ABSTRACT
Background. Multisystem Inflammatory Syndrome (MIS-C), a new entity in children which developed 2-4 weeks after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is a severe condition. It can affect the multisystem, while the most severe manifestation is cardiac involvement. Left ventricular dysfunction, cardiogenic shock, coronary artery dilatation/aneurysm, valvulitis, pericardial effusion, arrhythmia, and conduction abnormalities were reported in approximately 80% of children with cardiovascular system involvement. It is still unclear the duration of the cardiac symptoms, and even they are permanent or persistent. Few studies evaluated persistent cardiac abnormalities by cardiac magnetic resonance imaging (MRI). Therefore, we aimed to assess persisting cardiac abnormalities with MIS-C by cardiac MRI and compare them with echocardiograms. Methods. A retrospective study was conducted at a tertiary-level University Hospital between June 2020-July 2021. Thirty-four children diagnosed with MIS-C according to the criteria defined by the Centers for Disease Control and Prevention were retrospectively evaluated. Results. The study included 17 males and 17 females with a mean age of 9.31 +/-4.72 years. Initial echocardiographic evaluation showed cardiac abnormality in 18 (52.9%) patients;4 (11.8%) pericardial effusion, 4 (11.8%) left ventricular ejection fraction (LVEF) < 55%, 5 (14.7%) LV fractional shortening < 30%, 5 (14.7%) coronary artery dilatation. Echocardiography showed normal LV systolic function in all patients at follow-up;coronary dilatation persisted in 2 of 5 (40 %) patients at the 6th-month visit. Cardiac MRI was performed in 31 (91.2%) patients. We didn't detect abnormal T1 levels, whereas 9 (29%) had isolated elevated T2 values. 19 (61.3%) of 31 patients had at least one of the followingfindings: pericardial effusion, right ventricular dysfunction, LVEF abnormality. Conclusion. Cardiac involvement persisted at a higher rate which was shown by cardiac MRI in the late period, particularly pericardial effusion. Cardiac MRI may be suggested for all MIS-C patients at a later phase. Prospective studies with larger sample sizes are needed to determine long-term cardiac effects.
ABSTRACT
The COVID-19 pandemic causes an increase in oral health inequalities, restriction of oral health promotion programs and preventive oral health services for the community. According to the common risk approach, oral health services should be integrated into primary health care services in order to manage oral diseases that share the same risk factors with chronic systemic diseases. Multidisciplinary studies should be focused on public health practices by adopting the "One Health" concept. In order to increase the popuation based oral health outcomes, there is a need for oral health promotion programs that take into account the cooperation between sectors, working flexibility, capacity, the ethical rules of social justice, equality and human rights within the framework of the biopsychosocial approach. Information technologies and social media networks should be used to increase the literacy of the population on "COVID-19 and Oral Health". In this period, it is also important to carry out oral health needs assessment at population level through surveillance and public health studies. Priority should be given to programs for the protection and improvement of oral health among disadvantaged groups, children and the elderly who have difficulty in accessing oral health services due to limitation of movement and social determinants of health.
ABSTRACT
Objective. To investigate the course of biomarkers on admission and follow-up in order to identify early predictors for poor outcome in COVID-19 patients. Methods. In this study, 132 COVID-19 patients were classified as good outcome (n=62) and poor outcome (n=70) groups. Laboratory parameters were evaluated on admission and within 5-7 days after hospitalization. Results. Baseline levels of neutrophil-lymphocyte ratio, CRP, procalcitonin, ferritin, D-dimer and LDH were higher (p<0.01);lymphocyte count was lower in the poor outcome patients. During follow-up there was a larger decrease in lymphocyte count and more prominent increases in other biomarkers (p<0.001). In ROC analysis, the AUCs strongly indicated the poor outcome on days 5-7 of the hospitalization. Conclusions. This study suggests that the follow-up measurements of the biomarkers better predict the poor outcome in COVID-19 pneumonia.