Objectives. The NUTRIC (nutrition risk in the critically ill) score and the modified NUTRIC score are two scoring systems that show the nutritional risk status and severity of acute disease of patients. The only difference between them is the examination of interleukin-6 (IL-6) level. The aim of this study was to investigate whether or not the NUTRIC score is superior to the mNUTRIC score in the prediction of mortality of patients with COVID-19 followed up in the Intensive Care Unit (ICU). Material and Method. This retrospective study included 322 patients followed up in ICU with a diagnosis of COVID-19. A record was made of demographic data, laboratory values, clinical results, and mortality status. All the data of the patients were compared between high and low variations of the NUTRIC score and the mNUTRIC score. Results. A high NUTRIC score was determined in 62 patients and a high mNUTRIC score in 86 patients. The need for invasive mechanical ventilation, the use of vasopressors in ICU, the development of acute kidney injury, and mortality rates were statistically significantly higher in the patients with high NUTRIC and high mNUTRIC scores than in those with low scores ( p = 0.0001 for all). The AUC values were 0.791 for high NUTRIC score and 0.786 for high mNUTRIC score ( p = 0.0001 for both). No statistically significant difference was determined between the two scoring systems. Conclusion. Although the NUTRIC score was seen to be superior to the mNUTRIC score, no statistically significant difference was determined. Therefore, when IL-6 cannot be examined, the mNUTRIC score can be considered safe and effective for the prediction of mortality in COVID-19 patients.
Aim: The Delta Neutrophil Index (DNI) shows the ratio of immature granulocytes in the circulation and increases in conditions of infection and inflammation. The aim of this study was to investigate the suitability of using DNI as a prognostic marker of mortality in COVID-19 patients in the Intensive Care Unit (ICU). Material and Method: This retrospective study included 316 patients followed up in the ICU with a diagnosis of COVID-19. A record was made for each patient of demographic data, laboratory values, clinical results and mortality status. All the data of the patients were evaluated and compared between the two groups of surviving and non-surviving patients. Results: Mortality developed in 181 (57.27%) patients. The Glasgow Coma Scale score was lower and the APACHE II and SOFA scores were higher in the mortality group than in the surviving group (p<0.001 for all). The creatinine, procalcitonin, white blood cell, neutrophil count, neutrophil-lymphocyte ratio, lactate, interleukin -6 and C-reactive protein values were statistically significantly higher in the mortality group. In the comparison of DNI between the groups, a statistically significant difference was only determined on day 3 (p=0.026). For the DNI examined on day 3, the AUC value was 0.574 and the cutoff value was 1.35% for the prediction of mortality. Conclusion: DNI, which is low cost and simple to use, can be considered safe for use in the prediction of mortality of ICU patients diagnosed with COVID-19. The monitoring of increasing or decreasing trends by keeping regular records can be considered important for the clinical course.
Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), first appeared in Wuhan, China, in December 2019 and became a pandemic. Due to COVID-19's speed and ease of transmission, millions of patients all over the world were infected, and many of them died. The first case of COVID-19 in Türkiye was reported on March 11, 2020 by the Ministry of
Amaç: Bu çalışmanın amacı, pandemi süresince COVID-19 ve non-COVID-19 yoğun bakım ünitelerinde (YBÜ) takip edilen malign hastaların demografik, klinik, laboratuvar özelliklerini ve mortalite oranlarını karşılaştırmaktır. Gereç ve Yöntemler: Bu çalışma 23 Mart 2020- 31 Ocak 2022 tarihleri arasında COVID-19 ve non-COVID-19 YBÜ’de yatan onkolojik tanılı hastaların dahil edildiği retrospektif gözlemsel çalışmadır. Erişkin (≥18 yaş), hematolojik ya da solid organ malignitesi olan hastalar çalışmaya alındı. Hastalar iki gruba ayrıldı: Birinci grup COVID-19 tanısı (Polimerase chain reaction (PCR) testi pozitif) ile COVID-19 YBÜ’ne kabul edilen, ikinci grup ise COVID-19 tanısı dışlanarak (PCR testi negatif ve klinik ve radyolojik olarak COVID-19 olmadığı doğrulanan) non-COVID-19 YBÜ’ne kabul edilen hastalar oluşturdu. İki grubun verileri karşılaştırıldı. Bulgular: Çalışmaya 150 COVID-19 ve malignitesi olan, 133 non-COVID-19 ve malignitesi olan toplam 283 hasta dahil edildi. İki grubun malignite özellikleri karşılaştırıldığında; COVID-19 grubunda malignitede kür sağlananlar anlamlı olarak fazlaydı. Solid organ malignitesi olanların oranları COVID-19 grubunda (%85,3), hematolojik malignitesi olanların oranı (%24,1) ise non-COVID-19 grubunda istatistiksel farkla daha fazlaydı (sırasıyla, p=0.04 ve 0.03). Ayrıca akciğer karsinomu (%22) COVID-19 grubunda istatistiksel olarak anlamlı olarak fazla idi. Tüm malign hastalarda mortalite prediktörü olarak; invaziv mekanik ventilatör (IMV) ihtiyacı, IMV kalış süresinde artış, nörolojik hastalığın eşlik etmesi ve vazopressör/inotrop ihtiyacı olarak belirlendi. Sonuç: COVID-19 malign hastalarda mortalite oranının non-COVID-19 malign hastalardan daha düşük olduğu, tüm malign hastalarda mortaliteye IMV gereksinimi ve süresi, vazopessör/inotrop ihtiyacı ve nörolojik hastalığın eşlik etmesinin etkili olduğu sonucuna varıldı. Mortalitenin non-COVID-19 hasta grubunda daha fazla olmasını malignitenin ileri evresi, klinik seyri, uygulanan immunsuprese tedavi (radyoterapi, kemoterapi gibi) gibi faktörlere bağlı olabileceğini düşünüyoruz.
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