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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

Introduction: SARS-Corona Virus-2 (SARS-CoV-2/COVID-19) is a novel member of coronaviridae family. This new disease first appeared in China in December 2019, and can cause severe respiratory failure in advanced cases. COVID-19 was announced as a pandemic in March 2020 by WHO. It has infected 76 million people and has caused the death of more than 1.5 million people until December 2020. Common symptoms of this disease are mostly fever, cough, shortness of breath, anosmia, and fatigue. But atypical presentations have also being reported. Here, we present a COVID-19 patient with an unusual neurological symptom. Case: 82-years-old female patient with a history of hypertension and Sheehan’s syndrome came to the emergency room with the complaint of fever, shortness of breath and left hemiplegia. Although nasopharyngeal swab PCR test was negative (twice), acute phase reactants were elevated and chest CT revealed typical findings of COVID-19 pneumonia, so the patient was diagnosed as COVID-19. Since the patient had left hemiplegia, a cranial CT and diffusion-weighted MRI were performed to see whether a central neurological pathology was present. Both imaging revealed the findings of acute ischemic stroke (AIS). Afterwards, the patients was hospitalized and was started on Hydroxychloroquine, acetylsalicylic acid (ASA), favipiravir and methylprednisolone. At the 7th day of follow up, the nasopharyngeal swab PCR test was reperformed and found as positive. On the 10th day of treatment, the symptoms and acute phase reactants regressed. Left hemiplegia of the patient also regressed and she was discharged from the hospital at the 12th day of admission without a sequelae. Discussion and conclusion: Since there has been a recent evidence of strong relationship between COVID-19 and acute ischemic pathologies due to pathophysiology of COVID-19, we should be suspicious of acute ischemic stroke in a COVID-19 patient with neurological symptoms, especially when the patient had a history like Sheehan’s Syndrome disease may aggravate or hide the symptoms.

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.

Summary Background Coronavirus disease 2019 (COVID-19) is an acute inflammatory respiratory disease. Osteopontin (OPN) is a glycoprotein expressed in various cell types, such as bone, immune, smooth muscle, epithelial and endothelial cells. It also acts as a regulator of immune response. The aim of the present study was to reveal the place of serum osteopontin levels in predicting severity among patients with COVID-19. Methods This study included 84 patients, 43 female and 45 male. Patients were divided into 2 groups, group 1 non-severe group (n: 48), group 2 severe (n: 40). Demographic data, neutrophil, lymphocyte, platelet, white blood cell counts, albumin, procalcitonin, C‑reactive protein (CRP) and OPN levels were recorded. The OPN levels and these inflammatory parameters of the two groups were compared. Results There were no significant differences in terms of gender (female/male 25/23 vs. 18/22) and platelet count (178 K/μL vs. 191 K/μL) between the groups (p > 0.05). Ages (57.7 ± 17.0 years vs. 71.4 ± 12.8 years), procalcitonin (0.07 vs. 0.24 ng/mL), CRP (17 vs 158 mg/l), neutrophil count (3.7 vs 5.64 K/μL), WBC counts (5.38 vs 7.85 K/μL) and number of deaths (0 vs 26) (p

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 ratio as a predictor of mortality in Covid-19 patients provides clinical benefit. Materials and Methods: Data from 590 patients with Covid-19 from 15/03/2020 to 15/01/2021 in medicine wards and intensive care units (ICU) were retrospectively analyzed. Demographic data and other laboratory markers were collected from the electronic medical records. Relationship between FAR ratio 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:0.000) 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:0.000 )). Result: As a result of this study, increased FAR were found to be important markers in determining the mortality levels in Covid-19 patients. What is already known about FAR ratio: The fibrinogen albumin ratio is a value that has been used to determine the prognosis, especially in malignancies. [32] In a recent study 91 Covid-19 patients were analyzed 22 patients with severe disease higher FAR ratio compare to mild disaese [36] What does this article add about FAR ratio in Covid-19 patients: It has been concluded that the FAR ratio, which is used in diseases such as malignancy, hypertension, and coronary syndrome as a marker of disease progression, can be used as a mortality indicator in Covid-19

Aim: The aim of this study was to measure plasma midkine levels in patients with COVID-19 and to assess its clinical significance. Material and Method: 88 patients followed in our hospital with a diagnosis of COVID-19 were included in the study. Demographic characteristics, clinical and laboratory data of the patients were recorded, and the relationship between midkine level and prognosis and other parameters were investigated. Results: Of the 88 patients included in the study, 43 (48.9%) were female and 45 (51.1%) were male. 24 (27%) of our cases were died. The mean age of non-survivals was 70 ± 12.3 and the survivals were 61.9 ± 18.2 years. Mortality predictors due to COVID-19 in group 2 patients were significantly higher than those in group 2 (p

