CT features of pulmonary embolism in patients with COVID-19 pneumonia.

OBJECTIVE: The aim of this study was to describe the Computed Tomography (CT) features of pulmonary embolism in patients hospitalized for acute COVID-19 pneumonia and to evaluate the prognostic significance of these features. PATIENTS AND METHODS: This retrospective study included 110 consecutive patients who were hospitalized for acute COVID-19 pneumonia and underwent pulmonary computed tomography angiography (BTPA) on the basis of clinical suspicion. The diagnosis of COVID-19 infection was determined by CT findings typical of COVID-19 pneumonia and/or a positive result of a reverse transcriptase-polymerase chain reaction test. RESULTS: Of the 110 patients, 30 (27.3%) had acute pulmonary embolism and 71 (64.5%) had CT features of chronic pulmonary embolism. Of the 14 (12.7%) patients who died despite receiving therapeutic doses of heparin, 13 (92.9%) had CT features of chronic pulmonary embolism and 1 (7.1%) of acute pulmonary embolism. CT features of chronic pulmonary embolism were more common in deceased patients than in surviving patients (92.9% vs. 60.4%, p=0.01, respectively). Low oxygen saturation and high urine microalbumin creatinine ratio at admission in COVID-19 patients are important determinants of mortality after adjusting for sex and age in logistic procedures. CONCLUSIONS: CT features of chronic pulmonary embolism are common in COVID-19 patients undergoing Computed Tomography Pulmonary Angiography (CTPA) in the hospital. The coexistence of albuminuria, low oxygen saturation and CT features of chronic pulmonary embolism at admission in COVID-19 patients may herald fatal outcomes.

Pulmonary embolism in patients with dyspnea after COVID-19 infection.

OBJECTIVE: Pulmonary embolism as a potential complication that may occur late in the course of COVID-19 cases. The aim of our study is to evaluate the frequency of pulmonary embolism in patients with new or ongoing dyspnea after a COVID-19 infection. PATIENTS AND METHODS: This is a single-center, prospective observational study to evaluate the clinical and radiological outcomes of consecutive patients presenting outpatient clinic diseases to the chest and a new or ongoing dyspnea after a COVID-19 infection. Demographic, clinical and laboratory data were collected. Dyspnea was evaluated according to the New York Heart Association (NYHA) classification. RESULTS: Pulmonary embolism was detected in 23.8% (25/105) of patients with new or ongoing dyspnea after a COVID-19 infection. Proportion of pulmonary embolism in patients with NYHA classes I, II, III and IV were respectively 8.7%, 20.0%, 30.0% and 35.3% (p for trend=0.02). Compared to NYHA class I and II patients with dyspnea, those in NYHA classes III and IV showed a higher rate of pulmonary embolism [31.6% vs. 14.6%, OR: 2.7 (1.0 to 7.1), p=0.04, respectively]. In Logistic Procedures, NYHA classes of dyspnea (OR: 4.3, 95% CI: 1.2 to 16.6, p=0.03) (NYHA class III and IV vs. NYHA class I and II) determine the likelihood of pulmonary embolism after COVID-19 infection. CONCLUSIONS: Pulmonary embolism is common in patients with new or ongoing shortness of breath after a COVID-19 infection. Pulmonary embolism is more likely to develop in patients with higher NYHA classes.

Association among CO-RADS score, co-morbid diseases, and short-term prognosis in COVID-19 infection.

OBJECTIVE: CO-RADS scoring system is used as a diagnostic tool. However, the data about its association with co-morbid diseases and effectiveness in predicting intensive care need and short-term mortality are lacking. In our study, we aimed to investigate the association among CO-RADS score, co-morbid diseases, intensive care need, and 28-day-mortality. PATIENTS AND METHODS: The study included 665 patients with COVID-19 infection suspicion between 30 May 2020 and 30 October 2020. RESULTS: The sensitivity of CT was 77%, and specificity was 52%. A higher CT score was associated with the rate of positive PCR test results (p<0.001), and older patients had higher CO-RADS scores than younger patients (p<0.001). Hypertension (OR: 7.956; p=0.005) and diabetes mellitus (OR: 5.902; p=0.015) were associated with significantly higher CO-RADS scores. Most patients treated in the intensive care unit (ICU) had a CO-RADS score of 5. The CO-RADS score was 4 and above in 115 (89.2%) patients who were transferred to the intensive care unit due to worsening of clinical condition (p<0.001). The 28-day mortality was significantly higher in patients with a CO-RADS score of 4 and above than in patients with a score of 3 and below (97.3% vs. 2.7%) (p<0.001). CONCLUSIONS: Irrespective of PCR results, a higher CO-RADS score gives us useful information about ICU need or mortality risk and alerts us for early treatment to reduce the risk of further transmission, intensive care need, and mortality particularly in patients with co-morbid diseases.

Association of adenosine deaminase, superoxide dismutase, and catalase activities with Helicobacter pylori.

Our purpose was to investigate associations between adenosine deaminase (ADA), superoxide dismutase (SOD), and catalase (CAT) activities and H. pylori.Ninety-nine patients were studied. Eight antral mucosal biopsies were taken for biochemical assessment of ADA, CAT, AND SOD activity and histological assessment. H. pylori density wAS evaluated according to the updated Sydney system. Patients were divided into three groups according to Sydney classification. ADA activity was found to be higher in patients having H. pylori in the present study. Also, ADA activity was higher in patients with a severe density of H. pylori. SOD level was found to be significantly higher with increased H. pylori density in our study (P < 0.05). In addition, SOD activity was higher in it H. Pylori-positive than H. pylori-negative patients. We did not find CAT activity in some antral tissue specimens. The significantly high levels of ADA activity in patients with H. pylori infection may reflect the regulator role of ADA in acid secretion. The higher ADA level with increased H. pylori density and H. pylori positivity indicate the probable malign lymphoid process of the stomach. But these findings must be confirmed with larger studies that include different gastric lesions.

Effect of thinner inhalation on lipid peroxidation and some antioxidant enzymes of people working with paint thinner.

Paint thinner is a commonly used industrial solvent with considerable potential for abuse by inhalation. Paint thinner is taken into the body by inhalation or by contact with the skin. Paint thinner is oxidized gradually by cytochrome P450-dependent monooxygenase and consequently free radicals are produced. In the present study we measured plasma malondialdehyde (MDA, a product of lipid peroxidation) levels as an indicator of oxidative damage and activity levels of antioxidant enzymes gluthatione peroxidase (GSH-Px) and superoxide dismutase (SOD) in erythrocytes of a group of people (n = 18) working with paint thinner. The control group was composed of 18 healthy adults. There was a statistically significant (p < 0.001) increase in MDA (2.0+/-0.7 nmol ml(-1)) and GSH-Px (86.5+/-16.6 U g(-1) Hb) activity levels in people working with paint thinner compared with control subjects (MDA: 1.0+/-0.3 nmol ml(-1); GSH-Px: 53.9+/-14.5 U g(-1) Hb). Similarly, there was also an increase (p < 0.05) in the SOD levels (1079+/-214.6 U g(-1) Hb) of people working with paint thinner compared with controls (953.3+/-46.7 U g(-1) Hb). Based on our results, it can be concluded that paint thinner inhalation may increase lipid peroxidation and consequently induce antioxidant enzymes.