Objectives In many diseases, immature platelet fraction (IPF%) is related to coagulopathy and poor outcome. This study aimed to investigate the predictive value of IPF% for the severity of pneumonia in patients with Coronavirus Disease 2019 (COVID-19). Methods A total of 154 patients with COVID‐19 infections were included. The patients were divided into two groups according to the severity of pneumonia (severe and non-severe) regarding their oxygen demand. Results Given laboratory parameters, the median IPF% was significantly higher in the severe group (11.9 vs. 3.9%, p<0.001). Mean platelet volume (p<0.001), platelet-large cell ratio (p=0.001), platelet distribution width (p=0.001), D-Dimer (p<0.001), INR (p=0.003), and aPTT (p=0.007) were also found to be significantly higher in the severe group. Moreover, IPF (p=0.014, Odds ratio = 2.000, 95%CI: 1.149-3.482) was an independent predictor for the severity. The curve value from receiver operating characteristics was 0.879 (p<0.001, 95%CI: 0.784-0.943) for determining the severity of pneumonia. IPF% had a sensitivity and specificity value of 69.5 and 92.4% to detect the disease’s severity. Conclusions IPF% is an independent predictor for the severity of COVID-19 pneumonia. Assessment of IPF% may both help to early determine high-risk patients with COVID-19 and to alert the physicians.
Tobacco and its products are the well-known causes of premature deaths associated with cancer, cardiovascular disease, and chronic obstructive pulmonary disease, as well as they constitute a significant risk factor that increases the tendency to respiratory system infection and other systemic infections. Active tobacco use and passive smoking increase the risk of infection. Both increase peribronchial and alveolar inflammation and fibrosis and mucosal permeability, cause inadequate mucociliary cleaning, damage to the respiratory tract epithelium resulting in fibrosis, and they adversely affect cellular and humoral immunity. Smoking has been known to increase the risk for viral infections and influenza. Similar data have been approved found for coronavirus disease-2019 (COVID-19) pandemic. Smoking is reported to be associated with the frequency of the disease and its severity of the clinical course. Severe acute respiratory syndrome-coronavirus-2 penetrates the cell using the angiotensin-converting enzyme 2 receptors. Such receptor proteins had been shown to increase in smoker individuals. Also, smoking facilitates penetration of the virus into the cell. The frequency of smoking and the rates of admission to intensive care, mechanical ventilation, and mortality have been also found to be higher was higher in severe cases. The risk for disease progression was found to be 14-fold higher in smokers. Further, the World Health Organization emphasized similar negative effects of hookah and new tobacco products such as electronic cigarettes and heated tobacco products. It is vital to underline the adverse effects of tobacco and tobacco products and to raise awareness among the public and to make efforts to smoking on every opportunity during the COVID-19 pandemic. Public awareness campaigns during the pandemic must always accompanied by the methods and strategies to avoid active and passive smoking.
Genitourinary system tuberculosis (GUTB) is a chronic granulomatous infection in which tuberculous bacilli affect one or more organs in the genitourinary system. In this report, an unusual presentation of miliary tuberculosis was presented as GUTB. A 15-year-old girl presented with complaints of severe abdominal pain and dysuria. Abdominal examination showed tenderness and defense. Pyuria and microscopic hematuria were observed. Acute abdominal causes could not be excluded through abdominal ultrasound. On abdominal computed tomography, a necrotic lesion was detected in the right kidney. Acid-fast bacilli were detected in the urine. Quartet anti-tuberculosis therapy was started. After treatment, static renal scintigraphy with 99mTc-dimer captosuccinic acid and single-photon emission CT imaging showed parenchymal injury. In any suspected patient, voiding symptoms, abdominal or flank pain, sterile pyuria, and hematuria should be kept in mind as the presenting manifestations of GUTB in the differential diagnosis.
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