Browsing by Subject "favipiravir"
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Item What we learned about COVID-19 so far? Notes from underground(AVES, 2020) Akyıl F.T.; Karadoğan D.; Gürkan C.G.; Yüksel A.; Arıkan H.; Eyüboğlu T.Ş.; Emiralioğlu N.; Gürsoy T.R.; Şerifoğlu İ.; Töreyin Z.N.; Marim F.; Kara B.Y.; Özakıncı H.; Develi E.; Çakmakçı S.; Küsbeci T.Ç.; Karcıoğlu O.; Gülhan P.Y.; Erçelik M.; Er B.; Ataoğlu Ö.; Polat D.; Kaya İ.; Önyılmaz T.A.; Aydın A.; Kızılırmak D.; Er A.B.; Kılınç M.; Günaydın F.E.; Gürz S.; Karaoğlanoğlu S.; Çelik S.; Esendağlı D.; Toptay H.; Sertçelik Ü.Ö.; Akgün M.The novel coronavirus pandemic poses a major global threat to public health. Our knowledge concerning every aspect of COVID-19 is evolving rapidly, given the increasing data from all over the world. In this narrative review, the Turkish Thoracic Society Early Career Taskforce members aimed to provide a summary on recent literature regarding epidemiology, clinical findings, diagnosis, treatment, prevention, and control of COVID-19. Studies revealed that the genetic sequence of the novel coronavirus showed significant identity to SARS-CoV and MERS-CoV. Angiotensin-converting enzyme 2 receptor is an important target of the SARS-CoV-2 while entering an organism. Smokers were more likely to develop the disease and have a higher risk for ICU admission. The mean incubation period was 6.4 days, whereas asymptomatic transmission was reported up to 25 days after infection. Fever and cough were the most common symptoms, and cardiovascular diseases and hypertension were reported to be the most common comorbidities among patients. Clinical manifestations range from asymptomatic and mild disease to severe acute respiratory distress syndrome. Several patients showed typical symptoms and radiological changes with negative RT-PCR but positive IgG and IgM antibodies. Although radiological findings may vary, bilateral, peripherally distributed, ground-glass opacities were typical of COVID-19. Poor prognosis was associated with older age, higher Sequential Organ Failure Assessment score, and high D-dimer level. Chloroquine was found to be effective in reducing viral replication in vitro. Likewise, protease inhibitors, including lopinavir/ritonavir, favipiravir, and nucleoside analogue remdesivir were proposed to be the potential drug candidates in COVID-19 management. Despite these efforts, we still have much to learn regarding the transmission, treatment, and prevention of COVID-19. © 2020 by Turkish Thoracic Society.Item Fragmented QRS is a marker of mortality in patients with severe COVID-19: A retrospective observational study(Turkish Society of Cardiology, 2021) Özdemir İ.H.; Özlek B.; Özen M.B.; Gündüz R.; Çetin N.; Özlek E.; Yıldız B.S.; Tıkız H.Objective: In this study, we aimed to investigate the association of fragmented QRS (f-QRS) with in-hospital death in patients with severe novel coronavirus disease 2019 (COVID-19). Methods: This was a retrospective and observational study. A total of 201 consecutive patients with severe COVID-19 were enrolled. Demographic data, laboratory parameters, medications, electrocardiographic (ECG) findings, and clinical outcomes were recorded. Patients with and without f-QRS were compared, and predictors of all-cause in-hospital mortality were analyzed. Results: A total of 135 patients without f-QRS (mean age of 64 years, 43% women) and 66 patients with f-QRS (mean age of 66 years, 39% women) were included. C-reactive protein (CRP), D-dimer, troponin I, ferritin levels, and CRP to albumin ratio were significantly higher in patients with f-QRS. The need for invasive mechanical ventilation (63.6% vs. 41.5%, p=0.003) and all-cause in-hospital mortality [54.5% vs. 28.9%, log rank p=0.001, relative risk 1.88, 95% confidence interval (CI) 1.16–4.78] were significantly higher in patients with f-QRS. A number value of f-QRS leads ≥2 yields sensitivity and specificity (85.3% and 86.7%, respectively) for predicting in-hospital all-cause mortality. Multivariable analysis showed that f-QRS (odds ratio: 1.041, 95% Cl: 1.021–1.192, p=0.040) were