Evaluation of Covid-19 cases that applied to the hospital at the first peak of the pandemic

Abstract

Early diagnosis in COVID-19 is essential in terms of treatment and prevention of contagiousness. In this study, we aimed to find an alternative diagnosis method by using fewer laboratory parameters in the early diagnosis of COVID-19 disease by creating a fast, easily accessible, cost-effective index and has a diagnostic accuracy rate of over 90%. All patients over the age of 18 who applied to Hitit University Erol Olçok Training and Research Hospital Emergency COVID Outpatient Clinic with a pre-diagnosis of COVID-19 between March and April 2020 were evaluated retrospectively. Patients were divided into two groups as COVID-19 positive and COVID-19 negative. It was aimed to create a HITIT-19 index by evaluating the cases according to the clinical and laboratory results. Between March and April 2020 (in the first peak of the pandemic), 1586 patients were applied to the Emergency COVID-19 outpatient clinic with a pre-diagnosis of COVID-19. According to COVID-19 RT-PCR, card test, and CT involvement, 285 (13%) patients were diagnosed with COVID-19. PCR was positive in 285 (18%) of 1586 patients, and PCR was negative in 1301 (82%). While 153 (53.7%) of the patients diagnosed with COVID-19 were male and the median age was 45 (28-62.75), 883 (55.7%) of the patients not diagnosed with COVID-19 were male, and the median age was 43 (31-65). Hypertension (HT) was the most common underlying disease in 10.5% of patients applied to the emergency room with a diagnosis of COVID-19, while 38.9% dyspnea and 35.1% fever were the most common symptoms. While 76% of Plaquenil and 58% azithromycin were the most frequently started treatments, 31.4% (28.4% of them were hospitalized in the service, 3% in the intensive care unit) of them hospitalized. It was to create a HITIT-19 index that is fast, easily accessible, cost-effective, and has a diagnostic accuracy rate of over 90% by using laboratory tests. However, we could not achieve this goal due to the low accuracy of the diagnostic tests and the lack of significant change in the laboratory levels of the patients at admission. Considering that the pandemic is continuing rapidly, there is still a need to develop practical diagnostic methods that are easier and cheaper in diagnosis. In this sense, we believe that our study will be a guiding study for other studies that will be designed for diagnostic index studies.

Ideal predictor studies

“…We have read the article titled "Evaluation of Covid-19 cases that applied to the hospital at the first peak of the pandemic" prepared by Akdoğan et al with great interest (1). Firstly, we thank the authors for their research from Turkey that aims create an alternative diagnosis method by using some laboratory parameters in the early phase of COVID-19.…”

“…Lymphocyte count, C-reactive protein, D-dimer, ferritin were associated with mortality and critical illness. These parameters were used to decide on hospitalization and admission to the intensive care unit (1,(10)(11)(12). Weng et al, similar to Akdogan et al, developed the ANDC score by aiming for a quantitative tool for early predicting mortality risk of patients with COVID-19 in the early phase of the pandemic.…”