Gender-related prognostic value of cardiac troponin-ı in covid-19 patients

Amaç: Kardiyak troponinler kardiyak ve non-kardiak birçok hastalıkta yükselebilmektedir. Çalışmamızda COVID-19 hastalarının hastaneye kabulünde kardiyak troponin-I seviyesinin yoğun bakım ihtiyacı ve tüm nedenlere bağlı mortalite riskini önceden tahmin etme kabiliyetinin belirlenmesi ve cinsiyet ile ilişkisinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışma, hastanemizde 1 Nisan 2020 ile 1 Şubat 2021 tarihleri arasında yatırılan ve ilk 24 saatteki kardiyak troponin-I bakılmış COVID-19 hastalarının elektronik tıbbi kayıtlarının retrospektif olarak analiz edilmesi ile yapıldı. Çalışmada araştırılan tüm değişkenler için istatistiksel analiz yapıldı. Bulgular: Çalışmaya toplam 362 COVID hastası dahil edildi. 90 hastada kardiyak troponin-I düzeyi anormaldi. Hastaların 39'unda yoğun bakım ihtiyacı gelişti. Yoğun bakıma ihtiyaç duyan hastaların 17'sinde, yoğun bakım ünitesinde takip edilmeyen hastaların 73'ünde kardiyak troponin-I düzeyi anormaldi. Erkek cinsiyette yoğun bakım ihtiyacının %71 daha fazla olduğu ve kardiyak troponin-I düzeyinin negatif prediktif değerinin %87,5 olduğu görüldü. Kardiyak troponin-I düzeyi ölen hastaların 11'inde, sağ kalan hastaların 79'unda anormaldi. Erkek cinsiyette ölüm riskinin %75 daha yüksek olduğu ve kardiyak troponin-I düzeyinin negatif prediktif değerinin %91,7 olduğu belirlendi. Sonuç: Bu çalışmada, hastaneye yatışın ilk 24 saatindeki normal troponin seviyesinin, mortalite için kadın ve erkek cinsiyette yüksek negatif prediktif değere sahip olduğu görülmüştür. Kardiyak troponin-I seviyelerinin COVID-19 hasta takibinde klinisyenlere yol gösterici bir biyobelirteç olabileceği ve kardiyak troponin-I seviyesi normal olan hastaların diğer hastalara göre daha erken taburcu edilebileceği düşünülmüştür.Objective: Cardiac troponin levels can be increased in many cardiac and non-cardiac diseases. In our study, we aimed to measure the troponin-I level of COVID-19 patients at admission to the hospital to determine its ability to predict the intensive care need and all-cause mortality risk and to evaluate its relationship with gender. Material and Methods: The study was carried out retrospectively by analyzing the electronic medical records of COVID-19 patients who were hospitalized in our hospital between April 1, 2020 and February 1, 2021 and were tested for cardiac troponin-I in the first 24 hours. Statistical analysis was performed for all variables investigated in the study. Results: A total of 362 COVID patients were included in the study. Cardiac troponin-I level was abnormal in 90 patients. In 39 of the patients, the need for intensive care developed. Cardiac troponin-I level was abnormal in 17 of the patients in need of intensive care and in 73 of the patients who were not followed up in intensive care unit. It was observed that the need for intensive care was 71% higher in male gender and the negative predictive value of cardiac troponin-I level was 87.5%. Cardiac troponin-I level was abnormal in 11 of the patients who died and in 79 of the patients who survived. It was determined that the mortality risk was 75% higher in the male gender and the negative predictive value of cardiac troponin-I level was 91.7%. Conclusion: In this study, it was observed that normal troponin level in the first 24 hours of hospitalization has a high negative predictive value for mortality in men and women. It was thought that cardiac troponin-I levels could be a guiding biomarker for clinicians in the follow-up of COVID-19 patients, and patients with normal cardiac troponin-I could be discharged earlier than other patients

