Posttraumatic Stress Disorder Among Health Care Workers During the COVID-19 Pandemic.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has taken a significant toll on people worldwide, and in particular, on the health care workers (HCWs) who have worked on the frontlines in the fight against the pandemic. The goal of this study was to investigate the prevalence of posttraumatic stress disorder (PTSD) and related factors in HCWs in the era of COVID-19. METHODS: This cross-sectional survey study was conducted between September 15, and October 15, 2020, among HCWs in Turkey. The survey consisted of self-administered questionnaires, which included questions about sociodemographic variables, experiences caring for patients with COVID-19, and the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), a trauma screening tool. The online survey was completed by 1833 HCWs. Univariate and multivariate logistic regression analyses were used to identify independent predictors of PTSD. RESULTS: The mean age of the participants was 32.7±7.0 years; 81.9% were physicians, and 56.5% were female. The rates of COVID-19 history in the respondents, a family member, or a coworker were 13.6%, 32.3%, and 12.6%, respectively. Among the HCWs who participated, 39.9% met the criteria for PTSD. Compared with the physicians, the nonphysician HCWs had a higher rate of PTSD (49.5% vs. 36%) (P<0.001) and higher PCL-5 scores (53.31±19.6 vs. 42.5±20.3) (P<0.001). In addition, 9.7% of the surveyed HCWs reported having suicidal ideation during the COVID-19 pandemic. Independent predictors of PTSD in HCWs were working on a COVID-19 unit, feeling isolated, suicidal ideation, being a nonphysician HCW, fear of spreading coronavirus to family, female sex, and a history of having COVID-19. CONCLUSIONS: HCWs were at risk for impairment in mental well-being in the era of COVID-19, with a significant number experiencing PTSD as well as suicidal ideation. Therefore, HCWs, especially those who are working on a COVID-19 unit and are female, should be monitored regularly for PTSD.

Predictors of mortality in COVID-19 induced acute kidney injury.

BACKGROUND: We aimed to investigate the predictors of mortality in patients with COVID-19-induced acute kidney injury (COV-AKI). METHODS: We enrolled 803 patients who developed COV-AKI. The patients were divided into two groups: survivors and nonsurvivors. RESULTS: A multivariate logistic regression analysis showed that age (p < 0.001), increased admission C-reactive protein (p = 0.016), procalcitonin (p = 0.019), creatine kinase (p = 0.04), KDIGO stage 1 versus 2 AKI (p < 0.001), KDIGO stage 1 versus 3 (p < 0.001), the need for renal replacement therapy (p = 0.002) and highest creatinine (p = 0.004) were significantly associated with increased inhospital mortality. However, the mortality of patients with AKI on admission (p = 0.002) was found to be lower than those who developed AKI after hospitalization. CONCLUSIONS: Among patients with COV-AKI, high-inflammatory response and severe AKI were associated with significantly higher mortality.

A new parameter for predict the clinical outcome of patients with COVID-19 pneumonia: The direct/total bilirubin ratio.

AIM: An urgent need to define clinical and laboratory parameters to predict progression to the severe and lethal forms of Coronavirus Disease 2019 (COVID-19). To investigate the direct/total bilirubin ratio (D/TBil), as a novel parameter, to predict the poor survival of COVID-19 Pneumonia. METHODS: The clinical characteristics and laboratory parameters of hospitalised COVID-19 pneumonia patients were analysed from 20 March to August 1, 2020, in a tertiary hospital, retrospectively. All remarkable variables were selected for a forward stepwise binary logistic regression analysis to define the independent risk factors for mortality. RESULTS: 537 (248 women and 289 men) patients were separated into two groups for analysis: survivors vs deceased. The mean age of the deceased group was statistically significantly higher than the survivor group 72 (30-92) years vs 50 (18-97) years (P < .001). D/TBil, age, gender, hypertension and neutrophil-to-lymphocyte ratio (NLR) variables contributed significantly to the binary logistic regression model. The mortality risk increased 14.6 times in patients with D/TBil > 0.5, and 2.4 times in patients with NLR > 4. CONCLUSION: D/TBil > 0.5 was associated with a novel parameter to poor survival of COVID-19 on admission. Also, the combination of age, gender, the presence of hypertension, D/TBil and NLR contributed significantly to predicting the poor survival of COVID-19.

