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Objectives Chronic systemic diseases (CSD) and cancer are closely related to the clinical course, severity and mortality of COVID-19 due to the immunosuppressive conditions caused by these diseases. The purpose of this study was to investigate the differences between the effects of cancer and CSD on the clinical and laboratory parameters of patients with COVID-19. Methods The study included patients who received inpatient treatment with the diagnosis of COVID-19 at Ondokuz Mayıs University between March 16, 2020, and December 1, 2020. The participants were divided into four groups as follows: Those without comorbidities (Group 1), those with only CSD (Group 2), those with only cancer (Group 3), and those with both CSD and cancer (Group 4). Comparative statistical evaluation was performed in terms of clinical symptoms, biochemical parameters, and admission to intensive care and survival. Results In total, 750 patients were included: 242 patients in Group 1, 442 in Group 2, 27 in Group 3, and 39 in Group 4. The mean age of the patients was 57.1±9.4 years and 53.7% were male. Patients of Group 1 were significantly different from those of the other groups in terms of age, requirement for intensive care and intubation, complications, survival, white blood cell and lymphocyte count, neutrophil/lymphocyte ratio and levels of hemoglobin, lactic acid dehydrogenase, ferritin, D-dimer, and C-reactive protein (for each p<0.001). Conclusion No difference was observed among laboratory parameters, intensive care admission, intubation need, complication frequency, and survival rates in patients with CSD or cancer. It was detected that all three groups with CSD and cancer were worse than Group 1 in terms of intensive care need, intubation, and survival.

Familial Mediterranean fever (FMF) is the most common hereditary autoinflammatory disease worldwide and is characterized by recurrent fever and serositis. Serum soluble receptor for advanced glycation end products (sRAGE) is an isoform of RAGE and sRAGE acts as a trap receptor for ligands and blocks the RAGE–ligand axis. This study aimed to examine the change in sRAGE levels in FMF and to investigate its relationship with inflammation. This study included patients with FMF (n=20) and healthy controls (n=22). Morbidity status, sRAGE levels, demographic and laboratory data were recorded. Pregnant women, individuals aged <18 years, and those with other chronic inflammatory diseases were excluded. Statistical Package for Social Sciences (SPSS) Version 22.0 was used to conduct all statistical analyses and all data are expressed as mean and standard deviation (SD). The serum sRAGE levels were 12.21±6.70 ng/mL and 4.44±2.89 ng/mL in the patient and control groups, respectively. Accordingly, the sRAGE levels of patients with FMF were significantly higher (p<0.001). Comorbidities had no effect on the sRAGE levels of the patient group and no correlation was found between the sRAGE and inflammatory biomarkers. sRAGE levels are elevated in FMF but does not seem to be a promising candidate as a biomarker for FMF.

IntroductionZonulin is a protein that plays a role in the reversible regulation of epithelial permeability. As zonulin is released in large amounts into the intestinal lumen, it disrupts the integrity of the tight junctions and causes continuous migration of antigens to the submucosa. Consequently, it can trigger inflammatory processes and severe immune reactions. In severe cases, SARS-CoV-2 may have a major impact on the clinical manifestations of the disease by directly or indirectly affecting intestinal cells and triggering systemic inflammation. Therefore, our study aimed to investigate the role of one of the possible mediators, zonulin, in the severity of the COVID-19 infection. MethodsThirty COVID-19 patients and 35 healthy controls were included in the study. Blood samples were taken from the patients on the 1st, 4th, and 8th days of hospitalization. Serum zonulin levels were determined by enzyme-linked immunosorbent assay (ELISA). Complete blood count (white blood cell [WBC], neutrophil, lymphocyte, and platelet), biochemical parameters (serum lactic acid dehydrogenase [LDH], erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], D-dimer, ferritin, fibrinogen levels) were determined and chronic systemic disease states of the patients were assessed. ResultsSerum zonulin levels were notably higher in the healthy control group compared to the patient group (p=0.003). Although there was an increase in the zonulin values by time in hospitalization, this rising was not significant. Conversely, ESR and CRP levels were significantly higher in the patient group (p<0.001). There was no significant difference between the two groups regarding gender, age, and WBC counts. ConclusionThe serum zonulin levels of COVID-19 patients with the mild clinical course were lower than the healthy control group. Moreover, serum zonulin levels were not correlated with ESR, CRP, and other inflammation markers. Our results suggest that low serum zonulin levels in COVID-19 patients might represent a mild disease course.

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