Silicosis,pneumoconiosis,sandblasters,mortality,lung transplantation

Background: The clinical spectrum of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is broad; it can range from asymptomatic cases to mild upper respiratory tract illness, respiratory failure, and severe multiorgan failure resulting in death. Therefore, it is important to identify the clinical course of the disease and the factors associated with mortality. Objective: The aim of this study is to identify the risk factors associated with the severity of the disease, intensive care unit admission, and mortality in COVID-19 patients. Methods: A total of 1075 patients with clinical and radiological findings compatible with COVID-19 pneumonia and positive SARS-CoV-2 PCR were selected and retrospectively screened. All included patients were classified according to the 7th edition of the 2019 Coronavirus Disease Guidelines published by the National Health Commission of China. Results: It was observed that elevated white blood count (WBC) increased the severity of COVID-19 by 3.26 times and the risk of intensive care unit (ICU) admission by 3.47 times. Patients with high D-dimer levels had a 91% increased risk, and those with high fibrinogen levels had a 2.08 times higher risk of severe disease. High C-reactive protein (CRP) values were found to increase disease severity by 6.89 times, mortality by 12.84 times, and ICU admission by 3.37 times. Conclusions: Identifying the factors associated with disease severity, ICU admission, and mortality in COVID-19 patients could help reduce disability and mortality rates in pandemics.

Objectives: The onset and advancement of silicosis are intricately linked to immune system activation and oxidative stress. We aimed to examine whether occupational silica exposure induces alterations in neopterin levels, the immune system, or the oxidant/antioxidant system. Methods: Fifty-two healthy individuals, 47 workers with silica exposure who did not develop the disease, and 71 silicosis patients were included in the study, totaling 170 participants. Neopterin was measured in serum and urine. Chromatographic analysis of neopterin level was performed with Thermo Ultimate 3000 ultra-high-performance liquid chromatography system. Tumor necrosis factor alpha (TNF-α), interferon-gamma (IFN-γ), fibroblast growth factor (FGF), interleukin (IL)-1α, IL-1β, 8-hydroxy-2-deoxyguanosine (8-OH-dG), glutathione reductase (GR), glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase (CAT) were measured in serum. Immune and oxidative stress parameters were measured by spectrophotometric and spectrofluorometric methods. Results: Serum neopterin levels were significantly different between the study groups, while urinary neopterin levels were not. Serum neopterin levels were significantly decreased in the silicosis group compared to the exposure and non-exposed group groups. TNF-α, IFN-γ, FGF, IL-1α, 8-OH-dG, and GR increased with silica exposure, while SOD and GPx decreased. Serum neopterin, IL-1α, GR, age, and forced expired volume (FEV1%) were found to be risk factors for silicosis development. A negative correlation existed between neopterin levels, TNF-α, and overall exposure duration. Conclusions: Neopterin is applicable in the diagnosis and monitoring of oxidative stress and alterations in the immune system associated with silicosis. Thus, it can ensure that preventive measures are taken at an early stage.

Mild encephalopathy with reversible splenial lesion (MERS) is characterized with a reversible lesion in the splenium of the corpus callosum. It has been defined as a neuro-radiologic syndrome associated with viral infections. In addition, this lesion may related with epileptic seizures, antiepileptic drugs or metabolic disturbances. We presented a patient with MERS associated with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). Encephalopathy and psychiatric symptoms were the major initial clinical symptoms. Brain magnetic resonance imaging showed complete resolution of the corpus callosum lesion. The symptoms of patient recovered completely. Complete resolution of corpus callosum lesion and recovery of encephalopathy associated with SARS-COV-2 were similar to previous cases.

Lymphopenia is the most important criterion of the mortality and discharging feature for patients infected with coronavirus disease 2019 (COVID-19). This study aimed to investigate the clinical impact of a low molecular weight heparin (LMWH) treatment on the clinical course of COVID-19. Patients? clinical symptoms, radiologic outcomes, hematologic, biochemical, D-dimer, and C-reactive protein (CRP) results were obtained from medical records. Participants were separated into two groups: one was treated with LMWH and the other was not. Improvement in the patients was compared before and after treatment. Ninety-six patients who were diagnosed with COVID-19 between April and May 2020 were retrospectively analyzed. The multivariable analysis showed that the count of lymphocytes, D-dimer, and CRP levels were significantly improved in the LMWH group, as compared to the control group (OR, (95% CI) 0.628 (0.248?0.965), p < 0.001), OR, (95% CI) 0.356 (0.089?0.674), p < 0.001, respectively). The area under the receiver operating characteristic (ROC) curve analysis was AUC: 0.679 ± 0.055, 0.615 ± 0.058, 0.633 ± 0.057, respectively, the ß value was found as -1.032, -0.026, and -0.465, respectively. LMWH treatment group demonstrated better laboratory findings, including a recovery in the lymphocyte count, CRP, and D-dimer results.