Can Fetuin-A Deficiency Predict the Severity of COVID-19 Disease in Kidney Transplant Recipients?

BACKGROUND: This study aims to investigate whether fetuin A deficiency predicts the prognosis of COVID-19 disease in kidney transplant recipients (KTRs). METHOD: The study was conducted on 35 hospitalized KTRs with COVID-19 pneumonia between November 2020 and June 2021. Serums were collected for fetuin-A measurement at admission and after six months of follow-up. The demographic and laboratory data of the patients were recorded and analyzed with the appropriate statistical method. RESULTS: A total of 35 KTRs, 23 of which (65.7%) were men, were included in the study. The mean age of the patients was 51.6 ± 14.0 years. Seventeen (48.6%) patients had severe disease criteria and required intensive care (ICU) support. Biopsy-proven acute rejection developed in 6 (17.1%) patients in the follow-up. At admission, the median fetuin-A value was 173.5 mcg/mL (143.5-199.25) in the moderate disease group and 126.0 mcg/mL (89.4-165.5) in the severe patient group (p = 0.005). While the Median fetuin-A value at the time of diagnosis was 173.5 mcg/mL (143.5-199.25), and in the 6th month was 208 mcg/mL [184-229] (p<0.001). By ROC analysis, the effect of serum fetuin-A level in predicting the severity of COVID-19 disease was significant (AUC: 0.771, p = 0.006, 95% CI: 0.615-0.927). When serum fetuin-A cut-off value was taken as 138 mcg/mL to determine disease severity, it was shown to have 83.3% sensitivity and 64.7% specificity. CONCLUSIONS: Serum fetuin-A level can predict disease severity in kidney transplant recipients in the presence of active COVID-19 disease.

Leptospirosis during the COVID-19 pandemic: a case report.

Since SARS-CoV-2 disease (COVID-19) has been labeled as a pandemic, it took the spotlight in the differential diagnosis for patients presenting with acute respiratory and systemic symptoms. Leptospirosis is one of the most common zoonoses in the world, yet it is mainly a disease of differential diagnosis for places that do not have it as an endemic. Due to the high burden of COVID-19 on the healthcare field, patients suffering from other infections may have been inadvertently neglected. COVID-19 infection can mimic other infectious diseases and can confuse physicians in their search for a confirmatory diagnosis. Nonetheless, it is very crucial to broaden the differential diagnosis and keep diseases like leptospirosis within the differential diagnosis despite its rarity, especially in patients presenting with unexplained systemic infectious symptoms. This is a unique case of a patient who presented with dyspnea, jaundice and change in urine color who was suspected to be COVID-19 positive. After a detailed investigation, the patient was diagnosed with leptospirosis instead of COVID-19 and was treated with plasmapheresis and antibiotics accordingly.

Demographic, clinical and laboratory characteristics of adult-onset minimal change disease in Turkey: Turkish Society of Nephrology-Glomerular Diseases (TSN-GOLD) Working Group.

PURPOSE: In our study, diagnostic and demographic characteristics of patients diagnosed with minimal change disease (MCD) by biopsy, clinical and laboratory findings in our country were investigated. METHODS: Data were obtained from the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group database. Demographic characteristics, indications for biopsy, diagnosis of the glomerular diseases, comorbidities, laboratory and biopsy findings of all patients were recorded. The data presented are cross-sectional and includes application data for the biopsy period. RESULTS: Of 3875 patients, 233 patients with MCD (median age 35.0 years) were included in the study, which constitutes 6.0% of the total glomerulonephritis database. Renal biopsy was performed in 196 (84.1%) patients due to nephrotic syndrome. Median serum creatinine was 0.7 (0.6-1.0) mg/dl, mean eGFR was 104 ± 33 ml/min/1.73 m2 and median proteinuria 6000 mg/day. The number of patients under the age of 40 years was 139 (59.7%) (Group A), and the number of patients aged 40 years and over was 94 (40.3%) (Group B). Compared to Group A, global sclerotic glomeruli (24 vs. 43, p < 0.001) interstitial inflammation (15 vs. 34, p < 0.001), interstitial fibrosis (20 vs. 31, p = 0.001, vascular changes (10 vs. 25, p < 0.001) and tubular atrophy (18 vs. 30, p < 0.001) were found to be significantly higher in Group B. There was no difference in immunofluorescent staining properties between the two groups. CONCLUSION: Our data are generally compatible with the literature. Chronic histopathological changes were more common in patients aged 40 years and older than younger patients. Studies investigating the effects of these different features on renal survival are needed.

