The purpose of this study is to evaluate serum Pentraxin-3 (PTX-3) levels in Sars-CoV-2 virus infection (COVID-19) patients and to investigate whether PTX-3 predicts the disease prognosis. This study was conducted on 88 confirmed COVID-19 patients who were hospitalized due to symptomatic pneumonia between April 15 2020 and August 15 2020. The patients were divided into two groups as survived patients and non-survived patients. Both groups were compared according to demographic features, comorbid conditions and measurement of the PTX-3 and other laboratory parameters of the patients. Of 88 patients with COVID-19, 59 (67%) were discharged with complete cure and 29 (33%) resulted in death. 46 (52.3%) of the patients were men. PTX-3 median value [IQR] was 3.66 ng/mL (0.9-27.9) in all patients, 3.3 ng/mL (0.9-27.9) in survivors and 3.91 ng/mL (1.9-23.2) in non-survivors which was significantly higher (p= 0.045). As a receiver operating characteristic curve analysis the cut-off value of PTX-3 for predicting mortality in patients was 3.73 with 65% sensitivity and 65% specificity (AUC: 0.646, 95% CI: 0.525-0.767, P= 0.045). Also, we found significant cut-off values with respect to D-Dimer, D-Dimer/ PTX-3, high-sensitivity troponin, high-sensitivity troponin/ PTX-3, lymphocyte, PTX-3/ lymphocyte, procalcitonin, procalcitonin/ PTX-3, CRP, and CRP/ PTX-3 (P<0.05). In this study, as far as we know, for the first time, we have shown PTX-3 as the new mortality biomarker for COVID-19 disease.

SUMMARY INTRODUCTION This study aims to evaluate changes in hematological parameters after the follow-up of patients who received treatment with favipiravir due to COVID-19 infections. METHODS Sixty-two cases receiving favipiravir treatment for at least five days due to COVID-19 infection were evaluated retrospectively. Parameters including age, gender, nasopharyngeal swab positivity, and chronic diseases were analyzed. Hematologic parameters were analyzed before and after the treatment. RESULTS The mean age of the patients receiving treatment with favipiravir was 63.7±12.3 years. Nasopharyngeal swab positivity was detected in 67.7%. The most common comorbid conditions detected in patients were hypertension in 25 cases (40.3%) and diabetes in 16 cases (25.8%). In the statistical analysis of the hematological parameters before and after treatment with favipiravir, WBC, PT-PTT-INR levels were found to be unaffected; the mean RBC was found to have decreased from 4.33 ± 0.58 M/uL to 4.16 ± 0.54 M/uL (p:0.003); the median hemoglobin level was found to have decreased from 12.3 g/dl to 11.9 g/dl (p:0.041); the hematocrit level decreased from 38.1% ± 4.8 to 36.9% ± 4.2 (p:0.026); the median neutrophil count decreased from 4.57 K/uL to 3.85 K/uL (p:0.001); the mean lymphocyte count increased from 1.22 ± 0.53 K/uL to 1.84 ± 1.19 K/uL (p:0.000); and the mean platelet count increased from 244.1 ± 85.1 K/uL to 281.9 ± 103.3 K/uL (p:0.005). CONCLUSION We concluded that the pathological effect of treatment with favipiravir on the hematologic system was the suppression in the erythrocyte series, and there were no adverse effects in other hematologic parameters.

Objective No effective treatment has yet been found for SARS-cov-2, which caused a pandemic outbreak in 2019. It is crucial to detect the progression of Covid-19 in patients as early as possible. Fibrinogen to albumin ratio (FAR) has been used as a new inflammatory marker. We aimed to find out whether the use of the FAR as a predictor of mortality in Covid-19 patients provides clinical benefit. Materials and Methods Data from 590 patients with Covid-19 from 15/03/2020 to 15/01/2021 in medicine wards and intensive care units (ICU) were retrospectively analyzed. Demographic data and other laboratory markers were collected from the electronic medical records. Relationship between FAR was investigated between patients in the survivor/non-survivor patients. Findings The mean FAR levels in patients who were non survivor was 24.44±30.3 (n:272 and 11.29±6.29 (n:275) (p:0.000) in patients survivor COVID-19 infection. In ROC curve for FAR, the threshold FAR that may pose a risk for mortality was determined as 13.84 ((AUC: 0.808(0.771-0.844)); 74.9% Sensitivity, 74.6% Specificity; p:0.000 )). Result As a result of this study, increased FAR were found to be important markers in determining the mortality levels in Covid-19 patients.