independently associated with in-hospital death. Conclusion: This study revealed that the presence of f-QRS in ECG is associated with higher in-hospital all-cause mortality in patients with severe COVID-19. f-QRS is an easily applicable simple indicator to predict the risk of death in these patients. ©Copyright 2021 by Turkish Society of CardiologyItem Drug-induced QTc interval prolongation in PCR-positive non-ICU COVID-19 patients with diverse findings on chest computed tomography(John Wiley and Sons Inc, 2021) Ozyurtlu F.; Cetin N.; Yavuz V.Background: Some of the drugs used for the treatment of coronavirus disease (COVID-19) can increase the risk of corrected QT (QTc) interval prolongation, which may trigger arrhythmia or even death. Due to the low sensitivity of the reverse transcriptase-polymerase chain reaction (RT-PCR) test, chest computed tomography (CT) imaging is being used for COVID-19 diagnostic correlation and to evaluate whether there is pneumonic involvement in the lung. Objective: In this study, we aimed to investigate the correlation between lung changes on CT and QTc interval changes on ECG in non-ICU patients with COVID-19 who have a positive PCR test when using drugs that can prolong the QTc interval. Methods: This was a single-centre retrospective cohort study of hospitalized non-ICU patients. The study included 344 patients (56.1% men) with a mean age of 46.34 ± 17.68 years. The patients were divided into four groups according to their chest CT results: those having typical, atypical, indeterminate, or no pneumonic involvement. The mean QTc intervals and heart rates calculated from electrocardiograms (ECG) during admission to the hospital and after the treatment were compared. Results: No significant differences were found between the groups’ age, gender, and body mass index (BMI). In addition, no significant differences were found between the groups’ mean QTc interval values at admission (P:.127) or after the treatment (P:.205). The groups’ heart rate values were also similar, with no significant differences in the mean heart rate on admission (P:.648) and post-treatment (P:.229) ECGs. Conclusion: This study has demonstrated findings of COVID-19 infection based on chest CT does not correlate with QT interval prolongation in non-ICU COVID-19 patients. There is a need for additional larger studies investigating the effect of chest CT findings on QT interval prolongation and bradycardia in COVID-19 patients. © 2021 John Wiley & Sons LtdItem The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients(W.B. Saunders Ltd, 2021) Kokturk N.; Babayigit C.; Kul S.; Duru Cetinkaya P.; Atis Nayci S.; Argun Baris S.; Karcioglu O.; Aysert P.; Irmak I.; Akbas Yuksel A.; Sekibag Y.; Baydar Toprak O.; Azak E.; Mulamahmutoglu S.; Cuhadaroglu C.; Demirel A.; Kerget B.; Baran Ketencioglu B.; Ozger H.S.; Ozkan G.; Ture Z.; Ergan B.; Avkan Oguz V.; Kilinc O.; Ercelik M.; Ulukavak Ciftci T.; Alici O.; Nurlu Temel E.; Ataoglu O.; Aydin A.; Cetiner Bahcetepe D.; Gullu Y.T.; Fakili F.; Deveci F.; Kose N.; Tor M.M.; Gunluoglu G.; Altin S.; Turgut T.; Tuna T.; Ozturk O.; Dikensoy O.; Yildiz Gulhan P.; Basyigit I.; Boyaci H.; Oguzulgen I.K.; Borekci S.; Gemicioglu B.; Bayraktar F.; Elbek O.; Hanta I.; Kuzu Okur H.; Sagcan G.; Uzun O.; Akgun M.; Altinisik G.; Dursun B.; Cakir Edis E.; Gulhan E.; Oner Eyuboglu F.; Gultekin O.; Havlucu Y.; Ozkan M.; Sakar Coskun A.; Sayiner A.; Kalyoncu A.F.; Itil O.; Bayram H.The COVID-19-related death rate varies between countries and is affected by various risk factors. This multicenter registry study was designed to evaluate the mortality rate and the related risk factors in Turkey. We retrospectively evaluated 1500 adults with COVID-19 from 26 centers who were hospitalized between March 11 and July 31, 2020. In the study group, 1041 and 459 cases were diagnosed as definite and highly probable cases, respectively. There were 993 PCR-positive cases (66.2%). Among all cases, 1144 (76.3%) were diagnosed with non-severe pneumonia, whereas 212 (14.1%) had severe pneumonia. Death occurred in 67 patients, corresponding to a mortality rate