Ali Yeşiltepe

Adipokines regulate metabolic and inflammatory pathways and may be altered during critical illness. We explored sequential serum adipokine concentrations and their associations with nutritional and clinical variables in critically ill COVID-19 patients. This prospective observational, exploratory study included 30 critically ill COVID-19 patients and 10 age- and sex-matched healthy controls. Serum adiponectin, resistin, GLP-1, visfatin, IGF-1, leptin, and acylated ghrelin were measured at intensive care unit admission and on day 7. Biomarker-clinical correlations were analyzed using Spearman correlation, and the Benjamini–Hochberg false discovery rate procedure was applied to account for multiple biomarker comparisons. After false discovery rate correction, longer time to nutrition initiation remained inversely associated with day-7 adiponectin (ρ = −0.464, q = 0.027), GLP-1 (ρ = −0.568, q = 0.015), IGF-1 (ρ = −0.488, q = 0.022), leptin (ρ = −0.539, q = 0.015), and acylated ghrelin (ρ = −0.503, q = 0.021). Several adipokines showed exploratory associations with nutrition-initiation time in this small cohort of critically ill COVID-19 patients. These observational findings do not establish that earlier nutritional support causes changes in adipokine concentrations and require validation in larger, adequately controlled studies.

Background/Objectives: The function of adipokines, which play an important role in the etiopathogenesis of critical illness, has not been fully elucidated. We aim to investigate the sequential changes in serum adipokines and their association with clinical outcomes and nutritional parameters in ICU patients with SARS-CoV-2. Methods: This observational study was conducted prospectively in a Medical ICU. Blood samples were collected on admission and on the 7th day for analysis of adiponectin, GLP-1, resistin, visfatin, acyl ghrelin (AG), IGF-1, and leptin levels using ELISA kits. Results: This study included 30 critically ill patients and 10 healthy controls. Baseline and day 7 serum adiponectin, GLP-1, resistin, visfatin, baseline AG and day 7 IGF-1 levels are significantly lower in critically ill patients compared to the control group (pConclusions: This pilot study provides insights into serum adipokine dynamics in critically ill COVID-19 patients. Lower adiponectin, GLP-1, resistin, visfatin, AG, and IGF-1 levels suggest dysregulation in these pathways.

Various scoring systems and cytokines have been cited as predicting disease severity in COVID-19 infection. This study analyzed the link between mortality rate, levels of cytokines, and scoring systems such as the Glasgow Coma Scale (GCS), Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), and Charlson Comorbidity Index in patients infected with COVID-19. Adult patients infected with COVID-19 were followed up in the intensive care unit (ICU) and analyzed prospectively. We measured serum cytokine levels (Interleukin-10 (IL-10), Interleukin-8 (IL-8), Interleukin-6 (IL-6), Interleukin-1β (IL-1β), tumor necrosis factor-alpha (TNF-α) and High mobility group box 1 (HMGB-1)) and recorded GCS, APACHE II, SOFA, and Charlson comorbidity index scores on admission to the ICU. Receiver operating curve (ROC) analysis was performed to predict mortality from IL-1β, IL-6 IL-10, IL-8, TNF-α, and HMGB-1 values. Study participants were grouped as follows: Group A, survivors, and Group B, deceased, during the 28-day follow-up. The mean age was 65.69 (±13.56) in Group A (n = 36) and 70.85 (±10.06) in Group B (n = 27). The female/male ratio was 23/40. Age, sex, body mass index (BMI), comorbid illnesses, GCS, APACHE II, SOFA, and Charlson scores, duration of hospitalization or ICU admission, therapeutic choices, and lymphocyte, PMNL, NLR, platelet, D-dimer, fibrinogen, GGT, CRP, procalcitonin, and lactate levels were similar between the groups. The frequency of acute kidney injury (AKI) was higher in Group B (p = 0.005). Serum IL-10, IL-8, IL-6, IL-1β, TNF-α, HMGB-1, ferritin, and LDH values were higher, and PaO₂/FiO₂ was lower in Group B than in Group A. ROC analysis showed that there was an association between serum IL-1β (>1015.7), serum IL-6 (>116.7), serum IL-8 (>258.4), serum IL-10 (>247.5), serum TNF-α (>280.7), and serum HMGB-1 (>23.5) and mortality. AKI gave rise to a greater risk of mortality (odds ratio: 7.081, p = 0.014). Mortality was associated with serum IL-10, IL-8, IL-6, IL-1β, TNF-α, and HMGB-1 but not with GCS, APACHE II, SOFA, or Charlson comorbidity index scores. AKI increased the risk of mortality by seven times. Our findings suggest that cytokine levels (serum IL-10, IL-8, IL-6, IL-1β, TNF-α, and HMGB-1) were predictors of mortality in COVID-19 infection. In addition, our results might give an opinion about the course of COVID-19 infection.

