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.