of 4.5% (95% CI:3.5–5.6). The univariate analysis demonstrated that various factors, including male sex, age ≥65 years and the presence of dyspnea or confusion, malignity, chronic obstructive lung disease, interstitial lung disease, immunosuppressive conditions, severe pneumonia, multiorgan dysfunction, and sepsis, were positively associated with mortality. Favipiravir, hydroxychloroquine and azithromycin were not associated with survival. Following multivariate analysis, male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were found to be independent risk factors for mortality. Among the biomarkers, procalcitonin levels on the 3rd-5th days of admission showed the strongest associations with mortality (OR: 6.18; 1.6–23.93). This study demonstrated that the mortality rate in hospitalized patients in the early phase of the COVID-19 pandemic was a serious threat and that those patients with male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were at increased risk of mortality; therefore, such patients should be closely monitored. © 2021 Elsevier LtdItem Reversible lesion of the corpus callosum associated with COVID-19: A case report(ASEAN Neurological Association, 2021) Gemici Y.I.; Tasci I.Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may affect the central nervous system and peripheral nervous system. Major central nervous system manifestations of SARS-CoV-2 infection include seizures, meningoencephalitis, ischemic stroke, anosmia, and hypogeusia. The reversible splenial lesion syndrome was first described in 2004. Although reversible splenial lesion syndrome was initially recognized as a benign phenomenon, a second type of reversible splenial lesion syndrome was identified in later years, which has a poorer prognosis and potentially serious sequela. Reversible splenial lesion syndrome can be caused by numerous etiologies including viruses. In this report, we present a rare case of COVID-19 with reversible splenial lesion, who presented with ataxia and dizziness. © 2021, ASEAN Neurological Association. All rights reserved.Item Comparative Evaluation of the Treatment of COVID-19 with Multicriteria Decision-Making Techniques(Hindawi Limited, 2021) Yildirim F.S.; Sayan M.; Sanlidag T.; Uzun B.; Ozsahin D.U.; Ozsahin I.Objectives. The outbreak of coronavirus disease 2019 (COVID-19) was first reported in December 2019. Until now, many drugs and methods have been used in the treatment of the disease. However, no effective treatment option has been found and only case-based successes have been achieved so far. This study aims to evaluate COVID-19 treatment options using multicriteria decision-making (MCDM) techniques. Methods. In this study, we evaluated the available COVID-19 treatment options by MCDM techniques, namely, fuzzy PROMETHEE and VIKOR. These techniques are based on the evaluation and comparison of complex and multiple criteria to evaluate the most appropriate alternative. We evaluated current treatment options including favipiravir (FPV), lopinavir/ritonavir, hydroxychloroquine, interleukin-1 blocker, intravenous immunoglobulin (IVIG), and plasma exchange. The criteria used for the analysis include side effects, method of administration of the drug, cost, turnover of plasma, level of fever, age, pregnancy, and kidney function. Results. The results showed that plasma exchange was the most preferred alternative, followed by FPV and IVIG, while hydroxychloroquine was the least favorable one. New alternatives could be considered once they are available, and weights could be assigned based on the opinions of the decision-makers (physicians/clinicians). The treatment methods that we evaluated with MCDM methods will be beneficial for both healthcare users and to rapidly end the global pandemic. The proposed method is applicable for analyzing the alternatives to the selection problem with quantitative and qualitative data. In addition, it allows the decision-maker to define the problem simply under uncertainty. Conclusions. Fuzzy PROMETHEE and VIKOR techniques are applied in aiding decision-makers in choosing the right treatment technique for the management of COVID-19. © 2021 Figen Sarigul Yildirim et al.Item COVID-19 in pediatric nephrology centers in Turkey(Turkiye Klinikleri, 2022) Leventoğlu E.; Atikel Y.