Aim: Coronavirus disease 2019 (COVID-19) is a pandemic with potential life-threatening outcomes. The current study aims to demonstrate the effect of tocilizumab in COVID-19 related cytokine storm. Material and Method: This retrospective cross-sectional study evaluated the patients who received tocilizumab for COVID-19 related cytokine storm between March and August 2020. Demographic, clinical, and laboratory findings were recorded. Computerized tomography (CT) scans, which were performed before tocilizumab infusion were scored. The characteristics of the patients who survived versus those who did not survive were assessed. Results: There was a total of 137 patients, 99 (72.3%) male and 38 (27.7%) female, with a median age of 62 years. Eighty-six (62.7%) patients had severe; 51 (37.2%) patients had critical disease course. The mortality rate was 24.1%. Higher mortality rates were present among patients older than 65 years, females, and with comorbid diseases (p=0.02, p=0.031, and p=0.01, respectively). The non-survived group had higher rates of mechanical ventilation (MV) support (85.2%) and admission to the intensive care unit (58.8%) (p
We investigated whether Chest X-Ray (CXR) could replace computed tomography (CT) modality in the diagnosis and during the treatment of young adult COVID-19 patients with mild dyspnea with no comorbid diseases. This retrospective study involved an examination of the records of a total of 956 patients hospitalized between March 1, 2020, and May 15, 2020. The study included a total of sixty-four COVID-19 patients who underwent a CXR at admission and CT imaging within 24 hours, aged 21-60 years with mild dyspnea with no comorbid diseases. The diagnosis of infection was confirmed by the polymerase chain reaction test in all cases. The first CXR and CT images at the time of admission were evaluated in terms of lesions and localization. The clinical-radiological course of the disease was also statistically evaluated. CT was normal in 18/64 (28.1%) patients, all of whom also had normal CXR. The rest of the patients 46/64 (71.9%) with an abnormal CT, the CXR was normal in 18/46 (39.1%) and abnormal in 28/46 (60.9%). The time between the onset of complaints and admission to the hospital in patients with abnormal and normal CXR was 3.5±2.3 days and 2.1±1.1 days respectively and this difference was statistically significant (p=0.004). The hospital stay durations of the patients with abnormal and normal CXR was 9.6±3.5 and 9.5±3.4 days (p=0.928), respectively, and was not statistically significant. In conclusion, in the case of early admission to the hospital, there is not a significant difference between using CXR or CT in the management of young adult COVID 19 patients with mild dyspnea no comorbid disease. Therefore, the use of CXR in these patient groups will reduce the burden of CT units in pandemic conditions with limited resources.
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