Identifying Mortality Predictors in Hospitalized COVID-19 Patients: Insights from a Single-Center Retrospective Study at a University Hospital

INTRODUCTION

The pandemic instigated by the SARS-CoV-2 virus has led to over 7 million deaths globally, primarily attributable to viral pneumonia. Identifying fundamental markers associated with an elevated risk of mortality can aid in the early identification of patients prone to disease progression to a severe state, enabling prompt intervention.

METHODS

This was a single-center, retrospective study.

RESULTS

In this study, we examined 299 patients admitted to the Department of Infectology and Travel Medicine in Košice, Slovakia, with PCR-confirmed COVID-19 pneumonia. Patients were monitored from 1 January 2021 to 31 March 2021, with the endpoint being discharge from the hospital or death. All patient-related data were retrospectively collected from medical records. This study identified several risk factors significantly associated with an increased risk of mortality, including the requirement of HFNO (p < 0.001), age over 60 years (p < 0.001), Ne/Ly values of >6 (p < 0.001), as well as certain lymphocyte subtypes-CD4+ < 0.2 × 109/L (p = 0.035), CD8+ < 0.2 × 109/L (p < 0.001), and CD19+ < 0.1 × 109/L (p < 0.001)-alongside selected biochemical inflammatory markers-IL-6 > 50 ng/L (p < 0.001) and lactate > 3 mmol/L (p < 0.001).

CONCLUSIONS

We confirmed that the mentioned risk factors were significantly associated with the death of patients from viral pneumonia in the hospital.

Diagnostic Value of Radioisotope Cisternography Using 111In-DTPA in a Patient with Rhinorrhea and Purulent Meningitis

Cerebrospinal fluid (CSF) leakage is a rare condition. Prompt diagnosis and early treatment of CSF leakage minimizes the risk of severe complications such as bacterial meningitis. Different diagnostic modalities are used to detect the site of CSF leakage but often with unreliable results. The literature offers limited evidence-based guidance on the diagnostic approach for rhinorrhea. Correct localization of the defect is the mainstay for successful surgical treatment. Herein, we describe a case of recurrent meningitis due to cranio-nasal fistula and rhinorrhea successfully localized with radioisotope cisternography (RIC). We provide a detailed and practical overview of the RIC procedure and compare different imaging modalities used to detect the site of CSF leakage.

First documented case of visceral leishmaniasis with rare colonic involvement in an immunocompetent adult in Slovakia

BACKGROUND

This article presents the first documented case of visceral leishmaniasis in an adult patient in Slovakia, with an unusual involvement of the colon. Leishmaniasis is a tropical parasitic infection transmitted by sandflies, predominantly occurring in developing countries.

CASE PRESENTATION

The patient was a 57-year-old woman without comorbidities or immunocompromising conditions. The clinical presentation included non-specific symptoms such as prolonged fever, marked weakness, hepatosplenomegaly, and generalized lymphadenopathy. The diagnosis was established based on histopathological examination and bone marrow PCR, which confirmed the presence of Leishmania infantum amastigotes. After initiating treatment with amphotericin B, the patient's condition improved, but a relapse occurred shortly thereafter, presenting with colonic involvement-an extremely rare occurrence in immunocompetent patients. The diagnosis of relapse was confirmed by repeated histopathological examination and molecular analysis. Treatment was re-initiated with an extended regimen of amphotericin B and additional supportive therapy.

CONCLUSION

This case highlights the importance of early diagnosis and targeted treatment of visceral leishmaniasis, even in non-endemic areas of the world. It emphasizes the need to consider this diagnosis in the differential diagnosis of patients with unexplained febrile conditions and hepatosplenomegaly, as the clinical presentation can often mimic various other infectious diseases or hematological malignancies, significantly complicating the diagnostic process.