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    Evaluation of Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio in Covid-19 Patients Treated for Cytokine Storm
    (Selçuk Üniversitesi, 2023 Ekim) Duksal, Faysal; Burnik, Cengiz; Yavuz, Serkan; Mermer, Mehmet
    Background/Aims: There is a significant increase in proinflammatory cytokine levels in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients entering cytokine storm. Neutrophilto-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), also increase in inflammatory diseases. The aim was to evaluate the NLR and PLR of coronavirus disease 2019 (COVID-19) patients receiving tocilizumab (TCZ) due to cytokine storm. Materials and Methods: In this retrospective, cross-sectional study conducted between March and December 2020, adult patients with laboratory-confirmed COVID-19 were analyzed Results; The mean age of 519 patients included in the study was 61.6 ± 17.0 years, with male predominance (64.7%). 70.7% of patients had at least one type of comorbidity and the most common comorbid conditions were chronic obstructive pulmonary disease (45.9%) and asthma (28.7%). 399 patients who were given TCZ (group 1) and 120 patients who were not given TCZ (group 2) were evaluated. Compared with group 2, group 1 had more male predominance and they were older (p<0.001). The mortality rate, which was found as 48.6% in group 1, was approximately twice as high in the intensive care unit (ICU). NLR and PLR were significantly higher and lymphopenia was more prominent in group 1, especially in ICU patients than group 2 (p<0.001). Conclusion: High NLR, PLR and lymphopenia was more common in critically ill Covid-19 patients. Therefore, they may be used as a marker to predict poor prognosis. It can be suggested to treat these patients more aggressively in the initial period.
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    The Relationship Between Blood Parameters, Sleep, Anxiety and Depression Symptoms: A Retrospective Polysomnography Study
    (Selçuk Üniversitesi, 2023 Ekim) Eren, Fettah; Duksal, Faysal
    systemic diseases. This study aims to analyse the relationship between anxiety, depression symptoms and sleep parameters among the patients subjected to polysomnographic recording. Material and Methods: A total of 808 patients who were subjected to a polysomnographic recording were included in the retrospective cross-sectional and hospital-based study. Body mass index (BMI) was calculated. Anxiety and depression symptoms were evaluated using the Beck anxiety and Beck depression inventory. Patients were divided into groups according to anxiety and depression scores. The apnoea hypopnea index (AHI), oxygen desaturation index (ODI), and peripheral oxygen saturation (SaO2) were obtained from the polysomnographic recordings. Results: In the study, there were 528 (65.3%) male and 280 (34.7%) female patients with the mean age of 47.64 ± 12.25 (18-82). Depression was detected in 307 (38.0%) patients according to Beck depression score. Mild anxiety symptoms were detected in 516 (63.9%), moderate anxiety symptoms in 215 (26.6%) patients and severe anxiety symptoms in 77 (9.5%) patients according to Beck anxiety score. There was a statistical difference for all polysomnographic parameters in depression and anxiety severity groups (p=0.001). In patients with depression had lower free-T3 and higher C-reactive protein (CRP) levels (p=0.001, p=0.014). The difference between thyroid stimulating hormone (TSH) and FT4 levels was determined according to the severity of the depression (p=0.037, p=0.047). CRP was higher in patients with severe anxiety (p=0.008); and free-T3 was lower in patients with moderate and severe anxiety (p=0.003, p=0.001). In the logistic regression analysis, free-T3, minimum SaO2 and BMI had an impact on anxiety (p=0.002, p=0.033, p=0.031) and depression (p=0.001, p=0.017, p=0.035). Conclusion: Anxiety and depression symptoms are affected by numerous factors, especially sleep characteristics. Minimum SaO2, CRP and free-T3 are main predisposing factors on anxiety and depression.