Aim
In this study it was aimed to evaluate the prognostic factors for the geriatric patients with confirmed COVID-19 in a tertiary-care hospital at Kastamonu region of Turkey.
Method
Patients (≥65-year-old) who had PCR positivity for COVID-19 between March 2020 and April 2020 in our center were recorded retrospectively. A p value less than 0.05 was considered significant. Ethical committee approval was given from the Bolu University with decision number 2020/176.
Results
There were a total of 100 patients (44% female). In-hospital mortality was recorded as 7%. In univariate analysis for 1 month mortality, diabetes mellitus (p = 0.038), leucocyte count (p = 0.005), neutrophile count (p = 0.02), neutrophile-to-lymphocyte ratio (NLR) (p < 0.001), thrombocyte-to-lymphocyte ratio (TLR) (p = 0.001), C-reactive protein (CRP) (p = 0.002), lactate dehydrogenase (LDH) (p = 0.001), sequential organ failure assessment (SOFA) score (p = 0.001) and qSOFA score (p = 0.002) were found as independent risk factors. On admission, one point increase of NLR (p = 0.014, odds ratio (OR) = 1.371, 95% CI = 1.067–1.761) and one point increase of LDH (p = 0.047, OR = 1.011, 95% CI = 1.001–1.023) were associated with mortality on day 30 according to logistic regression analysis. The cut-off values were found as > 7.8 for NLR (83.33% sensitivity, 97.7% specificity) and > 300 U/L for LDH (100% sensitivity, 79.31% specificity) regarding the prediction of 30-day mortality.
Conclusion
In order to improve clinical management and identify the geriatric patients with COVID-19 who have high risk for mortality, NLR and LDH levels on admission might be useful prognostic tools.
Nosocomial infections occur 48-72 hours after hospitalization, especially caused by bacteria, and pose a high risk for patients in intensive care units (ICUs), including COVID-ICUs. This study aimed to reveal bacteria distribution and antibiotic susceptibility profiles isolated from various clinical samples of non-COVID-ICU and COVID-ICU patients. We included in this study bacterial strains isolated from ICUs patients in Kastamonu Training and Research Hospital between March 2020 and October 2020. We identified the strains using the Vitek 2 compact automated system (BioMerieux, France) and standard microbiological methods. Using the Vitek 2 automated system, we analyzed antibiotic susceptibility tests and interpreted the results based on the European Committee for Antimicrobial Susceptibility Tests (EUCAST) guideline. There were 302 patients in the non-COVID-ICUs and 440 patients in the COVID-ICUs. We isolated a total of 470 strains, 370 from non-COVID-ICUs and 100 from COVID-ICUs. Acinetobacter spp. was the most frequently isolated strains for both ICUs. Acinetobacter spp. isolated from non-COVID-ICUs had higher resistance rates to meropenem (p= 0.043), ceftazidime (p= 0.014), and levofloxacin (p<0.001) antibiotics than strains from COVID-ICUs. Antibiotic susceptibility profiles of other strains were similar for both ICUs. As a result, the incidence of nosocomial infections in COVID-ICU patients was lower than in non-COVID-ICU patients. Health personnel working in COVID-ICUs may have played an important role in this, as they were more careful about using personal protective equipment and complying with hygiene rules. However, antibiotic resistance continues to be a serious problem in ICUs, including COVID-ICUs.
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