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    Can copeptin predict the severity of coronavirus disease 2019 infection?
    (Assoc Medica Brasileira, 2021) In, Erdal; Kuluozturk, Mutlu; Telo, Selda; Toraman, Zulal Asci; Karabulut, Ercan
    OBJETIVE: Coronavirus disease 2019 (COVID-19) has quickly turned into a health problem globally. Early and effective predictors of disease severity are needed to improve the management of the patients affected with COVID-19. Copeptin, a 39-amino acid glycopeptide, is known as a C-terminal unit of the precursor pre-provasopressin (pre-proAVP). Activation of AVP system stimulates copeptin secretion in equimolar amounts with AVP. This study aimed to determine serum copeptin levels in the patients with COVID-19 and to examine the relationship between serum copeptin levels and the severity of the disease. METHODS: The study included 90 patients with COVID-19. The patients with COVID-19 were divided into two groups according to disease severity as mild/moderate disease (n=35) and severe disease (n=55). All basic demographic and clinical data of the patients were recorded and blood samples were collected. RESULTS: Copeptin levels were significantly higher in the patients with severe COVID-19 compared with the patients with mild/moderate COVID-19 (p<0.001). Copeptin levels were correlated with ferritin and fibrinogen levels positively (r=0.32, p=0.002 and r=0.25, p=0.019, respectively), and correlated with oxygen saturation negatively (r=-0.37, p<0.001). In the multivariate logistic regression analysis, it was revealed that copeptin (OR: 2.647, 95%CI 1.272-5.510; p=0.009) was an independent predictor of severe COVID-19 disease. A cutoff value of 7.84 ng/mL for copeptin predicted severe COVID-19 with a sensitivity of 78% and a specificity of 80% (AUC: 0.869, 95%CI 0.797-0.940; p<0.001). CONCLUSION: Copeptin could be used as a favorable prognostic biomarker while determining the disease severity in COVID-19.
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    Does Platelet Indices Play a Role in the Distinction of Pulmonary Embolism Clinical Forms?
    (2017) Telo, Selda; Kirkil, Gamze; Kaman, Dilara; Gulcu Bulmus, Funda
    The aim of this study is to investigate the changes in platelet indexes, including mean platelet volume (MPV), platelet distribution width (PDW) and platelet count (PC), in patients with acute pulmonary embolism (PE), in addition to evaluating the diagnostic value in clinical forms. Material and methods: The study consisted of 84 patients with PE and the control group consisted of 40 healthy subjects. PE patients were divided into two groups in accordance with the clinical forms as 60 submassive and 24 nonmassive. The differences in platelet count, MPV, PDW, PC, D-dimer, and other indicators were analyzed between the two groups. Venous peripheral blood samples to measure the MPV, PDW and PC were acquired on admission. Results: MPV levels were found to be statistically higher in the submassive group compared to the nonmassive group and the control group (p0.01 and p0.001, respectively). PDW levels were found to be statistically higher in the submassive group compared to the non-massive group and control group (p=0.027 and p0.001, respectively). PC was significantly lower in the submassive group compared to the non-massive group and control group (p=0.022 and p0.001, respectively). It was determined that a positive correlation existed between the MPV and right ventricular diameter (RVD) (r=0.27, p0.01). Conclusion: High MPV and PDW levels and low PC may be indicators of the severity of acute PE. Also, the correlation between the MPV and RVD suggests that MPV can be used as a marker of right ventricular function.
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    Does platelet indices play a role in the distinction of pulmonary embolism clinical forms?
    (2017) Telo, Selda; Kırkıl, Gamze; Dilara, Kaman; Gülcü Bulmuş, Fatma
    Abstract:Aim: The aim of this study is to investigate the changes in platelet indexes, including mean platelet volume (MPV), platelet distribution width (PDW) and platelet count (PC), in patients with acute pulmonary embolism (PE), in addition to evaluating the diagnostic value in clinical forms. Material and methods: The study consisted of 84 patients with PE and the control group consisted of 40 healthy subjects. PE patients were divided into two groups in accordance with the clinical forms as 60 submassive and 24 nonmassive. The differences in platelet count, MPV, PDW, PC, D-dimer, and other indicators were analyzed between the two groups. Venous peripheral blood samples to measure the MPV, PDW and PC were acquired on admission. Results: MPV levels were found to be statistically higher in the submassive group compared to the nonmassive group and the control group (p<0.01 and p<0.001, respectively). PDW levels were found to be statistically higher in the submassive group compared to the non-massive group and control group (p=0.027 and p<0.001, respectively). PC was significantly lower in the submassive group compared to the non-massive group and control group (p=0.022 and p<0.001, respectively). It was determined that a positive correlation existed between the MPV and right ventricular diameter (RVD) (r=0.27, p<0.01). Conclusion: High MPV and PDW levels and low PC may be indicators of the severity of acute PE. Also, the correlation between the MPV and RVD suggests that MPV can be used as a marker of right ventricular function.
