Introduction: Raynaud phenomenon (RP) is a multifactorial disorder. If any underlying disease cannot be detected responsible for RP then it considered as primary RP (pRP). We aimed to investigate the differences between laboratory markers and impaired endothelial function in pRP. Material and Methods: Forty-two pRP patients included as study and control groups were created from 30 healthy individuals. The endothelial function was evaluated with flow-mediated dilatation (FMD) of the brachial artery. The blood samples were obtained both groups and white blood cell [WBC], hemoglobin, platelet, mean platelet volume [MPV], creatinine, alanine aminotransferase [ALT], aspartate aminotransferase[AST], D-dimer, fibrinogen, albumin, fibrinogen to albumin ratio [FAR], Neutrophil to Lymphocyte ratio [NLR], D-dimer to albumin ratio [DDAR] and monocyte chemo-attractant protein-1 [MCP-1]. Obtained blood parameters and FMD values were compared between groups. Results: The groups were found as similar in regards to age, gender, smoking history (p<0.05). There was no difference between the two groups in regards to hemoglobin, platelet, MPV, creatinine, ALT, D-dimer, albumin, FAR, NLR, DDAR levels (p<0.05). AST levels were slightly higher in pRP group (p=0.027). Markedly increased WBC, fibrinogen, MPV and MCP-1 values were detected in pRP group (p=0.000). Additionally, higher abnormal FMD responses were detected in pRP group (p=0.000). There was a direct correlation between abnormal FMD response and serum MCP-1 values in patients with pRP (R: 0.308, R2: 0.095, p: 0.044). Conclusion: It seems to be that MCP-1 levels are higher in patients with pRP and increased values of MCP-1 levels seem to be related to impaired endothelial functions
Objectives. Fifteen potentially low value practices in adult orthopaedic trauma care were previously identified in a scoping review. The aim of this study was to synthesize the evidence on these practices. Methods. We searched four databases for systematic reviews, randomized controlled trials (RCTs), cohort studies and case series that assessed the effectiveness of selected practices. Methodological quality was evaluated using the Measurement Tool to Assess Systematic Reviews version 2 (AMSTAR-2) for systematic reviews and the Critical Appraisal Checklist for Case Series. We evaluated risk of bias with the Cochrane revised tool for RCTs and the risk of bias in non-randomized studies of interventions tool for observational studies. We summarized findings with measures of frequency and association for primary outcomes. Results. Of the 30,670 records screened, 70 studies were retained. We identified high-level evidence of lack of effectiveness or harm for routine initial imaging of ankle injury, orthosis for A0-A3 thoracolumbar burst fracture in patients < 60 years of age, cast or splint immobilization for suspected scaphoid fracture negative on MRI or confirmed fifth metacarpal neck fracture, and routine follow-up imaging for distal radius and ankles fractures. However, evidence was mostly based on studies of low methodological quality or high risk of bias. Conclusion. In this review, we identified clinical practices in orthopedic injury care which are not supported by current evidence and whose use may be questioned. In future research we should measure their frequency, assess practice variations and evaluate root causes to identify practices that could be targeted for de-implementation.
Purpose Women with atypical hyperplasia (AH) is associated with a higher risk of later breast cancer. However, whether AH found at margins in patients with breast-conserving surgery (BCS) and neoadjuvant chemotherapy (NAC) needs re-excision is not well-defined. The aim of the present study was to evaluate the impact of atypical hyperplasia at the surgical margins on the local recurrence and survival outcomes in breast cancer patients treated with NAC and BCS. Methods A retrospective analysis comparing patients who received NAC with AH and received no re-excision to those without AH at the margins of BCS was performed. Results 323 patients were included in this study. The 5-year rates of ipsilateral breast tumor recurrence (IBTR) were 6% and 4.5% in patients with and without AH, respectively. Distant-metastasis-free survival (DMFS) at 5 years was 81.2% in the AH group, and 88.1% in the no-AH group. No significant differences were observed among the two groups in terms of IBTR, DMFS, or OS. Conclusion Our study suggests that AH involved at the surgical margins of BCS in patients who received NAC does not increase the risk of ipsilateral breast cancer, and there is insufficient evidence for surgeon to further resect AH found at the margins of BCS in these patients.
