if no results are obtained, high flow nasal cannulation should be applied, and if this method fails, noninvasive mechanical ventilation should be started. If the target oxygen saturation, respiratory rate and optimal respiratory physiology could not be reached despite the oxygen support treatment, intubation and mechanical ventilation support treatment should be started without wasting time.