Importance of evaluation of heart-type fatty acid binding protein (H-FABP) in COVID-19 Patients.

INTRODUCTION: Recent studies have documented the cardiovascular consequences of acute coronavirus disease 2019 (COVID-19), although one of the early cardiac markers that can be used for diagnosis, the heart-type fatty acid-binding protein (H-FABP), has not been covered. Through the evaluation of H-FABP levels, we aim to contribute to the early diagnosis and treatment of cardiac problems in COVID-19 infection patients. METHODOLOGY: Seventy-five patients who were admitted to the emergency department of Mehmet Akif Ersoy Hospital with a complaint of chest pain in the last 6 hours and whose corona PCR tests were positive, were included in our study as the case group and 60 healthy volunteers as the control group. The routine cardiac markers such as creatine kinase MB (CK-MB) cardiac troponin T (cTnT), and H-FABP levels were analyzed by routine laboratory methods. RESULTS: The mean age and gender distributions of the groups did not differ statistically (p > 0.05). CK-MB, cTnT, and H-FABP measurements were statistically different between the groups (p = 0.001; p < 0.01). CONCLUSIONS: The relationship between AMI and COVID-19 with routine cardiac markers is already supported by recent studies. We also evaluated H-FABP levels in our study, as it affects the prognosis of the disease independent of the chronic disease history. At the same time, we showed that H-FABP levels increase earlier than routine cardiac markers, so it will be useful for COVID-19 patients with cardiac complaints.

Evaluation of Ischemic Modified Albumin Levels in Coronavirus Disease 2019-Positive and -Negative Patients with Acute Cardiac Injury.

BACKGROUND: The severe acute respiratory syndrome coronavirus 2 is the source of the global pandemic known as coronavirus disease 2019, and the disease prognosis is also linked to the prevalence of cardiac problems. In our study, we aimed to contribute to the early diagnosis and treatment of cardiac complications by evaluating ischemic modified albumin levels in adults with coronavirus disease 2019 disease. METHODS: Our study was conducted with a total of 176 cases: group 1 (n = 70) with cardiac injury and coronavirus disease 2019 (+), group 2 (n = 57) with cardiac injury and coronavirus disease (-), and group 3 (n = 49) with healthy volunteers. The Mann-Whitney U test, the average, SD, minimum and maximum values, intergroup comparison of the results, and statistical significance were evaluated with the Pearson correlation coefficient. RESULTS: As a result of the bilateral comparisons, ischemic modified albumin measurements of the coronavirus disease 2019 (+) and coronavirus disease 2019 (-) groups were higher than the control group (P =.006 and P =.006, respectively). There was no statistically significant difference between ischemic modified albumin measurements of coronavirus disease 2019 (+) and coronavirus disease 2019 (-) groups. CONCLUSION: Ischemic modified albumin measurement accelerates the diagnosis and treatment process in the evaluation of cardiac injuries in coronavirus disease 2019 patients.

One-Year Post-Vaccination Longitudinal Follow-Up of Quantitative SARS-CoV-2 Anti-Spike Total Antibodies in Health Care Professionals and Evaluation of Correlation with Surrogate Neutralization Test.

Numerous vaccines have been generated to decrease the morbidity and mortality of COVID-19. This study aims to evaluate the immunogenicity of the heterologous boosts by BioNTech against homologous boosts by CoronaVac at three-month intervals in two health care worker (HCW) cohorts, with or without prior COVID-19, for one year post-vaccination. This is a prospective cohort study in which the humoral responses of 386 HCWs were followed-up longitudinally in six main groups according to their previous COVID-19 exposure and vaccination status. Anti-SARS-CoV-2 spike-RBD total antibody levels were measured and SARS-CoV-2 neutralization antibody (NAbs) responses against the ancestral Wuhan and the Omicron variant were evaluated comparatively using international standard serum for Wuhan and Omicron, as well as with the aid of a conversion tool. The anti-SARS-CoV-2 spike-RBD total Ab and Nab difference between with and without prior COVID-19, three months after two-dose primary vaccination with CoronaVac, was statistically significant (p = 0.001). In the subsequent follow-ups, this difference was not observed between the groups. Those previously infected (PI) and non-previously infected (NPI) groups receiving BioNTech as the third dose had higher anti-SARS-CoV-2 spike total Ab levels (14.2-fold and 17.4-fold, respectively, p = 0.001) and Nab responses (against Wuhan and Omicron) than those receiving CoronaVac. Ab responses after booster vaccination decreased significantly in all groups at the ninth-month follow-up (p < 0.05); however, Abs were still higher in all booster received groups than that in the primary vaccination. Abs were above the protective level at the twelfth-month measurement in the entire of the second BioNTech received group as the fourth dose of vaccination. In the one-year follow-up period, the increased incidence of COVID-19 in the groups vaccinated with two or three doses of CoronaVac compared with the groups vaccinated with BioNTech as a booster suggested that continuing the heterologous CoronaVac/BioNTech vaccination, revised according to current SARS-CoV-2 variants and with at least a six-month interval booster would be an effective and safe strategy for protection against COVID-19, particularly in health care workers.

Diagnostic values of edema-sensitive T2-weighted imaging, TSE T1-weighted early contrast-enhanced imaging, late gadolinium enhancement, and the Lake Louise criteria in assessing acute myocarditis: A single-center cardiac magnetic resonance study.