Comparison of two pandemics: H1N1 and SARS-CoV-2

OBJECTIVE: We aimed to compare the clinical, epidemiological, and prognostic features of the H1N1 pandemic in 2009 and the severe acute respiratory syndrome coronavirus 2 pandemic in 2020. METHODS: This retrospective study involved subjects from seven centers that were admitted and found to be positive for H1N1 or COVID-19 real-time polymerase chain reaction test. RESULTS: A total of 143 patients with H1N1 and 309 patients with COVID-19 were involved in the study. H1N1 patients were younger than COVID-19 ones. While 58.7% of H1N1 patients were female, 57.9% of COVID-19 patients were male. Complaints of fever, cough, sputum, sore throat, myalgia, weakness, headache, and shortness of breath in H1N1 patients were statistically higher than in COVID-19 ones. The duration of symptoms until H1N1 patients were admitted to the hospital was shorter than that for COVID-19 patients. Leukopenia was more common in COVID-19 patients. C-reactive protein levels were higher in COVID-19 patients, while lactate dehydrogenase levels were higher in H1N1 ones. The mortality rate was also higher in H1N1 cases. CONCLUSIONS: The severe acute respiratory syndrome coronavirus 2 pandemic is a major public health problem that continues to affect the world with its high rate of contagion. In addition, no vaccines or a specific drug for the benefit of millions of people have been found yet. The H1N1 pandemic is an epidemic that affected the whole world about ten years ago and was prevented by the development of vaccines at a short period. Experience in the H1N1 pandemic may be the guide to prevent the COVID-19 pandemic from a worse end

Diagnostic value of Chest CT and Initial Real-Time RT-PCR in COVID-19 Infection

Objectives: To evaluate the diagnostic value of the rtRT-PCR test and CT in patients presenting with typical clinical symptoms of COVID-19. Methods: The study with the participation of four center in Turkey was performed retrospectively from 20 March-15 April 2020 in 203 patients confirmed for COVID-19. The initial rtRT-PCR test was positive in 142 (70.0%) of the patients (Group-I) and negative in 61 patients (Group-II). Results: The mean age of the patients in Group-I was 49.718.0 years and the time between the onset of symptoms and admission to the hospital was 3.6 +/- 2.0 days; whereas the same values for the patients in Group-II were 58.1 +/- 19.9 and 5.3 +/- 4.2, respectively (p=0.004; p=0.026). Initial rtRT-PCR was found positive with 83.5% sensitivity and 74.1% PPV in patients with symptom duration of less than five days. It was found that rtRT-PCR positivity correlated negatively with the presence of CT findings, age, comorbidity, shortness of breath, and symptom duration, while rtRT-PCR positivity correlated positively with headache. Presence of CT findings was positively correlated with age, comorbidity, shortness of breath, fever, and the symptom duration. Conclusions: It should be noted that a negative result in the rtRT-PCR test does not rule out the possibility of COVID-19 diagnosis in patients whose symptom duration is longer than five days, who are elderly with comorbidities and in particular who present with fever and shortness of breath. In these patients, typical CT findings are diagnostic for COVID-19. A normal chest CT is no reason to loosen up measures of isolation in patients with newly beginning symptoms until the results are obtained from the PCR test

The role of CO-RADS scoring system in the diagnosis of COVID-19 infection and its correlation with clinical signs

Background: Computed tomography (CT) evaluation systematics has become necessary to eliminate the difference of opinion among radiologists in evaluating COVID-19 CT findings. Introduction: The objectives of this study were to evaluate the efficiency of CO-RADS scoring system in our patients with COVID-19 as well as to examine its correlation with clinical and laboratory findings. Methods: The CO-RADS category of all patients included in the study was determined by a radiologist who did not know the rtRT-PCR test result of the patients, according to the Covid-19 reporting and data system of Mathias Prokop et al. Results: A total of 1338 patients were included. CT findings were positive in 66.3%, with a mean CO-RADS score of 3,4 +/- 1,7. 444 (33.1%) of the patients were in the CO-RADS 1-2, 894 (66.9%) were in the CO-RADS 3-5 group. There were positive correlations between CO-RADS score and age, CMI, hypertension, diabetes mellitus, chronic pulmonary diseases presence of symptoms, symptom duration, presence of cough, shortness of breath, malaise, CRP, and LDH, while CO-RADS score was negatively correlated with lymphocyte count. The results of the ROC analysis suggested that those with age >= 40 years, symptom duration >2 days, CMI score >1 and/or comorbid conditions were more likely to have a CO-RADS score of 3-5. Conclusion: The CO-RADS classification system is a CT findings assessment system that can be used to diagnose COVID-19 in patients with symptoms of cough, shortness of breath, myalgia and fatigue for more than two days