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    Efficacy of copeptin in distinguishing COVID-19 pneumonia from community-acquired pneumonia
    (Wiley, 2021) Kuluozturk, Mutlu; In, Erdal; Telo, Selda; Karabulut, Ercan; Geckil, Aysegul Altintop
    The clinical symptoms of community-acquired pneumonia (CAP) and coronavirus disease 2019 (COVID-19)-associated pneumonia are similar. Effective predictive markers are needed to differentiate COVID-19 pneumonia from CAP in the current pandemic conditions. Copeptin, a 39-aminoacid glycopeptide, is a C-terminal part of the precursor pre-provasopressin (pre-proAVP). The activation of the AVP system stimulates copeptin secretion in equimolar amounts with AVP. This study aims to determine serum copeptin levels in patients with CAP and COVID-19 pneumonia and to analyze the power of copeptin in predicting COVID-19 pneumonia. The study consists of 98 patients with COVID-19 and 44 patients with CAP. The basic demographic and clinical data of all patients were recorded, and blood samples were collected. The receiver operating characteristic (ROC) curve was generated and the area under the ROC curve (AUC) was measured to evaluate the discriminative ability. Serum copeptin levels were significantly higher in COVID-19 patients compared to CAP patients (10.2 +/- 4.4 ng/ml and 7.1 +/- 3.1 ng/ml; p < .001). Serum copeptin levels were positively correlated with leukocyte, neutrophil, and platelet count (r = -.21, p = .012; r = -.21, p = .013; r = -.20, p = .018; respectively). The multivariable logistic regression analysis revealed that increased copeptin (odds ratio [OR] = 1.183, 95% confidence interval [CI], 1.033-1.354; p = .015) and CK-MB (OR = 1.052, 95% CI, 1.013-1.092; p = .008) levels and decreased leukocyte count (OR = 0.829, 95% CI, 0.730-0.940; p = .004) were independent predictors of COVID-19 pneumonia. A cut-off value of 6.83 ng/ml for copeptin predicted COVID-19 with a sensitivity of 78% and a specificity of 73% (AUC: 0.764% 95 Cl: 0.671-0.856, p < .001). Copeptin could be a promising and useful biomarker to be used to distinguish COVID-19 patients from CAP patients.
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    Is 4-Hydroxynonenal a Predictive Parameter for the Development of Joint Erosion in Patients With Rheumatoid Arthritis?
    (2016) Akgöl, Gürkan; Ulusoy, Hasan; Telo, Selda; Gülkesen, Arif; Yıldırım, Tülay; Poyraz, Ahmet Kürşad; Kaya, Arzu
    Abstract: Objectives: This study aims to evaluate serum 4-hydroxynonenal (4-HNE) levels and its clinical and radiological significance in patients with rheumatoid arthritis (RA).Patients and methods: The study included 40 patients (8 males, 32 females; mean age 51.4±11.2 years; range 24 to 72 years) with RA and 30 healthy controls (8 males, 32 females; mean age 53.0±11.7 years; range 24 to 72 years. Serum 4-HNE levels were measured using sandwich enzyme-linked immunosorbent assay method. Patients with disease activity score 28 <=3.2 and >3.2 were allocated into low and high/moderate disease activity groups, respectively. Additionally, patients were divided into two groups as early RA (disease duration <=2 years) and established RA (disease duration >=2 years). Functional disability was evaluated using health assessment questionnaire. Radiographs were scored using the modified Larsen scoring.Results: Serum 4-HNE levels in patients with RA were significantly higher than controls (p=0.001). Serum 4-HNE levels did not correlate with laboratory or clinical parameters of disease activity including erythrocyte sedimentation rate, C-reactive protein, disease activity score 28, and health assessment questionnaire. Serum 4-HNE levels were higher in patients with established RA than patients with early RA (r=0.487, p=0.001). Besides, modified Larsen score which indicates structural damage correlated significantly with serum 4-HNE levels (p=0.001).Conclusion: These results indicate that serum 4-HNE levels may be used as an indicator for structural damage such as erosions in the early stage of RA; however, they are not efficient to monitor disease activity.
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    Is 4-Hydroxynonenal a Predictive Parameter for the Development of Joint Erosion in Patients With Rheumatoid Arthritis?
    (Turkish League Against Rheumatism, 2016) Akgtol, Gurkan; Ulusoy, Hasan; Telo, Selda; Guslkesen, Arif; Yildirim, Tulay; Poyraz, Ahmet Kursad; Kaya, Arzu
    Objectives: This study aims to evaluate serum 4-hydroxynonenal (4-HNE) levels and its clinical and radiological significance in patients with rheumatoid arthritis (RA). Patients and methods: The study included 40 patients (8 males, 32 females; mean age 51.4 +/- 11.2 years; range 24 to 72 years) with RA and 30 healthy controls (8 males, 32 females; mean age 53.0 +/- 11.7 years; range 24 to 72 years. Serum 4-HNE levels were measured using sandwich enzyme-linked immunosorbent assay method. Patients with disease activity score 28 <= 3.2 and >3.2 were allocated into low and high/moderate disease activity groups, respectively. Additionally, patients were divided into two groups as early RA (disease duration <= 2 years) and established RA (disease duration >= 2 years). Functional disability was evaluated using health assessment questionnaire. Radiographs were scored using the modified Larsen scoring. Results: Serum 4-HNE levels in patients with RA were significantly higher than controls (p=0.001). Serum 4-HNE levels did not correlate with laboratory or clinical parameters of disease activity including erythrocyte sedimentation rate, C-reactive protein, disease activity score 28, and health assessment questionnaire. Serum 4-HNE levels were higher in patients with established RA than patients with early RA (r=0.487, p=0.001). Besides, modified Larsen score which indicates structural damage correlated significantly with serum 4-HNE levels (p=0.001). Conclusion: These results indicate that serum 4-HNE levels may be used as an indicator for structural damage such as erosions in the early stage of RA; however, they are not efficient to monitor disease activity.