Does COVID-19 Increase the Risk of Central-Line-Associated Bloodstream Infections?

Objectives: All over the world, there has been a rapid and significant increase in the number of critically ill patients requiring mechanical ventilation, which was over the capacity of the intensive care units (ICU). This resulted in an increased risk of healthcare-associated infections. The most significant increase was in central-line-associated bloodstream infections (CLABSI). Our study aimed to determine the effect of COVID-19 infection on CLABSI rates in patients in the COVID-ICU and the factors affecting it. Methods: Adult patients hospitalized in the ICU between January 01, 2021, and December 31, 2021, and diagnosed with CLABSI were evaluated retrospectively. Only the first infection data of patients diagnosed with more than one CLABSI during hospitalization were included in the study. The patients were divided into two groups COVID-ICU and general ICU patients and were compared in terms of infection rate, risk factors, and agent distributions. Results: Twenty-two patients in the COVID-ICU and 32 patients in the general ICUs were diagnosed with CLABSI, and the infection rates were 2.05 and 1.03, respectively. The patients in the COVID-ICU had a shorter length of stay in the ICU and a significantly shorter time from ICU admission to CLABSI diagnosis. There was no difference in mortality between the two groups. Infections caused by Gram-negative microorganisms developed most frequently in both groups, and Acinetobacter baumannii was the most frequent among them. Conclusion: CLABSI is seen more frequently and earlier in patients followed in the COVID-ICU. According to our study, this situation did not significantly affect mortality. To prevent CLABSI in COVID-ICUs and improve health care quality, additional management strategies must be determined, and close data monitoring is needed.

Does COVID-19 Increase the Risk of Central-Line-Associated Bloodstream Infections?

Objectives: All over the world, there has been a rapid and significant increase in the number of critically ill patients requiring mechanical ventilation, which was over the capacity of the intensive care units (ICU). This resulted in an increased risk of healthcare-associated infections. The most significant increase was in central-line-associated bloodstream infections (CLABSI). Our study aimed to determine the effect of COVID-19 infection on CLABSI rates in patients in the COVID-ICU and the factors affecting it. Methods: Adult patients hospitalized in the ICU between January 01, 2021, and December 31, 2021, and diagnosed with CLABSI were evaluated retrospectively. Only the first infection data of patients diagnosed with more than one CLABSI during hospitalization were included in the study. The patients were divided into two groups COVID-ICU and general ICU patients and were compared in terms of infection rate, risk factors, and agent distributions. Results: Twenty-two patients in the COVID-ICU and 32 patients in the general ICUs were diagnosed with CLABSI, and the infection rates were 2.05 and 1.03, respectively. The patients in the COVID-ICU had a shorter length of stay in the ICU and a significantly shorter time from ICU admission to CLABSI diagnosis. There was no difference in mortality between the two groups. Infections caused by Gram-negative microorganisms developed most frequently in both groups, and Acinetobacter baumannii was the most frequent among them. Conclusion: CLABSI is seen more frequently and earlier in patients followed in the COVID-ICU. According to our study, this situation did not significantly affect mortality. To prevent CLABSI in COVID-ICUs and improve health care quality, additional management strategies must be determined, and close data monitoring is needed.

Does COVID-19 Increase the Risk of Central-Line-Associated Bloodstream Infections?

Objectives: All over the world, there has been a rapid and significant increase in the number of critically ill patients requiring mechanical ventilation, which was over the capacity of the intensive care units (ICU). This resulted in an increased risk of healthcare-associated infections. The most significant increase was in central-line-associated bloodstream infections (CLABSI). Our study aimed to determine the effect of COVID-19 infection on CLABSI rates in patients in the COVID-ICU and the factors affecting it. Method(s): Adult patients hospitalized in the ICU between January 01, 2021, and December 31, 2021, and diagnosed with CLABSI were evaluated retrospectively. Only the first infection data of patients diagnosed with more than one CLABSI during hospitalization were included in the study. The patients were divided into two groups COVID-ICU and general ICU patients and were compared in terms of infection rate, risk factors, and agent distributions. Result(s): Twenty-two patients in the COVID-ICU and 32 patients in the general ICUs were diagnosed with CLABSI, and the infection rates were 2.05 and 1.03, respectively. The patients in the COVID-ICU had a shorter length of stay in the ICU and a significantly shorter time from ICU admission to CLABSI diagnosis. There was no difference in mortality between the two groups. Infections caused by Gram-negative microorganisms developed most frequently in both groups, and Acinetobacter baumannii was the most frequent among them. Conclusion(s): CLABSI is seen more frequently and earlier in patients followed in the COVID-ICU. According to our study, this situation did not significantly affect mortality. To prevent CLABSI in COVID-ICUs and improve health care quality, additional management strategies must be determined, and close data monitoring is needed. Copyright © 2022, DOC Design and Informatics Co. Ltd.. All rights reserved.

