Background Hashimoto's thyroiditis (HT) is the most prevalent autoimmune thyroid disorder. Both neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are reported to be increased in various inflammation-related diseases, but their clinical significance in HT remains unclear. Objectives The aim of this study was to investigate the relationship between thyroid autommunity and NLR and PLR as markers of systemic inflammation in HT. Methods In this study, we evaluated 145 women with HT and 60 age-matched healthy controls. We compared the PLR and the NLR of HT patients with controls and the correlation between the NLR, PLR, and C-reactive protein (CRP), thyroid-stimulating hormone (TSH) and thyroid antibody titers in the patient group. Also we compared the PLR and the NLR of HT patients that received levothyroxine with those who did not receive levothyroxine Results There were no significant differences between patient and control groups in terms of overall leukocyte counts, neutrophil counts, and other laboratory tests. In the patient group lymphocyte counts were lower while the platelet counts, NLR (2.29±0.65 vs1.68±0.40), PLR (164.95±55.14 vs106.88±32.19) were higher than those of the control (p<0.001 for all comparisons). Conclusion In this study we found that NLR and PLR were higher in euthyroid Hashimoto patients than in a healthy control group. NLR and PLR are likely non-specific indicators of immune disorder and their implications for HT and other conditions remain to be elucidated.

Introduction We evaluated several biological indicators based on inflammation and/or nutritional status, such as systemic immune-inflammation index (SII), early warning score (ANDC) and prognostic nutritional index (PNI) in hospitalized COVID-19 patients with and without malignancies for a prognostic significance. Methodology This is a retrospective and observational study on 186 patients with SARS-CoV-2, who were diagnosed with COVID-19 by real-time PCR testing and hospitalized due to COVID-19 pneumonia. 75 patients had various malignancies, and the rest (111), having a similar age and comorbidity profile based on propensity score matching, had no malignancy. Results None of the measures as neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, monocyte to lymphocyte ratio, SII, PNI or ANDC was found to be significantly different between two groups. Odds ratio for the mortality, OR 2.39 (%95 CI 1.80–3.16) was found to be significantly higher for the malignancy group, even though the duration of hospitalization was statistically similar for both groups. PNI was found to be significantly lower for deceased patients compared with survivors in the malignancy group. Contrarily, ANDC was found to be significantly higher for deceased patients in the malignancy group. Conclusions PNI and ANDC have independent predictive power on determining the in-hospital death in COVID-19 malignancy cases. It is suggested that ANDC seems to be a more sensitive score than SII in COVID-19 cases with malignancies.

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One of the reasons for the high mortality in COVID-19 patients is the increased risk of disseminated intravascular coagulation (DIC) and venous thromboembolism. For this reason, the use of anticoagulant treatments has become widespread. One of the rare complications of anticoagulant therapy is retroperitoneal hemorrhage. These hemorrhagies require immediate intervention. Retroperitoneal hemorrhage should be kept in mind among the many complications that develop in the patient who was followed up during the pandemic period. For this purpose, we present 2 cases who developed spontaneous retroperitoneal bleeding while clinically recovering under COVID-19 treatment.

Objective: Several vaccines have been recommended for adults with diabetes. This study aimed to determine the rates of uptake of recommended vaccines in diabetic adults and estimate their association with sociodemographic and clinical factors. Material and Methods: This was a cross-sectional study conducted on patients with either type 1 or type 2 diabetes, who had attended the outpatient clinics of internal medicine and endocrinology. The patients were inquired about their immunization status against influenza, pneumococcus, zoster, measles, pertussis, and diphtheria. Results: Among the 350 diabetic patients, 38 (10.8%) had received a vaccine against pneumococcus, 90 (26%) against seasonal influenza, and only one patient had been administered the zoster vaccine. None of the patients had been vaccinated against measles, diphtheria, and pertussis. The rate of pneumococcal vaccination (PV) increased with age (65.5±9.7 vs. 57±9.1 [OR 2.9 (95% CI=14.3-2.67], p=0.005), although there was no such association between influenza vaccination (IV) and age (p=0.456). The rate of PV increased with the number of routine follow-up visits per year (10/38 vs. 28/38 [4][5][6][7][8][9][10][11][12][13][14][15][16].096], (p=0.039). The rates of PV and IV were significantly higher in diabetic patients with chronic pulmonary disease (21/38 vs. 14/312 ], p=0.001) respectively. The rates of IV in diabetic patients with chronic renal failure were also significantly different from those without (27/90 vs. 8/260, [OR 14.28 95% CI 1.51-133.74], p=0.013). Conclusion: We observed low rates of vaccination against influenza, pneumococcus, and zoster in patients with diabetes, which were below the targets recommended by the World Health Organization.

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