Ö.; Nalçacioğlu H.; Dursun I.; Dursun H.; Yildirim Z.Y.; Yildiz N.; Aksoy G.K.; Taşdemir M.; Çelakil M.; Kiliç B.D.; Selçuk Ş.Z.; Canpolat N.; Çakici E.K.; Özlü S.G.; Tülpar S.; Yüksel S.; Atmiş B.; Döven S.S.; Taner S.; Ertan P.; Kavaz A.; Bayram M.T.; Kalyoncu M.; Gülleroğlu K.; Kabasakal C.; Demir B.K.; Çiçek R.Y.; Bilge I.; Dönmez O.; Kara A.; Yavaşcan Ö.; Özçelik G.; Yildirim D.G.; Güler M.A.; Sönmez F.; Poyrazoğlu H.; Akman S.; Topaloğlu R.; Alpay H.; Bakkaloğlu S.A.Background/aim: There is limited data on COVID-19 disease in children with kidney disease. We aimed to investigate the characteristics and prognosis of COVID-19 in pediatric nephrology patients in Turkey. Materials and methods: This was a national, multicenter, retrospective cohort study based on an online survey evaluating the data between 11th March 2020 and 11th March 2021 as an initial step of a detailed pediatric nephrology COVID-19 registry. Results: Two hundred and three patients (89 girls and 114 boys) were diagnosed with COVID-19. One-third of these patients (36.9%) were between 10–15 years old. Half of the patients were on kidney replacement therapy: kidney transplant (KTx) recipients (n = 56, 27.5%), patients receiving chronic hemodialysis (n = 33, 16.3%) and those on peritoneal dialysis (PD) (n = 18, 8.9%). Fifty-four (26.6%) children were asymptomatic. Eighty-two (40.3%) patients were hospitalized and 23 (28%) needed intensive care unit admission. Fifty-five percent of the patients were not treated, while the remaining was given favipiravir (20.7%), steroid (16.3%), and hydroxychloroquine (11.3%). Acute kidney injury developed in 19.5% of hospitalized patients. Five (2.4%) had MIS-C. Eighty-three percent of the patients were discharged without any apparent sequelae, while 7 (3.4%) died. One hundred and eight health care staff were infected during the study period. Conclusion: COVID-19 was most commonly seen in patients who underwent KTx and received HD. The combined immunosuppressive therapy and frequent exposure to the hospital setting may increase these patients’ susceptibility. Staff infections before vaccination era were alarming, various precautions should be taken for infection control, particularly optimal vaccination coverage. © TÜBİTAK.Item The association of antiviral drugs with COVID-19 morbidity: The retrospective analysis of a nationwide COVID-19 cohort(Frontiers Media S.A., 2022) Babayigit C.; Kokturk N.; Kul S.; Cetinkaya P.D.; Atis Nayci S.; Argun Baris S.; Karcioglu O.; Aysert P.; Irmak I.; Akbas Yuksel A.; Sekibag Y.; Baydar Toprak O.; Azak E.; Mulamahmutoglu S.; Cuhadaroglu C.; Demirel A.; Kerget B.; Baran Ketencioglu B.; Ozger H.S.; Ozkan G.; Ture Z.; Ergan B.; Avkan Oguz V.; Kilinc O.; Ercelik M.; Ulukavak Ciftci T.; Alici O.; Nurlu Temel E.; Ataoglu O.; Aydin A.; Cetiner Bahcetepe D.; Gullu Y.T.; Fakili F.; Deveci F.; Kose N.; Tor M.M.; Gunluoglu G.; Altin S.; Turgut T.; Tuna T.; Ozturk O.; Dikensoy O.; Yildiz Gulhan P.; Basyigit I.; Boyaci H.; Oguzulgen I.K.; Borekci S.; Gemicioglu B.; Bayraktar F.; Elbek O.; Hanta I.; Kuzu Okur H.; Sagcan G.; Uzun O.; Akgun M.; Altinisik G.; Dursun B.; Cakir Edis E.; Gulhan E.; Oner Eyuboglu F.; Gultekin O.; Havlucu Y.; Ozkan M.; Sakar Coskun A.; Sayiner A.; Kalyoncu A.F.; Itil O.; Bayram H.Background and objectives: Although several repurposed antiviral drugs have been used for the treatment of COVID-19, only a few such as remdesivir and molnupiravir have shown promising effects. The objectives of our study were to investigate the association of repurposed antiviral drugs with COVID-19 morbidity. Methods: Patients admitted to 26 different hospitals located in 16 different provinces between March 11–July 18, 2020, were enrolled. Case definition was based on WHO criteria. Patients were managed according to the guidelines by Scientific Board of Ministry of Health of Turkey. Primary outcomes were length of hospitalization, intensive care unit (ICU) requirement, and intubation. Results: We retrospectively evaluated 1,472 COVID-19 adult patients; 57.1% were men (mean age = 51.9 ± 17.7years). A total of 210 (14.3%) had severe pneumonia, 115 (7.8%) were admitted to ICUs, and 69 (4.7%) were intubated during hospitalization. The median (interquartile range) of duration of hospitalization, including ICU admission, was 7 (5–12) days. Favipiravir (n = 328), lopinavir/ritonavir (n = 55), and oseltamivir (n = 761) were administered as antiviral agents, and hydroxychloroquine (HCQ, n = 1,382) and azithromycin (n = 738) were used for their immunomodulatory activity. Lopinavir/ritonavir (β [95% CI]: 4.71 [2.31–7.11]; p = 0.001), favipiravir (β [95% CI]: 3.55 [2.56–4.55]; p = 0.001) and HCQ (β [95% CI]: 0.84 [0.02–1.67]; p = 0.046) were associated with increased risk of lengthy hospital stays. Furthermore, favipiravir was associated with increased risks of ICU admission (OR [95% CI]: 3.02 [1.70–5.35]; p = 0.001) and invasive mechanical ventilation requirement (OR [95% CI]: 2.94 [1.28–6.75]; p = 0.011). Conclusion: Our findings demonstrated that antiviral drugs including lopinavir, ritonavir, and favipiravir were associated with negative clinical outcomes such as increased risks for lengthy hospital stay, ICU admission, and invasive mechanical ventilation requirement. Therefore, repurposing such agents without proven clinical evidence might not be the best approach for COVID-19 treatment. Copyright © 2022 Babayigit, Kokturk, Kul, Cetinkaya, Atis Nayci, Argun Baris, Karcioglu, Aysert, Irmak, Akbas Yuksel, Sekibag, Baydar Toprak, Azak, Mulamahmutoglu, Cuhadaroglu, Demirel, Kerget, Baran Ketencioglu, Ozger, Ozkan, Ture, Ergan, Avkan Oguz, Kilinc, Ercelik, Ulukavak Ciftci, Alici, Nurlu Temel, Ataoglu, Aydin, Cetiner Bahcetepe, Gullu, Fakili, Deveci, Kose, Tor, Gunluoglu, Altin, Turgut, Tuna, Ozturk, Dikensoy, Yildiz Gulhan, Basyigit, Boyaci, Oguzulgen, Borekci, Gemicioglu, Bayraktar, Elbek, Hanta, Kuzu Okur, Sagcan, Uzun, Akgun, Altinisik, Dursun, Cakir Edis, Gulhan, Oner Eyuboglu, Gultekin, Havlucu, Ozkan, Sakar Coskun, Sayiner, Kalyoncu, Itil and Bayram.Item Covid-19 infection-induced neuromyelitis optica: a case report(Taylor and Francis Ltd., 2022) Batum M.; Kisabay Ak A.; Mavioğlu H.Introduction: Acute respiratory syndrome coronavirus-2 (Covid-19) can infect the respiratory system, as well as the central, peripheral nervous system, and muscles, leading to neurological symptoms and signs. The most common neurological symptoms are dizziness, headache, impaired consciousness, ataxia, hypogosis, hyposmia, neuralgia, and myalgia. The most common neurological diseases are acute cerebrovascular disease, epilepsy, acute hemorrhagic necrotizing encephalopathy, miyelitis, and Gullian-Barre syndrome. Methods: In this case report, a patient infected with Covid-19 and diagnosed as neuromyelitis optica (NMO) with anamnesis, clinical and radiological findings is presented. Results: A 50-year-old woman presented with weakness of both legs, urine retention, high fever, and cough. Spinal magnetic resonance imaging revealed expensive long-segment and centrally located demyelinating lesion extending from the cervical cord (at the level of C3) to the conus. Thoracic-computerized tomography revealed consolidation areas located on the lower segments of bilateral lungs and ground-glass density, air bronchograms, and peribronchial thickening surrounding these areas. Aquaporin-4 immune globulin-G was found to be positive. Conclusion: It was considered appropriate to present this case because of being the first case of parainfectious NMO considered to be induced by SARS-CoV-2. © 2020 Informa UK Limited, trading as Taylor & Francis Group.Item COVID-19 disease in children presenting to the pediatric emergency department: A multicenter study with 8886 cases from Turkey(W.B. Saunders, 2022) Duman M.; Şık N.; Tekşam Ö.; Akça H.; Kurt F.; Çağlar A.A.; Yıldız L.A.; Taşar M.A.; Fidancı İ.; Yayla B.C.C.; Yılmaz D.; Güngör E.; Demir Ş.; Çokuğraş H.; Cebeci S.O.; Önal P.; Saz E.U.; Yurtseven A.; Uysalol M.; Yıldız R.; Gümüş S.; Bal A.; Bayturan S.