Background: The evaluation of solitary lung nodules via FDG PET/CT has high sensitivity for nodules larger than 8 mm and is utilized to exclude lung cancer. Aim: This study aimed to retrospectively explore whether the lesions in patients who underwent F18 fluorodeoxyglucose-positron emission tomography/computed tomography imaging with the staging of the solitary pulmonary nodule and lung mass were within the local imaging area. It also investigated whether a relationship existed between the size of the lung lesion and extrathoracic spread. Materials and Method: Three hundred eight patients histopathologically diagnosed lung cancer were included in this study. All patients lung lesions were measured and patients were classified as four groups according to the size of the lung lesion. In all groups, the F18 FDG PET/CT examination was used to detect liver, adrenal, bone and supraclavicular lymph node metastasis, besides extrathoracic metastasis. Results: Liver, bone and extrathoracic metastasis of group-1 was statistically lower than group-2 (P < 0.001, p<0.01 and P = 0.03, respectively). Liver, extrathoracic, adrenal and bone metastasis of group-3 was statistically lower than the group-4 (P<0.001, P = 0.01, and P = 0.04, p<0.01 respectively). Extrathoracic extension was observed in only one patient in the group-3. In addition liver, adrenal, and bone metastases were not observed in any group-3 patients. Conclusions: PET/CT may be a more appropriate approach to be aplied in cases with nodule diameter ≤20mm. Performing local imaging in patients with a nodule diameter of ≤20 mm could not only reduce radiation exposure but also save radiopharmaceuticals used in PET/CT imaging. Keywords: lung cancer, solitary pulmonary nodule, PET/CT, fluorodeoxyglucos
Purpose: Kidney transplant recipients are prone to metabolic bone diseases and consequent fractures. This study aimed to evaluate the incidence of incipient vertebral fractures, osteopenia, osteoporosis, and the clinical factors associated with incipient vertebral fractures in a group of kidney transplant patients. Methods: Two hundred sixty-four patients (F/M:124/140, 45.3±13 years) who had undergone kidney transplantation between 2008 and 2018 and who were followed up at least one year in third care centers were included in this multicenter retrospective study. Bone mineral densitometry was performed using dual-energy X-ray absorptiometry. Vertebral fractures were assessed semi-quantitatively using conventional thoracolumbar lateral radiography in 202 of the patients. Results: Vertebral fractures were observed in 56.4% (n=114) of the study group. Severe vertebral fractures were observed in 30.7% (n=62) of the patients in vertebral X-ray evaluation. The frequency of osteoporosis was 20.0% (53 of 264 patients), and osteopenia was 35.6% (94 of 264 patients). BMD levels were in the normal range in 40.3% (n=46) of the subjects with vertebral fractures. It was in the osteoporotic range in 20.1% (n=23) and the osteopenic range in 40.3% (n=46). Serum calcium, parathormone vitamin, and creatinine levels were similar between the patients with and without vertebral fractures. Femoral neck BMD was negatively correlated with age (r: −0.21, p<0.001) and positively correlated with body mass index (r:0.29, p<0.001). Vertebral fractures were associated with age, duration of hemodialysis, BMI, femoral neck Z score (R2: 37.8%, p=0.027). Conclusion: BMD was in the normal or osteopenic range in 79.8% in our cohort of renal transplant patients with incipient vertebral fractures. As incipient vertebral fractures can be observed in patients with normal BMD levels in kidney transplant recipients, conventional X-ray screening for vertebral fractures may be beneficial for a proper therapy decision of metabolic bone disease in kidney transplant recipients.
Background: This study was conducted to determine the frequency and clinical features of patients who were diagnosed incidentally as having diabetes mellitus (DM) in the emergency department. Aim: Our aim was to investigate the frequency of DM in patients whose high blood glucose levels were detected, and to examine the subsequent treatment these patients. Methods: The participants were selected from among patients who had a glucose level of ≥200 mg/dL and admitted to emergency department with symptoms of hyperglycemia in the past 1 year. Age, sex, presence of chronic disease, and the laboratory blood parameter results of the patients were recorded. We divided the patients into three groups as those who had never been admitted to clinics for treatment, those who were admitted and given treatment, and not given treatment. Results: According to their sexes, 73 (52.1%) were male and 67 (47.9%) were female. It was determined that 86 of the 140 patients included in the study were admitted to clinics for treatment. It was determined that no medication was given to 50 of these patients, but treatment was initiated in 36. Patients with glucose level ≥300 mg/dL were found to be receiving more treatment significantly (p=0.031). Conclusions: In this study, diabetic patients whose blood sugar is between 200-300 mg/dL should be sent to the DM related clinic immediately when diagnosed in the emergency department.
