The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients

he COVID-19-related death rate varies between countries and is affected by various risk factors. This multi center registry study was designed to evaluate the mortality rate and the related risk factors in Turkey. We retrospectively evaluated 1500 adults with COVID-19 from 26 centers who were hospitalized between March 11 and July 31, 2020. In the study group, 1041 and 459 cases were diagnosed as definite and highly probable cases, respectively. There were 993 PCR-positive cases (66.2%). Among all cases, 1144 (76.3%) were diagnosed with non-severe pneumonia, whereas 212 (14.1%) had severe pneumonia. Death occurred in 67 patients, corre sponding to a mortality rate of 4.5% (95% CI:3.5–5.6). The univariate analysis demonstrated that various factors, including male sex, age ?65 years and the presence of dyspnea or confusion, malignity, chronic obstructive lung disease, interstitial lung disease, immunosuppressive conditions, severe pneumonia, multiorgan dysfunction, and sepsis, were positively associated with mortality. Favipiravir, hydroxychloroquine and azithromycin were not associated with survival. Following multivariate analysis, male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were found to be independent risk factors for mortality. Among the biomarkers, procalcitonin levels on the 3rd-5th days of admission showed the strongest associations with mortality (OR: 6.18; 1.6–23.93). This study demonstrated that the mortality rate in hospitalized patients in the early phase of the COVID-19 pandemic was a serious threat and that those patients with male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were at increased risk of mortality; therefore, such patients should be closely monitored

Serebral İskemi/Reperfüzyon Hasarında Hesperidinin Nöroprotektif Etkisi

Amaç: Bu çalışmanın amacı, sıçanlarda serebral iskemi/reperfüzyon hasarına karşı hesperidinin farklı dozlarının koruyucu etkisini araştırmaktır. Gereç ve Yöntemler: Çalışmada kontrol, sham, iskemi/reperfüzyon (İ/R), hesperidin 50 (Hes 50) ve hesperidin 100 (Hes 100) olmak üzere 5 grup hazırlandı. İskemi oluşturmak için Pulsinelli ve Brierly'nin dört damar oklüzyon modeli kullanıldı. 30 dakika iskemi ve 30 dakika reperfüzyon uygulandı. Hesperidin, iskemiden 30 dakika önce intraperitonal olarak enjekte edildi. Histopatolojik çalışma için beyin dokusuna Golgi Cox ve Caspase 3 boyaması uygulandı. Ayrıca beyin dokusunda SOD, CAT, MDA ve total protein seviyeleri belirlendi ve TNF-α mRNA ekspresyon seviyeleri RT-qPCR tekniği ile ölçüldü. Bulgular: İ/R grubunda kontrol grubuna göre CAT ve SOD değerlerinde azalma, MDA değerinde artış, toplam protein değerinde hafif artış saptandı. Hes 50 ve Hes 100 gruplarında, İ/R grubu ile kıyaslandığında CAT, SOD değerleri arttı, MDA ve toplam protein değerleri önemli ölçüde azaldı. I/R grubunda kontrol grubuna kıyasla önemli bir CA1 nöron kaybı gözlendi. Hes 50 grubunda I/R grubuna göre hipokampustaki nöron hasarının azaldığı ve nöron sayısının istatistiksel olarak anlamlı düzeyde arttığı bulundu. Beyin dokusundaki TNF-α mRNA ekspresyon değerleri, I/R grubunda kontrol ve sham gruplarına göre anlamlı derecede yüksekti. Hes 50 grubunda I/R grubuna kıyasla mRNA ekspresyon miktarında önemli bir azalma gözlendi. Sonuç: Bu çalışmanın sonuçlarına göre, antioksidan potansiyeli olan hesperidin, serebral iskemi/reperfüzyonunun neden olduğu oksidatif stres hasarına karşı nöroprotektif ve antiinflamatuar etkiler göstermiştir. Düşük doz hesperidin (Hes 50) grubunda antiinflamatuar ve nöroprotektif etkiler öne çıkarken, hem Hes 50 hem de Hes 100 gruplarında antioksidan etkinin daha baskın olduğu tespit edilmiştir.Aim: The aim of this study was to investigate the protective effect of different doses of hesperidin against cerebral ischemia/reperfusion injury. Material and Method: In this study, 5 groups were prepared as control, sham, ischemia/reperfusion (I/R), hesperidin50 (Hes 50), and hesperidin100 (Hes 100). Four vessel occlusion model was used to induce ischemia. 30minutes of ischemia and 30minutes of reperfusion were applied. Hesperidin was injected intraperitoneally 30minutes before ischemia. GolgiCox and Caspase3 staining were performed, SOD, CAT, MDA, and total protein levels were determined, TNF-α mRNA expression levels were measured in brain tissue. Results: In the I/R group, CAT and SOD values decreased, the MDA value increased, a slight increase in the total protein value was found compared to the control group. CAT, SOD values increased, MDA and total protein values decreased significantly in Hes 50 and Hes 100 groups. A significant loss of CA1 neurons was observed in the I/R group. It was found that neuron damage in the hippocampus decreased and the number of neurons increased statistically significantly in the Hes 50 group compared to the I/R group. TNF-α mRNA expression values in brain tissue were significantly higher in the I/R group than control and sham groups. A significant decrease in the amount of mRNA expression was observed in the Hes50 group compared to the I/R group. Conclusion: According to the results of this study, hesperidin, which has antioxidant potential, showed neuroprotective and anti-inflammatory effects against oxidative stress damage caused by cerebral ischemia/reperfusion. While anti-inflammatory and neuroprotective effects were prominent in the low-dose hesperidin (Hes 50) group, the antioxidant effect was more dominant in both Hes 50 and Hes 100 groups