COVID-19 experience of the major pandemic response center in the capital: results of the pandemic’s first month in Turkey

Abstract

the causative agent was identified as a new Coronavirus (2019-nCoV), which had not previously been detected in humans [1]. Later, the name of 2019-nCoV disease was accepted as COVID-19, and the virus was named SARS-CoV-2 because of its close resemblance to SARS CoV. After this date, the number of patients increased rapidly, and the WHO declared an "International Public Health Emergency" regarding the coronavirus outbreak at its meeting on January 30, 2020.Although the world was caught unprepared to the sudden emergence and rapid spread of the COVID-19 outbreak, Turkey managed to postpone the emergence of the disease within its borders through the implementation of effective preventive measures until March 11, 2020, when the first case was detected. After cases seen in China, Italy, and Spain starting from January, Turkey executed a meticulous monitoring and evaluation process to decide, implement, and follow up with comprehensive and timely measures. These measures have given time to be prepared for both the community and the healthcare system in this pandemic. Furthermore, since the beginning of the pandemic, Turkish citizens infected with COVID-19 have Background/aim: The aim of this study is to evaluate the epidemiological and clinical characteristics and parameters that determined the clinical course and prognosis of the COVID-19 patients admitted to Ankara City Hospital during the first month of the pandemic in Turkey.Materials and methods: SARS-CoV-2 PCR positive patients who were hospitalized between March 10 and April 10, 2020 were included.Results: Among 222 patients, mean age was higher in severe acute respiratory illness (SARI)/critical disease group (P < 0.001). Median time from illness onset to admission and presence of comorbidity, especially coronary artery disease and chronic obstructive pulmonary disease, were significantly higher in the SARI/critical disease group (P < 0.05). Cough and fever were the most common symptoms, while anosmia and loss of taste were observed in 8.6% and 7.7% patients, respectively. The mortality rate was 5.4%. A high neutrophil/lymphocyte ratio; low lymphocyte, monocyte, and platelet count; elevated liver enzymes; low GFR; and high levels of muscle enzymes, ferritin, and IL-6 on admission were found to be associated with SARI/critical disease (P < 0.05). Bilateral ground-glass opacity and patchy infiltration were more frequently seen in the SARI/critical disease group (P < 0.001). Patients older than 65 years had an 8-fold increased risk for development of SARI/critical disease. Conclusion:This cohort study regarding COVID-19 cases in Turkey reveals that older age, presence of comorbidity, bilateral infiltration on CT, high neutrophil/lymphocyte ratio, low monocyte and platelet count, elevated liver enzymes, low GFR, high levels of muscle enzymes, and high levels of ferritin and IL-6 on admission are predictors of SARI and severe disease.

Evaluation of the Characteristics and Clinical Results of the Patients Hospitalized With Covid-19 Pneumonia in the Province of Mus: A State Hospital Experience

“…This can be explained by the fact that, unlike others, mild patients without pneumonia were not included in our study. The ratio of the patients aged over 65 years was also higher than the ratio in previous studies, which scrutinized clinical outcomes of the patients from China and Turkey (11)(12)(13)(14). The mean age of the patients and the ratio of the patients' aged over 65 years were found to be significantly higher in patients with severe disease similar to other studies (11,14,15).…”

Effect of comorbid pulmonary disease on the severity of COVID‐19: A systematic review and meta‐analysis

“…From these 53 studies, 13,19–70 data from 658,073 patients were included in the pool, with average ages ranging from 38.0 to 79.7 years. In these studies, the average prevalence of COPD was 0.9% (range: 0.3%–20.0%, n = 6435), that of CRD was 2.9% (range: 2.1%–24.0%, n = 19,490) and that of asthma was 2.0% (range: 0%–22.0%, n = 13,692).…”

Neutrophil-to-lymphocyte ratio on admission to predict the severity and mortality of COVID-19 patients: a meta-analysis

“…All the studies were retrospective observational studies, except for one which was prospective 32 . Most of the studies were conducted in China, with only four studies (11%) performed outside of China, among which two studies were in Turkey 39,40 , and two were in the United States of America 32,33 ( Table 1, Table 2, Table S3-4 ). Studies with severity as the outcome measure had a median risk of bias score of 7 (IQR 5.5-8.5; range 5-9).…”