Early diagnosis in COVID-19 is essential in terms of treatment and prevention of contagiousness. In this study, we aimed to find an alternative diagnosis method by using fewer laboratory parameters in the early diagnosis of COVID-19 disease by creating a fast, easily accessible, cost-effective index and has a diagnostic accuracy rate of over 90%. All patients over the age of 18 who applied to Hitit University Erol Olçok Training and Research Hospital Emergency COVID Outpatient Clinic with a pre-diagnosis of COVID-19 between March and April 2020 were evaluated retrospectively. Patients were divided into two groups as COVID-19 positive and COVID-19 negative. It was aimed to create a HITIT-19 index by evaluating the cases according to the clinical and laboratory results. Between March and April 2020 (in the first peak of the pandemic), 1586 patients were applied to the Emergency COVID-19 outpatient clinic with a pre-diagnosis of COVID-19. According to COVID-19 RT-PCR, card test, and CT involvement, 285 (13%) patients were diagnosed with COVID-19. PCR was positive in 285 (18%) of 1586 patients, and PCR was negative in 1301 (82%). While 153 (53.7%) of the patients diagnosed with COVID-19 were male and the median age was 45 (28-62.75), 883 (55.7%) of the patients not diagnosed with COVID-19 were male, and the median age was 43 (31-65). Hypertension (HT) was the most common underlying disease in 10.5% of patients applied to the emergency room with a diagnosis of COVID-19, while 38.9% dyspnea and 35.1% fever were the most common symptoms. While 76% of Plaquenil and 58% azithromycin were the most frequently started treatments, 31.4% (28.4% of them were hospitalized in the service, 3% in the intensive care unit) of them hospitalized. It was to create a HITIT-19 index that is fast, easily accessible, cost-effective, and has a diagnostic accuracy rate of over 90% by using laboratory tests. However, we could not achieve this goal due to the low accuracy of the diagnostic tests and the lack of significant change in the laboratory levels of the patients at admission. Considering that the pandemic is continuing rapidly, there is still a need to develop practical diagnostic methods that are easier and cheaper in diagnosis. In this sense, we believe that our study will be a guiding study for other studies that will be designed for diagnostic index studies.
Background/Aim: Lamivudine (LAM), which has been used for the treatment of Chronic Hepatitis (CHB) infection for many years, is now provided for short-time use to immunosuppressive patients due to resistance. We aimed to evaluate the current state and pandemic period routine follow-ups in patients who still used LAM today due to treatment or prophylaxis in terms of virologic or serologic treatment response. Methods: In this retrospective cohort study, we included 33 patients who received LAM treatment or prophylaxis due to CHB. Evaluations included patients' serologic results for Hepatitis B, platelet counts, comprehensive metabolic panel, HBV DNA levels, ultrasonographic (USG) evaluation of the liver, and the number and duration of outpatient visits between 01.01.2020 and 31.12.2021. Results: Of all the patients, 51.5% (n=17) were males, and the average age was 57.3 (12.3) years. The median LAM treatment duration was found 10 (2.58) years. The ratio of receiving LAM due to immunosuppressive therapy was 27.27% (n=9). Except for HBV DNA-negative patients or patients with no accessed results, the virologic response rate of patients was found 60.7% (n=20). Within the study period, while Anti-Hbe seroconversion was found 3.2% (n=1), Anti-Hbs seroconversion was found 6.5% (n=2). One patient whose virologic response was not obtained, received the treatment without any alterations in the regimens. While the number of outpatient follow-ups in the study period was found 1.94 (0.24) on average, the duration between follow-ups was found 13.82 (12.8) months. Conclusion:It is pleasing to obtain virologic response and Anti-HBs, Anti-HBe seroconversion in patients with low resistance profile who receive the LAM treatment. While watchful waiting is recommended for patients receiving long-term LAM treatment, our retrospective analysis showed that planned outpatient follow-ups for every three months was done in longer intervals. The treatment is not altered in one patient whose virologic response was not obtained because of inadequate number of follow-ups within the study period. Since monitoring without having prolonged follow-up durations due to the pandemic is of importance in terms of preventing complications, we believe that there is a need for further studies on this issue.
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