Recollection & Traumatic Growth: Unique Mediational Pathways Through Traumatic Stress Components

Although the severity of the COVID-19 outbreak varies from time to time, the pandemic has affected larger audiences worldwide. Given the increasingly severe measures taken by the authorities, healthcare professionals have experienced positive and negative effects of the events, both personally and vicariously. The main aim is to examine how remembering influences vicarious traumatization and post-traumatic growth in a sample of healthcare workers. We proposed a multiple mediation model testing of distinct roles of stress components (hypervigilance, avoidance, intrusion) on the link between recollective features of remembering and post-traumatic growth, which allows characterizing memory-linked mechanisms underlying the effects of traumatic stress on growth. We demonstrated unique pathways by which remembering influenced traumatic growth. For the links of emotional intensity and imagery with growth, we found full mediation through avoidance and intrusion Individuals recalling events with high emotional intensity and imagery tend to experience more intrusions of trauma, which then resulted in traumatic growth. On the other hand, the opposite pattern was found for avoidance. Emotionally intense and vivid recall of events increased avoidance responses, but high avoidance reduced traumatic growth. With respect to reliving, while the pattern was similar, we found a partial mediation, showing the significant role reliving has in supporting traumatic growth. © Cognitive Science Society: Comparative Cognition: Animal Minds, CogSci 2021.All rights reserved.

SPONTANEOUS PNEUMOMEDIASTINUM IN COVID-19 PATIENTS

Introduction: COVID-19 disease, thought to originate from China, is now a global pandemic. It shows a variety of pulmonary manifestations, mostly in the form of ground-glass opacities with a peripheral distribution. Less common manifestations such as pneumomediastinum have also been reported. The aim of this study is to make a contribution to the literature to be familiar with uncommon symptoms and presentations and highlight the importance of early diagnosis. Materials and methods: Patients with pneumomediastinum on computed tomography (CT) and COVID-19, which was confirmed by positive real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) test result included in the study. Patient data were collected retrospectively from medical records. Results: In 7 patients, pneumomediastinum was the initial presentation, while two were diagnosed with CT Pneumomediastinum after the COVID-19 diagnosis. All patients had mild disease, underwent conservative therapy, and no complication was observed during the follow-up period. Conclusion: In the second year of the pandemic, the disease still manifests itself with some rare pulmonary and extrapulmonary symptoms. It is crucial to be familiar with these uncommon presentations and diagnose patients at early stages.

Patient Communication and Consultation Experience with Tele-medicine in Patients with Movement Dısorders in COVID-19 Pandemic: Its Usability, Benefits and Problems

Objective: Access to health centers was restricted during the coronavirus disease-2019 pandemic, which hit our country in March 2020. Ensuring the medical control of patients who were followed up in the neurology outpatient clinic with the tele-medicine method was an important step to decrease the viral load of patients and physicians. This study aimed to share our tele-medicine experience with patients with movement disorders. Materials and Methods: The data of 71 patients with movement disorder who communicated with our unit between March 11, 2020 and June 20, 2020 were retrospectively analyzed. Results: A total of 117 verbal and written interviews with 71 patients were mostly conducted via WhatsApp®. The evaluation of reasons for physician consultation revealed that patients most frequently communicated for worsening rigidity and prescription-drug requests. Of these interviews, 25 (21.4%) resulted in setting patient appointments for a physical examination. The tele-medicine service in 92 (78.6%) interviews solved the problem without physical contact with patients. Conclusion: Movement disorder evaluations are suitable through teleconference. Therefore, our teleneurology application, which we actively use, is effective in reducing the risk of viral transmission to both patients and healthcare workers during the pandemic. Developing telemedical applications is necessary in terms of their legal aspects and implementation in the world, especially in our country. ©Copyright 2021 by Turkish Neurological Society.

Effect of High-Flow Nasal Oxygen Therapy on Tracheobronchial Mucosa in COVID-19 Cases

In the ongoing COVID-19 pandemic, several patients have experienced respiratory failure, for which high-flow nasal oxygen therapy (HFNO) is a frequently preferred treatment modality. In the present study, three COVID-19 patients being followed up with HFNO in the intensive care unit underwent fiberoptic bronchoscopy, and a burned/wounded mucosa with widespread hyperemia, hyperpigmentation and mucosal damage throughout the entire tracheobronchial system mucosa was detected in all cases, the long-term effects of which are unknown. Herein, we aim to draw attention to the possible development of mucosal damage after HFNO, which should be kept in mind during the provision of ventilation support to COVID-19 patients.

The ability of patients with Parkinson’s disease to recognize masked faces during the COVID-19 pandemic

Patients with Parkinson’s disease (PwP) have face recognition difficulties. Objective: This study aimed to evaluate the difficulties of PwP in recognizing masked faces during the COVID-19 pandemic. Methods: A total of 64 PwP, 58 age-matched older healthy controls (OHCs), and 61 younger healthy controls (YHCs) were included in the study. The Benton Face Recognition Test – short form (BFRT-sf) and the 13-item questionnaire on face recognition difficulties due to masks during the pandemic developed by the authors were applied to all three study groups. Results: Both the PwP and OHC groups scored worse in BFRT-sf when compared with the YHC group (p<0.001 and p<0.001, respectively). The number of those who had difficulty in recognizing people seen every day and the number of those who asked people to remove their masks because they did not recognize them were higher in the PWP group (p=0.026 and p=0.002, respectively). The number of individuals who looked at the posture and gait of people when they did not recognize their masked faces and those who stated that this difficulty affected their daily lives were higher in the OHC group (p=0.002 and p=0.009, respectively). The number of participants whose difficulty in recognizing masked faces decreased over time was higher in the YHC group (p=0.003). Conclusions: The PwP group demonstrated similar performance to their peers but differed from the YHC group in recognizing masked faces. Knowing difficulties experienced by elderly people in recognizing people who are masked can increase awareness on this issue and enhance their social interaction in pandemic conditions through measures to be taken. © 2022, Associacao Arquivos de Neuro-Psiquiatria. All rights reserved.