The Use of Health Institutions by Patients in the "Normalization" Process of the COVID-19 Pandemic and its Relationship with Health Literacy

Introduction: The aim of this study was to evaluate the behaviors of patients applying to the outpatient triage of a university hospital during the restriction period and normalization process and to use health institutions and to examine the relationship of these behaviors with health literacy. Materials and Methods: In this cross-sectional analytical study, 116 patients who applied to the outpatient triage of a university hospital between August and September 2020, who did not have communication problems at age 18 and over and who agreed to participate in the study, formed the research group. Participants were given the "Health Institution Usage Characteristics Survey" and the "Turkish Health Literacy Scale (TSOY-32)" for the evaluation of health literacy in order to determine the characteristics of the use of health institutions. Descriptive statistics included numbers, percentages, averages, standard deviations, lowest and highest values. In cases where the two groups were compared, T-test in independent groups in parametric conditions, Mann-Whitney U test in non-parametric conditions, Oneway ANOVA test in parametric conditions, Kruskal Wallis test in non-parametric conditions were applied. The McNemar Bowker test was used to evaluate dependent groups with multiple categorical variables. p< 0.05 was considered statistically significant. Results: The overall TSOY-32 index score average of the research group was 33.38 +/- 8.38 (lowest 14.58, highest 50.00). Of the participants, 20.7% were inadequate, 31.0% had limited-problem, 31.0% were adequate and 17.2% had excellent health literacy. The average TSOY-32 index score of the participants who stated that the current application complaint started during the epidemic restrictions and postponed their application was found to be significantly higher than those who stated that the application complaint was an emergency and those who indicated that it was a chronic condition (respectively p= 0.024, p= 0.043 and p= 0.024). Conclusion: In this study, it was concluded that people with high levels of health literacy were less likely to apply to health institutions. Low health literacy can lead to increased unnecessary hospital admissions, failure to observe preventive measures, lack of contact and further spread of the disease. The importance of health literacy should be taken into account in order to combat the pandemic and the aim should be to raise the level of health literacy.

COVID-19 Cases Admitted to Hospital for Other Reasons

Introduction: As the pandemic continues, SARS-CoV-2 infection has inevitably been detected in patients hospitalized for other reasons. Detection of SARS-CoV-2 infected cases after hospitalization may lead to delay in taking appropriate infection control measures. Materials and Methods: The present study retrospectively scanned all electronic and hard copy records of the cases presented to the hospital and hospitalized for other reasons and then diagnosed as COV1D-19 in Suleyman Demirel University Faculty of Medicine, Research and Training Hospital between 01 April 2020 and 31 December 2020. Results: Accordingly, 22 cases were decided as community-acquired, 3 cases as probable community-acquired, 5 cases as hospital-acquired, and 4 cases as probable hospital-acquired. The reason for sampling for SARS-CoV-2 was determined as having symptoms compatible with COVID-19 in 23 (67.6%) of 34 cases, preoperative screening of COVID-19 infection in 9 (26.5%), and high risky contact in 2 cases (5.9%). Considering contact histories epidemiologically, it was thought that transmission occurred to 8 healthcare staff from 2 cases, and to other patients or relatives from 8 cases, but sequence analysis could not be performed. Conclusion: The high number of hospitalized patients diagnosed as COVID-19 creates a significant burden on the healthcare system in terms of infrastructure and management capacity. It is recommended that patients and healthcare professionals be screened widely and thoroughly, especially in conditions where COVID-19 cases are detected in non-COVID-1 9 units. This kind of screening will allow the potential outbreak to be controlled.

Effectiveness of favipiravir prior to admission to the intensive care unit in COVID-19 pneumonia

After emerging in Wuhan city in December 2019, the coronavirus disease 2019 (COVID-19) rapidly spread throughout China. Although high rates of hospitalization are seen with COVID-19, no specific treatment has been reported, and the choice of antiviral therapies is limited. Favipiravir, approved in Japan for influenza, is one of the drugs that targets RNA-dependent RNA polymerase (RdRP). It significantly decreases the duration of fever, cough dyspnea, and the need of oxygen therapy or noninvasive mechanical ventilation, especially in moderate COVID-19 cases. In the current paper we presented four cases with worsening clinical conditions and the development of hypoxia who were treated with Favipiravir before being admitted to the intensive care unit, and who recovered from the disease.