Ş.; Zengin N.; Atik S.; Çiftdoğan D.Y.; Berksoy E.; Çiçek A.; Şahin S.; Kızıl M.C.; Kara Y.; Apa H.; Ulusoy E.; Kara A.A.; Yesil E.; Erdem M.; Turan C.; Arslanoglu S.; Duyu M.; Besli G.E.; Arslan G.; Oflu A.T.; Çeleğen M.; Buldu E.; Pişkin İ.E.; Kardeş H.; Yılmaz H.L.; Yıldızdaş D.; Gökulu G.; Çay P.; Özer U.; Güleryüz O.D.; Çolak Ö.; Güneysu S.T.Background: The aim was to evaluate the epidemiological, clinical, laboratory, and radiologic data of children with SARS-CoV-2 positivity by polymerase chain reaction (PCR) together with treatment strategies and clinical outcomes and to evaluate cases of multisystem inflammatory syndrome in children (MIS-C) in this population. Methods: This was a multicenter retrospective observational cohort study performed in the pediatric emergency departments of 19 tertiary hospitals. From March 11, 2020, to May 31, 2021, children who were diagnosed with confirmed nasopharyngeal/tracheal specimen SARS-CoV-2 PCR positivity or positivity for serum-specific antibodies against SARS-CoV-2 were included. Demographics, presence of chronic illness, symptoms, history of contact with SARS-CoV-2 PCR-positive individuals, laboratory and radiologic investigations, clinical severity, hospital admissions, and prognosis were recorded. Results: A total of 8886 cases were included. While 8799 (99.0%) cases resulted in a diagnosis of SARS-CoV-2 with PCR positivity, 87 (1.0%) patients were diagnosed with MIS-C. Among SARS-CoV-2 PCR-positive patients, 51.0% were male and 8.5% had chronic illnesses. The median age was 11.6 years (IQR: 5.0–15.4) and 737 (8.4%) patients were aged <1 year. Of the patients, 15.5% were asymptomatic. The most common symptoms were fever (48.5%) and cough (30.7%) for all age groups. There was a decrease in the rate of fever as age increased (p < 0.001); the most common age group for this symptom was <1 year with the rate of 69.6%. There was known contact with a SARS-CoV-2 PCR-positive individual in 67.3% of the cases, with household contacts in 71.3% of those cases. In terms of clinical severity, 83 (0.9%) patients were in the severe-critical group. There was hospital admission in 1269 (14.4%) cases, with 106 (1.2%) of those patients being admitted to the pediatric intensive care unit (PICU). Among patients with MIS-C, 60.9% were male and the median age was 6.4 years (IQR: 3.9–10.4). Twelve (13.7%) patients presented with shock. There was hospital admission in 89.7% of these cases, with 29.9% of the patients with MIS-C being admitted to the PICU. Conclusion: Most SARS-CoV-2 PCR-positive patients presented with a mild clinical course. Although rare, MIS-C emerges as a serious consequence with frequent PICU admission. Further understanding of the characteristics of COVID-19 disease could provide insights and guide the development of therapeutic strategies for target groups. © 2022 Elsevier Inc.Item Frontal QRS/T angle can predict mortality in COVID-19 patients(W.B. Saunders, 2022) Gunduz R.; Yildiz B.S.; Ozgur S.; Ozen M.B.; Bakir E.O.; Ozdemir I.H.; Cetin N.; Usalp S.; Duman S.Aims: The frontal QRS-T (fQRS) angle has been investigated in the general population, including healthy people and patients with heart failure. The fQRS angle can predict mortality due to myocarditis, ischaemic and non-ischaemic cardiomyopathies, idiopathic dilated cardiomyopathy, and chronic heart failure in the general population. Moreover, no studies to date have investigated fQRS angle in coronavirus disease 2019 (COVID-19) patients. Thus, the purpose of this retrospective multicentre study was to evaluate the fQRS angle of COVID-19 patients to predict in-hospital mortality and the need for mechanical ventilation. Methods and results: An electrocardiogram was performed for 327 COVID-19 patients during admission, and the fQRS angle was calculated. Mechanical ventilation was needed in 119 patients; of them, 110 died in the hospital. The patients were divided into two groups according to an fQRs angle >90° versus an fQRS angle ≤90°. The percentages of mortality and the need for mechanical ventilation according to fQRS angle were 67.8% and 66.1%, respectively, in