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Öğe Evaluation of Annexin-1 (ANXA-1), Annexin-2 (ANXA-2) and Bone Morphogenetic Protein-7 (BMP-7) Serum Levels in Patients Followed Up With A Diagnosis of COVID-19(Ankara Microbiology Soc, 2022) Ural, Onur; Kiratli, Hatice Esranur; Sumer, Sua; Aktug Demir, Nazlim; Yilmaz Kirik, Sema; Vatansev, Husamettin; Akyurek, FikretCoronavirus disease 2019 (COVID-19) is a global health problem caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). SARS-CoV-2 infection may present with clinical pictures ranging from asymptomatic or mild forms to respiratory failure requiring intensive care follow-up and mechanical ventilation. The course of this disease with different clinical presentations raises many immunological questions. This study aimed to evaluate the serum levels of Annexin-1 (ANXA-1), Annexin-2 (ANXA-2) and bone morphogenetic protein-7 (BMP-7) in patients diagnosed with COVID-19 and to investigate whether these markers are associated with lung involvement. The study was conducted in 173 patients who were followed and treated with the diagnosis of COVID-19 and 51 healthy control group. Patients were primarily divided into two groups based on the presence of typical lung involvement (ground glass opacities, consolidation, and both) in the thoracic computed tomography (CT) scans for COVID-19. Those who found to have involvement in thoracic CT scans were divided into three groups as mild (< 33%), moderate (34-66%), and severe (> 67%) according to the extent of their lesions. Of the 173 patients included in the study, 130 had typical thoracic CT involvement for COVID-19, while 43 did not. ANXA-1, ANXA-2 and BMP-7 values were found to be higher in the patients than the control group (p=0.001, p=0.001, p=0.001). ANXA-2 levels were higher in patients with thoracic CT involvement than those without thoracic CT involvement (p=0.023). In addition, when the patients were evaluated according to their thorax CT involvement levels, it was found that as the lung involvement levels increased, ANXA-2 increased, ANXA-1 decreased, and BMP-7 levels did not change. While the increase in ANXA-2 was statistically significant, the decrease in ANXA-1 was not found statistically significant. When the relationship between the laboratory parameters and the thorax CT involvement level was evaluated; it was found that, the lymphocyte and thrombocyte counts decreased as the thorax CT involvement increased, and lactate dehydrogenase (LDH), ferritin, procalcitonin (PCT), C-reactive protein (CRP), D-dimer and troponin levels were increased. While no significant correlation was found between ANXA-1 and BMP-7 and laboratory parameters, a positive correlation was found between ANXA-2 and leukocyte count, LDH, troponin, PCT, ferritin, D-dimer, and CRP. The data obtained in our study suggest that the ANXA-2 level at the time of admission was related with the lung involvement and the level of involvement of the disease. As a result, molecular studies are needed today to understand the pathogenesis of COVID-19 and to investigate new treatment targets. Evaluation of ANXA-2 level may be important in predicting the level of lung involvement due to COVID-19.Öğe Evaluation of Patients Followed by COVID-19 After Quarantine(Bilimsel Tip Yayinevi, 2020) Ural, Onur; Sumer, Sua; Aktug Demir, Nazlim; Yalcinkaya, Emine; Ucan, Elif; Demir, Lutfi SaltukIntroduction: The COVID-19 pandemic continues to affect the world with serious number of cases and deaths. For this reason, knowing the clinical findings and course of the disease is important for early diagnosis and treatment. In this article, COVID-19 cases followed up after quarantine were discussed. Materials and Methods: In this study, the data of 99 patients who were followed up during travel and post-Umrah quarantine between 31 March and 15 April 2020 were retrospectively reviewed. Results: Of the 99 patients included in the study, 66 (66.7%) were females, 33 (33.3%) were males, and mean age was 59.8 +/- 11.4 years. SARS-CoV-2 RT-PCR test was positive at the time of admission in 97 (98.0%) of the 99 patients. Thirty-nine (39.4%) of the patients were symptomatic and 25.3% of the patients had cough, 8.1% had fever, and 7.1% had shortness