Association of mortality and endothelial dysfunction with serum ADMA level in COVID-19 patients.

Objectives: To investigate the role of asymmetric dimethylarginine (ADMA) level in predicting intensive care and mortality in patients affected with coronavirus disease 2019 (COVID-19). Methods: This retrospective, cross-sectional study was conducted at Sakarya University Training and Research Hospital (Sakarya, Turkey) between April and August of 2020. We enrolled patients who were diagnosed with COVID-19 via real-time reverse-transcription polymerase chain reaction and admitted to the intensive care (Severe COVID-19; S-COVID) or non intensive care (Moderate COVID-19; M-COVID). We then analyzed the relationship of the ADMA level with various parameters between S-COVID and M-COVID groups. Results: This study included 87 patients, comprising 43 females and 44 males, with a mean age of 61 and 71.50 years, respectively. The male/female distribution was 22/25 (46.8%/53.2%) in the M-COVID group and 22/18 (55%/45%) in the S-COVID group. The hospitalization time, white blood cell count, neutrophil count, lymphocyte-to-albumin ratio, international normalization ratio, D-dimer, troponin, ferritin, lactate dehydrogenase, C-reactive protein, procalcitonin, erythrocyte sedimentation rate, fibrinogen, lactate, ADMA, and mortality rate were significantly higher (p < 0.05). In contrast, lymphocyte, total cholesterol, high-density lipoprotein, calcium, and albumin values were lower (p < 0.05) in the S-COVID group than in the M-COVID group. While the mortality rate was 55% in S-COVID patients, no mortality was detected in M-COVID patients (p < 0.05). Moreover, ADMA level was 6618 ± 3000 (6400) in S-COVID patients and 5365 ± 3571 (3130) in M-COVID patients, indicating a statistically significant difference (p = 0.012). Conclusion: The asymmetric dimethylarginine level increases in severe outcomes; hence, it can potentially predict severity in patients with COVID-19.

Association of C-reactive Protein/Albumin, Procalcitonin/Albumin, Platelet/Lymphocyte, and Lymphocyte/Monocyte Ratio with Mortality in Hospitalised COVID-19 Patients.

OBJECTIVE: To investigate and compare complete blood count and biochemistry parameters such as c-reactive protein/albumin (CRP/ALB) ratio, procalcitonin/albumin (PRO/ALB) ratio, lymphocyte/monocyte (LYM/MON) ratio, platelet/lymphocyte (PLT/LYM) ratio of the recovered/deceased, and ICU (intensive care unit) /ward patients with COVID-19. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Department of Internal Medicine, Sakarya University Training and Research Hospital, Turkey, from April 2020 to January 2021. METHODOLOGY: The study was conducted with 590 diagnosed patients with COVID-19. The patients were divided into 2 groups as deceased (n = 294) /survivor (n = 296) and those in need of ICU (n= 418) /ward (n = 172). The information was obtained from the hospital information system and analysed retrospectively. The relationships of crp/alb, pro/alb, lym/mon, and PLT/LYM ratios with patient groups were investigated. RESULTS: Of the total 590 patients in the study, 358 (60.6%) were males. The total mean age was 65.63 ±14.9 years. The mean age of survivor and deceased groups was 71.32±10.9 and 59.97±16.2 years, respectively (p.

Depression and Anxiety Disorders in COVID-19 Survivors: Role of Inflammatory Predictors.

