What Is the Place of Intermediate Care Unit in Patients with COVID-19? A Single Center Experience.

Introduction: COVID-19 pandemic has led to an increased rate of intensive care unit (ICU) stays. Intermediate care units (IMCUs) are a useful resource for the management of patients with severe COVID-19 that do not require ICU admission. In this research, we aimed to determine survival outcomes and parameters predicting mortality in patients who have been admitted to IMCU. Materials and Methods: Patients who were admitted to IMCU between April 2019 and January 2021 were analyzed retrospectively. Sociodemographics, clinical characteristics, and blood parameters on admission were compared between the patients who died in IMCU and the others. Blood parameters at discharge were compared between survived and deceased individuals. Survival analysis was performed via Kaplan-Meier analysis. Blood parameters predicting mortality were determined by univariate and multivariate Cox regression analysis. Results: A total of 140 patients were included within the scope of this study. The median age was 72.5 years, and 77 (55%) of them were male and 63 (45%) of them were female. A total of 37 (26.4%) patients deceased in IMCU, and 40 patients (28.5%) were transferred to ICU. Higher platelet count (HR 3.454; 95% CI 1.383-8.625; p=0.008), procalcitonin levels (HR 3.083; 95% CI 1.158-8.206; p=0.024), and lower oxygen saturation (HR 4.121; 95% CI 2.018-8.414; p < 0.001) were associated with an increased risk of mortality in IMCU. At discharge from IMCU, higher procalcitonin levels (HR 2.809; 95% CI 1.216-6.487; p=0.016), lower platelet count (HR 2.269; 95% CI 1.012-5.085; p=0.047), and noninvasive mechanic ventilation requirement (HR 2.363; 95% CI 1.201-4.651; p=0.013) were associated with an increased risk of mortality. Median OS was found as 41 days. The overall survival rate was found 40% while the IMCU survival rate was 73.6%. Conclusions: IMCU seems to have a positive effect on survival in patients with severe COVID-19 infection. Close monitoring of these parameters and early intervention may improve survival rates and outcomes.

Adverse events report of inactivated COVID-19 vaccine from 4040 healthcare workers.

OBJECTIVES: Numerous vaccination studies are conducted to protect against COVID-19 infection, and preclinical and clinical studies are still ongoing worldwide. During this extraordinary period, the necessity to perform COVID-19 vaccine studies and immunization programs together has emerged. Vaccine Adverse Effects (VAEs) need to be documented quickly. We aimed to determine the VAEs and to compare the frequency of VAEs between groups according to sociodemographic characteristics after the inactivated vaccine (CoronaVac) was administered to healthcare workers (HCWs) in Turkey. METHODS: An online questionnaire was delivered to 4040 volunteer HCWs across the whole country who were vaccinated with CoronaVac. Sociodemographic characteristics, medical history, history of COVID-19 infection, and VAEs occurring after the first and second doses of the inactivated vaccine were evaluated. RESULTS: The most common local and systemic VAEs after first and second doses of the COVID-19 vaccine were reported as, pain at the injection site (37.9%; 37.6%), headache (21.5%; 16.8%), fatigue (18%; 15%), drowsiness (9.6%; 8.2%), back pain (8.8%; 8.2%), nausea (6.3%; 4.8%), and joint pain (4.7%; 4.7%). Individuals with a history of allergies (generalized or vaccine-related) and females had a higher rate of VAE. Participants aged 60 and over reported less frequent VAEs. CONCLUSION: It is extremely important to identify and document the VAEs occurring in the early postvaccination period in different groups of the community. These initial findings may provide reassurance to healthcare providers and vaccine recipients and promote confidence in the safety of this inactive COVID-19 vaccine, however longitudinal follow-up studies are recommended.