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Objective:The number of patients with COVID-19 has rapidly increased, thereby exceeding the capacities of health systems and causing serious losses in affected countries because of the rapid spreading potential, high virulence, and lack of vaccine and proven antiviral therapy. This may indicate the importance of protocol-based treatments in maintaining the treatment process accurately, with minimal errors. This study aimed to present the results of a protocol-based treatment prepared in accordance with the “Surviving Sepsis Campaign COVID-19 treatment guideline.”Materials And Methods:This retrospective and prospective study used data of five hospitals. Intensive care and treatment approaches were carried out in accordance with the “COVID-19 approach protocol” prepared according to the “Surviving Sepsis Campaign COVID-19 treatment guideline.”Results:A total of 1143 patients admitted to five hospitals were hospitalized with a prediagnosis of COVID-19, and 115 patients needed intensive care. Among them, patients without COVID-19 were excluded and the remaining 77 patients were evaluated. In this study, 9 (11.7%) of the 77 patients were lost. While the mortality rate did not differ by sex (p=0.661), the mean age of deceased patients was significantly higher (p=0.006). Considering their comorbidities, the mortality rates of patients with hypertension, chronic renal failure, and cancer were significantly higher (p=0.034, p=0.014, and p=0.007, respectively).Conclusion:The mortality rate in this series may suggest that the treatments performed in line with the “Survival in Sepsis Campaign COVID-19 treatment guideline” are useful. However, when the causes of mortality and morbidity were evaluated, good observation of neurological, infective, respiratory, and immune complications may be considered the main factor in reducing mortality and should be included in the guideline.

Dincer, Alp/0000-0001-9158-8353; Afsar, Nazire/0000-0001-8123-8560; KAYA, DILAVER/0000-0002-7364-171X; Yildirim, Duzgun/0000-0002-5411-229X; Sarikaya, Zeynep Tugce/0000-0002-1352-7667; Dogan, Lerzan/0000-0002-1456-4072; Korkmazer, Bora/0000-0001-7015-365X; Mammadov, Orkhan/0000-0001-7648-2948 WOS:000574262800006 PubMed ID: 32384020 [No abstract available]

Background An association between IL-6 levels and cytokine storm syndrome in COVID-19 patients has been suggested. Cases with higher IL-6 levels have more rapid progression and a higher complication rate. On the other hand, COVID-19 cases with anosmia have a milder course of the disease. Objective We aimed to investigate whether there is a relationship between serum IL-6 levels and presence of anosmia in COVID-19 patients. Methods Patients with a confirmed diagnosis of COVID-19 based on laboratory (PCR) were stratified into two groups based on presence of olfactory dysfunction (OD). In all cases with and without anosmia; psychophysical test (Sniffin' Sticks test) and a survey on olfactory symptoms were obtained. Threshold (t) – discrimination (d) – identification (i), and total (TDI) scores reflecting olfactory function were calculated. Clinical symptoms, serum IL-6 levels, other laboratory parameters, and chest computed tomography (CT) findings were recorded. Results A total of 59 patients were included, comprising 23 patients with anosmia and 36 patients without OD based on TDI scores. Patients with anosmia (41.39 ± 15.04) were significantly younger compared to cases without anosmia (52.19 ± 18.50). There was no significant difference between the groups in terms of comorbidities, smoking history, and symptoms including nasal congestion and rhinorrhea. Although serum IL-6 levels of all patients were above normal values (7 pg/mL), patients with anosmia had significantly lower serum IL-6 levels (16.72 ± 14.28 pg/mL) compared to patients without OD (60.95 ± 89.33 pg/mL) (p = 0.026). Conclusion Patients with COVID-19 related anosmia tend to have significantly lower serum levels of IL-6 compared to patients without OD, and the lower IL-6 levels is related to milder course of the disease. With the effect of low cytokine storm and IL-6 level, it may be said that anosmic cases have a milder disease in COVID-19., Highlights • Cytokine storm syndrome in COVID-19 is associated with poor prognosis and mortality. • IL-6 is one of the most important mediators of cytokine storm syndrome. • Patients with COVID-19-related anosmia usually have a mild disease. • Serum IL-6 level of patients with COVID-19-related anosmia is higher than normal, it is lower than patients without anosmia.