Introduction: Infection-triggered perturbation of the immune system, which was observed after previous coronavirus outbreaks, could induce psychiatric sequelae. The spreading of the Coronavirus-19 (COVID-19) pandemic could be associated with psychiatric implications. In this study, we aimed to evaluate the association between inflammatory biomarkers and the levels of depression and anxiety in patients who recovered from COVID-19. Methods: We screened 109 COVID-19 survivor adults for psychiatric symptoms on the 15th day of follow-up after discharge from the hospital. The patients were split into two groups, the ones with depression and anxiety, and the ones without depression or anxiety, after the psychiatric interview. Self-rating Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were applied to assess the levels in patients with depression and anxiety. We collected and recorded the sociodemographic information, clinical data, and baseline inflammatory markers. Results: Higher baseline neutrophil/lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) were found in patients with depression and anxiety. Higher levels of depression and anxiety were found in younger and female patients. Besides, a significant correlation was found between BAI and ferritin levels in patients with anxiety, while no association was found between BAI and other inflammatory biomarkers. Moreover, no significant relationship was found between BDI scores and inflammatory biomarkers in patients with depression. Conclusion: COVID-19 primarily affects the respiratory and cardiovascular systems. Nonetheless, psychiatric involvement is not uncommon and can lead to severe problems if not detected and managed at an early stage. It is recommended that clinicians should be vigilant in terms of psychiatric involvement in COVID-19 patients presenting with high inflammatory parameters.

Short and mid-term SARS-CoV-2 antibody response after inactivated COVID-19 vaccine in hemodialysis and kidney transplant patients.

The efficacy of the inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine has not been fully elucidated across the whole spectrum of patients on kidney replacement therapy. We aimed to characterize the long-term antibody response of inactivated SARS-CoV-2 vaccine administered in kidney transplant recipients (KTRs) and hemodialysis (HD) patients. We performed this prospective observational study in 50 HD, 64 KTR, and 41 healthy control groups (HG) given two doses of CoronaVac. We measured anti-Spike antibodies after 28 days of every vaccine dose, 3rd and 6th months after the first dose, and compared them between cohorts. After two doses, an anti-spike immunoglobulin G of ≥50 AU/ml was present in HD, KTR, and HG as 44%, 7.2%, and 58.5%, respectively (p < 0.001). Furthermore, the proportion of antibody titers peaked at 86.5%, 23%, and 97.6% (p < 0.001) at the 3rd month and decreased significantly at the 6th month in most HD and HG participants, whereas this effect was not observed in KTRs from basal until the 6th month (p < 0.001). During the follow-up, the incidence of coronavirus disease 2019 disease was higher (p < 0.003) in KTRs compared to the other groups, but there was no requirement for an intensive care unit and no death was recorded. We found a negative correlation between antibody seroconversion and age (p < 0.016). The antibody response following inactivated vaccine in dialysis patients is almost comparable to controls for 6 months. In contrast, kidney transplant patients have a poor response. These findings reinforce the need to discuss the vaccination strategy in immunocompromised patients, including the third dose with homologous or heterologous vaccines.

Serum calprotectin as a novel biomarker for severity of COVID-19 disease.

BACKGROUND: Some biomarkers have been reported to be related to the prognosis of the coronavirus disease 2019 (COVID-19). There are sparse data regarding the prognostic value of serum calprotectin in COVID-19 patients. AIMS: This study aimed to investigate the relationship between serum calprotectin level and clinical severity of COVID-19 disease in hospitalized patients. METHODS: This retrospective cross-sectional cohort study included 80 consecutive hospitalized patients with confirmed diagnosis of COVID-19. The study population was divided into two groups as patients hospitalized in the intensive care unit (ICU) and patients hospitalized but not in the ICU. The serum calprotectin levels, other laboratory, and clinical parameters were compared between groups. RESULTS: The mean age of the patients was 66.5 ± 15.7 years. Of the patients, 42 were in the ICU and 38 were not. Serum calprotectin level and acute-phase reactants such as C-reactive protein, procalcitonin, ferritin, fibrinogen, and white blood cell were significantly higher in ICU patients than in non-ICU patients. ROC curve analysis identified that serum calprotectin level was a predictor for ICU requirement with an area under the curve of 0.641 (p = 0.031). Logistic regression analysis revealed that serum calprotectin was a significant determinant for whether or not patient required the ICU. CONCLUSIONS: These findings demonstrate that serum calprotectin level seems to be a useful biomarker that can predict the severity of COVID-19 disease. Serum calprotectin is a significant predictor of ICU requirement in patients with COVID-19.

The effectiveness of dexamethasone on the prognosis of dialysis patients with severe COVID-19.

