Aim of this study is to evaluate the epidemiological, clinical characteristics and the parameters that determine the clinical course and prognosis of the COVID-19 patients admitted to the Ankara City Hospital during the first month of the pandemic In Turkey. SARS-CoV-2 PCR positive patients who were hospitalized between March 10 and April 10, 2020 were included. Among 222 patients, mean age was higher in SARI/critical disease group (p < 0,001). Median time from illness onset to admission, presence of co-morbidity, especially coronary artery disease and chronic obstructive pulmonary disease, was significantly higher in severe acute respiratory illness (SARI)/critical disease group (p < 0.05). Cough and fever were the most common symptoms, while anosmia and loss of taste were observed in 8.6 % and 7.7 % patients, respectively. Mortality rate was 5.4 %. High neutrophil/lymphocyte ratio, low lymphocyte, monocyte and platelet count, elevated liver enzymes, low GFR, high levels of muscle enzymes, ferritin and IL-6 on admission were found to be associated with SARI/critical disease (p<0.05). Bilateral ground-glass opacity and patchy infiltration were more frequently seen in SARI/critical disease group (p < 0.001). Patients older than 65 years have 8-fold increased risk for development of SARI/critical disease. This cohort study regarding COVID-19 cases in Turkey reveals that older age, presence of co-morbidity, bilateral infiltration on CT, high neutrophil/lymphocyte ratio, low monocyte and platelet count, elevated liver enzymes, low GFR, high levels of muscle enzymes, and high levels of ferritin and IL-6 on admission are predictors of SARI and severe disease.

Objectives. The NUTRIC (nutrition risk in the critically ill) score and the modified NUTRIC score are two scoring systems that show the nutritional risk status and severity of acute disease of patients. The only difference between them is the examination of interleukin‐6 (IL‐6) level. The aim of this study was to investigate whether or not the NUTRIC score is superior to the mNUTRIC score in the prediction of mortality of patients with COVID‐19 followed up in the Intensive Care Unit (ICU). Material and Method. This retrospective study included 322 patients followed up in ICU with a diagnosis of COVID‐19. A record was made of demographic data, laboratory values, clinical results, and mortality status. All the data of the patients were compared between high and low variations of the NUTRIC score and the mNUTRIC score. Results. A high NUTRIC score was determined in 62 patients and a high mNUTRIC score in 86 patients. The need for invasive mechanical ventilation, the use of vasopressors in ICU, the development of acute kidney injury, and mortality rates were statistically significantly higher in the patients with high NUTRIC and high mNUTRIC scores than in those with low scores (p = 0.0001 for all). The AUC values were 0.791 for high NUTRIC score and 0.786 for high mNUTRIC score (p = 0.0001 for both). No statistically significant difference was determined between the two scoring systems. Conclusion. Although the NUTRIC score was seen to be superior to the mNUTRIC score, no statistically significant difference was determined. Therefore, when IL‐6 cannot be examined, the mNUTRIC score can be considered safe and effective for the prediction of mortality in COVID‐19 patients.

Background: Activated inflammation and oxidant stress during cerebral ischemia reperfusion injury (IRI) lead to brain damage. Astaxanthin (ASX) is a type of carotenoid with a strong antioxidant effect.Objective: The aim of this study was to investigate the role of ASX on brain IRI.Methods: A total of 42 adult male Sprague-Dawley rats were divided into 3 groups as control (n=14) group, IRI (n=14) group and IRI + ASX (n=14) group. Cerebral ischemia was instituted by occluding middle cerebral artery for 120 minutes and subsequently, reperfusion was performed for 48 hours. Oxidant parameter levels and protein degradation products were evaluated. Hippocampal and cortex cell apoptosis, neuronal cell count, neurological deficit score were evaluated.Results: In the IRI group, oxidant parameter levels and protein degradation products in the tissue were increased compared to control group. However, these values were significantly decreased in the IRI + ASX group (p<0.05). There was a significant decrease in hippocampal and cortex cell apoptosis and a significant increase in the number of neuronal cells in the IRI + ASX group compared to the IRI group alone (p<0.05). The neurological deficit score which was significantly lower in the IRI group compared to the control group was found to be significantly improved in the IRI + ASX group (p<0.05).Conclusion: Astaxanthin protects the brain from oxidative damage and reduces neuronal deficits due to IRI injury.

