BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has resulted in high mortality among patients in critical intensive care units. Hence, identifying mortality markers in the follow-up and treatment of these patients is essential. This study aimed to evaluate the relationships between mortality rates in patients with COVID-19 and the neutrophil/lymphocyte ratio (NLR), derived NLR (dNLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), systemic inflammation response index (SII), and systemic inflammatory response index (SIRI). MethodologyIn this study, we assessed 466 critically ill patients diagnosed with COVID-19 in the adult intensive care unit of Kastamonu Training and Research Hospital. Age, gender, and comorbidities were recorded at the time of admission along with NLR, dNLR, MLR, PLR, SII, and SIRI values from hemogram data. Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and mortality rates over 28 days were recorded. Patients were divided into survival (n = 128) and non-survival (n = 338) groups according to 28-day mortality. ResultsA statistically significant difference was found between leukocyte, neutrophil, dNLR, APACHE II, and SIRI parameters between the surviving and non-surviving groups. A logistic regression analysis of independent variables of 28-day mortality identified significant associations between dNLR (p = 0.002) and APACHE II score (p < 0.001) and 28-day mortality. ConclusionsInflammatory biomarkers and APACHE II score appear to be good predictive values for mortality in COVID-19 infection. The dNLR value was more effective than other biomarkers in estimating mortality due to COVID-19. In our study, the cut-off value for dNLR was 3.64.

Introduction: Despite significant advances in the management of patients with COVID-19, there is a need for markers to guide treatment and predict disease severity. In this study, we aimed to evaluate the relationship of the ferritin/albumin (FAR) ratio with disease mortality. Methodology: Acute Physiology and Chronic Health Assessment II scores and laboratory results of patients diagnosed with severe COVID-19 pneumonia were retrospectively analyzed. The patients were divided into two groups: survivors and non-survivors. Data for ferritin, albumin, and ferritin/albumin ratio among COVID-19 patients were analyzed and compared. Results: The mean age was higher in non-survivors (p = 0.778, p < 0.001, respectively). The ferritin/albumin ratio was significantly higher in the non-survival group (p < 0.05). Taking the cut-off value of the ferritin/albumin ratio of 128.71 in the ROC analysis, it predicted the critical clinical status of COVID-19 with 88.4% sensitivity and 88.4% specificity. Conclusions: ferritin/albumin ratio is a practical, inexpensive, and easily accessible test that can be used routinely. In our study, the ferritin/albumin ratio has been identified as a potential parameter in determining the mortality of critically ill COVID-19 patients treated in intensive care.

Aim: Malnutrition can increase the frequency of infections by reducing the immune system response. Parenteral nutrition (PN) is considered an important treatment for patients who cannot receive adequate oral or enteral nutrition. The contents of nutritional products may be different. In this study, we aimed to investigate the effects of soy-based and olive oil-based parenteral nutrition products on infection parameters. Material and Method: A total of 82 patients were included in the study, 50 of which were soy (Group 2) and 32 were olive-based (Group 1) parenteral nutrition. Patient files and laboratory results were reviewed. Age, gender, 1st, 7th, 14th and 21st days in intensive care, leukocyte and platelet counts, Neutrophil lymphocyte ratio (NLR), C-Reactive Protein (CRP) values, Acute Physiology and Chronic Health Evaluation (Apache II) score and first blood culture results after hospitalization were recorded. Results: The 7th and 21st day CRP values in Group 1 were statistically significantly lower than the 7th and 21st days CRP values in Group 2. In Group 1, growth in blood culture was statistically significantly lower and in Group 2 there was a statistically significant early growth. Conclusion: As a result, it was found that olive oil-based lipid-containing nutritional solutions were more advantageous in terms of infection on intensıve care than soy-based nutrition products. It was concluded that patients who received postoperative mechanical ventilator support fed with olive oil-based parenteral nutrition products had less infectious growth.

Covid-19 disease can have many neurological complications, posterior reversible encephalopathy being one of them. A 42-year-old female patient was admitted to the emergency department on the 4th day of PCR test positivity with decreased consciousness. Patient with a Glasgow coma score of 6 (E1M3V2). The patient's vital signs were stable and there was no abnormality in his laboratory. No pathology was found in the brain tomography to explain the loss of consciousness. In MRI evaluation, the patient was diagnosed with Posterior reversible encephalopathy syndrome (PRES) according to radiological and clinical information. The standard Covid -19 treatment added to the antiedema treatment was applied to the patient. Brain MRI was repeated four days later and previous MRI findings showed regression. The patient was discharged to the ward with stable neurological status on the 22nd day of hospitalization. PRES is a rare but serious complication in Covid-19. Especially in the Covid-19 intensive care unit, intubation and sedation suppress the clinical picture, and the difficulty in getting patients on magnetic resonance imaging can complicate the diagnosis. Therefore, PRES should be kept in mind in the presence of neurological symptoms such as encephalitis, meningitis, encephalopathy and cerebrovascular disease.

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