OBJECTIVE: This study aimed to investigate the effectiveness of dexamethasone in dialysis patients with COVID-19 and whether it predicts mortality. METHODS: This is a comparative cross-sectional study of 113 consecutive patients with COVID-19 with severe pneumonia signs. The patients were divided into two groups according to the use of dexamethasone treatment: group 1 (n=45) included patients who were treated with dexamethasone and group 2 (n=68) who did not receive dexamethasone. RESULTS: The mean age of both groups was 67.0±10.6 and 67.2±13.0 years, respectively (p=0.947). With respect to demographic and laboratory findings, there were no significant differences between the two groups (p>0.05). The hospitalization time of patients in group 1 was longer than that in group 2 (11 [7-17] days vs. 8 [5.3-14] days, p=0.093]. The 28-day survival rate was 54.2% in the group receiving dexamethasone treatment and 79.5% in the group not receiving dexamethasone treatment (p=0.440). CONCLUSION: Dexamethasone did not reduce mortality rates and the requirement for intensive care unit in dialysis patients with COVID-19. Larger prospective randomized clinical trials are required to associate personalized medicine with the corticosteroid treatment to select suitable patients who are more likely to show a benefit.

The prognostic significance of erythrocyte sedimentation rate in COVID-19.

OBJECTIVE: There are limited data about the significance of erythrocyte sedimentation rate as a single prognostic parameter for the prognosis and mortality of COVID-19. This study aimed to investigate the diagnostic utility of erythrocyte sedimentation rate as a prognostic factor for the disease severity and mortality in patients with COVID-19. METHODS: A total of 148 consecutive patients with a confirmed diagnosis of COVID-19 and hospitalized at the intensive care unit or non-the intensive care unit were included in the study. The patients were allocated to groups as severe/critical disease versus nonsevere disease and survivors and nonsurvivors. The prognostic role and predictable values of erythrocyte sedimentation rate were analyzed. RESULTS: Erythrocyte sedimentation rate was found to be higher among patients with severe/critical disease compared to those with nonsevere disease (p<0.001) and among nonsurvivors compared to survivors (p<0.001). The logistic regression analysis showed that erythrocyte sedimentation rate was an independent parameter for predicting disease severity and mortality. The role of erythrocyte sedimentation rate in the assessment of severity and mortality in patients with COVID-19 was analyzed using the receiver operating characteristic curve and was found to be significant in both. The analyses suggested that the optimum erythrocyte sedimentation rate cutoff point for disease severity and mortality were 52.5 mm/h with 65.5% sensitivity and 76.3% specificity and 56.5 mm/h with 66.7% sensitivity and 72.5% specificity. CONCLUSION: Our results suggest that erythrocyte sedimentation rate was an independent prognostic factor for severity and mortality in patients with COVID-19.

Predictive role of FAR ratio in COVID-19 patients.

OBJECTIVE: No effective treatment has yet been found for SARS-Cov-2, which caused a pandemic outbreak in 2019. It is crucial to detect the progression of COVID-19 in patients as early as possible. Fibrinogen to albumin ratio (FAR) has been used as a new inflammatory marker. We aimed to find out whether the use of the FAR as a predictor of mortality in COVID-19 patients provides clinical benefit. MATERIALS AND METHODS: Data from 590 patients with COVID-19 from March 15, 2020 to January 15, 2021 in medicine wards and intensive care units (ICU) were retrospectively analysed. Demographic data and other laboratory markers were collected from the electronic medical records. Relationship between FAR was investigated between patients in the survivor/non-survivor patients. FINDINGS: The mean FAR levels in patients who were non-survivor was 24.44 ± 30.3 (n = 272 and 11.29 ± 6.29 (n = 275) (P = .000) in patients survivor COVID-19 infection. In ROC curve for FAR, the threshold FAR that may pose a risk for mortality was determined as 13.84 ((AUC: 0.808 (0.771-0.844)); 74.9% sensitivity, 74.6% specificity; P = .000)). RESULT: As a result of this study, increased FAR were found to be important markers in determining the mortality levels in COVID-19 patients.

The levels of inflammatory biomarkers in hemodialysis and peritoneal dialysis patients.