Purpose: The aim of our study is to investigate the prognostic value of Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) in determining mortality in patients hospitalized for intensive care unit (ICU) sepsis. Materials and Methods: This study retrospectively evaluates all patients hospitalized with sepsis in our ICU between February 2017 and April 2018. In addition to the demographic and clinical characteristics of the patients, complete blood count parameters were also recorded. Demographic and clinical characteristics, mainly NLR, MLR and PLR results, and other laboratory results of patients with sepsis were compared between the ones with and without mortality. Results: Four hundred and eleven patients were included in the study. 55.7% (229/411) of patients with sepsis died and 44.3% (182/411) were discharged alive. NLR, MLR and PLR were higher in the group with mortality compared to the survivor group. The cut-off value for predicting mortality in patients with sepsis was 9.2 for NLR, ≥0.8 for MLR, and ≥187.3 for PLR. The area under the curve (AUC) value for NLR was 0.825, the AUC value for MLR 0.835 and the AUC value for PLR was 0.720. Conclusion: High NLR, MLR and PLR values are associated with mortality in sepsis patients hospitalized in ICU, and the most significant parameter for mortality indicator among the three rates was found to be MLR with the highest AUC value.

The impact of the coronavirus disease 2019 (COVID-19) pandemic has been unceasingly ongoing worldwide. Recent bioinformatics analysis and epidemiologic studies have highlighted that the functional polymorphisms on the angiotensin converting enzyme (ACE) gene may have an impact on the clinical progress of COVID-19. In this study, we aimed to determine the impact of the ACE1 gene I/D polymorphism and ACE2 peptidase-2 domain variants on disease severity. Hundred patients with confirmed COVID-19 related pneumonia [50 patients with severe disease in intensive care unit (ICU) and 50 patients not in ICU] were compared on the basis of genetic and clinical characteristics. Genomic DNA was purified from peripheral blood lymphocytes with an automated QIA symphony DSP DNA Mini-Kit. The Sanger sequencing analysis was performed. The frequencies of ACE1 gene polymorphism and ACE2 PD variants were compared in patients hospitalized in ICU and those not in ICU. The Statistical Package for Social Sciences version 22.0 was used for statistical analysis. The sequencing analysis of the ACE2 gene exon 1 and 2 revealed none of the polymorphisms investigated or any other variants in the present cohort. The frequencies of the ACE1 ID, DD, and II genotypes were 51%, 31%, and 18%, respectively. The frequency of the D allele was similar between the ICU and non-ICU groups (50.4% versus 49.6%). Older age and the presence of advanced stage radiologic abnormalities on admission were detected as independent predictors of ICU requirement. No effect of any ACE1 gene polymorphism on predicting ICU requirement was detected. To the best of our knowledge, this is the first study investigating the impact of ACE gene polymorphisms on clinical severity of COVID-19 in a Turkish cohort.

Amaç: Pandeminin ilk dört aylık döneminde koronavirüs hastalığı-2019 (COVİD-19) şüphesiyle, COVİD-19 YBÜ’lerine kabul edilen hastalar tanılarına ve dönemlere göre karşılaştırıldı. Gereç ve Yöntem: Tek merkezde aynı algoritma ile COVİD-19 YBÜ’ye kabul edilen 1,430 hasta verisi retrospektif olarak kaydedildi. Hastalar polimeraz zincirleme reaksiyonu sonucu ile radyolojik ve klinik bulgulara göre COVİD-19 ve non-COVİD-19 hastalar olarak sınıflandırıldılar. Ayrıca COVİD-19 hastaları mortalite ve sağkalım açısından da karşılaştırıldı. Bunun yanında, pandeminin başlangıcı ve normalleşme döneminde COVİD-19 YBÜ’lerine kabul edilen hastaların verileri değerlendirildi. Bulgular: Çalışmaya alınan 1,430 hastanın 630’u COVİD-19, 800’ü non-COVİD-19 gruptaydı. Yaş ortalamalarında anlamlı bir farklılık bulunurken, cinsiyetler arasında bir farklılık yoktu (p=0,001, p=0,262). COVİD-19 ölen grubun yaş ortalaması yaşayan gruptan daha yüksekti (p