Background: This study examined the possible association between the prognostic nutritional index (PNI) and in-hospital mortality rates in cases with a high cardiovascular risk burden and hospitalized with the diagnosis of coronavirus disease 2019 . Material and Methods: This retrospective and cross-sectional study included 294 COVID-19 patients hospitalized in a tertiary referral pandemic center. The study cohort was grouped into tertiles based on the initial PNI values as T1, T2, and T3. The PNI was calculated for each case and the prognostic value of this index was compared to CURB-65 and 4C mortality risk scores in predicting in-hospital mortality. Results: Patients stratified into the T1 tertile had a lower lymphocyte count, serum albumin level, and PNI values. In a multivariate analysis, the PNI (OR: 0.688,%95CI: 0.586À0.808, p < 0.001) was an independent predictor for all-cause in-hospital death. After adjusting for confounding independent parameters, patients included in the T1 tertile were found to have 11.2 times higher rates of in-hospital mortality compared to the T3 group, which was presumed as the reference group. In addition, we found that the area under curve (AUC) value of PNI was significantly elevated than that of serum albumin level and total lymphocyte counts alone. [(AUC):0.79 vs AUC:0.75 vs AUC:0.69; respectively). Conclusion: This study demonstrated that the PNI is independently related with in-hospital mortality in patient with COVID-19 and cardiovascular risk factors. The power of the PNI was also validated using wellaccepted risk scores of COVID-19 such as CURB-65 and 4C mortality risk scores.

Introduction:The objective of the present research was to evaluate the possible association between the N-terminal pro-brain type natriuretic peptide (NT-proBNP) levels and in-hospital mortality in coronavirus disease 2019 (COVID-19) pneumonia patients who did not have pre-existing heart failure (HF). Methods:A total of 137 consecutive patients without pre-existing HF and hospitalized due to COVID-19 pneumonia were enrolled into the current research. The main outcome of the research was the in-hospital death. The independent parameters linked with the in-hospital death were determined by multivariable analysis. Results: A total of 26 deaths with an in-hospital mortality rate of 18.9% was noted. Those who died were older with an increased frequency of co-morbidities such as hypertension, chronic kidney disease, coronary artery disease, stroke and dementia. They had also increased white blood cell (WBC) counts and had elevated glucose, creatinine, troponin I, and NT-pro-BNP levels but had decreased levels of hemoglobin. By multivariable analysis; age, NT-pro-BNP, WBC, troponin I, and creatinine levels were independently linked with the in-hospital mortality. After ROC evaluation, the ideal value of the NT-pro-BNP to predict the in-hospital mortality was found as 260 ng/L reflecting a sensitivity of 82% and a specificity of 93% (AUC:0.86; 95%CI:0.76-0.97). Conclusion: The current research clearly shows that the NT-proBNP levels are independently linked with the in-hospital mortality rates in subjects with COVID-19 pneumonia and without HF. Thus, we believe that this biomarker can be used as a valuable prognostic parameter in such cases.

OBJECTIVE: Patients with atrial fibrillation (AF) constitute a significant portion of hip fracture patients, and both diseases tend to present more frequently in older age. Our goal was to evaluate the long-term mortality of patients with AF who were free from heart failure undergoing hip fracture surgery.METHODS: This observational, retrospective study was done in a single research and training hospital setting. Hospital electronic health record data, National Health Registry data, and National Death Registry System data for 233 consecutive patients who were above 65 years of age and were planned to undergo surgery for hip fracture were retrieved and analyzed. An experienced cardiologist evaluated the patients prior to surgery. Each member of the research cohort was categorized into one of the two groups based on their survival status (survivor and non-survivor groups). RESULTS:Of the 233 cases, 89 (38.2%) who were included in the investigation died during the follow-up period. The median long-term follow-up period was 34 (12-42) months. The frequency of AF was significantly higher in the non-survivor group. In multivariable Cox regression analysis, AF (HR: 2.195, 95%CI 1.365-3.415, p<0.001), advanced age, and blood urea level were determined as independent predictors for all-cause long-term mortality.CONCLUSIONS: AF is an independent predictor for long-term death in hip fracture cases above 65 years of age who were free from heart failure.

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Prognostic performance of CHA₂DS₂-VASc scores for predicting mortality among COVID-19 patients: A single pandemic center experience In recent months, the outbreak of coronavirus disease 2019 (COVID-19) has placed a great strain on the health systems of many countries. Effective prognosis of the disease can play a key role in guiding their limited healthcare resources and ensuring the timely identification and intervention of cases with an elevated mortality risk. For this purpose, several prognostic models have been developed to predict the mortality risk in such patients [1,2]. The CHA₂DS₂-VASc scoring system (congestive heart failure [1 point], hypertension [1 point], age ≥ 75 years [2 points], diabetes mellitus [1 point], prior stroke or transient ischemic attack [1 point], vascular disease [1 point], age 65-74 years [1 point], sex class [female, 1 point]) has been accepted as a key prediction tool for determining the risk of thromboembolism in atrial fibrillation patients [3]. Since the components of the CHA₂DS₂-VASc score, including advanced age, hypertension, diabetes mellitus, and previous cardiovascular disease, are strongly associated with an increased risk of mortality in COVID-19 cases, this study aimed to investigate the prognostic performance of CHA₂DS₂-VASc scores in predicting in-hospital mortality in this patient population. In total, 318 COVID-19 cases were included in the study. Baseline characteristic features were retrieved from the hospital's electronic database, and COVID-19 infection was confirmed using real-time RT-PCR testing in all cases. The CHA₂DS₂-VASc score was calculated for each subject. Our study was registered with the Ministry of Health's Scientific Research COVID-19 Committee and then approved by the Local Ethics Committee (approval number: 2020/KK/171-2845). We divided the study population into two groups based on the survival status during the index hospitalization. The in-hospital mortality was 9.9% (n = 32 cases). Patients who died during index hospitalization tended to be older and male (Table 1). The frequency of insulindependent diabetes mellitus, chronic obstructive pulmonary disease, coronary artery disease, chronic renal failure, cerebrovascular disease, and smoking were significantly higher among non-survivor cases. In regard to laboratory data, non-survivors' cases had significantly higher levels of lactate dehydrogenase, D-dimer, C-reactive protein, and troponin, compared to those who survived. The median CHA₂DS₂-VASc scores were significantly higher in non-survivor cases [2.0 (2.0-6.0) vs 1.0 (1.0-2.0), P < 0.001, respectively]. The independent predictors of in-hospital death were established using univariable and multivariable logistic regression (LR) analysis, as shown in Table 2. In a multivariable analysis, lymphocytes, albumin, and CHA₂DS₂-VASc scores (OR; 1.669, 95%CI: 1.193-2.334, P = 0.003) were independent predictors of in-hospital mortality in COVID-19 cases. Moreover, we found that patients with a CHA₂DS₂-VASc score ≥ 4 had an 8.8 times greater mortalit...