OBJECTIVE: In this study, we aimed to determine fibroblast growth factor 23, soluble alpha klotho, osteocalcin, indoxyl sulphate, sclerostin, Procollagen 1 N Terminal Propeptide, and beta-CrossLaps levels in hemodialysis and peritoneal dialysis patients, and to compare the levels of these markers among hemodialysis and peritoneal dialysis patients, as well as healthy individuals. METHODS: The study included 30 hemodialysis and 23 peritoneal dialysis patients who were followed-up for at least six months at the Sakarya University Hospital, besides 30 healthy volunteers. RESULTS: The participants were divided into three groups with similar characteristics in terms of age, gender and body mass index. Fibroblast growth factor 23, soluble alpha klotho, indoxyl sulphate, beta-CrossLaps, and Procollagen 1 N Terminal Propeptide levels were significantly higher in patients of both the hemodialysis and peritoneal dialysis groups than in the healthy volunteers' group. There was no difference in levels of these molecules between hemodialysis and peritoneal dialysis groups. CONCLUSIONS: Fibroblast growth factor 23, sclerostin, indoxyl sulphate, beta-CrossLaps, and Paclitaxel-induced neuropathic pain levels were higher in patients of both groups as inflammatory markers. In our study, we found higher soluble alpha klotho levels in patients of both groups than in the healthy volunteers' group, suggesting that blood soluble alpha klotho levels may not correlate with renal klotho levels.

The prognostic significance of erythrocyte sedimentation rate in COVID-19

SUMMARY OBJECTIVE: There are limited data about the significance of erythrocyte sedimentation rate as a single prognostic parameter for the prognosis and mortality of COVID-19. This study aimed to investigate the diagnostic utility of erythrocyte sedimentation rate as a prognostic factor for the disease severity and mortality in patients with COVID-19. METHODS: A total of 148 consecutive patients with a confirmed diagnosis of COVID-19 and hospitalized at the intensive care unit or non-the intensive care unit were included in the study. The patients were allocated to groups as severe/critical disease versus nonsevere disease and survivors and nonsurvivors. The prognostic role and predictable values of erythrocyte sedimentation rate were analyzed. RESULTS: Erythrocyte sedimentation rate was found to be higher among patients with severe/critical disease compared to those with nonsevere disease (p<0.001) and among nonsurvivors compared to survivors (p<0.001). The logistic regression analysis showed that erythrocyte sedimentation rate was an independent parameter for predicting disease severity and mortality. The role of erythrocyte sedimentation rate in the assessment of severity and mortality in patients with COVID-19 was analyzed using the receiver operating characteristic curve and was found to be significant in both. The analyses suggested that the optimum erythrocyte sedimentation rate cutoff point for disease severity and mortality were 52.5 mm/h with 65.5% sensitivity and 76.3% specificity and 56.5 mm/h with 66.7% sensitivity and 72.5% specificity. CONCLUSION: Our results suggest that erythrocyte sedimentation rate was an independent prognostic factor for severity and mortality in patients with COVID-19.

The effectiveness of dexamethasone on the prognosis of dialysis patients with severe COVID-19

SUMMARY OBJECTIVE: This study aimed to investigate the effectiveness of dexamethasone in dialysis patients with COVID-19 and whether it predicts mortality. METHODS: This is a comparative cross-sectional study of 113 consecutive patients with COVID-19 with severe pneumonia signs. The patients were divided into two groups according to the use of dexamethasone treatment: group 1 (n=45) included patients who were treated with dexamethasone and group 2 (n=68) who did not receive dexamethasone. RESULTS: The mean age of both groups was 67.0±10.6 and 67.2±13.0 years, respectively (p=0.947). With respect to demographic and laboratory findings, there were no significant differences between the two groups (p>0.05). The hospitalization time of patients in group 1 was longer than that in group 2 (11 [7-17] days vs. 8 [5.3-14] days, p=0.093]. The 28-day survival rate was 54.2% in the group receiving dexamethasone treatment and 79.5% in the group not receiving dexamethasone treatment (p=0.440). CONCLUSION: Dexamethasone did not reduce mortality rates and the requirement for intensive care unit in dialysis patients with COVID-19. Larger prospective randomized clinical trials are required to associate personalized medicine with the corticosteroid treatment to select suitable patients who are more likely to show a benefit.

