Background and aims A national lockdown to prevent the spread of coronavirus disease (COVID-19) in Turkey was introduced in March 2020. We think that lockdowns may lead to weight gain and worsening of glycemic parameters in patients with type 2 diabetes mellitus (DM). The purpose of this study was to investigate how type 2 DM patients were affected by the lockdown. Method Type 2 DM patients unable to attend regular follow-ups due to lockdown over a 75-day period between March and June 2020 and who again attended polyclinic follow-up when the lockdown was lifted were included in the study. These patients’ glycemic control and weight status were compared with the pre-lockdown period. In addition, patients’ general habits, and adherence to diet and exercise were evaluated, while their general health was assessed using the Short-Form 36-item survey. Result The research involved 101 type 2 DM patients, 57 men (56.5%) and 44 women (44.5%), with a mean age of 55 ± 13. Patients’ mean pre-lockdown weight was 84.7 ± 16.4 kg, rising to 85.5 ± 16.8 kg post-lockdown, although the increase was not statistically significant (p = 0.781). In terms of glycemic parameters, Hba1c rose from 7.67 ± 1.76 to 8.11 ± 2.48, and fasting glucose from 157.9 (83–645) mg/dl to 163.2 (84–550) mg/dl, none of which were statistically significant (p = 0.253, p = 0.079, respectively). Conclusion In addition to weight gain among type 2 DM patients during the Covid 19 lockdown, statistically insignificant increases were also observed in such glycemic parameters. This was a small sample and further studies with larger sample are needed.

SUMMARY OBJECTIVE The present study aimed to investigate the role of neutrophil/lymphocyte ratio (NLR), an inflammation marker, complete blood count, and biochemical parameters in the diagnosis of COVID-19. METHODS A total of 80 patients who had been hospitalized in the internal medicine clinic were enrolled in the study. The cases were allocated into two groups, i.e., COVID (+) and (-), based on real-time reverse transcription-polymerase chain reaction. The demographic, clinical, and laboratory [NLR, platelet/lymphocyte ratio (PLR), complete blood count, biochemistry, and serology] data of the patients were retrospectively obtained from the hospital data management system. RESULTS NLR and fever levels were found to be higher in COVID-19 (+) cases (P=0.021, P=0.001, respectively). There was no difference between males and females with regard to COVID-19 positivity (P=0.527). Total bilirubin levels were found to be lower in COVID-19 (+) cases (P=0.040). When the ROC analysis was carried out for NLR in COVID-19 (+) cases, the AUC value was found to be 0.660 (P=0.021), sensitivity as 69.01 %, specificity as 65.40 %, LR+: 1.98 and LR- : 0.48, PPV: 80.43, and NPV: 50.00, when the NLR was ≥2.4. The risk of COVID-19 was found to be 20.3-fold greater when NLR was ≥ 2.4 in the logistic regression (P=0.007). CONCLUSION NLR is an independent predictor for the diagnosis of COVID-19. We also found that fever and total bilirubin measurements could be useful for the diagnosis of COVID-19 in this population.

Subclinical hypothyroidism should be treated in iron-deficiency anemia patients when both conditions coexist. This would provide a desired therapeutic response to oral iron replacement and prevent ineffective iron therapy.

Mean platelet volume (MPV) is an indicator of platelet activation. The present study was designed to investigate platelet function by measuring MPV, platelet count (PLC) and platelet mass (PLM) in prehypertensive (PHT) subjects. Additionally, we also evaluated the effects of lifestyle modification on platelet functions by measuring MPV, PLC and PLM. We selected 36 newly diagnosed PHT patients and 21 control subjects (BP < 120/80 mmHg) matched for age and sex. Lifestyle modifications (weight loss, reduced sodium intake, increased physical activity, limited alcohol consumption and the Dietary Approaches to Stop Hypertension (DASH) diet) were recommended to PHT individuals for 20 weeks. At entry into the study, although PLM and PLC values were similar between study groups, MPV values were significantly higher in the PHT group than in the control group (respectively, 10.41 +/- 0.93 fl vs. 9.56 +/- 1.04 fl, p < 0.01). Additionally, MPV was positively correlated with the systolic blood pressure (BP), body mass index (BMI) and insulin resistance (IR) in the PHT group (r: 0.41; p < 0.02, r: 0.37; p < 0.04, r: 0.35; p < 0.05, respectively). Only age and PHT were found to be independent predictors of MPV after regression analysis. The program substantially lowered BP (net reductions in systolic and diastolic BPs of 16.2 and 8.7 mmHg, p < 0.001, p < 0.001, respectively). In addition, BMI, waist circumference (WC) and IR were significantly reduced in the PHT group (p < 0.01, p < 0.01, p < 0.05, respectively). At the end of study, although PLM, PLC values were reduced in the PHT group, only the decrease in MPV reached statistical significance (respectively, 10.41 +/- 0.93 fl vs. 9.67 +/- 1.2 fl, p < 0.01). In closing, to our best notice, our study is the first to display a significant increase in MPV in PHT subjects and to show a decrease in MPV by lifestyle modification after 20 weeks. As a result, we consider that decreased platelet activation with multi-aspect effects of lifestyle modification therapy might play an important role in reducing thrombotic risk in PHT patients.

This study has shown that an increased MPV is closely associated with poor glycaemic control, which may be a risk factor for diabetic retinopathy. Nonetheless, further prospective studies are needed to assess the relationship between MPV, glycaemic indices and microvascular complications.