Since SARS-CoV-2 disease (COVID-19) has been labeled as a pandemic, it took the spotlight in the differential diagnosis for patients presenting with acute respiratory and systemic symptoms. Leptospirosis is one of the most common zoonoses in the world, yet it is mainly a disease of differential diagnosis for places that do not have it as an endemic. Due to the high burden of COVID-19 on the healthcare field, patients suffering from other infections may have been inadvertently neglected. COVID-19 infection can mimic other infectious diseases and can confuse physicians in their search for a confirmatory diagnosis. Nonetheless, it is very crucial to broaden the differential diagnosis and keep diseases like leptospirosis within the differential diagnosis despite its rarity, especially in patients presenting with unexplained systemic infectious symptoms. This is a unique case of a patient who presented with dyspnea, jaundice and change in urine color who was suspected to be COVID-19 positive. After a detailed investigation, the patient was diagnosed with leptospirosis instead of COVID-19 and was treated with plasmapheresis and antibiotics accordingly.

Background: Whether the initial clip type selected during transcatheter edge-to-edge repair (TEER) of the mitral valve—grasping width and arm length—independently influences procedural and echocardiographic outcomes remains uncertain. Methods: We retrospectively analyzed 138 consecutive patients undergoing mitral TEER. The first implanted clip was classified as narrow standard-length (NT), long narrow-arm (XT), or long wide-arm (XTW). Determinants of initial clip selection and its association with procedural success (residual mitral regurgitation [MR] ≤ 1+), post-procedural transmitral gradient, and the need for ≥2 clips were assessed using multivariable logistic and linear regression. Results: Median age was 74.0 (66.0–80.0), 74.5 (66.0–82.5), and 75.0 (70.0–79.0) years, and median LVEF was 35.0% (30.0–50.0), 30.0% (25.0–45.0), and 40.0% (25.0–45.0), for the NT, XT, and XTW groups, respectively; 66% of patients overall were male. An XTW clip was implanted first in 61.6% of patients. XTW selection was independently associated with larger effective regurgitant orifice area, lower LVEF, longer posterior leaflet length, and secondary MR (all p < 0.05), whereas NT selection favored younger age, smaller orifice, and higher LVEF. After adjustment for these factors, no statistically significant independent association was detected between initial clip type and residual MR ≥2+, post-procedural transmitral gradient, or the need for additional clips (all p > 0.05); however, confidence intervals were wide. On univariable analysis, larger left atrial size and moderate-to-severe tricuspid regurgitation were associated with residual MR ≥ 2+, but neither remained significant after multivariable adjustment. Conclusions: Initial clip selection was associated with valve anatomy, LVEF and MR etiology. No statistically significant independent association between initial clip type and procedural or short-term echocardiographic outcomes was detected in this cohort. Given the observational design, confounding by indication, limited sample size and wide confidence intervals, clinically relevant effects cannot be excluded, and these findings do not establish the superiority or equivalence of any clip-selection strategy.

Background and Objectives: Atrial fibrillation (AF) is a common arrhythmia in patients with mitral valve prolapse (MVP) after mitral valve repair surgery and is associated with adverse cardiac outcomes. Early identification of patients at high risk for AF development after repair surgery is crucial for early treatment and follow-up of these patients. This study aimed to identify ECG predictors of AF in patients with MVP following mitral valve repair surgery. Materials and Methods: This retrospective, non-randomized study included 62 patients who underwent mitral valve repair for MVP. The patients’ ECGs were analyzed preoperatively and at 1, 3, and 6 months post-surgery to identify patients who developed AF. AF was diagnosed based on ECG findings or Holter monitoring. The P wave dispersion, P wave peak time (PWPT), P wave duration, PR interval, P wave terminal force in lead V1 (PWTF), interatrial block, P wave axis, biphasic P waves in inferior leads, QRS duration, corrected QT interval (QTc), fragmented QRS (fQRS), and ST segment-T wave abnormalities were analyzed on baseline ECG as AF predictors. Results: The PWPT, P wave dispersion, and maximum P wave duration were significantly longer on preoperative ECG in patients who developed AF postoperatively compared to those who did not. Biphasic P waves were more frequently observed in patients who developed AF postoperatively. Univariate analysis identified biphasic P waves, P wave dispersion, maximum P wave duration, PWPT, and left ventricular ejection fraction (LVEF) as potential predictors of postoperative AF. However, multivariate analysis revealed that P wave dispersion, PWPT, and left atrial volume index (LAVI) were independent predictors of AF in six months after mitral valve repair. No significant changes were observed in QRS duration, QT interval, or the fQRS. Conclusions: The P wave dispersion, PWPT, and LAVI are significant ECG predictors of AF following mitral valve repair surgery in MVP patients. These ECG markers may help identify individuals at higher risk for postoperative AF, allowing for targeted monitoring and management strategies.

Objective: This research aims to analyze the HALP. (hemoglobin, albumin, lymphocyte. platelet) score of.survivor-deceased Covid-19 patients. Material and methods: 590 patients with. Covid-19 were. included. in. this. study. Patients. were. divided. into two groups as survivor (n:296) and deceased (n:294). Patient information was collected from the hospital online system. The Study was conducted retrospectively, and it aims to.investigate.the association.between HALP score and.mortality.in Covid-19.patients. Results: In.the deceased group.the.mean.age was 71.32±10.9 (n:294) while in the survivor.group, it.was 59.97±16.2 (n:296) (p:0.000). 65,6% of the deceased group were.male, while 55% of survivor group were male (p<0.001). The median HALP score was 11,45 (1,00-1594,00) in the deceased group, while it was 23,58 (1,73-231,75) (p<0.001) in survivor group. Through our analysis,.we have found.that.the.HALP score.was associated with mortality, thus the.relationship.between 1/HALP.score.and.mortality was examined. While the median 1/HALP was 0.08 (0.01-1.00) in deceased group, it was 0.04 (0.01-0.58) in the survivor group. ROC (receiver.operating.characteristic) analysis was executed for determining the cut off value of 1/HALP. The cut.off.value of 1/HALP for mortality was 0,064 ((AUC: 0,724 (0,682-0,767); 67,3% Sensitivity, 67,0% Specificity; p<0.001)). Conclusion: There is a meaningful correlation established between low HALP score and.mortality. in.Covid-19.patients. We.have reached the.conclusion that using HALP score.to. predict.mortality.in.Covid-19.patients might be useful.