Correlation between venous blood gas indices and radiological involvements of COVID-19 patients at first admission to emergency department.

BACKGROUND: The purpose of this study was to investigate the relation between venous blood gas and chest computerized tomography findings and the clinical conditions of COVID-19 pneumonia. METHODS: A total of 309 patients admitted to the emergency department and subsequently confirmed COVID-19 cases was examined. Patients with pneumonia symptoms, chest computerized tomography scan, venous blood gas findings, and confirmed COVID-19 on reverse transcription-polymerase chain reaction (PCR) were consecutively enrolled. Multiple linear regression was used to predict computerized tomography and blood gas findings by clinical/laboratory data. RESULTS: The median age of patients was 51 (interquartile range 39-66), and 51.5% were male. The mortality rate at the end of follow-up was 18.8%. With respect to survival status of patients pCO2 and HCO3 levels and total computerized tomography score values were found to be higher in the surviving patients (p<0.001 and p=0.003, respectively), whereas pH and lactate levels were higher in patients who died (p=0.022 and p=0.001, respectively). With logistic regression analysis, total tomography score was found to be significantly effective on mortality (p<0.001). The diffuse and random involvement of the lungs had a significant effect on mortality (p<0.001, 95%CI 3.853-38.769, OR 12.222 and p=0.027; 95%CI 1.155-11.640, OR 3.667, respectively). With linear regression analysis, the effect of pH and lactate results were found to have a positive effect on total tomography score (p=0.003 and p<0.001, respectively), whereas pCO2 was found to have a negative effect (p=0.029). CONCLUSION: There was correlation between venous blood gas indices and radiologic scores in COVID-19 patients. Venous blood gas taken in emergency department can be a fast, applicable, minor-invasive, and complementary test in terms of diagnosing COVID-19 pneumonia and predicting the prognosis of disease.

Evaluation of coagulation parameters: Coronavirus disease 2019 (COVID-19) between survivors and nonsurvivors.

OBJECTIVE: This study aims to investigate and compare the coagulation parameters of coronavirus disease 2019 (COVID-19) patients with mortal and nonmortal conditions. METHODS: In this study, 511 patients diagnosed with COVID-19 were included. Information about 31 deceased and 480 recovered COVID-19 patients was obtained from the hospital information management system and analyzed retrospectively. Whether there was a correlation between coagulation parameters between the mortal and nonmortal patients was analyzed. Descriptive analyses on general characteristics of the study population were performed. Visual (probability plots and histograms) and analytical methods (Kolmogorov-Smirnov and Shapiro-Wilk test) were used to test the normal distribution. Analyses were performed using the SPSS statistical software package. RESULTS: Out of 511 patients, 219 (42.9%) were females and 292 (57.1%) were males. There was no statistically significant difference between males and females in terms of mortality (p=0.521). In total, the median age was 67 (22). The median age was 74 (13) in the nonsurvivor group and 67 (22) in the survivor group, and the difference was statistically significant (p=0.007). The D-dimer, prothrombin time, international normalized ratio, neutrophil, and lymphocyte median age values with p-values, in the recovered and deceased patient groups were: 1070 (2129), 1990 (7513) µg FEU/L, p=0.005; 12.6 (2.10), 13.3 (2.1), p=0.014; 1.17 (0.21), 1.22 (0.19), p=0.028; 5.51 (6.15), 8.54 (7.05), p=0.001; and 0.99 (0.96), 0.64 (0.84), p=0.037, respectively, with statistically significant differences. CONCLUSIONS: As a result of this study, D-dimer, prothrombin time, and international normalized ratio increase were found to be associated with mortality. These parameters need to be closely monitored during the patient follow-up.

Evaluation of cardiac parameters between survivors and nonsurvivors of COVID-19 patients.