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) prevalence data in Türkiye is limited. We aimed to determine the nationwide prevalence of MASLD and advanced hepatic fibrosis risk in subjects with cardiometabolic risk factors (CMRF). Despite recent international consensus redefining fatty liver disease terminology, no nationwide MASLD study has been reported in Türkiye. Methods: This cross-sectional study included 14,371 adults with ≥1 CMRF from 44 centers across 31 cities. MASLD was diagnosed using liver ultrasonography plus cardiometabolic criteria. Advanced fibrosis risk was assessed by fibrosis-4 (FIB-4) score (≥1.3 for ≤65 years; ≥2.0 for >65 years). Logistic regression was used to identify independent predictors of high FIB-4. Results: A total of 61.4% of participants were women, the mean age was 51.3 ± 14.4 years, and the mean BMI was 31.4 ± 6.0 kg/m². MASLD prevalence was 75.7% (n = 10,873), rising with the number of CMRFs (56.5% with one factor vs. 83.4% with all). The prevalence of high FIB-4 scores was 12.0% overall, being lower in MASLD patients than non-MASLD patients (11.2% vs. 14.4%, p < 0.001). FIB-4 scores decreased with increasing BMI (28.1% underweight vs. 8.7% class III obesity). Male sex, T2DM, and hypertension independently predicted high FIB-4 scores, while smoking, higher BMI, and MASLD were inversely associated. Conclusions: Three-quarters of Turkish adults with CMRF have MASLD. Standard FIB-4 thresholds may underestimate fibrosis risk in obese and smoking populations, underscoring the need for adjusted cut-offs or alternative tools. This study is the first to provide nationwide MASLD prevalence data in Türkiye.

Objectives: To investigate the role of asymmetric dimethylarginine (ADMA) level in predicting intensive care and mortality in patients affected with coronavirus disease 2019 (COVID-19). Methods: This retrospective, cross-sectional study was conducted at Sakarya University Training and Research Hospital (Sakarya, Turkey) between April and August of 2020. We enrolled patients who were diagnosed with COVID-19 via real-time reverse-transcription polymerase chain reaction and admitted to the intensive care (Severe COVID-19; S-COVID) or non intensive care (Moderate COVID-19; M-COVID). We then analyzed the relationship of the ADMA level with various parameters between S-COVID and M-COVID groups. Results: This study included 87 patients, comprising 43 females and 44 males, with a mean age of 61 and 71.50 years, respectively. The male/female distribution was 22/25 (46.8%/53.2%) in the M-COVID group and 22/18 (55%/45%) in the S-COVID group. The hospitalization time, white blood cell count, neutrophil count, lymphocyte-to-albumin ratio, international normalization ratio, D-dimer, troponin, ferritin, lactate dehydrogenase, C-reactive protein, procalcitonin, erythrocyte sedimentation rate, fibrinogen, lactate, ADMA, and mortality rate were significantly higher (p < 0.05). In contrast, lymphocyte, total cholesterol, high-density lipoprotein, calcium, and albumin values were lower (p < 0.05) in the S-COVID group than in the M-COVID group. While the mortality rate was 55% in S-COVID patients, no mortality was detected in M-COVID patients (p < 0.05). Moreover, ADMA level was 6618 ± 3000 (6400) in S-COVID patients and 5365 ± 3571 (3130) in M-COVID patients, indicating a statistically significant difference (p = 0.012). Conclusion: The asymmetric dimethylarginine level increases in