Objectives: This study aimed to investigate whether ferritin level can predict the severity of coronavirus disease 2019 (COVID-19). Background: The COVID-19 pandemic has been challenging for both patients and caregivers. Many laboratory markers have been used to better understand the causes of poor outcomes and to improve the management of COVID-19 patients. Methods: A total of 93 patients who had a positive polymerase chain reaction test result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in this study. Demographic features, comorbidities, clinical and laboratory findings were obtained from the hospital database retrospectively. Patients were divided into two groups according to the disease severity as follows: mild group (n = 70) and severe group (n = 23). Results: The median age of the study population was 42.5 (28.3-62.8) with 69.9% male patients. Patients in the severe group were significantly older and showed a higher frequency of hypertension, diabetes mellitus, coronary artery disease, and heart failure in comparison with those in the mild group. In addition, gamma-glutamyl transferase, C-reactive protein, ferritin, interleukin-6, procalcitonin, and neutrophil to lymphocyte ratio were higher whereas albumin level was lower in patients in the severe group. Linear regression analysis demonstrated that ferritin level was the only significant predictor of disease severity (β = 0.487, t = 2.993, p = 0.004). In receiver operator characteristics curve analysis, ferritin level ≥264.5 ng/mL predicted severe COVID-19 with a sensitivity of 73.9% and specificity of 94.2%. Conclusion: Early analysis of ferritin levels in patients with COVID-19 might effectively predict the disease severity.

There are limited data on the long-term outcomes of COVID-19 from different parts of the world. To determine risk factors of 90-day mortality in critically ill patients in Turkish intensive care units (ICUs), with respiratory failure. Retrospective, observational cohort. Patients with laboratory-confirmed COVID-19 and who had been followed up in the ICUs with respiratory failure for more than 24 hours were included in the study. Their demographics, clinical characteristics, laboratory variables, treatment protocols, and survival data were recorded. A total of 421 patients were included. The median age was 67 (IQR: 57-76) years, and 251 patients (59.6%) were men. The 90-day mortality rate was 55.1%. The factors independently associated with 90-day mortality were invasive mechanical ventilation (IMV) (HR 4.09 [95% CI: [2.20-7.63], P < .001), lactate level >2 mmol/L (2.78 [1.93-4.01], P < .001), age ≥60 years (2.45 [1.48-4.06)], P < .001), cardiac arrhythmia during ICU stay (2.01 [1.27-3.20], P = .003), vasopressor treatment (1.94 [1.32-2.84], P = .001), positive fluid balance of ≥600 mL/day (1.68 [1.21-2.34], P = .002), PaO₂/FiO₂ ratio of ≤150 mmHg (1.66 [1.18-2.32], P = .003), and ECOG score ≥1 (1.42 [1.00-2.02], P = .050). Long-term mortality was high in critically ill patients with COVID-19 hospitalized in intensive care units in Turkey. Invasive mechanical ventilation, lactate level, age, cardiac arrhythmia, vasopressor therapy, positive fluid balance, severe hypoxemia and ECOG score were the independent risk factors for 90-day mortality.

Background and Objectives: This study aimed to investigate the clinical significance of sarcopenia, defined by the cross-sectional area of the masseter muscle (CSA-M), as an early marker for sarcopenia diagnosis and its association with mortality in patients with cerebrovascular events (CVE). Materials and Methods: In this retrospective cohort study, 120 patients aged 65 years or older with CVE admitted to Bilkent City Hospital between September 2020 and September 2023 were included. Patients with malignancy, prior CVE, or incomplete data were excluded. Parameters such as CSA-M measured via brain CT, Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores, Nutritional Risk Score (NRS), duration of ICU and hospital stays, and 28-day mortality were evaluated. The CSA-M thresholds for sarcopenia were defined as <400 mm² for men and <300 mm² for women. Results: Sarcopenia prevalence was significantly associated with prolonged ICU (27.0 ± 33.1 days vs. 16.5 ± 22.4 days, p = 0.042) and hospital stays (34.8 ± 38.4 days vs. 21.3 ± 22.3 days, p = 0.017). Right and left CSA-M values were significantly lower in sarcopenic patients (p < 0.001). ROC analysis revealed CSA-M cut-off values of <300 mm² (AUC = 0.82) for men and <295 mm² (AUC = 0.83) for women as strong predictors of sarcopenia. Multivariate regression analysis showed a significant association between CSA-M and 28-day mortality (p < 0.05). Sarcopenia also correlated with lower albumin levels, a higher prevalence of ischemic stroke, and increased mechanical ventilation needs. Conclusions: CSA-M measured via brain CT is a reliable marker for sarcopenia and a predictor of clinical outcomes in CVE patients. Early identification and management of sarcopenia could improve patient prognosis. Further research is warranted to explore its potential in broader clinical contexts.

