Background/aim: In this study, we aimed to evaluate the initial hematological findings analyzed on admission in confirmed COVID-19 patients who were transferred to the intensive care unit (ICU), to predict possible hematological indices. Materials and methods: Initial neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), red cell distribution width to platelet ratio (RPR), mean platelet volume to platelet ratio, and lymphocyte multiplied by platelet count (LYM x PLT), of 695 patients with laboratory-confirmed COVID-19 were investigated and compared between the mild/moderate and severe groups. Results: The proportion of COVID-19 cases admitted to ICU was 3.9%. The median age of patients admitted to ICU was significantly higher than those who were not; (68.5 (interquartile range (IQR); 21.5) years vs. 41.0 (IQR; 15.7) years; p <0.001). Severe cases had higher NLR (6.6 vs 2.4; P <0.001), and MLR (0.40 vs 0.28; P=0.004) and lower PLR (180.0 vs 129.0; P <0.001) compared to that of mild or moderate patients. Among all of the parameters, the ROC curve of NLR gave us the best ability to distinguish serious patients at an early stage (AUC = 0. 819, 95% confidence interval 0.729-0.910; p<0.001). Conclusion: These data showed that age, initial NLR, PLR, and LYM x PLT were associated with the severity of COVID-19 disease and patients' need for the ICU. Therefore, initial hemogram parameters may be essential to predict the prognosis of COVID-19 patients.

Research ArticleR ecent advances in technology led to the quantitation of new parameters with automated hematology analyzers. Some of these parameters have been accepted as additional markers in diagnosing various clinical conditions [1][2][3][4][5]. They are cost effective and easier to perform in a routine setting than tests for some other markers. C-reactive protein (CRP) is a commonly used inflammation marker in both acute and chronic inflammation. Most healthy individuals have a CRP concentration of 3 mg/L or less; a CRP level higher than 10 mg/L indicates a clinically significant inflammatory disease [6]. Low-grade inflammation typically refers to conditions in which Objectives: The term low-grade inflammation is usually used to indicate chronic conditions in which the findings of classic, clinical inflammation are lacking, but there is an elevated C-reactive protein (CRP) level of 3 to 10 mg/L. Recently, the systemic immune-inflammation index (SII) was developed based on lymphocyte, neutrophil, and platelet counts, which can project the inflammatory and immune imbalances. The aim of this study was to examine the SII and new parameters derived from hemograms to determine if they have the potential to detect patients with subclinical lowgrade inflammation in an unselected, elderly, outpatient population. Methods: The CRP level was analyzed with a BN II System nepholometer (Siemens Healthineers, Erlangen, Germany). Participants were stratified according to CRP level: Group 1 had a serum CRP result <3.0 mg/L and Group 2 had a serum CRP result 3.0-9.0 mg/L. Blood samples that had been analyzed with an automated hematology analyzer (Mindray BC-5800; Mindray Biomedical Electronics Co., Ltd., Shenzhen, China) were selected for evaluation of the results. The SII (neutrophil x platelet / lymphocyte), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR) were calculated. PLR (r=0.773; p<0.001), and the platelet count (r=0.653; p<0.001) was found. However, there was no correlation between the CRP, SII (r=-0.312; p=0.210), and PLR (r=-0.165; p=0.117). Conclusion: A high PLR and SII appears to be associated with subclinical low-grade inflammation. These data do not support hematological screening parameters as a substitute for CRP. These findings are limited to the cohort studied here, and may not be entirely applicable to other ethnic origins. Keywords: C-reactive protein, lymphocyte, neutrophil, platelet Relationship between C-reactive protein, systemic immuneinflammation index, and routine hemogram-related inflammatory markers in low-grade inflammation

The aim of this study is to investigate if serum asymmetric dimethylarginine (ADMA) levels can predict restenosis and major adverse cardiac events (MACE) in patients who undergo percutaneous coronary interventions. The most important cause of restenosis following percutaneous coronary intervention is neointimal hyperplasia. Nitric oxide (NO) prevents the neointimal hyperplasia growing. Asymmetric dimethylarginine is a competitive inhibitor of NO synthesis. The effect of ADMA on the restenosis has not yet been investigated. A total of 105 (80 male and 25 female) patients were included in our study. All patients underwent elective percutaneous transluminal coronary angioplasty (PTCA) with bare metal stent implantation or direct stenting for one coronary artery between September 2004 and January 2006. All patients were clinically followed for a period of 6 months, and a control angiography was performed at the end of this period. The probrain natriuretic peptide (pro-BNP), high-sensitivity Creactive protein (hs-CRP), and ADMA levels of the patients were evaluated before the procedure and 6 months afterwards. Biochemical parameters and angiographic features were evaluated in order to determine if they could predict the development of restenosis and MACE by using univariate and multivariate Cox regression analysis. The 65 (61.9%) patients (50 males and 15 females) who had not developed restenosis were designated as Group 1. The 27 (25.7%) patients (21 males and 6 females) who had developed restenosis were designated as Group 2. In terms of predicting the development of restenosis, the presence of diabetes mellitus (hazard ratio [HR]: 2.78; confidence interval [CI]: 1.25-6.20; P = 0.01), type of lesion (HR: 1.89; CI: 1.01-3.55; P = 0.04), form of procedure (HR: 0.30; CI: 0.11-0.81; P = 0.01), and ADMA (HR: 4.08; CI: 1.73-9.62; P = 0.001) were found to be significant in univariate Cox regression analysis. In contrast, only the levels of ADMA were found to be a significant predictor of restenosis in the multivariate Cox regression analysis (HR: 3.02; CI: 1.16-7.84; P = 0.02). The restenosis prediction of ADMA levels continued after excluding the patients with diabetes mellitus in the univariate and multivariate Cox regression analysis (HR: 5.23; CI: 1.99-13.76; P = 0.001 and HR: 5.61; CI: 1.79-17.62; P = 0.003, respectively). Regarding the development of cardiac events, hs-CRP (HR: 1.03; CI: 1.00-1.06; P = 0.01) and ADMA (HR: 17.1; CI: 3.06-95.8; P = 0.001) were found to be significantly correlated with adverse cardiac events in univariate Cox regression analysis, whereas only ADMA levels were significant in the multivariate Cox regression analysis (HR: 2.83; CI: 1.27-6.31; P = 0.01). The levels of ADMA obtained before the procedure predict the development of restenosis and MACE in patients who underwent elective PTCA and bare metal stent procedures.

Adequate health literacy in bladder cancer patients is associated with better compliance with the treatment protocol. Young patients show better compliance with the follow-up protocol recommended by the physician. Increasing the follow-up protocol compliance of elderly patients with inadequate health literacy is necessary.