ABSTRACT
In the COVID-19 pandemic, due to the difficulties in patients' applications to health centres, changes have occurred in the places of death of older adults. It is aimed to investigate the change in the places of death of older adults in Turkey, which is one of the countries most affected by the pandemic. Patients admitted to the geriatric outpatient clinic of a university hospital from 01.01.2013 to 29.02.2020 were included. Place and date of death were recorded as hospital or out-of-hospital death. According to results, while the median age of those who died during the pandemic was higher than before (p < 0.001) and during the pandemic, the hospital mortality ratio was higher than before. During the pandemic period, the hospital mortality ratio of older adults has increased in Turkey. This situation, which has occurred despite the increasing healthcare burden, can show the importance of the measures taken and robust health infrastructure.
ABSTRACT
Coronavirus disease 2019 increases transplant recipients' susceptibility to rare opportunistic infections as a consequence of the impairment that COVID-19 can cause in the immune system. Mucormycosis is a rare complication but has a high risk of fatal outcome. A 50-year-old woman who received a kidney transplant 10 years previously was admitted to the hospital with COVID-19. During follow-up by the inpatient service, the patient developed pain, edema, and proptosis in the right eye. She was diagnosed with rhino-orbitalcerebral mucormycosis. This is the first reported case of rhino-orbital-cerebral mucormycosis in a renal transplant recipient with COVID-19 infection.
Subject(s)
COVID-19 , Kidney Transplantation , Mucormycosis , Orbital Diseases , COVID-19/diagnosis , Female , Humans , Kidney Transplantation/adverse effects , Middle Aged , Mucormycosis/complications , Mucormycosis/diagnosis , Mucormycosis/drug therapy , Orbital Diseases/diagnostic imaging , Orbital Diseases/etiology , Transplant Recipients , Treatment OutcomeABSTRACT
The rapidly increased number of patients with COVID-19 resulted in the shortage of hospital beds. An outpatient follow-up plan was developed for COVID-19 patients with stable clinical condition and no concomitant diseases. The records of COVID-19 first admission clinic were retrospectively reviewed to identify the COVID-19 patients who were followed on home isolation as outpatients between March 17, 2020 and April 18, 2020 in Ankara, Turkey. Demographic and clinical characteristics of the patients, compliance with isolation rules, re-admission rates, and outcomes were investigated. A total of 41 patients with COVID-19 were followed on home isolation without hospitalization. The median age of the patients was 36 years. Twenty-four (58.5%) of 41 patients were female. Twenty-nine (70.7%) patients were healthcare workers. The most common symptoms at admission were cough, myalgia/arthralgia, and loss of smell and/or taste. Fourteen (34.1%) patients were asymptomatic on the first admission. Anti-viral treatment was given to 27 (65.8%) of 41 patients. Four of 41 patients were readmitted to the outpatient clinic and hospitalized. Three patients had worsening respiratory symptoms and pneumonia was detected in CT scans. One patient was hospitalized because of disseminated herpes zoster infection. Two patients who jeopardized the isolation rules were isolated and monitored at another hospital by provincial health directorate teams. If adequate conditions are provided, follow-up on home isolation seems to be a feasible method in carefully selected patients. However, these patients should be monitored closely by an experienced team during the isolation period.