severe outcomes; hence, it can potentially predict severity in patients with COVID-19. doi: https://doi.org/10.12669/pjms.38.7.5327 How to cite this:Karacaer C, Yaylaci S, Demirci T, Cekic D, Suner KO, Cokluk E, et al. Association of mortality and endothelial dysfunction with serum ADMA level in COVID-19 patients. Pak J Med Sci. 2022;38(7):1808-1815. doi: https://doi.org/10.12669/pjms.38.7.5327 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objective: In this study, we aimed to evaluate the relationship between thiol-disulfide homoeostasis and hemogram parameters in COVID-19 patients. Methods: Total thiol(TT), Native thiol(NT), dynamic disulfide status(DDS), DDS/NT, DDS/TT, NT/TT ratio and CBC parameters were analyzed in 68 patients with positive COVID-19 and 31 healthy individuals. Results: TT, NT, DD, hemoglobin and hematocrit levels were higher in the control group than in patient groups. TT, NT, DD and lymphocyte levels of COVID-19 patients treated in medical floor were higher than those treated in intensive care unit; WBC, neutrophil and NLR were low(P<0.05).PLR was higher in intensive care patients compared with the control group(P<0.05).COVID-19 patients who did not need mechanical ventilation were retrospectively evaluated according to their mortality. TT, NT, DDS and lymphocyte levels were higher; WBC, Neutrophil, PLR and NLR were lower(P<0.05) in survivors. The diagnostic performance of TT, NT and DDS levels to define requirement of intensive care treatment in COVID-19 patients were evaluated by using Receiver Operating Characteristic (ROC) curve analysis. By using ROC analysis, the optimum cut-off points for of TT, NT and DDS levels showed high sensitivity and specificity for requirement of intensive care treatment(P<0.05). Conclusions: According to our results, it has been observed that the thiol-disulfide balance is disrupted In COVID-19 patients. It may be beneficial to monitor the thiol-disulfide balance in the follow-up and treatment of the patients. Amaç: Bu çalışmada, COVID-19 hastalarında tiyol-disülfid homoeostazı ile hemogram parametreleri arasındaki ilişkiyi değerlendirmeyi amaçladık. Gereç Yöntem: Total tiyol (TT), Native tiyol (NT), dinamik disülfid durumu (DDS), DDS / NT, DDS / TT, NT / TT oranı ve CBC parametreleri COVID-19 pozitif 68 hasta ve 31 sağlıklı bireyde analiz edildi. Bulgular: Kontrol grubunda TT, NT, DD, hemoglobin ve hematokrit düzeyleri hasta gruplarına göre daha yüksekti. Serviste tedavi gören COVID-19 hastalarının TT, NT, DD ve lenfosit seviyeleri yoğun bakım ünitesinde tedavi edilenlere göre daha yüksekti; WBC, nötrofil ve NLO düşüktü (P <0.05). Yoğun bakım hastalarında PLR, kontrol grubuna göre daha yüksekti (P <0.05). Mekanik ventilasyona ihtiyaç duymayan COVID-19 hastaları mortalitelerine göre geriye dönük olarak değerlendirildi. TT, NT, DDS ve lenfosit seviyeleri daha yüksekti; Hayatta kalanlarda WBC, Nötrofil, PLR ve NLR daha düşüktü (P <0.05). COVID-19 hastalarında yoğun bakım tedavisi gereksinimini tanımlamak için TT, NT ve DDS düzeylerinin tanısal performansı, ROC eğrisi analizi kullanılarak değerlendirildi. ROC analizine göre, yoğun bakım tedavisi gereksinimi için TT, NT ve DDS düzeyleri optimum kestirim değerlerinde, yüksek duyarlılık ve özgüllük göstermiştir (P <0.05). Sonuç: Sonuçlarımıza göre COVID-19 hastalarında tiyol-disülfid dengesinin bozulduğu görüldü. Hastaların takip ve tedavisinde tiyol-disülfid dengesinin izlenmesi faydalı olabilir.