Aims: The effects of the COVID-19 pandemic continue around the world. Imaging methods play an important role in the diagnosis of COVID-19. The aim of this study was to develop a system that would allow for the distinguishing of lesions at different stages of the disease based on similar signs of other viral diseases and monitoring the emergence, progression, and/or remission of lesions in different areas of the lungs. Methods: For the deep learning (DL) system, the thoracic CT images from 1,382 images were reviewed. These belonged to patients whose SARS-CoV-2 RT-PCR tests turned out positive, were diagnosed with COVID-19, and had signs of lung involvement. Of 1,382 images in the dataset, 180 were assigned for testing and 1,202 were assigned for training. Apart from our dataset, 131 images for internal testing and 1,365 images for external testing were used. The trainings were continued to cover 316,000 steps. Results: Internal and external analyses were used to assess the developed model. The internal analysis success rate was 93.12%. For first external analysis we used 85 images. In the first external analysis we assessed a single CT image of each patient who was in the mixed image lists, and the success rate was found to be 70.31%. In the second external analysis, 645 thoracic CT images of patients diagnosed with COVID-19 and 635 images of another patients who had signs of non-COVID-19 diseases were used. We assessed the thoracic CT images with both COVID-19 and non-COVID-19 disease signs. The success rate in the identification of COVID-19 patients was 88.4%. Conclusion: Special modeling systems developed using DL may help accelerate workflow and making the process easier. This is especially important in cases in which fast and accurate assessment is essential for of a large number of patients, as happens in a pandemic.
Aims Primary hyperparathyroidism (PHPT) is common disorder in which parathyroid hormone (PTH) is excessively secreted from one or more of four parathyroid glands. Primary hyperparathyroidism (PHPT) is an endocrinological disorder associated with increased systemic inflammation, endothelial dysfunction. The systemic inflammation may cause subclinical decrease in cardiac function. Our aim in our study is to compare the markers of systemic inflammation in preoperative, postoperative period with PHPT, to show that PDW (platelet distribution width) value may be a predictive value for the development of cardiovascular (CVO), thromboembolic events (TBO) in patients with primary hyperparathyroidism. Results In this study, patients who underwent parathyroidectomy for primary hyperparathyroidism between 2014 - 2021 were retrospectively screened. A total of 56 patients who underwent parathyroidectomy for PHPT were included in the study. In addition to demographic and clinical information; PTH, corrected calcium, phosphate, white blood cell (WBC) count, platelet counts and PDW of the patients were recorded before and three months after parathyroidectomy. Systemic inflammatory index (SII) was calculated according to appropriate formula. Discussion The preoperative PDW value of the patients was found to be significantly higher when compared with the postoperative period and control groups. Preoperative platelet value, on the other hand, was statistically significantly higher when compared with control group. PDW values were found to be statistically significantly decreased in the postoperative period compared to the preoperative period in patients. Conclusion Increased PDW value before parathyroidectomy may be a predictive value of inflammatıon and the development of CVO ,TBO. Keywords: primary hyperparathyroidism, PDW (platelet distribution width), platelets, parathyroidectomy It is known to cause subclinical inflammation and subclinical cardiac dysfunction in primary hyperparathyroidism. There are conflicting studies on inflammation markers. Our article is the first to study PDW in primary hyperparathyroidism. High preoperative PDW indicates that PHPT may be a risk factor for cardiovascular events.
Objective: The objective of this study was to evaluate the effects of Metabolic Syndrome (MetS) and MetS components on tumor size, Fuhrman grade and pathological T stage in renal cell carcinoma (RCC). Materials and Methods: The data of 151 patients who were operated for RCC between January 2010 and April 2018 were retrospectively reviewed according to the he National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), and the effects of MetS and its components on tumor size, Fuhrman grade and pathological T stage were comparatively investigated. Results: Of the 151 patients operated for RCC in our clinic, 27.2% had MS, 29.1% had diabetes mellitus (DM), 41% had hypertension (HT), 68.3% had low high-density lipoprotein (HDL), 41% had elevated triglyceride (TGL) elevation, and 27.2% had obesity. It was found that the size of the tumor was statistically significantly increased in the presence of the metabolic criteria examined. There was a statistically significant increase in the Fuhrman grade of the patients with MetS, DM, low HDL, high TGL and obesity. In the presence of clinical conditions such as HT, low HDL and high TGL, there was a statistically significant increase in the pathological T stage. Conclusion: In patients undergoing surgery for RCC, MetS and its components had a statistically significant correlation with tumor size, Fuhrman grade, and pathological stage. If our results are supported by further studies, the correlation between MetS and RCC could be revealed more clearly.