Amaç:Bu çalışmanın amacı; yoğun bakım ünitesinde yatan hastaların cinsiyetine ve yaşına göre böbrek taşı insidansı, mortalite durumları, yoğun bakım yatış süreleri ve hastane yatış sürelerini incelemektir. Materyal ve Metod: Bu çalışma retrospektif kesitsel bir çalışma tasarımı olarak yapılmıştır. 2020-2021 tarihleri arasında Sağlık Bilimleri Üniversitesi Şanlıurfa Mehmet Akif İnan SUAM Cerrahi Yoğun Bakım Ünitesi ve Üroloji Kliniği tarafından 10-94 yaş arası yoğun bakım ünitesine yatan 376 hasta ile gerçekleştirilmiştir. Çalışma kapsamına hastaların cinsiyet, yaş, görüntüleme sonuncunda böbrek taş veya kist durumu, mortalite durumu, yoğun bakım yatış süresi, hastane yatış süresi kayıt edilmiştir. Veriler Ki-kare, ANOVA ve bağımsız t-test kullanılarak analiz edilmiştir. Bulgular: Elde edilen bulgulara göre bu çalışmaya katılan hastaların böbrek taşı genel insidansı %7,38 olarak bulunmuştur. Bu çalışma kapsamında kadın hastaların ve erkek hastaların böbrek taşı insidansı incelendiğinde kadın hastalarda %6,45 olarak bulunurken erkek hastalarda %7,60 olarak bulunmuştur. Ancak bu farklılık istatiksel olarak anlamlı bulunmamıştır. Ayrıca yaş ile birlikte böbrek taşı insidansının yükseldiği anlaşılmıştır. Böbrek taşı olanların ölüm oranı %1,9 olarak bulunmuştur. Sonuçlar: Bu çalışma sonunda elde edilen bulgular literatür ile paralellikler göstermektedir. Çalışmanın uygulandığı coğrafyanın ve hasta profilinin farklı olmasından dolayı mevcut verilerin farklı demografik yapı verileri ile desteklenmesi sağlanmıştır.

Sepsis is a syndrome in which immune recovery is impaired and the clinical course becomes more severe, particularly in older patients. Although lymphopenia is an easily monitored indicator of sepsis-associated immune dysfunction, the clinical significance of daily lymphocyte changes during the first week in older intensive care patients remains unclear. This study evaluated associations between absolute lymphocyte count (ALC) dynamics, 28-day mortality, and a culture-based secondary microbiological outcome in patients aged ≥ 65 years with sepsis. In this single-center retrospective cohort, patients aged ≥ 65 years admitted from the emergency department to the ICU with sepsis between January 1, 2022 and December 31, 2025 were included. Daily ALC during days 1-7 was categorized as no lymphopenia (≥ 1000 cells/mm³), moderate lymphopenia (500-999 cells/mm³), or severe lymphopenia (< 500 cells/mm³). The primary outcome was 28-day all-cause mortality; the secondary outcome was 28-day nosocomial culture positivity. Among 566 patients, the mean age was 80.7 ± 8.0 years, 48.2% were female, and 28-day mortality was 41.0%. ALC was available for all patients through ICU day 3 and for 514/566 patients (90.8%) on ICU day 7; later non-availability reflected shortened observation time rather than random laboratory omission. Severe lymphopenia declined from 33.9% on day 1 to 24.7% on day 7. Mortality was highest in severe lymphopenia, with FDR-corrected significance on day 2 and days 4-7. In the prespecified day-4 multivariable model, severe lymphopenia was independently associated with mortality (aOR 1.84, 95% CI 1.08-3.14; p = 0.025), whereas moderate lymphopenia was not. Increasing severe-lymphopenia burden was also associated with mortality during days 1-4 (aOR 1.16; p = 0.033) and days 1-7 (aOR 1.13; p = 0.013). Nosocomial culture positivity showed unadjusted late-week associations, but not after adjustment. In older ICU patients with sepsis, day-4 severe lymphopenia and first-week severe-lymphopenia burden were associated with 28-day mortality. The culture-based secondary outcome was not confirmed after adjustment and should be considered exploratory. First-week ALC monitoring may aid bedside risk stratification, but prospective multicenter validation is needed.