Definitions and Treatment
In patients, temperatures taken as axillary and found to be above 37.3 C were defined as fever. In patients with high fever observed under treatment for Covid-19, blood, urine and culture of sputum for possible bacterial, fungal superinfections were taken and empirically given antibio therapies were revised according to culture results. Diagnosis and rating of acute respiratory failure was made according to Berlin 2015 diagnostic criteria 10. If the cardiological specific troponin level of patients was observed above normal, it was evaluated in terms of cardiological pathologies that may have just developed with echocardiography. Coagulopathy was defined as 3 seconds above normal at the time of prothrombin and 5 seconds above normal at the level of partial thromboplastin. Treatment strategy according to the weight of the patients was made according to the Covid-19 adult diagnosis and treatment guide of the Ministry of Health of the Republic of Turkey. in case of symptoms such as resistant fever, which continues despite treatment, CRP and ferritin values, which are constantly high or continue to increase, cytopenias in the form of lymphopenia and thrombocytopenia, impaired liver function tests, pitofibrinogenemia or elevation in triglyceride values, patients were followed up for MAS D-dimer height. In case of increase in daily sequential measurements in these parameters and when this situation cannot be explained by secondary bacterial infections, 400 mg of tosilizumab was applied to patients if there was no contraindication for MAS. After 24 hours, the appropriate clinical and laboratory response was not repeated in the patients received. However, the appropriate clinic and laboratory were repeated in the same dose in case of no response.