The relationship of serum asymmetric dimethylarginine concentrations and lung involvement in patients with COVID-19 infection

Aim: COVID-19 infections the tissue through angiotensin converting enzyme 2 receptor, which is also expressed on endothelial cells. Endothelial dysfunction may be associated with lung involvement. Asymmetric dimethylarginine (ADMA) is an indirect marker of endothelial dysfunction. The aim of our study was to evaluate ADMA concentrations and to identify its association with lung involvement in patients with COVID-19 disease. Methods: We included 42 patients with COVID-19 infection and lung involvement (Group 1). Forty-two age and sex matched patients without pneumonia acted as the control group (Group 2). All patients gave blood samples for ADMA at the 1st month control visit after discharge. We compared C-reactive protein (CRP) and ADMA concentrations in addition to routine biochemical parameters between groups. Results: Patients with lung involvement had higher admission glucose, CRP, and ADMA concentrations, and displayed lower hemoglobin concentration and lymphocyte count compared to patients without lung involvement. Although patients with lung involvement had higher ADMA concentrations with respect to those without; plasma ADMA levels were also higher than normal values in control group. Multivariate analysis identified log CRP concentration (OR= 3.047, 95% CI=1.881-5.023, p<0.001) as the independent predictor for lung involvement. And, there was a correlation between ADMA and CRP (r: 0.318, p: 0.003). Conclusion: We revealed elevated ADMA concentrations as the surrogate of endothelial dysfunction in COVID-19 patients whether they have pneumonia or not

Holotranscobalamin Levels in Mid Vitamin B12 Values

Amaç: B12 vitamini, vücutta önemli fonksiyonlar üstlenmektedir. Eksikliğinde pek çok hematolojik ve nörolojik bozukluklar ile kendini gösterebilmektedir. Erken dönemde tedaviye başlanmadığında ise bu nörolojik bozukluklar kalıcı olabilmektedir. Ancak yapılan çalışmalarda eksiklik başladıktan sonra bile total B12 vitamini düzeyinin referans aralıklarda seyrettiği görülmüştür. Bununla birlikte literatürde, B12 vitamininin aktif formu olan holotranskobalaminin daha erken dönemde eksiklik tanısı konulmasında faydalı olabileceğine dair yayınlar bildirilmektedir. Biz de çalışmamızda total B12 vitamini düzeyleri 100300 ng/L aralığında olan hastalarda holotranskobalamin düzeylerini belirleyerek aralarındaki ilişkiyi ortaya koymayı amaçladık. Materyal ve Metot: Hastalar (n: 449) B12 vitamini düzeylerine göre iki gruba ayrıldı: grup 1 (189ng/L). Vitamin eksikliğini belirlemede total B12 vitamini için 189 ng/L düzeyi, holotranskobalamin için ise 25,1 pmol/L düzeyi kesim değeri olarak kabul edildi. Her iki test Kemilüminesan Mikropartikül İmmünassay (CMIA) yöntemi ile çalışıldı. Vitamin düzeyleri arasındaki ilişki Pearson korelasyon analizi yöntemi kullanılarak değerlendirildi. Sonuçlar: Gruplarımızda B12 vitamini ile holotranskobalamin arasında pozitif yönde istatistiksel olarak anlamlı bir ilişki bulundu (sırasıyla r=0,491, p189ng/L). We used cut-off values 189 ng/mL for vitamin B12 and 25,1 pmol/L for holotranscobalamin as deficiency indicators. Both analytes were measured by Chemiluminesans Microparticule Immunassay (CMIA) method. The relation between two vitamins was evaluated by Pearson corelation analysis method. Results: There was a positive statistically significant correlation between vitamin B12 and holotranscobalamin in our groups. (r=0,491, p<0.001 and r=0,271, p<0.001, respectively). By the way it seems the relation power decreased while total vitamin B12 levels increased, especially in second group that in reference ranges Holotranscobalamin levels were below cut-off value in 31,4% patients. Discussion: Its shown that total vitamin B12 measurement isn’t enough to diagnose deficiency, esspecially in 100-300ng/L levels holotranscobalamin can assist for early diagnosis and lead to early treatment that protect clinical impairment