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Introduction: Primarily, this study aimed to investigate the effect of TPE (therapeutic plasma exchange) treatment on successful ECMO weaning in severe COVID-19 ARDS patients treated with V-V ECMO., Methods: The study was applied retrospectively on patients over the age of 18 who were hospitalized in the ICU between January 1, 2020 and March 1, 2022., Results: The study was performed on 33 patients, 36.3% (n: 12) of whom received TPE treatment. The rate of successful ECMO weaning was statistically higher in the TPE treatment group (without TPE: 14.3% [n: 3], with TPE: 50% [n: 6], p = 0.044). The 1-month mortality was also statistically lower in the TPE treatment group (p = 0.044). In the logistic analysis, It was found that the risk of unsuccessful ECMO weaning increased 6 times in those who did not receive TPE treatment (OR; 6.0, 95% CI; 1.134-31.735, p = 0.035)., Conclusion: TPE treatment may increase the success rate of V-V ECMO weaning in severe COVID-19 ARDS patients treated with V-V ECMO., (© 2023 International Society for Apheresis and Japanese Society for Apheresis.)

Objective: To investigate the possible relationship between the severity of the disease and some oxidant-antioxidant markers in patients diagnosed with coronavirus disease-2019 (COVID-19). Methods: A total of 130 cases with a diagnosis of COVID-19 were included in the study, classified as severe (group 1, n=65) and mild/moderate (group 2, n=65) and control group (group 3, n=54). Routine laboratory methods were used to analyze serum C-reactive protein, D-dimer, procalcitonin, and ferritin levels. In addition, the levels of oxidants, including malondialdehyde (MDA) and myeloperoxidase (MPO), as well as antioxidants, such as glutathione peroxidase (Gpx), superoxide dismutase (SOD), uric acid, and native thiol, were analyzed. The descriptive statistics of continuous variables were reported as the median with a range of minimum to maximum values. Furthermore, statistical tests such as the Kolmogorov-Smirnov and Mann-Whitney U tests were used. The chi-square test was used to investigate any statistical associations between groups and other categorical independent variables. To determine the significance, analysis of covariance (ANCOVA) was performed. Results: The results showed that both group 1 and group 2 COVID-19 patients had considerably higher levels of routine laboratory tests than the control group (p<0.001). Furthermore, significantly lower levels of native thiol were found in both groups 1 and 2 compared with the control group (p<0.001 for both). In addition, a significant difference was observed between group 1 and group 2, with group 1 showing markedly lower levels of native thiol (p<0.001). Conclusion: We concluded that the oxidative stress indicators MDA and MPO and the antioxidant indicators Gpx and SOD cannot be used to determine the severity of COVID-19, but decreasing natural thiol levels can be an indicator of disease severity in this population. In addition, these data may be important in explaining the mechanism of N-acetylcysteine therapy in COVID-19 cases. [ABSTRACT FROM AUTHOR]

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The Coronavirus disease (COVID-19) rapidly spread all around the world and was declared a worldwide pandemic by World Health Organization in March 2020. We aimed to investigate the clinical, demographic and laboratory characteristics of COVID-19 in children admitted to the pediatric emergency triage. Epidemiological, clinical, laboratory, and radiological data of children were collected retrospectively and analyzed to compare by symptoms. A total of 213 pediatric cases with COVID-19 were included. Most of the patients were asymptomatic (63.8%). The main clinical features were mild symptoms including fever (7.5%), cough (6.5%), myalgia (6.3%) or no (63.8%). Of the patients who had CT scan, 25% had specific findings of COVID-19. Ground-like opacities were common radiological findings (25%). Symptomatic patients had higher lymphopenia rate (p=0.03), higher CRP and procalcitonin (PCT) values (p=0.04, p=0.04), lower age (p<0.001) and lower neutrophil count (p=0.01). The rate of neutropenia and leukopenia were higher in asymptomatic patients (p=0.15, p=0.05, respectively). The most common cause of transmission in children is family contact. Home isolation was recommended for 89.6% of the patients, 10.3% were hospitalized, 2.3% needed an intensive care unit (ICU). Only one death was reported. We found found that children with COVID-19 are generally mild severe or asymptomatic clinic. Young children were relatively more symptomatic than older children, and those with underlying diseases often needed intensive care unit. The most important laboratory findings difference between symptomatic and asymptomatic patients are lymphopenia, increased CRP and PCT values (p=0.04 for all three parameter). [ABSTRACT FROM AUTHOR]

Copyright of Ankara Medical Journal is the property of Yildirim Beyazit Üniversity and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Amaç: Veno-arteriyel ECMO desteği gerektiren akut fulminant miyokardit ve PRES sendromu COVID-19 hastalığına nadiren eşlik eden tablolardır. Bu her iki tablonun da eşlik ettiği bir COVID-19 hastasının tedavi yönetimini sunmayı amaçladık. Olgu: COVID-19 nedeniyle serviste takipli 28 yaşında kadın hasta beklenmeyen ani bir kardiyak arrest sonrasında mavi kod ekibi tarafından yapılan 30 dakikalık CPR ile spontan dolaşımın geri dönmesi sonrasında orotrakeal entübe halde yoğun bakıma kabul edilmiştir. Yüksek doz noradrenalin, adrenalin ve dopamin infüzyonuna rağmen hipotansif seyreden hastanın bakılan ekokardiyografisinin akut fulminan miyokardit ile uyumlu olması (EF %20) üzerine hastaya mekanik dolaşım desteği amaçlı Veno-arteriyel ECMO desteği başlandı. Hastanın yoğun bakım kabulünün 6. gününde vazopressor/inotrop desteğinin minimale düşmesi, EF’nin %40’a çıkması ve ECMO kan akımının dakikada 500 mL’ye kadar gerilemesi üzerine ECMO cihazından weaning uygulanmıştır. Hastanın yoğun bakım kabulünün 15. günü bilinci tamamen açıldı ve mekanik ventilatörden weaning sağlandı. Hastada yoğun bakım kabulünün 18. gününde enfeksiyon parametreleri gerilerken ve genel klinik durumu iyiye giderken akut hipertansiyon (170/110), ateş (>38 °C), bilinç bozukluğu, jeneralize nöbetler, kusma, görme/konuşma bozukluğu gelişmiştir. Klinik tablonun düzelmemesi üzerine 24 saat sonra çekilen kraniyal MR görüntülemesi PRES sendromuyla uyumlu bulundu (Şekil 1). PRES için uygulanan semptomatik antihipertansif, antiepileptik ve intrakraniyal antiödem tedaviyle bilinci giderek düzelerek 1 hafta sonrasında klinik semptomları tamamen geriledi. Sonuç: Hem miyokardit hem PRES tablosu COVID-19 hastalığında nadiren tanı almaktadır, fakat sunduğumuz olguda bu iki tabloyu tek bir hastada saptadık. Miyokardit ve PRES erken tanı ve tedavi edilmesi gereken ciddi tablolardır. Miyokardit tablosu olgumuzda olduğu gibi kardiyojenik şok ve arreste kadar giden ciddi hayati tehlikeye yol açabilir, Veno-arteriyel-ECMO miyokardite bağlı kardiyojenik şok tedavisinde etkili ve hayat kurtarıcı bir tedavidir. PRES tablosunun pek çok risk faktörünün olduğu bilinmekte olup COVID-19 hastalarında da gelişebileceği bilinmelidir. Bu tablonun erken tanısı ve tedavisiyle klinik iyileşme hızla gerçekleşebilir; bununla birlikte oluşabilecek kalıcı nörolojik hasar ve mortalite önlenebilir. [ABSTRACT FROM AUTHOR]