Background. Metabolic alterations, particularly disorders of lipoprotein metabolism in COVID‐19, may affect the course and outcome of the disease. This study aims at evaluating the lipoprotein profile and redox status in SARS‐CoV‐2 infected patients with different pneumonia severity and their association with lethal outcomes. Methods. The prospective cohort study was performed on 98 COVID‐19 patients with mild, moderate, and severe pneumonia. Lipid and inflammatory parameters, lipoprotein subclasses, and redox status biomarkers were determined at the study entry and after one week. Results. Compared to patients with mild and moderate pneumonia, severely ill patients had higher oxidised low‐density lipoprotein (oxLDL) and malondialdehyde levels and lower high‐density lipoprotein cholesterol (HDL‐C) concentrations and paraoxonase 1 activity. Reduction in the proportion of large HDL 2a subclasses with a concomitant increase in the proportion of smallest HDL 3c and small dense LDL (sdLDL) particles was observed in patients with severe disease during the time. However, these changes were reversed in the mild and moderate groups. The results showed a positive association between changes in oxLDL and total antioxidative status. However, prooxidants and antioxidants in plasma were lower in patients with lethal outcomes. Conclusions. Increased levels of oxLDL and sdLDL particles may contribute to the severity of COVID‐19. The role of oxidative stress should be clarified in further studies, mainly its association with lethal outcomes.

Background/Aim. The COronaVIrus Disease 2019 (COVID-19) primarily affects the respiratory system, so radiological diagnosis has been shown to be necessary. Chest computed tomography (CT) is to be shown the best modality in suspected COVID-19 cases for initial evaluation because CT findings may be present before the onset of symptoms. The purpose of this study is to show different CT imaging features or patterns in COVID-19 patients with a different time course and disease severity. Methods. This is a prospective cohort study that analysed 330 patients (the average age was 52.37±15.36) with confirmed COVID-19 via laboratory testing. During hospitalization, all patients included in the study underwent chest CT in order to assess the extent of changes in their lungs. Because chest CT images could show different imaging features or patterns in COVID-19 patients with a different time course and disease severity, we classified them into four categories: lung, bronchial, pleural and mediastinal changes. Based on the time interval between the onset of symptoms and the CT scan, all patients were divided into three groups: group 1 (CT scans done ≤1 week after symptom onset); group 2 (CT scans done >1 to 2 weeks after symptom onset); group 3 (CT scans done >2 weeks after symptom onset). In order to more accurately monitor the distribution of changes in the lungs, bilateral lungs were divided into 12 ‘lung’ zones. Each zone was assigned a CT score. ‘Total severity score‘ was calculated by summing the scores for each zone. Results. In 93.6% patients with COVID-19 the CT findings were positive. About 92.1% patients had multiple lesions. The lesions were bilateral in 87.6% of patients, had both peripheral and centrally localised lesions in 63.3% of patients, and occurred more frequently in posterior areas (93%), as well as in lower lung zones (91.2%). The average ‘Total severity score’ was 11.00 (7.00-16.00). The most common CT findings in all patients are the ground- glass opacities (97.7%), reticular pattern (91.3%), consolidation (71.5%) and fibrotic streaks (63.8%). When the time interval is monitored between onset of symptoms and the CT scan, it is noticed that in group 1 changes on CT were found in 80.0% of patients, in group 2 in 95.0%, and in group 3 in 99.4%. Conclusion. CT has proven to be a very important diagnostic method in COVID-19 patients, and together with clinical and laboratory findings, gives a complete picture of the patient's condition and significantly contributes to decision- making for further treatment.

Background/Objectives: Although COVID-19 is generally more severe in males, data on sex-specific differences in the predictive value of commonly used inflammatory biomarkers remain limited. The study aimed to evaluate the sex-specific prognostic performance of selected biomarkers during the Alpha variant wave. Methods: In single-center study, univariate and multivariable regressions analyses, along with receiver operating characteristic curve (ROC) analyses, were performed to assess the association of acute-phase proteins, cytokines, and white blood cell indices (at admission and 7 days later) and disease severity and mortality in patients with severe-to-critical COVID-19. Results: At admission, the combined assessment of ferritin and D-dimer predicted disease severity in both sexes; however, optimal cut-off values and diagnostic performance (specificity and sensitivity) differed between males and females. In males, neutrophil and lymphocyte counts provided additional clinically relevant predictive value. Seven days after admission, the combination of ferritin, D-dimer, and fibrinogen in males, and ferritin, as an independent predictor within a model including lactate dehydrogenase, in females demonstrated strong predictive performance for severe-to-critical COVID-19. At this time-point, lymphocyte count in males was also identified as an independent predictor of disease severity. Notably, C-reactive protein and neutrophil count correlated with mortality in males with severe-to-critical disease. Conclusions: Severe COVID-19 is predicted by distinct acute-phase proteins and shared, sex-specific biomarkers, but with distinct cut-offs and predictive accuracy. In males, white blood cell indices also serve as independent predictors. Furthermore, prognostic utility changes of these biomarkers over the course of the disease, suggesting sex-specific and time-dependent role in COVID-19 pathogenesis.

Background/Objectives: While COVID-19 is typically more severe in males, there is limited data on sex-specific differences in the predictive value of common inflammatory biomarkers. To address this gap, their predictive capacity was evaluated in a single-center study of male and female patients during the Alpha variant wave. Methods: Univariate, multivariable, and receiver operating characteristic (ROC) analyses were used to evaluate the association of acute-phase proteins, cytokines, and white blood cell counts (measured on admission and day seven) with COVID-19 severity and mortality in severely/critically ill COVID-19 subjects. Results: On admission, the combination of ferritin and D-dimer effectively predicted disease severity in both sexes, though cut-off values and diagnostic accuracy (specificity and sensitivity) varied by sex. In males, neutrophil and lymphocyte counts provided additional clinically relevant predictive value. Seven days post-admission the combination of ferritin, D-dimer and fibrinogen in males and ferritin (as independent predictor comprising model with lactate dehydrogenase) in females emerged as efficient predictors of severe/critical COVID-19. On this evaluation-point, lymphocytes in males and neutrophil-to-lymphocyte ratio in females were also identified as independent predictors of severe/critical COVID-19. Notably, on this evaluation-point C-reactive protein and neutrophil count independently predicted mortality in males with severe/critical disease. Conclusion: Different acute-phase proteins (or the same proteins with distinct cut-off values and predictive characteristics) and white blood cell indices should be considered as independent predictors of severe/critical COVID-19 in males and females and ii) the prognostic capacity of many of them evolves during disease progression, indicating their sex-specific, time-dependent pathogenetic role in COVID-19.