Abstract Objective: To systematically research the impact of warming needle moxibustion (WNM) for Alzheimer’s Disease (AD). Methods: Four Chinese databases and six English databases were systematically searched. Randomized controlled trials (RCTs) involving the use of WNM to intervene in AD patients were included. Data were extracted from the included studies and methodological quality was evaluated according to the Cochrane Handbook for Systematic Reviews of Intervention 5.1.0. Meta-analysis was performed using RevMan 5.4 software. Results: 8 RCTs comprising 524 patients were included. The study showed that WNM was more effective in the treatment of AD than acupuncture or pharmacotherapy. The findings were as follows: MMSE (MD=1.01, 95%CI: 0.13, 1.90, P=0.03) and CDR (MD=-0.73, 95%CI: -0.84, -0.61, P<0.00001) for global cognitive function, ADL (MD=-1.84, 95%CI: -2.47, -1.22, P<0.00001) for activities of daily living, Syndrome Differentiation Scale of Dementia (SDSD) (MD=-2.67, 95%CI: -3.62, -1.72, P<0.00001), and the total effective rate of patients (OR=3.89, 95%CI: 2.49, 6.09, P<0.00001). The differences in all indicators were statistically significant. Conclusion: WNM has a significant effect on improving cognitive function and daily living ability, reducing the symptoms of AD, and increase the total effective rate. WNM is an effective non-pharmacological therapy for patients with AD. Keywords: Warming needle moxibustion, Alzheimer’s disease, Randomized Controlled Trials, systematic review and meta-analysis
Background Lack of definitive cure for COVID-19 and the late introduction of a vaccine were responsible to push the general public to look for a remedy to treat or prevent COVID-19. The objective of this study was to evaluate patterns and factors that affect self-medication practices in Jordan during the pandemic. Methods This was a cross-sectional study using an online questionnaire that was developed, piloted and distributed to the general public via various social media platforms. The questionnaire assessed the type of drugs and treatments used to self -medicate, the reasons behind their self- medication, and the factors affecting their practices. Results A total of 1179 participants (females 46.4%) with a mean age of 32 (SD=12.5) completed the questionnaire. The overall prevalence of the use of at least one product to treat or prevent COVID-19 was 80.4 %. The most commonly used products to self-medicate were vitamin C (57.6%), followed by paracetamol (51.9%), zinc (44.8%) and vitamin D (32.5%). Female gender (odds ratio [OR]) = 1.603, working in the medical field (OR =1.697), and history of COVID-19 infection (OR =2.026) were variables associated with self-medication. The most common sources of participants’ information about drugs to prevent or treat COVID-19 were newspapers (n=519, 44.0%), followed by pharmacists (43.4%), friends (33.8%) and internet searching such as Google (30.7%). Conclusion This study identified the main drugs and supplements used during COVID-19 and the motives behind their use. It also identified the most influential source of information on the public during the pandemic. Self-medication can lead to worsening of the patient’s health and delay seeking medical advice from healthcare professionals. Efforts should be done to help mitigate risks of self-medications by active involvement of pharmacists and other members of healthcare team to refute false claims about drug, especially in the media.
Background and Study Aims: Microsatellite instability pathway caused by loss of DNA “Mismatch Repair genes” (MMR) is responsible of Lynch Syndrome-related tumors and 10-15% of sporadical colorectal cancers. Although MSI-test is regarded as the golden standard for detection of “Lynch Syndrome-related tumors”, there are increasing evidence on similar analytic sensitivity of immunohistochemical evaluations. Patinets and Metods: We retrospectively evaluated 1002 colorectal tumors for loss of DNA MMR protein (MLH1, PMS2, MSH2, MSH6) immunohistochemically. The results were correlated with clinicopathological features and high level-microsatellite instability (MSI-H) related histological parameters. Results: MMR protein expression loss was observed in 9.8% of the cases. MLH1-PMS2 loss (53.2%) was the most common loss followed by MSH2-MSH6 (31.6%), isolated PMS2 loss (12%), and isolated MSH6 loss (2%). MMR deficiency was more frequent under 50 years-old (p<0.0001), in right colon tumors (p<0.0001), poorly differentiated tumors (p<0.0001), tumors with tumor infiltrating lymphocytes (p<0.0001), mucinous component (p=0.001), and medullary component (p<0.0001). Also MMR deficiency was less frequent in tumor with tumor budding (p<0.0001) and dirty necrosis (p<0.0001). The 5 years-survival rate was 55.7%. No significant correlation was found with MMR deficiency and survival. Conclusions: MMR deficiency was observed in 9.8% of the cases with distinct clinicopathological features. The results were consistent with previous studies. Unlike the literature, we did not find any statistically significant difference between MMR deficiency and prognosis.