Use of the COVID-19 Reporting and Data System (CO-RADS) classification and chest computed tomography involvement score (CT-IS) in COVID-19 pneumonia.

PURPOSE: The increasing tendency of chest CT usage throughout the COVID-19 epidemic requires new tools and a systematic scheme for diagnosing and assessing the lung involvement in Coronavirus Disease 2019 (COVID-19). To investigate the use of the COVID-19 Reporting and Data System (CO-RADS) classification and chest CT Involvement Score (CT-IS) in COVID-19 pneumonia. MATERIAL AND METHODS: This retrospective study enrolled 280 hospitalized patients diagnosed with COVID-19 pneumonia in a tertiary hospital in Turkey. All patients underwent non-contrast CT chest imaging. Two radiologists interpreted all CT images according to CO-RADS classification without knowing the clinical features, laboratory findings. We used CT involvement score (CT-IS) for assessing chest CT images of COVID-19 patients. Also, we examined the relationship between CT-IS and clinical outcomes in COVID-19 patients. RESULTS: Of the patients, 111(39.6%) had positive real-time reverse transcriptase-polymerase chain reaction (RT-PCR) results. CO-RADS 5 group patients had statistically significant positive RT-PCR results than the other groups (P < 0.001). All of the CO-RADS 2 group patients (30) had negative RT-PCR results. The mean total CT-IS in CO-RADS 2 group was 3.4 ± 2.8. The mean total CT-IS in CO-RADS 5 group was 8.2 ± 4.7. Total CT-IS was statistically significantly different among CO-RADS groups (P < 0.001). The mean total CT-IS was statistically significantly different between survivors and patients died of COVID-19 pneumonia (P < 0.001). CONCLUSIONS: CO-RADS is useful in detecting COVID-19 disease, even if RT-PCR testing is negative. CT-IS is also helpful as an imaging tool for evaluation of the severity and extent of COVID-19 pneumonia.

Investigation of mental health among hospital workers in the COVID-19 pandemic: a cross-sectional study

ABSTRACT BACKGROUND: The rapid spread of the COVID-19 epidemic has led to extraordinary measures taken worldwide, and has led to serious psychological disorders. Healthcare professionals face greater severity of stress burden, due both to their direct contact with patients with the virus and to the isolation dimension of this outbreak. OBJECTIVE: To examine psychiatric disorders such as anxiety, depression and sleep disorders among healthcare professionals working in an emergency department and a COVID-19 clinic. DESIGN AND SETTING: Cross-sectional study including healthcare professionals in the emergency department and other units serving patients with COVID-19, of a training and research hospital in Turkey. METHODS: 210 volunteers, including 105 healthcare professionals in the emergency department and 105 healthcare professionals working in other departments rendering services for COVID-19 patients, were included in this study. A sociodemographic data form and the Hospital Anxiety Depression Scale (HAD), Pittsburg Sleep Quality Index (PSQI), World Health Organization Quality of Life scale (WHOQOL-BREF-TR) and Religious Orientation Scale were applied to the volunteers. RESULTS: The perceived stress levels and PSQI subscores were found to be significantly higher among the volunteers working in the emergency department than among those in other departments. The risk of development of anxiety among women was 16.6 times higher than among men. CONCLUSIONS: Healthcare professionals on the frontline need systematic regular psychosocial support mechanisms. Anxiety due to fear of infecting family members can be prevented through precautions such as isolation. However, it should be remembered that loneliness and feelings of missing family members consequent to isolation may increase the risk of depression.

Investigation of mental health among hospital workers in the COVID-19 pandemic: a cross-sectional study.

