The Role of Sequentially Monitored Laboratory Values and Inflammatory Biomarkers in Assessing the Severity of COVID-19.

With the onset of the pandemic in 2020, COVID-19 pneumonia has become a common cause for hospitalization and is associated with high mortality rates. Inflammatory biomarkers play a crucial role in understanding and monitoring the progression of various diseases, including COVID-19. The objective of this study was to assess the significance of sequentially monitored standard laboratory tests, including complete blood cell count, D-dimer, fibrinogen, ferritin, albumin, C-reactive protein (CRP), as well as newly calculated inflammatory biomarkers in predicting the severity and prognosis of COVID-19 pneumonia. This single-center retrospective study included 194 patients hospitalized due to COVID-19 pneumonia. Patients were grouped based on the severity of their clinical symptoms, with 134 categorized as severe disease and 60 as mild-moderate disease. The patients' demographic data and laboratory values at hospital admission and on the third day of hospitalization were comparatively evaluated. In the severe illness group, there were more complaints about shortness of breath and a significant drop in the SPO2 value was observed at the time of application (p =0.005 and p<0.001, respectively). The overall mortality rate in all patients was 9% (18/194), and all deaths occurred within the severe disease group. All laboratory parameters, with the exception of platelet count and ferritin levels, were significantly associated and correlated with the severity of the disease during the hospitalization period. Among the biomarkers, there was no significant difference in neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) on the first day, a significant increase was observed on the third day of hospitalization in the severe disease group (p=0.050 vs. 0.003 and p=0.073 vs. 0.020, respectively). No significant difference was observed only in the PNR (platelet/neutrophil ratio) value among the inflammatory biomarkers (p=0.090 vs. p=0.354). In conclusion, the SPO2 level of COVID-19 patients at admission and the subsequent laboratory parameters examined show a significant relationship with the severity of the disease. In addition, simple inflammation biomarkers derived from laboratory values have shown a very significant relationship and correlation in the diagnosis and follow-up of the disease. In both admission and follow-up evaluation, a more significant association was observed with CRP-related biomarkers such as CRP/albumin ratio and CRP/lymphocyte ratio rather than NLR and PLR, which are widely used in the literature, in showing the severity of COVID-19. In patients with pneumonia, the laboratory assessment made on the third day of hospitalization reflects the severity of the disease more clearly than on the first day.

Mean platelet volume in patients with obstructive sleep apnea syndrome and its relationship with cardiovascular diseases.

Obstructive sleep apnea syndrome (OSAS) is an independent risk factor for the development of cardiovascular events and hypertension. Mean platelet volume (MPV), an indicator of platelet activation and aggregation, is closely related with cardiovascular diseases (CVDs). We aimed to show the relationship between OSAS and MPV with CVD. The medical records of 205 patients who were admitted to the sleep study were evaluated. OSAS was diagnosed by polysomnography if the apnea-hypopnea index (AHI) was greater than 5. MPV was calculated from blood samples. According to AHI, individuals in whom AHI was less than 5 were recruited as the control group, those in whom AHI was 5-15 as the mild OSAS group, those in whom AHI was equal to 15-30 as the moderate OSAS group, and those in whom AHI was greater than 30 as the severe OSAS group. Of the patients, 137 (67%) were men and 68 (33%) were women; the mean age was 53.0±14.1 years. There were 35 (17%), 20 (10.2%), 42 (20.4%), and 108 (52.6%) participants in groups 1, 2, 3, and 4, respectively. There were significant differences in terms of coronary artery disease and hypertension between all groups (P<0.05). There was a significant association between the severity of OSAS and MPV in groups 3 and 4, whereas there was not any association in groups 1 and 2 (group 1=9.3±0.7, group 2=9.4±0.8, group 3=9.5±1.1, group 4=10.2±1.2; P for trend 0.03). We showed that MPV was significantly increased in patients with OSAS, which is an independent risk factor for CVD. Therefore, MPV could be used as a marker to predict CVD in OSAS.

Gluteal abscess: An unusual complication of Bacille Calmette-Guérin.

Bacille Calmette-Guerin (BCG) has been used extensively as a vaccine against human tuberculosis. Herein, we describe gluteal tuberculosis abscess due to inadvertently injected BCG a patient with bladder cancer.