OBJECTIVE: The aim of this study was to evaluate the diagnostic accuracy of the Lake Louise consensus criteria using cardiac magnetic resonance (CMR) imaging assessment of edema, hyperemia, and late gadolinium enhancement (LGE) in the diagnostic determination of acute myocarditis. METHODS: A total of 44 patients with acute myocarditis and 24 healthy controls were included in this retrospective study. The presence of edema was defined as a myocardial mean signal intensity >1.9 times that of the skeletal muscle in the same slice on T2-weighted short tau inversion-recovery sequences. Hyperemia was defined as an early gadolinium enhancement ratio (EGEr) ≥4 calculated using the contrast-enhancement of the myocardium and skeletal muscle on TSE T1-weighted sequences, and LGE was assessed by visual examination. The reference methods used to determine the presence of myocarditis were based on the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases guidelines for clinical and biochemical findings. RESULTS: The diagnostic accuracy of edema, hyperemia, LGE, and the Lake Louise criteria (at least 2 of 3 components) was 75.7%, 64.2%, 88.5%, and 84.2%, respectively. Among the 3 components of the Lake Louise criteria, edema had the highest specificity (100%), and LGE had the highest sensitivity (86%). The use of LGE and/or edema as a criterion for acute myocarditis revealed the highest diagnostic accuracy (92.8%) among the CMR sequences and combinations of components examined. CONCLUSION: LGE and/or edema as a sole criterion for the diagnosis of acute myocarditis demonstrated better diagnostic accuracy than the Lake Louise criteria. The use of EGEr did not improve the performance of CMR-based diagnosis. Alternatives to the use of EGEr are recommended for the diagnosis of acute myocarditis.

[Investigation of high-risk ST131 clone in ESBL-producing Escherichia coli isolates isolated from urine and non-urinary clinical specimens with MALDI-TOF MS and real time PCR]. / Idrar ve idrar disi klinik örneklerden izole edilen GSBL üreten Escherichia coli izolatlarinda yüksek riskli ST131 klonunun MALDI-TOF MS ve gerçek zamanli PCR ile arastirilmasi.

In recent years, the ST131 clone was identified as a high risk pandemic clone among Escherichia coli isolates by multilocus sequence typing (MLST) studies and has been associated with extended spectrum beta-lactamase (ESBL) production (often with CTX-M-15) and antibiotic resistance especially against fluoroquinolones. The aim of this study was to determine the rate of high risk ST131 clone in ESBL producing E.coli isolates in our region, to investigate the sensitivity of MALDI-TOF MS in the detection of ST131 clone, and to compare the frequency of antimicrobial resistance among ST131 and non-ST131 isolates. A total of 251 urinary and 50 non-urinary E.coli isolates identified in our hospital central laboratory between February 2016-February 2017 were included in the study. Real-time PCR and MALDI-TOF MS methods were used for the detection of E.coli ST131 clone. For the statistical evaluation of the rate of antibiotic resistance among isolates of ST131 and non-ST131 clones, chi-square test was used. p value under 0.05 was considered as significant. Of the 301 isolates, 110 (36.6%) and 92 (30.6%) isolates were identified as ST131 clone by real-time PCR and MALDI-TOF MS, respectively. According to real-time PCR results, 91 (36.3%) of 251 urinary isolates and 19 (38%) of 50 non-urinary isolates were found as ST131 clone; there was no statistically significant difference between the groups. Ciprofloxacin resistance was found to be significantly higher in ST131 isolates than the non-ST131 isolates (78.2%, n= 86 vs. 53.4%, n= 102). No statistically significant difference was determined for the other antibiotics tested. For the detection of E.coli ST131 clone; sensitivity of MALDI-TOF MS was 84%, specificity was 100% while positive predictive value was 100% and negative predictive value was 92%. In conclusion, further investigation of the high risk E.coli ST131 clone in our country, in which ESBL ratios and antibiotic resistance rates, especially in fluoroquinolones, are high, is important for the development of new strategies to control antibiotic resistance. MALDI-TOF MS method is particularly useful for easy and fast detection of the high risk E.coli ST131 clone.

Molecular characterization of carbapenem- resistant Enterobacteriaceae yields increasing rates of NDM-1 carbapenemases and colistin resistance in an OXA-48- endemic area.

We aimed to characterize carbapenem-resistant isolates in a tertiary hospital in Istanbul, Turkey, high-prevelance area for OXA-48 producers. About 76 Enterobacteriaceae clinical isolates were included. Carbapenemase production was detected by Carbapenem Inactivation Method and carbapenemase genes were investigated by PCR. The clonal relationships were evaluated by AP-PCR. Nineteen Klebsiella pneumoniae isolates were colistin resistant. About 75 isolates yielded carbapenemase by CIM. 52 OXA-48, 17 NDM-1 and 2 VIM-5 carbapenemase genes were detected. Co-production of 'OXA-48 and NDM-1' and 'OXA-48 and VIM-5' were demonstrated in two Klebsiella pneumoniae isolates. The total clustering rate was 20.2%. About 69 Klebsiella pneumoniae yielded 60 profiles and 12 isolates formed five clusters. We have demonstrated the presence of OXA-48 carbapenemases in the majority of isolates in a large collection of carbapenemase-producing isolates from a single hospital. The relatively high rates of NDM-1-producing isolates and colistin resistance is noteworthy.