COVID-19 experience of the major pandemic response center in the capital: results of the pandemic's first month in Turkey

Authors: HATİCE RAHMET GÜNER, İMRAN HASANOĞLU, BİRCAN KAYAASLAN, ADALET AYPAK, AYŞE KAYA KALEM, FATMA ESER, BURCU ÖZDEMİR, ELİF MUKİME SARICAOĞLU, MÜGE AYHAN, YEŞİM AYBAR BİLİR, IŞIL ÖZKOÇAK TURAN, DENİZ ERDEM, NEVZAT MEHMET MUTLU, TURAN BUZĞAN, BEDİA DİNÇ, ESRAGÜL AKINCI

Abstract: Background/aim: The aim of this study is to evaluate the epidemiological and clinical characteristics and parameters that determined the clinical course and prognosis of the COVID-19 patients admitted to Ankara City Hospital during the first month of the pandemic in Turkey. Materials and methods: SARS-CoV-2 PCR positive patients who were hospitalized between March 10 and April 10, 2020 were included. Results: Among 222 patients, mean age was higher in severe acute respiratory illness (SARI)/critical disease group (P < 0.001). Median time from illness onset to admission and presence of comorbidity, especially coronary artery disease and chronic obstructive pulmonary disease, were significantly higher in the SARI/critical disease group (P < 0.05). Cough and fever were the most common symptoms, while anosmia and loss of taste were observed in 8.6% and 7.7% patients, respectively. The mortality rate was 5.4%. A high neutrophil/lymphocyte ratio; low lymphocyte, monocyte, and platelet count; elevated liver enzymes; low GFR; and high levels of muscle enzymes, ferritin, and IL-6 on admission were found to be associated with SARI/critical disease (P < 0.05). Bilateral ground-glass opacity and patchy infiltration were more frequently seen in the SARI/critical disease group (P < 0.001). Patients older than 65 years had an 8-fold increased risk for development of SARI/critical disease. Conclusion: This cohort study regarding COVID-19 cases in Turkey reveals that older age, presence of comorbidity, bilateral infiltration on CT, high neutrophil/lymphocyte ratio, low monocyte and platelet count, elevated liver enzymes, low GFR, high levels of muscle enzymes, and high levels of ferritin and IL-6 on admission are predictors of SARI and severe disease.

Keywords: COVID-19, Turkey, epidemiology, prognosis, IL-6, mortality

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