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Objective: The method for predicting the risk of intubation in patients with coronavirus disease 2019 (COVID-19) is yet to be standardized. This study aimed to introduce a new disease prognosis scoring model that may predict the intubation risk based on the symptoms, signs, and laboratory tests of patients hospitalized with the diagnosis of COVID-19., Method: This cross-sectional retrospective study analyzed the intubation status of 733 patients hospitalized with COVID-19 diagnosis between March and December 2020 at Ondokuz Mayıs University Faculty of Medicine, Turkey, based on 33 variables. Binary logistic regression analysis was used to select the variables that significantly affect intubation, which constitute the risk factors. The Chi-square Automatic Interaction Detection algorithm, one of the data mining methods, was used to determine the threshold values of the important variables for intubation classification., Results: The following variables found were mostly associated with intubation: C-reactive protein, lactate dehydrogenase, neutrophil-to-lymphocyte ratio, age, lymphocyte count, and malignancy. The logistic function based on these variables correctly predicted 81.13% of intubated (sensitivity), 99.52% of nonintubated (specificity), and 96.86% of both intubated and nonintubated (accurate classification rate) patients. The scoring model revealed the following risk statuses for the intubated patients: very high risk, 75.47%; moderate risk, 20.75%; and very low risk, 3.77%., Conclusions: On the basis of certain variables measured at admission, the OTO-COVID-19 scoring model may help clinicians identify patients at the risk of intubation and subsequently provide a prompt and effective treatment at the earliest.

COVID-19 affects pregnant women more severely than nonpregnant women of reproductive age. However, the rate of critical illness and fatality reported in other studies varied in a wide range in both groups. The study aims to investigate the clinical outcomes of COVID-19 in the pregnant and nonpregnant matched control patients admitted to the hospital. Pregnant and nonpregnant patients of reproductive age (18-45 years) infected with COVID-19 who were admitted to Ondokuz Mayıs University Hospital, Samsun, Turkey, from March 11 to December 11, 2020, were enrolled in the study. The clinical, radiological, and laboratory data of the patients were analyzed retrospectively. A total of 153 patients were investigated; 123 were nonpregnant, and 30 were pregnant. Emergency delivery occurred in 5 (17%) pregnant women due to acute respiratory failure associated with COVID-19 and 1 (3%) pregnant woman due to obstetric reasons. Four premature births, one perinatal death, and no stillbirth or miscarriage were reported. The rate of admission to the intensive care unit (ICU) [7/30 (23.3%) vs 3/123 (2.4%), p<0.001] and the need for invasive mechanical ventilation (IMV) [5/30 (17.0%) vs 2/123 (1.6%), p=0.003] were significantly higher in pregnant than in non-pregnant patients. However, hospital length of stay (HLOS) and mortality did not differ between groups: HLOS was median 4 vs 5 days, p=0.68, and the mortality rate was 1/123 (0.8%) vs 0/30 (0%), p=0.62 in nonpregnant and pregnant patients respectively. We observed that COVID-19 has a more severe course in pregnant women versus the nonpregnant control group, but no difference was noted in terms of hospital length of stay and mortality. The overall case fatality rate of COVID-19 in hospitalized pregnant or nonpregnant women of reproductive age was found to be much lower than the general hospitalized population worldwide. [ABSTRACT FROM AUTHOR]

Background/aim: Remdesivir, which was first developed for the treatment of Ebola disease but failed to meet expectations, has become hope in the fight against the COVID-19 pandemic. This study aimed to evaluate risk factors for mortality and prognosis of adult moderate/severe COVID-19 patients treated with remdesivir, and safety and tolerability of 5 days of remdesivir treatment. Materials and methods: This multicenter prospective observational study was conducted in 14 centers in Turkey. Pregnancy or breastfeeding, multiorgan failure, or usage of vasopressors for septic shock, ALT > 5 x the upper limit of the normal range, or eGRF <30 mL/min or dialysis and receiving favipiravir were the exclusion criteria of the study. Results: Among 500 patients, 494 patients were included in the study. On admission, 392 (79.3%) patients had moderate and 102 (20.6%) patients had severe COVID-19. The 28-day mortality was 10.1%. The median of the scores of the seven-category ordinal scale assessed on days 0, 3, 5, 7 were 4 and 3 on day 14. When the survival status of the patients was evaluated according to the time between the remdesivir start date and the end date of the symptoms, no statistically significant difference was found between the medians of the groups (p = 0.404). In multivariable analysis, age (OR, 1.05; 95%CI, 1.02-1.08; p = 0.003), SpO2 level on admission (OR, 3.03; 95%CI, 1.35-6.81; p = 0.007), heart rate (OR, 2.48; 95%CI, 1.01-6.07; p = 0.047), follow-up site at the hospital (clinic/ICU) (OR, 26.4; 95%CI, 11.6-60.17; p < 0.001) were independently associated with increased mortality. Grade 3 adverse event (AE) was observed in 4 (0.8%) patients. None of the patients experienced grade 4 or 5 AEs. Conclusion: Remdesivir is a safe and well-tolerated drug and older age, low SpO2 level on admission, tachycardia, and ICU admission are independently associated with increased mortality among patients with moderate/severe COVID-19 receiving remdesivir treatment. [ABSTRACT FROM AUTHOR]