Background: The importance of sST2 has been increasingly appreciated because of its associated with the development of heart failure and related diseases. Objective: The aim of this study was to evaluate the association of sST2 with CD4+T cells in patients with organ failure. Methods: 100 (M:F=60:40) organ failure patients aged (mean±SD=69.08±16.68) and 30 (M:F=14:16) normal control aged (mean±SD=60.23±13.99) serum sST2 were detected by chemiluminescence assay (CLIA) and the expression of serum IL-1, IL-6 and TNF-α were analyzed by enzyme-linked immunosorbent assay (ELISA). The proportion of CD4+T cells in peripheral blood was determined by flow cytometry (FCM). Association of sST2 with CD4+T cells in organ failure patents were analyzed by SPASS. Results: The expression of sST2 in organ failure patients (107.4±5.79ng/mL) was significantly higher than normal control (8.57±0.35ng/mL). Inflammatory factors IL-1 and IL-6 in patients were also increased than normal controls (IL-1: 0.33±0.04pg/mL vs 0.14±0.02pg/mL. IL-6: 165.7±10.53pg/mL vs 95.33±7.42pg/mL. TNF-α: 1.57±0.14pg/mL vs 6.11±0.77pg/mL). In patients, the results showed CD4+T cells were reduced compare with normal control (238.3±13.67/μL vs 1081±39.13/μL). Additionally, sST2 was found to be inversely associated with CD4+T cell in patients with organ failure. Conclusion: sST2 level was closely related to the development of organ failure and sST2 was obviously correlated with CD4+T cell in patients with organ failure.
Objective We performed a retrospective analysis to investigate the clinical characteristics and therapeutic strategies of 20 refractory/recurrent PNH patients, including the clinical efficacy of chemotherapy treatment and survival. Main Measures The clinical data of 20 classic PNH patients that were refractory/recurrent or had glucocorticoid dependence in our hospital were analyzed, including clinical manifestations, laboratory examinations, treatment efficacy and survival. Key Results Seventeen patients had a marked improvement in anemia after chemotherapy, 14 patients acquired blood transfusion independence, and the Hb of 3 patients increased to normal levels. Although 6 patients still needed blood transfusion, the transfusion interval was significantly prolonged. The percentages of LDH, TBIL and RET, which are indicators of hemolysis, were significantly lower than those before chemotherapy. The dosage of adrenal glucocorticoids was reduced by more than half compared with that before chemotherapy. Conclusions Chemotherapy can reduce PNH clones, promote normal hematopoiesis, and control hemolytic attack. It is a promising and widely used therapeutic method.
Introduction: The RIPASA scoring system was established specifically for Asians. Chong CF in his study consisting of 312 patients who had an emergency appendectomy concluded that optimal cut-off threshold score for negative appendectomy was 7.5. Objective: To determine the diagnostic accuracy of RIPASA scoring system in presumptive accurate diagnosis of acute appendicitis by taking histopathology as the gold standard. Materials and methods: This Cross Sectional Study was carried out at Surgery department at a tertiary care hospital, Karachi over a period of 6 months, from 15th December 2019 to 15th June 2020. A total of 141 patients of both gender of suspected cases of acute appendicitis presenting with sign and symptoms were included in the study. Patients underwent detailed history, general and physical examination and scoring of patients according to RIPASA scoring scale and then decision of appendectomy was taken on the basis of RIPASA score. Removed appendix samples were sent for histopathology. Results: Age range in this study was from 15 to 50 years with mean age of 30.191±6.09 years and mean RIPASA score was 5.375±1.77. Majority of patients were males (58.9%). RIPASA score diagnosed 28(19.9%) and histopathology diagnosed 27(19.1%) patients with acute appendicitis. RIPASA score showed sensitivity of 85.2%, specificity 95.6%, diagnostic accuracy 94%, PPV 82.1% and NPV was 96.4%. Conclusion: We conclude that RIPASA scoring system is the scoring system of choice in diagnosis of the acute appendicitis with good sensitivity albeit a hit high and specificity albeit a bit low profile.
