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 as a predictor of mortality in COVID‐19 patients provides clinical benefit. Materials and Methods Data from 590 patients with COVID‐19 from March 15, 2020 to January 15, 2021 in medicine wards and intensive care units (ICU) were retrospectively analysed. Demographic data and other laboratory markers were collected from the electronic medical records. Relationship between FAR 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 = .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 = .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.
The efficacy of the inactivated severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccine has not been fully elucidated across the whole spectrum of patients on kidney replacement therapy. We aimed to characterize the long‐term antibody response of inactivated SARS‐CoV‐2 vaccine administered in kidney transplant recipients (KTRs) and hemodialysis (HD) patients. We performed this prospective observational study in 50 HD, 64 KTR, and 41 healthy control groups (HG) given two doses of CoronaVac. We measured anti‐Spike antibodies after 28 days of every vaccine dose, 3rd and 6th months after the first dose, and compared them between cohorts. After two doses, an anti‐spike immunoglobulin G of ≥50 AU/ml was present in HD, KTR, and HG as 44%, 7.2%, and 58.5%, respectively ( p < 0.001). Furthermore, the proportion of antibody titers peaked at 86.5%, 23%, and 97.6% ( p < 0.001) at the 3rd month and decreased significantly at the 6th month in most HD and HG participants, whereas this effect was not observed in KTRs from basal until the 6th month ( p < 0.001). During the follow‐up, the incidence of coronavirus disease 2019 disease was higher ( p < 0.003) in KTRs compared to the other groups, but there was no requirement for an intensive care unit and no death was recorded. We found a negative correlation between antibody seroconversion and age ( p < 0.016). The antibody response following inactivated vaccine in dialysis patients is almost comparable to controls for 6 months. In contrast, kidney transplant patients have a poor response. These findings reinforce the need to discuss the vaccination strategy in immunocompromised patients, including the third dose with homologous or heterologous vaccines.
Background/aim: COVID-19 infection which started in Wuhan City, China in December 2019 turned into a pandemic in a very short time, affecting mainly the elderly and those with serious chronic illnesses. COVID-19 infection has been observed with a high mortality rate especially in patients undergoing maintenance haemodialysis. Materials and methods: Forty-two patients over 18 years of age, who underwent a maintenance haemodialysis program at our unit, and being tested positive for COVID-19 by PCR from nasopharyngeal swabs and/or were observed to have disease-related signs in their CTs were included in the study. Results:In this study, 23 of 42 patients receiving haemodialysis support in our clinic were included. The median age was 67 years (min 35; max 91 years) and all of them had primary hypertension and other comorbidities. Their clinical evaluation showed that dry cough (47.8%) and shortness of breath (47.8%) were the most common symptoms. Fever was less pronounced (30.4%). The median time from the onset of symptoms to hospitalization was 1 day (min 0; max) and time from hospitalization to death was 18 days (min:1; max 22). Transfer from the inpatient ward to ICU took a median of 7 days (min 1; max 13). Among the 23 patients, three died during the follow-up and 20 were discharged with full recovery. Baseline ferritin, procalcitonin levels and CRP/albumin rates higher and neutrophil/lymphocyte levels lower in patient who died. In these patients, despite being nonsignificant, there were more diabetic patients and D-dimer levels were higher than 1000 ugFEU/L. 2 Conclusion: COVID-19 infection is associated with increased mortalit in chronic kidney diseases patients. Despite being non-significant, there was a trend towards increased mortality in patient with diabetes, D-dimer levels >1000 ugFEU/L and higher ferritin, prokalsitonin levels, increased CRP/albumin raio and lower neutrophil/lymphocyte ratio.
Introduction: The aim of this study is to investigate whether macrophage migration inhibitory factor (MIF) predicts the prognosis of COVID-19 disease. Methodology: This descriptive and cross-sectional study was conducted on 87 confirmed COVID-19 patients. The patients were separated into two groups according to the admission in the ICU or in the ward. MIF was determined batchwise in plasma obtained as soon as the patients were admitted. Both groups were compared with respect to demographic characteristics, biochemical parameters and prediction of requirement to ICU admission. Results: Forty seven patients in ICU, and 40 patients in ward were included. With respect to MIF levels and biochemical biomarkers, there was a statistically significant difference between the ICU and ward patients (p< 0.024). In terms of ICU requirement, the cut-off value of MIF was detected as 4.705 (AUC:0.633, 95%CI:0.561-0.79, p= 0.037), D-dimer was 789 (AUC:0.779, 95%CI: 0.681-0.877, p= 0.000), troponin was 8.15 (AUC: 0.820, 95%CI:0.729-0.911, p= 0.000), ferritin was 375 (AUC: 0.774, 95%CI:0.671-0.876, p= 0.000), and lactate dehydrogenase (LDH) was 359.5 (AUC:0.843, 95%CI: 0.753-0.933, p= 0.000). According to the logistic regression analysis; when MIF level > 4.705, the patient’s requirement to ICU risk was increased to 8.33 (95%CI: 1.73-44.26, p= 0.009) fold. Similarly, elevation of troponin, ferritin and, LDH was shown to predict disease prognosis (p< 0.05). Conclusions: Our study showed that MIF may play a role in inflammatory responses to COVID-19 through induction of pulmonary inflammatory cytokines, suggesting that pharmacotherapeutic approaches targeting MIF may hold promise for the treatment of COVID-19 pneumonia.
SUMMARY INTRODUCTION: This study aims to determine the incidence of de novo nephritic syndrome (NS) in COVID-19 patients and identify its associated factors. METHODS: All ward patients with COVID-19 pneumonia were investigated. After determining the inclusion and exclusion criteria, the study population was identified. The urine dipstick test and urine protein creatinine ratio (UPCR) measurements were performed. Patients with de novo NS findings, nasopharyngeal swab, and urine RT-PCR tests were performed simultaneously RESULTS: This descriptive cross-sectional study was conducted with 21 patients with COVID-19. The mean age of the patients was 42.2±8.8 years, and 71.4% of them were male. The mean duration of follow-up was 28.4±9.3 days. The urine RT-PCR test was positive in one patient (4.8%). Improvements were observed in hematuria by 71.4%, and proteinuria by 85.7% at the end of the follow-up. A significant decrease in the measured UPCR was found in comparison to the baseline(P=0.000). Also, improvements were recorded in the complete blood counts, inflammatory parameters, ferritin, and coagulation tests, compared to the baseline. There was a positive correlation between baseline UPCR and ferritin, and a negative correlation between baseline UPCR and sodium values CONCLUSION: COVID-19-induced de novo nephritic syndrome may occur mainly due to tubulointerstitial involvement and often results in spontaneous remission. However, why these findings were not present in all patients who had no comorbidities is not clear.
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