In this report, we present two cases of delayed parosmia, a rare complication that occurs in the late period after COVID-19. A 28year-old male and a 32-year-old female, found to be positive in rRT-PCR tests for SARS-CoV-2, had a loss of taste and smell, respectively. Following the regaining of their ability to smell after 87 and 72 days, respectively, the male patient reported that the smell he perceived felt the smell of burnt rubber, while the female patient stated that it was similar to the smell of onion. As a result of evaluations, a diagnosis of delayed parosmia was made occurring in the late period secondary to SARS-CoV-2 infection. Although anosmia is a common symptom in the early phase of COVID-19, olfactory damage due to Sars-CoV-2 can be persistent, and distorted sense of smell can be prolonged.

Coronavirus disease 2019 (COVID-19) is a new zoonotic infectious disease that was first reported to the World Health Organization (WHO) on December 31, 2019, and declared as a pandemic by WHO on March 11, 2020. Due to the increased incidence of multimorbidity in geriatric age groups, COVID-19 disease leads to more severe consequences in the elderly. We aimed to determine the effects of age, comorbidity factors, symptoms, laboratory findings, and radiological results on prognosis by dividing our patients into 3 different geriatric age groups, using a retrospective descriptive analysis method. Patients included in the retrospective study ( n = 483) were divided into the following three different geriatric age groups: young-old (65–74 years), middle-aged (75–84 years), and the oldest-elderly (85 years and over).The length of stay in the intensive care unit of the patients between the ages of 75–84 was higher than the other two groups ( p = 0.013). Mortality rates were lowest in patients aged 65–74 years ( p < 0.001). The rate of ground glass opacity in thorax CT was higher in patients with mortality ( p < 0.001). While the rate of COPD-bronchial asthma was higher in surviving patients ( p = 0.001), malignancy ( p = 0.005) and cerebrovascular disease ( p < 0.001) were higher in patients who died. Patients aged between 75 and 84 (OR: 2.602; 95% CI: 1.306–5.183; p = 0.007) or ≥ 85 (OR: 4.086; 95% CI: 1.687–9.9; p = 0.002) had higher risk for mortality compared to patients aged between 65 and 74. The lowest mortality rates were observed in patients aged 65–74 years. Among the supportive diagnostic methods in 3 different geriatric age groups, PCR positivity has no effect on mortality, while the ground glass opacity on tomography is closely related to the need for intensive care and increased mortality. In patients with COPD-bronchial asthma comorbidity and those with symptoms of fatigue, dry cough, and sore throat, transfer to intensive care and mortality rates were lower, while patients who were transferred to intensive care and who developed mortality had higher malignancy and cerebrovascular disease comorbidities and dyspnea symptoms.

Objectives This prospective study was performed to evaluate the diagnostic role of point‐of‐care lung ultrasound (LUS) and inferior vena cava (IVC) ultrasound in patients with acute decompensated heart failure (ADHF). Methods A prospective cohort study was conducted between January 2018 and November 2018 on patients with a diagnosis of ADHF in the emergency department (ED). On admission, LUS findings, inspiratory and expiratory IVC diameters, and the inferior vena cava collapsibility index (IVCCI) were obtained. After therapeutic interventions, third‐hour changes in LUS and the IVC index and the treatment response were assessed. Results Eighty patients were enrolled. Forty‐six (58%) patients had an ejection fraction (EF) greater than 40%, and 34 (42%) had an EF of less than 40%. Significant differences were detected between the admission and third‐hour inspiratory IVC diameter, expiratory IVC diameter, and IVCCI (P = .001). There was no correlation between the EF and inspiratory IVC diameter (r = −0.03; P = .976), expiratory IVC diameter (r = −109; P = .336), or IVCCI (r = −0.72; P = .523) and between the B‐type natriuretic peptide level and inspiratory IVC diameter (r = −0.58; P = .610), expiratory IVC diameter (r = −0.33; P = .774), or IVCCI (r = −0.78; P = .493) either. A comparison of admission and third‐hour numbers of B‐lines on LUS imaging showed a significant decrease in the number of B‐lines in all zones at the end of 3 hours (P = .001). A significant difference existed between the hospitalized and discharged patients with respect to IVC diameters and number of B‐lines. Conclusions In the ED setting, an assessment of B‐lines and measurement of IVC diameters are better markers than the B‐type natriuretic peptide level, EF, or chest x‐ray for diagnosis of ADHF and can be used to make decisions for hospitalization or discharge from the ED.

Our study aims to ascertain the diagnostic value of the Monocyte-lymphocyte ratio (MLR) and red cell distribution width (RDW)-lymphocyte ratio (RLR) by comparing them with other biomarkers in distinguishing patients with and without acute appendicitis (AA). A total of 223 children were recruited in the study conducted according to the Cross-Sectional Study design. Patients under 18 years were assigned to 3 groups; AA, nonspecific abdominal pain (NAP), and a control group. According to the outcome of our research, while C-reactive protein (CRP), white blood cell (WBC), neutrophil count (NEU), neutrophil to lymphocyte ratio (NLR), and MLR had excellent diagnostic power, RLR had acceptable diagnostic power, and platelet to lymphocyte ratio (PLR) had only fair diagnostic power. MLR and NLR, which are simple, inexpensive, and easily accessible parameters, can be recommended to be used together with other biomarkers in diagnosing AA in children.

BackgroundPulmonary embolism (PE) is among the most difficult conditions to diagnose in emergency department. The majority of patients thought to have PE are tested positive for D-dimer and subsequently tested with advanced diagnostic modalities. Novel noninvasive tests capable of excluding PE may obviate the need for advanced imaging tests. We studied the role of combined clinical probability assessment and end-tidal carbon dioxide (ETCO2) measurement for diagnosis of possible PE in emergency department.MethodsWe included 100 consecutive subjects suspected to have PE and a positive D-dimer test to study clinical probability of PE and ETCO2 levels. ETCO2 > 34 mm Hg was found to be the best cut-off point for diagnosing PE. PE was ultimately eliminated or diagnosed by spiral computed tomography (CT).ResultsDiagnostic performances of tests were as follows: ETCO2 and D-dimer had a sensitivity of 100% and a negative predictive value (NPV) of 100% at the cut-off levels of 34 mm Hg and 500 ng/mL, respectively; Wells score had a sensitivity of 80% and NPV of 69.7% at a score of 4.ConclusionsETCO2 alone cannot reliably exclude PE. Combining it with clinical probability, however, reliably and correctly eliminates or diagnoses PE and prevents further testing to be done.