Introduction Caregivers of hemodialysis patients may experience stress, depression, fatigue, and decreased quality of life. This study aimed to examine the caregiver burden and related factors in patients’ caregivers under dialysis treatment. Method Our study was conducted between February and April 2019 in the Hemodialysis Unit of our Hospital Internal Diseases Clinic. Eighty-three people providing primary care to patients who had received hemodialysis service for at least three months were included in the study. The socio-demographic data of the caregivers were recorded. Care burden was evaluated by Zarit Burden Interview (ZBI) and dependency status with Katz Activities of Daily Living (ADL) instrument. Quality of life was evaluated with the 36-Item Short Form Survey (SF-36). Results The mean age of 183 caregivers included in the study was 46.35 ± 24.20 years; 67.5% of them were female. The mean ZBI score of the caregivers was 32.5 ± 14.4. Care burden was observed to be absent or very mild in 20.5% of the caregivers, mild-moderate in 57.8%, moderate-heavy in 19.3%, and heavy in 2.4%. The care burden was higher in those who felt insufficient to provide care or did not receive help from other family members for patient care (p<0.05). Besides, if the hemodialysis frequency was more than three times a week, the care burden was higher (p=0.003). Care burden was higher in functionally dependent patient (p=0.013). ZBI was negatively correlated with the SF-36 subscales, except for the physical function subscale (p<0.05). Conclusion The care burden was high in primary caregivers of hemodialysis patients. The care burden was higher in caregivers of patients with bedridden, high frequency of hemodialysis, and low quality of life. In addition to hemodialysis patients’ routine treatment, it may be appropriate to develop support groups and new care approaches for caregivers to reduce the care burden.
Aim: To evaluate the effect of adding dry needling treatment to conventional rehabilitation on pain, range of motion, and functionality on hemiplegic shoulder pain. Methods: A total of 38 patients with hemiplegic shoulder pain were divided into two groups. A multimodal rehabilitation protocol including physical therapy methods and exercise treatments was applied to both groups (5 sessions per week for a total of 15 sessions). In addition to the rehabilitation, three sessions of dry needling treatment were applied for dry needling group. Pain with visual analog scale, range of motion with a goniometer, functionality was evaluated by quick disability of the arm, shoulder, and hand and fugl meyer assessment upper extremity. Evaluations were made before treatment, after treatment, and at the third month of treatment. Results: Patients aged from 30-60 years (mean±SD=53.1± 5.3). The average duration of HSP was 6.7±1 months. While a significant improvement was observed in both groups in all parameters after the treatment, a statistical superiority was found in the dry needling group (p<0.05). At the 3rd month follow-up, there was no difference in pain and functionality parameters between the groups, while flexion and abduction measurements were higher in the dry needling group (p <0.05). Conclusion: Adding dry needling treatment to conventional rehabilitation did not show any difference except for some joint range of motion measurements in the subacute period.
Background: Coronavirus disease 2019 (COVID-19) is commonly complicated with coagulopathy presented with venous thromboembolism and arterial thromboses. The aim of this study was to evaluate the effect of routine thromboprophylaxis with low molecular weight heparin (LMWH) on clinical outcomes including mortality and need for intensive care unit (ICU) admission in hospitalized COVID-19 patients. Methods: All confirmed patients with COVID-19 hospitalized to COVID-19 dedicated wards, from March 15 to May 15, 2020, were included in this retrospective cohort study. Two groups of patients were established, according to the non-routine and routine application of LMWH with therapeutic, weight-based, anticoagulation dosing. Clinical, laboratory and treatment data were collected, analyzed and compared between the two groups. A logistic regression model was developed to assess the factors related to in-hospital adverse outcomes. Results: A total of 1511 patients (797 men, median age 59.0 years) were retrospectively analyzed (Group non-routine LMWH (n=828); group routine LMWH (n=683)). Multivariate logistic regression analysis showed routine use of LMWH, favipiravir administration, extreme values of WBC count, NLR, and troponin I as factors independently associated with in-hospital adverse outcomes (OR=0.25, 95% CI: 0.83-0.91; p<0.001 for routine use of LMWH). Conclusion: Routine thromboprophylaxis with LMWH reduced mortality and ICU admission in patients admitted with COVID-19 infection.