of breath. While SARS-CoV-2 RT-PCR test was negative in 2 (3.3%) of the 60 patients without complaints, 58 (96.7%) of them were positive for SARS-CoV-2 RT-PCR test. Leukopenia was detected as 3%, lymphopenia 66.7%, D-dimer height 47.5%, LDH elevation 38.4%, CRP elevation 45.5%. Ground glass opacities were present in 81 (81.8%) of the patients with lung involvement, and consolidation areas were present in 40 patients (40.4%). Underlying disease was present in 38 (38.4%) of the patients. Hypertension and diabetes mellitus were the most common underlying diseases. It was observed that 89 (89.4%) of our cases had negative SARS-CoV-2 RT-PCR test on the 5th day. Conclusion: COVID-19 infection is an infectious disease that can present with many different clinics. In asymptomatic COVID-19 cases, lung involvement findings and disorders in laboratory parameters may be observed. It should be kept in mind that asymptomatic cases pose a risk in terms of transmission.Öğe Serum Neutrophil Gelatinase-Associated Lipocalin Levels in Acute Brucellosis and Brucellar Spondylodiscitis(Ankara Microbiology Soc, 2022) Sumer, Sua; Aktug Demir, Nazlim; Demir, Lutfi Saltuk; Findik, Duygu; Kolgelier, Servet; Ural, OnurBrucellosis is a zoonotic infectious disease caused by Brucella spp., an intracellular bacterium. The complications of acute Brucellosis may affect all organs and systems. The most common complication of the disease is musculoskeletal system involvement. The neutrophil gelatinase-associated lipocalin (NGAL) is a marker of neutrophil formation and acts as a siderophore-binding protein to prevent bacterial iron uptake and its use as a marker in the diagnosis and follow-up of bacterial infections is being investigated. The aim of this study was to measure the serum levels of NGAL in patients with acute Brucellosis and Brucellar spondylodiscitis, and to determine whether there is a correlation between NGAL levels and the progression and complications of the disease. This prospective case control study was conducted with 240 patients and 120 healthy controls. The diagnosis of acute Brucellosis was established when a person was asked to take an STA test due to clinical symptoms within the past eight weeks, and the test result that exceeded 1/160, or a 4-fold titer increase was found in the STA test after an interval of two weeks, and/or there was Brucella spp. growth in the blood culture. A contrasted lumbar magnetic resonance (MR) scan was performed on patients diagnosed with acute Brucellosis who had lower back pain. Presence of spondylodiscitis was assessed radiologically with contrasted lumbar MR images. NGAL levels were determined with ELISA assay. The median NGAL value was found to be 456.67 ng/L (101.41-5804.41 ng/L) in patients with acute Brucellosis and 113.84 ng/L (58.29-542.34 ng/L) in the control group. The median NGAL value was statistically higher in the patients than the control group (p= 0.001). Brucellar spondylodiscitis was detected in 57 (23.7%) of 240 patients diagnosed with acute Brucellosis. The median NGAL value was 1885.62 ng/L (143.21-5804.41 ng/L) in patients with Brucellar spondylodiscitis, and 356.87 ng/L (101.41-1874.07 ng/L) in those who did not have Brucellar spondylodiscitis. This difference was statistically significant (p= 0.001). Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values were found to be higher in patients who had Brucellar spondylodiscitis. Blood cultures were drawn from 186 (77.5%) of the 240 patients diagnosed with acute Brucellosis. The blood culture positivity rate was 36.02%. Patients whose blood cultures were positive had higher NGAL levels (p= 0.001). The blood culture positivity rate was higher in patients who were diagnosed with Brucellar spondylodiscitis (p= 0.001). A regression analysis showed that female gender and high levels of NGAL, ESR, and alanine aminotransferase (ALT) could be used as predictors of Brucellar spondylodiscitis. The explanatoriness of the model was 82.3%. Although determination of NGAL levels is seen as a useful marker in the diagnosis of acute Brucellosis and predicting the presence of Brucellar spondylodiscitis, more comprehensive studies are required to be used in clinical practice in regions where Brucellosis is endemic.