Introduction: some factors have been shown to be associated with survival in patients with pancreatic adenocarcinoma. Recently, some studies suggested that malnutrition, muscle mass, and inflammation might have an effect on survival in patients with pancreatic malignancy. Objectives: to investigate the association between psoas muscle mass, inflammation, nutritional status at the time of diagnosis, and survival in patients with pancreatic adenocarcinoma. Methods: this retrospective study included 219 patients diagnosed with pancreatic carcinoma. The nutritional status, inflammation, and psoas muscle mass of the patients at the time of diagnosis were evaluated. Nutritional status was assessed using the Prognostic Nutritional Index (PNI). Leucocyte count and neutrophil/lymphocyte ratio (NLR) were used for inflammation assessment. Psoas muscle mass was calculated by using abdominal computed tomography images of the patients. Results: the mean age of patients (80 female and 139 male) was 66.6 ± 11.7 years. According to the PNI results, 155 patients had a normal nutritional status (70 %), whereas 64 patients were malnourished (30 %). The survival of the patients with normal nutritional status was significantly longer than that of those who were malnourished (p0.001). There was no significant relationship between psoas muscle area, leucocyte count, NLR, and survival time. Conclusion: the survival of pancreatic adenocarcinoma patients with malnutrition at the time of diagnosis was significantly shorter than for patients without malnutrition.Introducción: se ha demostrado que algunos factores se asocian a la supervivencia en los pacientes con adenocarcinoma de páncreas. Recientemente, algunos estudios sugirieron que la desnutrición, la masa muscular y la inflamación podrían afectar a la supervivencia de los pacientes con neoplasias malignas pancreáticas. Objetivo: investigar la asociación entre masa muscular del psoas, inflamación, estado nutricional en el momento del diagnóstico y supervivencia en pacientes con adenocarcinoma de páncreas. Métodos: este estudio retrospectivo incluyó a 219 pacientes diagnosticados de carcinoma de páncreas. Se evaluaron el estado nutricional, la inflamación y la masa del músculo psoas de los pacientes en el momento del diagnóstico. El estado nutricional de los pacientes se evaluó con el Índice Nutricional Pronóstico (PNI). El recuento de leucocitos y el cociente de neutrófilos/linfocitos (NLR) se emplearon para la evaluación de la inflamación. La masa del músculo psoas se calculó utilizando las imágenes de tomografía computarizada abdominal de los pacientes. Resultados: la edad media de los pacientes (80 mujeres y 139 hombres) fue de 66,6 ± 11,7 años. Según los resultados del PNI, 155 pacientes tenían un estado nutricional normal (70 %) mientras que 64 pacientes estaban desnutridos (30 %). La supervivencia de los pacientes con estado nutricional normal fue significativamente mayor que la de los pacientes desnutridos (p0,001). No hubo ninguna relación significativa entre el área del músculo psoas, el recuento de leucocitos, el NLR y el tiempo de supervivencia. Conclusión: la supervivencia de los pacientes con adenocarcinoma de páncreas con desnutrición en el momento del diagnóstico fue significativamente menor que la de los pacientes sin desnutrición.

SUMMARY 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

Background: In December 2019, cases of pneumonia (COVID-19) due to a new coronavirus infection (SARS-COV-2) started to appear in Wuhan City, China. It quickly spread from China to the whole world. In our study, we objective to investigate the demographic data, applied treatments and outcomes of the patients with COVID-19 that we followed in our clinic according to their genders. Methods: In this study, we included a total of 96 patients whose clinical, radiological or laboratory parameters were compatible with COVID-19 and who were hospitalised, treated and followed-up in our Internal Medicine Clinic. The demographic data, treatments and prognostic data of these patients were retrospectively recorded and analysed in order to see if there were statistically significant differences between genders. Results: The average age of all COVID-19 cases included in our study was 63.54 ± 15.8. The average age of male patients was 65.6 ± 14.44 and the one of female patients was 61.82 ± 17.1: no statistical significance was found. The number of smoking male patients was 16, and this value was found to be 3 in females, and it was statistically significantly higher in males (p

Background Familial Mediterranean fever (FMF) is known the most common monogenic autoinflammatory disease. Its prevalence is reported high from the eastern Mediterranean areas (1) The disease is characterized by episodes of fever, serositis, arthritis,renal complications and other different clinical manifestations (2) Objectives Here, we aimed to present our data of our 139 FMF patients for demonstrating the demographic and clinical features of the study group,from North-western part of Turkey. Methods A total of 139 FMF patients who were diagnosed and treated in the department of Internal medicine/Rheumatology, Sakarya University (North-western area of Turkey) were included in the study and the demographic and clinical characteristics of the patients were examined. Results The mean age of the patients was 39.02 ± 11.3. Male gender was 42 (30.2%) and female gender was 97 (69.8%).107 (77%) of patients had fever and 32 (23%) had no history of fever. 127 (91.4%) patients complained about peritonitis, 27 (%19.4) patients had pleuritic pain, 19 (13.7%) patients had erysipelas like erythema and 53 (38.1%) patients had arthritis attack. 34 (24.5%) patients also had sacroiliitis. The ratio of resistance of treatment response to colchicine drugs that can be available in Turkey (Colchicum dispert®), 6 (4.3%) was determined. Interestingly these patients responded to the colchicine drugs available from some other countries from Europe (as Colchicine-opocalcium® and Colchicina-lirca®) None of our patients needed anti-IL1 therapies. The rate of amyloidosis was 5 (3.6%). Conclusion FMF is a disease with high morbidity and mortality, 95.7% of the patients in our region have response to colchicine drugs which is available in our country. The remaining patients have also response to colchicine available from some other countries. None of our patients had anti-IL1 therapies. References [1] ozen S, Batu ED, Demir S. Familial Mediterranean Fever: Recent Developments in Pathogenesis and New Recommendations for Management. Front Immunol. 2017 23;8:253. [2] Alghamdi M. Familial Mediterranean fever, review of the literatureClin Rheumatol. 2017;36:1707-1713. Disclosure of Interests None declared