BACKGROUND: The rapid spread of the COVID-19 epidemic has led to extraordinary measures taken worldwide, and has led to serious psychological disorders. Healthcare professionals face greater severity of stress burden, due both to their direct contact with patients with the virus and to the isolation dimension of this outbreak. OBJECTIVE: To examine psychiatric disorders such as anxiety, depression and sleep disorders among healthcare professionals working in an emergency department and a COVID-19 clinic. DESIGN AND SETTING: Cross-sectional study including healthcare professionals in the emergency department and other units serving patients with COVID-19, of a training and research hospital in Turkey. METHODS: 210 volunteers, including 105 healthcare professionals in the emergency department and 105 healthcare professionals working in other departments rendering services for COVID-19 patients, were included in this study. A sociodemographic data form and the Hospital Anxiety Depression Scale (HAD), Pittsburg Sleep Quality Index (PSQI), World Health Organization Quality of Life scale (WHOQOL-BREF-TR) and Religious Orientation Scale were applied to the volunteers. RESULTS: The perceived stress levels and PSQI subscores were found to be significantly higher among the volunteers working in the emergency department than among those in other departments. The risk of development of anxiety among women was 16.6 times higher than among men. CONCLUSIONS: Healthcare professionals on the frontline need systematic regular psychosocial support mechanisms. Anxiety due to fear of infecting family members can be prevented through precautions such as isolation. However, it should be remembered that loneliness and feelings of missing family members consequent to isolation may increase the risk of depression.

ABO blood groups in COVID-19 patients; Cross-sectional study.

AIM: The aim of this study was to investigate the ABO and Rh blood group distribution and clinical characteristics in patients with COVID-19. MATERIALS AND METHODS: The clinical characteristics and blood groups of 1667 patients who were hospitalised because of COVID-19 (with a positive PCR test) between 16 March and 10 July were reviewed cross-sectionally. RESULTS: When blood groups of patients diagnosed with COVID-19 and control group were compared, it was observed that there was an increase in the number of COVID-19 patients with blood groups A and AB, decrease in the number of COVID-19 patients with blood group O, a statistically significant increase in the number of individuals with blood group A in COVID-19 patients compared with healthy individuals, and almost significant increase in the number of COVID-19 patients with blood group AB and a very significant decrease in the number of COVID-19 patients with blood group O. CONCLUSION: Our study has found that having blood group O may be protective, that blood group A may have greater susceptibility to the disease, but this does not affect the course of the disease and is not associated with mortality.

Risk factors affecting ICU admission in COVID-19 patients; Could air temperature be an effective factor?

AIM: As the COVID-19 pandemic has been spreading rapidly all over the world, there are plenty of ongoing works to shed on light to unknown factors related to disease. One of the factors questioned is also to be the factors affecting the disease course. In this study, our aim is to determine the factors that affect the course of the disease in the hospitalised patients because of COVID-19 infection and to reveal whether the seasonal change has an effect on the disease course. METHODS: Our study was conducted on 1950 PCR test positive patients who were hospitalised for COVID-19 disease between March 16 and July 15. RESULTS: As the seasonal temperature increases, decrease in WBC, PLT and albumin levels and increase in LDH and AST levels were observed. Risk of need for ICU has been found statistically significant (P < .05) with the increase in the age, LDH levels and CRP levels and with the decrease in the Ca and Albumin levels. CONCLUSIONS: It is predicted with these results that, seasonal change might have affects on the clinical course of the disease, although it has no affect on the spread of the disease. And it might beneficial to check biochemical parameters such as LDH, CRP, Ca and Albumin to predict the course of the disease.

Association Between the Rh Blood Group and the Covid-19 Susceptibility

We aimed to investigate whether there is a predisposition to COVID-19 with ABO and Rh blood group systems. This study was a retrospective study that investigate the patients admitted to our hospital between March 16 -May 20 due to Covid-19 pandemic and conducted with data revealed from the hospital Information Management System A total of 392 patients were included in this study, including 227 PCR test positive patients with blood group information in the system and 165 possible patients with CT findings in favor of Covid-19. Data from a blood group study conducted with 127091 people in our province in 2019 were used as a control group. In our study, a significant increase was observed in the blood group A in patients diagnosed with Covid-19, and a decrease was found in the blood groups B, AB and especially O. However, statistical analysis showed no significant difference between Covid-19 patients and healthy individuals in terms of ABO blood group system. When analyzed in terms of Rh blood group system, it was found that Rh positivity was statistically significantly higher in patients with Covid-19 (p= 0.000). Our study suggests that the Rh (-) blood group is protective and the Rh (+) blood group is predisposed to Covid 19 significantly. We think that it is valuable because it is the first study to reveal the relationship between Covid-19 and blood type in our country and the only one to reveal the relationship between Covid-19 and Rh (+) in the world literature.