OBJECTIVE: The present study compares the cardiac parameters of the survivor and nonsurvivor patients with COVID-19 infection. METHODS: This study was conducted in 379 patients diagnosed with COVID-19 disease. Information of 21 nonsurvivor and 358 survivor patients with COVID-19 was obtained from the hospital information management system and analyzed retrospectively. Relationship between cardiac parameters in patients categorized into the mortal and immortal groups was investigated. RESULTS: Of the total 379 patients involved in this study, 155 (40.9%) were females and 224 (59.1%) were males. No statistically significant difference in mortality was found between females and males (p=0.249). The total median age was 70, the median age in the nonsurvivor group was 74 (35-89), and it was 69.5 (18-96) in the survivor group (p=0.249). The median values of high-sensitivity troponin (hs-Tn), creatine kinase MB form, and especially myoglobin in the survivor and nonsurvivor groups were 25/64.9 (p=0.028), 18/23 (p=0.02), and 105.5/322.4 (p<0.001), and the difference was statistically significant. Comparing mortality, while there was 1 (0.7%) nonsurvivor out of 134 patients in the service unit, there were 20 (8.2%) nonsurvivors out of 245 patients in the intensive care unit. This difference was statistically significant (p=0.003). The cutoff value of myoglobin, which may pose a risk of mortality, was found to be 191.4 µg/L, while it was 45.7 ng/l for hs-Tn and 60.1 U/L for creatine kinase MB. CONCLUSIONS: Advanced age and increased levels of high-sensitivity troponin, creatine kinase MB, and myoglobin were found to be associated with mortality.

Prealbumin: A New Biomarker for Predicting Prognosis in Patients with Severe COVID-19.

OBJECTIVE: To analyse whether prealbumin could be a new biomarker for predicting mortality in severe COVID-19 patients. STUDY DESIGN: An observation study. PLACE AND DURATION OF STUDY: Intensive care units (ICU) of Sakarya University Training and Research Hospital, Sakarya, Turkey, from October 2020 to December 2020. METHODOLOGY: The data of 149 patients, who were admitted to the ICU were collected and analysed retrospectively. Routine blood samples were collected from all patients at the time of admission to the ICU; and 102 patients with the mortal course and 47 patients with the non-mortal course were included in the study. The data obtained from these patients were analyzed in the biostatistics programme.  Results: The median age of all patients was 68 years; while 94 of them were males (63.1%) and 55 of them were females (36.9%). Median levels of potassium (K) (p=0.04), uric acid (p=0.001), C-reactive protein (CRP) (p=0.004), and procalcitonin (PCT) (p<0.001) were significantly higher and median level of prealbumin (p=0.002) was significantly lower in the deceased group. The cut-off level of prealbumin for mortality was found as 0.085 g/L (p=0.002). Further analysis revealed that the risk of mortality was found as 2.193 times more in patients with prealbumin levels of <0.085 g/L (Odds Ratio (OR): 2.193, 95% CI: 1.084-4.434). CONCLUSION: As a result of this study, it was found that patients with lower levels of prealbumin at the time of admission to the ICU have a higher risk for mortality. It was showed that prealbumin can be a useful biomarker for predicting mortality in patients with severe COVID-19. Key Words: Prealbumin, COVID-19, Mortality, Prognostic biomarkers, Severe disease.

Association of ABO blood group and age with COVID-19 positive test.

OBJECTIVE: The aim of this study is to evaluate the relation between the coronavirus (SARS-CoV-2) disease (COVID-19) and blood groups and the Rh factor. METHOD: A total of 313 patients hospitalized in the Internal Medicine clinic, at the intensive care unit (ICU) were included in the study. The cases were divided into two groups: those who were COVID-19 positive and those negative, detected with real-time reverse transcription polymerase chain reaction testing. The demographic, clinical, ABO blood groups, and Rh factor data of the cases were obtained from the hospital records retrospectively. RESULTS: The mean age of COVID-19 positive (+) cases was 57.74±16 years and of COVID-19 negative (-) cases, 66.41±15 years. The difference was significant (p<0.001); there was no difference between the two groups in terms of sex (p=0.634). When age was categorically separated in COVID-19 (+) cases, χ2 was extremely significant. Among the ABO blood groups of COVID-19 (+) and (-) cases, χ2 was 4.975 (p=0.174). In the logistic regression, it was 4.1 (p=0.011) in the O blood group. COVID-19 positive test was determined as 13, 4, and 4 times higher in the 31-40, 41-50, and 51-60 age groups, respectively (p=0.001, p=0.010, p=0.003). CONCLUSION: The incidence of COVID-19 has increased in the younger population and in the O blood group. Our findings support that, in this population, the ABO blood groups can contribute to the early detection of COVID-19.