Background: Coronavirus disease 2019 (COVID-19) has become a global health threat, and thus, an early and effective set of predictors is needed to manage the course of the disease. Objectives: We aim to determine the effect of SARS-CoV-2 on lipid profile and to evaluate whether the atherogenic index of plasma (AIP) could be used to predict in-hospital mortality in COVID-19 patients. Methods: In this retrospective chart review study, a total of 139 confirmed COVID-19 patients, whose diagnoses are confirmed by PCR and computerized tomography results, are enrolled. The study population is divided into two groups: the deceased patient group and the survivor group. For each patient, fasting total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and the triglyceride values are obtained from the laboratory tests required at the admission to hospital. Finally, the AIP is calculated as the base 10 logarithm of the triglyceride to HDL-C ratio. Distributional normality of the data is checked and depending on the normality of the data, either T test or Mann Whithey U test is employed to compare the two aforementioned study groups. Results: Mean age of the study population is 49.2 § 20.8 and 61.2% (n = 85) is male. Out of the 139 patients 26 have deceased and the remaining 113 patients survived the disease. Mean age of the deceased patients was 71.8*8.9 and mean age of the survivor patients is 44.0*19.2 (p < 0.001). The deceased group had more patients with hypertension (50.0% vs. 23.0, p = 0.006), diabetes mellitus (35.6% vs. 10.6%, p = 0.002), cardiovascular diseases (23.1% vs. 4.4%, p = 0.001), chronic renal insufficiency (11.5% vs. 0.9%, p = 0.003) and atrial fibrillation (7.7% vs 0%, p = 0.003). The AIP values in the deceased group are found to be statistically higher (p < 0.001) than the survivor group. As a measure of mortality, the area under the operating characteristic curve for the AIP is calculated as 0.850 (95% confidence interval: 0.772À0.928) along with the optimal cutoff value of 0.6285 (78.6% sensitivity and 80.5% specificity). Furthermore, the AIP value is observed to be elevated in patients with pneumonia, intubation history, and intensive care admission during hospital stay (p = 0.002, p < 0.001 and p < 0.001, respectively). Finally, compared to the survivor group, total cholesterol, HDL-C, LDL-C values are lower (p = 0.004, p < 0.001 and p < 0.001, respectively) and triglyceride levels are higher (p < 0.001) in deceased patients. Conclusion: In this study, we show that the AIP levels higher than 0.6285 can predict in-hospital mortality for COVID-19 patients. Moreover, the AIP emerges as a good candidate to be used as an early biomarker to predict pneumonia, intubation and intensive care need. Hence, regular check of the AIP levels in COVID-19 patients can improve management of these patients and prevent deterioration of the disease.

In conclusion, RA patients have similar values in terms of nocturnal blood pressure dipping and hypertension diagnosis as compared to normal population.

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Lightning strike is an infrequent natural phenomenon with serious medical complications, like multiple organ damage, and it is associated with increased risk of mortality. Cardiovascular complications are among the most hazardous complications of lightning strike. Lightning strike can cause various serious consequences ranging from electrocardiographic changes to death. We reported a 21-year-old patient with no cardiovascular risk factors struck by lightning and presented by inferior ST elevated myocardial infarction (MI). The patient was followed up in the intensive care unit and MI complication did not develop during follow-up. The patient was lost due to multi-organ failure after 20 hours.Aydin F, Turgay Yildirim O, Dagtekin E, Huseyinoglu Aydin A, Aksit E. Acute inferior myocardial infarction caused by lightning strike.

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Aim: Hypertension is a major risk factor for cardiovascular system. Recent studies showed that atherogenic index of plasma (AIP) has a strong association with cardiovascular morbidity, all-cause mortality, atherosclerosis and severity of coronary artery disease. It also has a relationship with endothelial damage in hypertensive patients. With this study we aim to investigate the association between AIP and hypertension. Methods: A total of 213 patients were enrolled for the study. Patients with previous hypertension, nephrotic syndrome, diabetes mellitus, hypotiroidism diagnosis, patients under statin treatment and patients under 18 years of age were excluded. Diagnosis of hypertension and blood pressure (BP) results were obtained with 24-hour ambulatory blood pressure monitoring (ABPM). AIP was defined as the logarithmic transformation of the triglyceride to high-density lipoprotein-cholesterol ratio. Results: Mean age of the population was 49.2 ± 14.6 years and 41.8% (n=89) was male. According to 24-hour ABPM results, AIP was positively correlated with daytime systolic blood pressure (SBP) (r=0.244, p<0.001), daytime diastolic blood pressure (DBP) (r=0.276, p<0.001), night-time SBP (r=0.259, p<0.001), night-time DBP (r=0.299, p<0.001), average SBP (r=0.213, p=0.002) and average DBP (r=0.296, p<0.001). AIP was also increased in hypertensive patients compared to normotensive subjects (p=0.001). Conclusion: Results of our study showed that AIP was positively correlated with blood pressure and statistically higher in patients with hypertension.