Introduction
We evaluated several biological indicators based on inflammation and/or nutritional status, such as systemic immune-inflammation index (SII), early warning score (ANDC) and prognostic nutritional index (PNI) in hospitalized COVID-19 patients with and without malignancies for a prognostic significance.
Methodology
This is a retrospective and observational study on 186 patients with SARS-CoV-2, who were diagnosed with COVID-19 by real-time PCR testing and hospitalized due to COVID-19 pneumonia. 75 patients had various malignancies, and the rest (111), having a similar age and comorbidity profile based on propensity score matching, had no malignancy.
Results
None of the measures as neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, monocyte to lymphocyte ratio, SII, PNI or ANDC was found to be significantly different between two groups. Odds ratio for the mortality, OR 2.39 (%95 CI 1.80–3.16) was found to be significantly higher for the malignancy group, even though the duration of hospitalization was statistically similar for both groups. PNI was found to be significantly lower for deceased patients compared with survivors in the malignancy group. Contrarily, ANDC was found to be significantly higher for deceased patients in the malignancy group.
Conclusions
PNI and ANDC have independent predictive power on determining the in-hospital death in COVID-19 malignancy cases. It is suggested that ANDC seems to be a more sensitive score than SII in COVID-19 cases with malignancies.
One of the reasons for the high mortality in COVID-19 patients is the increased risk of disseminated intravascular coagulation (DIC) and venous thromboembolism. For this reason, the use of anticoagulant treatments has become widespread. One of the rare complications of anticoagulant therapy is retroperitoneal hemorrhage. These hemorrhagies require immediate intervention. Retroperitoneal hemorrhage should be kept in mind among the many complications that develop in the patient who was followed up during the pandemic period. For this purpose, we present 2 cases who developed spontaneous retroperitoneal bleeding while clinically recovering under COVID-19 treatment.
Objective: Pneumonia and acute respiratory distress syndrome are observed as major complications in Coronavirus disease-2019 . Cholesterol is a principal lipid component of the cell membranes. Lipoproteins have a fundamental role as the first line of defense against microbes. Lipoprotein levels are altered during viral infections. This study aimed to investigate the association between low-density lipoprotein cholesterol (LDL-C) levels and disease severity of patients hospitalized with COVID-19 pneumonia.Methods: This is a retrospective and observational study of 817 patients with Severe Acute Respiratory syndrome-Coronavirus-2 (SARS-CoV-2), who are diagnosed with COVID-19 using the real-time polymerase chain reaction and are hospitalized due to moderate and severe COVID-19 pneumonia.Results: Among 817 patients with COVID-19 pneumonia, 347 (42.5%) were moderate and 470 (57.5%) were severe. Total cholesterol (TC) and LDL-C levels reduced in patients who have severe condition than those with moderate condition (p=0.02, p=0.03, respectively). TC and LDL-C were negatively correlated with the hospitalization duration (r=-0.163, p=0.02, r=-0.154, p=0.03, respectively).
Conclusion:Our results suggest a decreased LDL-C levels in patients with COVID-19 in relation to disease severity. Therefore, a strong link was found between lipid metabolism and SARS-CoV-2, which allow us to suggest LDL as a marker indicating COVID-19 severity in the near future.
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