Aim: COVID-19 disease can progress from pneumonia to acute respiratory distress syndrome (ARDS). Performing computed tomography on all patients is expensive and exposes them to high radiation. The simple and reproducible Radiographic Evaluation Pulmonary Edema (RALE) score, used in ARDS and acute pulmonary edema in the emergency department, can predict the severity of the disease in COVID-19 patients. Material and Method: In our study, a total of 221 COVID-19 patients we followed up between July-November, 2021 were evaluated retrospectively. The patients were divided into two as Intensive care hospitalization and no intensive care hospitalization. Results: Ninety-five (43%) patients were admitted to the intensive care unit. The mean age (p<.001), white blood cell count (WBC) (p=.001), neutrophil count (p<.001), RALE score, and the number of hospitalization days of the patients admitted to the intensive care unit were higher (p<.001). These findings were positively correlated with the RALE score (p<.001). Age (p<.001), RALE score (p=.022), WBC (p=.029), and neutrophil count (p=.004) were independent risk factors in the multivariate analysis of factors affecting intensive care admission. RALE score cut-off value in predicting intensive care unit admission was ≥10.5. In the analysis with an Area Under the Curve value of 0.716, the application of this threshold resulted in a sensitivity of 67.4% and a specificity of 69.8%. Conclusion: In conclusion, performing chest computed tomography in all patients admitted to the emergency department with COVID-19 disease increases the cost and exposure to radiation. The simple and recalculated RALE score can be used to predict intensive care admission in COVID-19 pneumonia.

Anamnez Alma Şema ve Özellikler Başak OĞUZ İNAN Hasta Şikayeti ve Kimlik Bilgisi Muhammet KIZMAZ Anamnez Alma Gülru AVCI Özgeçmiş Tuğba Sevinç GAMSIZ Soy Geçmiş Yıldız İPEK Sosyal Durum ve Alışkanlıklar Vildan GÜRSOY Kullandığı İlaçlar Hilal HEYBELİ Beden Fonksiyonları Fatma AYKAŞ Genel Durum Sorgusu Alper Tuna GÜVEN Solunum Sistemiyle İlgili Sorgu Sonat Pınar KARA Kardiyovasküler Sistemle İlgili Sorgu Tolga Onur BADAK Gastrointestinal Sistemle İlgili Sorgu Gülden BİLİCAN Üroloji’de Anamnez Ersin GÖKMEN Lokomotor Sistemle İlgili Sorgulama Hatice AĞIR Sinir Sistemi İle İlgili Sorgu Ayşegül AKKAN SUZAN Fizik Muayene Usulleri–İnspeksiyon İsmail KIRLI Fizik Muayene Usulleri (Palpasyon) Ayşe Nilgün KUL Perküsyon Deniz TAZEOĞLU Oskültasyon Mehmet Emre AY Metabolik Nedenlere Bağlı Karın Ağrıları Özgür BAHADIR Beslenme Durumunun Değerlendirilmesi Büşra Betül ÇAĞIR Boy ve Önemli Gelişim Hastalıkları (I) Seçil ÖZIŞIK Boy ve Önemli Gelişim Hastalıkları (II) Mustafa CAN Postür Muayenesi Hatice AĞIR Anormal Hareket Bozuklukları-I Fatma Ebru ALGÜL Anormal Hareket Bozuklukları-II Fatma Ebru ALGÜL Yürüyüş Funda GÖKGÖZ DURMAZ Konuşmanın Değerlendirilmesi ve Konuşma Bozuklukları Tuba GÜLLÜ KOCA Koku Alma Ali YEŞİLTEPE Ateş Aslıhan METE YILDIRIM Ateş ve Tipleri Pınar ERGEN, Fatma YILMAZ KARADAĞ Terleme Nursel AKBAY Tırnaklar (I) Müge BİLGE Tırnaklar (II) Fatma KAPLAN EFE Epidermis, Dermis, Subkutan Doku Sümeyra Alan YALIM Primer Deri Lezyonları Nida ÖZTOP Sekonder Deri Lezyonları Şengül BEYAZ Derinin Muayenesi Gökçem YALIN KOCAMAZ Baş Muayenesi Aylia YEŞİLOVA Yüzün ve Saçın Muayenesi-Özel Hastalıklarda Müçteba CAN Göz Hastalıklarında Ön Segment Muayenesi Ayşe Yeşim ORAL, İbrahim Ethem AY Göz Hastalıklarında Arka Segment Muayenesi Müberra AKDOĞAN, İbrahim Ethem AY Burun Muayenesi Tuğba Sevinç GAMSIZ Dudakların Muayenesi Gülşah BOZ Kulaklar Zekiye Pınar İPEK EYVAZ Boyun Muayenesi, Boyun Damarlarının Muayenesi, Boyun Lenf Ganglionlarının Muayenesi, Trachea Muayenesi Selman GENCER Tiroid Muayenesi Ebru ÖZDEN YILMAZ, Arda Şakir YILMAZ