the fQRs >90° group and 26.1% and 29.9% in the fQRS ≤90°group. Heart rate, oxygen saturation, fQRS angle, estimated glomerular filtration rate, and C-reactive protein level were predictors of mortality on the multivariable analysis. The mortality risk increased 2.9-fold on the univariate analysis and 1.6-fold on the multivariate analysis for the fQRS >90° patient group versus the fQRS ≤90° group. Conclusion: In conclusion, a wide fQRS angle >90° was a predictor of in-hospital mortality and associated with the need for mechanical ventilation among COVID-19 patients. © 2022 Elsevier Inc.Item THE PREDICTORS OF IN-HOSPITAL MORTALITY IN HYPERTENSIVE ELDERLY INTENSIVE CARE UNIT PATIENTS WITH CORONAVIRUS DISEASE 2019(Geriatrics Society, 2022) Çetin N.; Özdemir İ.H.Introduction: Advanced age is an important prognostic indicator for the mortality of coronavirus disease 2019, especially in patients over 65. Patients with chronic underlying conditions such as hypertension showed the worst outcomes. This study aimed to identify predictors of mortality in elderly hypertensive patients hospitalized in intensive care units. Materials and Methods: Demographic, clinical, treatment, and laboratory data were extracted from electronic medical records and compared between survivors and non-survivors. Univariate and multivariate logistic regression methods were used to explore the indicators of in-hospital mortality. Results: One hundred and ninety-eight patients with a median age of 75 years (65–94 years) were included in this study, of whom 95 were discharged from the intensive care units, and 103 died. Shortness of breath [hazard ratio (HR): 1.65, 95% confidence interval (CI): 1.04–2.61, p: 0.034], C-reactive protein (CRP)/albumin ratio (>51.32) (HR: 1.83, 95% CI: 1.12–2.97, p: 0.015), serum creatinine (>1.62 mg/dl) (HR: 2.04, 95% CI: 1.13–3.33, p: 0.001), aspartate transaminase (>34 u/l) (HR: 1.99, 95% CI: 1.28–3.09, p: 0.002), D-dimer (>781 ng/ml) (HR: 1.59, 95% CI: 1.04–2.43, p: 0.031), leukocyte (>12,000´ 103/µl) (HR: 1.68, 95% CI: 1.09–2.59, p: 0.018) and lymphocyte count, (≤660´ 103/µl) (HR: 1.76, 95% CI: 1.17–2.63, p: 0.006) were independent predictors for mortality in elderly hypertensive patients. Conclusion: Using these predictors with cut-off values can identify patients at risk of death and needing aggressive intervention earlier in the disease course. © 2022, Geriatrics Society. All rights reserved.Item Assessment of in-vitro cytotoxicity and in-ovo virucidal antiviral efficacy of various plant extracts and bioactive molecules(Veteriner Fakultesi Dergisi, 2024) Çöven F.O.; Gür S.; Uyar E.; Alsakini K.A.M.H.; Karabey F.; Çöven F.; Çaliş İ.; Nalbantsoy A.The viral diseases that occurred in recent years have increased the interest in non-toxic to healthy cells and naturally isolated agents to struggle with these diseases. The key intention of this research is to examine both antiviral potentials against the Infectious Bronchitis model virus (IBV) and cytotoxic activities on determined cell lines of different active ingredients and medical herbs extracts for developing new antiviral agents or drugs towards SARS-CoV-2. The antiviral potency of the samples against IBV was determined as in ovo virucidal antiviral activity in specific pathogen-free (SPF) embryonated chicken eggs (ECEs). To detect antiviral activity, the haemagglutination test was performed after 48 h of incubation for all samples. The cytotoxic activity of the samples was identified on HepG2, Caco-2, HeLa, HEK293, PANC-1, PC-3, A549, MDA-MB-231, and CCD-34Lu cell lines by the MTT protocol. Hypericum perforatum extract was found to have a dominant role in cytotoxicity and antiviral activity. In addition, while nobiletin and Sambucus nigra do not exhibit cytotoxic activity on cells, they play a significant role in antiviral activity. As a consequence of our investigation, the cytotoxic and antiviral properties of Laurus nobilis, H. perforatum, and S. nigra extracts were found remarkable and the potential of these extracts was demonstrated. © 2024, Veteriner Fakultesi Dergisi. All rights reserved.