Bagcilar Medical Bulletin (Jun 2022)
A Multicenter Evaluation of the Temporal and Clinical Differences of COVID-19 in Two Different Regions in Turkey: Comparison of İstanbul and Diyarbakır
Abstract
Objective:This study compared the temporal course of virulence and symptomatology of severe coronavirus-19 (COVID-19) infection in two metropolitan cities with different geographic features. The study aimed to shed light on the possible etiology of the differences observed between two regions.Method:We retrospectively reviewed polymerase chain reaction confirmed COVID-19 cases for the period of March-June 2020 in two different cities (İstanbul and Diyarbakır) located in northern and southern parts of Turkey, respectively. Data on demographic features, presenting symptoms, clinical history, radiological findings, laboratory parameters, and mean hospitalization duration were collected. Additionally, meteorological data including daily temperature, diurnal temperature variation, relative humidity, wind speed, mean rainfall, ultraviolet index, altitude, and latitude were retrieved for the study period.Results:Total case number was higher in İstanbul during March and April, whereas it was higher in Diyarbakır during May and June (p=0.001). During the study period, daily temperature, diurnal temperature variation, and ultraviolet index were higher in Diyarbakır, whereas relative humidity, wind speed, and mean rainfall was higher in İstanbul (p=0.001). In Diyarbakır, patients presented with a predominance of dyspnea, whereas there was a predominance of fever and cough in İstanbul. Patients in Diyarbakır had significantly elevated neutrophil, neutrophil/lymphocyte ratio, D-dimer, lactate dehydrogenase, ferritin and C-reactive protein values compared to patients in İstanbul (p=0.018; p=0.006; p=0.001, p=0.001; p=0.001, p=0.001 respectively). The predominant computed tomography infiltration was multicentric and bilateral crazy-paving pattern in Diyarbakır, whereas unilateral ground-glass opacity was the dominant pattern in İstanbul.Conclusion:The socio-cultural and genetic factors may affect the epidemiological, clinical and imaging features of COVID-19 more than meteorological variations.
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