Inflammation-based Indices Predicting Mortality in COVID-19.

Efficiency of various inflammation-based indices, including neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), C-reactive protein/lymphocyte ratio (CLR), albumin/globulin ratio (AGR), haemoglobin, albumin, lymphocyte, and platelet (HALP), systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI), was examined in predicting mortality in COVID-19 patients. The study population consisted of 827 COVID-19 patients, including 733 survivors and 94 non-survivors. Compared with the survivor group, the NLR, PLR, CLR, and SII values of the non-survivor group were markedly higher; however, the LMR, PNI, HALP and AGR values were markedly lower. Multivariate analysis identified PNI, NLR, CLR, older age, male gender and dyslipidemia as independent factors for mortality in COVID-19 patients. PNI had the largest area under the curve to predict mortality, followed by CLR, NLR, and other indexes. This data revealed that PNI, NLR, and CLR are independent factors of mortality in COVID-19 patients among inflammation-based indexes. Key Words: COVID-19 mortality, Prognostic nutritional index, C-reactive protein/lymphocyte ratio, Neutrophil/lymphocyte ratio.

Investigation of Pneumocystis jirovecii in Lung Cancer Patients with the Nested PCR Method

Objective: Pneumocystis jirovecii (P. jirovecii) is an opportunistic pathogen in humans. Early diagnosis and optimal treatment of patients with P. jirovecii pneumonia (PJP) remains a key priority. This study investigated P. jirovecii in patients with lung cancer using the nested-polymerase chain reaction (PCR) method and examined the relationship between P. jirovecii and clinical findings. Methods: The study included 60 patients with lung cancer and 30 patients without lung cancer. The bronchoalveolar lavage (BAL) fluid samples of these 90 individuals were taken for diagnostic purposes in the University of Health Sciences Turkey, Van Training and Research Hospital, Clinic of Chest Diseases. Patient information was recorded. After DNA isolation from the BAL fluid samples taken from patients, the nested-PCR protocol for amplification of mtLSUrRNA in P. jirovecii was performed. Results: P. jirovecii DNA was detected in 40 (66.67%) of the lung cancer patients included in the study and in six (20%) patients without lung cancer, that is, in 46 (51.11%) patients. The rate of nested-PCR positivity in the lung cancer group was significantly higher than that in the non-lung cancer group (p=0.0001). Additionally, a statistically significant correlation was found between anorexia and weight loss, fever and sputum P. jirovecii positivity in patients with lung cancer (p<0.005). Conclusion: These findings suggest that lung cancer patients should be evaluated for PJP.

COVID-19 infection in pregnancy: a single center experience with 75 cases.

OBJECTIVES: This study aimed to summarize the clinical features, maternal, fetal, and perinatal outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) proven infections of pregnancies. MATERIAL AND METHODS: This retrospective single center study was conducted on 75 pregnant patients diagnosed of coronavirus disease 2019 (COVID-19). Demographic characteristics, clinical courses, laboratory and radiological findings, and maternal and perinatal outcomes were analyzed using medical records. RESULTS: Of the 75 pregnant women infected with COVID-19, 49 had mild infections. The most common initial symptoms were myalgia (61.4%), cough (57.9%), headache (50.9%), and dyspnea (49.1%). More than half of the patients (57.3%) on admission were in their third trimester. Three patients had pre-existing chronic illnesses (hypothyroidism, asthma and rheumatoid arthritis) and three patients had gestational diabetes. There were two cases admitted to intensive care unit, one of whom was due to COVID-19 infection. No maternal mortality was recorded. The mode of delivery was a cesarean section in 20 cases among the 35 labors. Six gestations ended in a miscarriage and 11 women gave birth prematurely. One stillbirth occurred at the 38th week of gestation. Among 37 neonates, 14 necessitated admission to neonatal intensive care unit. Neonatal mortality, congenital malformation, and mother to child transmission were not seen in the newborns. CONCLUSIONS: The results of our study suggest that the clinical course of COVID-19 infection in pregnant women was mostly asymptomatic/mild. There was also no evidence of vertical transmission of COVID-19 infection.

Evaluation of Meibomian Glands in Obstructive Sleep Apnea-Hypopnea Syndrome.

PURPOSE: To evaluate the effect of obstructive sleep apnea-hypopnea syndrome (OSAHS) on the meibomian glands, ocular surface, and tear parameters. METHODS: The study included 59 individuals (32 subjects with OSAHS, 27 control subjects) who underwent polysomnography in the Chest Diseases Clinic. The right eyes of all individuals were evaluated in the Ophthalmology Clinic. The first noninvasive tear break-up time (f-NTBUT) and the average noninvasive tear break-up time were measured, and Schirmer test was applied. Meibography was taken (Sirius; CSO, Florence, Italy), and meiboscore was used for indexing meibography. Finally, a sample was taken for conjunctival impression cytology. RESULTS: In the study and control groups, the median of f-NTBUT was 2.1 seconds [interquartile range (IQR); 1.5-5.0] and 5.7 seconds (IQR; 2.9-8.8) and the median of average noninvasive tear break-up time was 5.6 seconds (IQR; 3.6-9.5) and 7.2 seconds (IQR; 4.2-10.7), respectively (P = 0.007 and P = 0.487, respectively). The mean Schirmer value was 16.3 ± 5.9 mm (range; 5-25) and 17.3 ± 6.6 mm (range; 5-30) in the study and control groups (P = 0.604). In upper eyelid meibography, the median of loss in the meibomian glands was 20.10% (IQR; 11.60%-40.80%) in the study group and 14.70% (IQR; 10.40%-21.30%) in the control group (P = 0.043). In lower eyelid meibography, the median of loss in the meibomian glands was 19.00% (IQR; 13.60%-35.30%) in the study group and 12.40% (IQR; 9.10%-16.40%) in the control group (P = 0.002). The median of the Nelson grade in conjunctival impression cytology was 1 (IQR; 0-1) in the study group and 1 (IQR; 0-1) in the control group (P = 0.445). CONCLUSIONS: The loss in the meibomian glands together with the shortened f-NTBUT shows that there could be a predisposition in OSAHS for evaporative dry eye originating from meibomian gland damage.