P wave peak time and P wave dispersion in severe COVID-19 infection.

OBJECTIVE: With this study, we aimed at evaluating the association between electrocardiographic P wave indices and the severity of COVID-19 infection indicated as intensive care unit (ICU) admission. PATIENTS AND METHODS: We included 247 patients who were hospitalized with a diagnosis of COVID-19 infection and underwent 12 lead standard Electrocardiography (ECG). P wave indices, P wave dispersion (Pdis), P wave peak time in V1 lead (PWPTV1), and D2 lead (PWPTD2) were measured using admission ECG. Comparisons were performed between ICU admitting and non-ICU admitting patients. RESULTS: 160 patients were hospitalized in normal wards, and 87 patients were admitted to ICU. Pdis, PWPTV1, and PWPTD2 were prolonged in ICU admitted patients compared with the normal ward admitted patients [40 (30-50) ms vs. 50 (40-55) ms; p<0.001, 61±9 ms vs. 68±9 ms; p<0.001, and 55±7 ms vs. 64±7 ms; p<0.001, respectively]. In multiple logistic regression analysis, PWPTV1 and PWPTD2 were independent predictors of ICU admission. A cut-off point of 67.5 ms PWPTv1 has a sensitivity of 62.1% and a specificity of 69.4% (AUC=0.710, 95% CI: 0.642-0.777, p<0.001) and a cut-off point of 62.5 ms PWPTD2 has a sensitivity of 60.9% and a specificity of 83.6% (AUC=0.819, 95% CI: 0.777-0.871, p<0.001). CONCLUSIONS: Admission ECG atrial indices Pdis and PWPT were associated with intensive care unit admission in newly diagnosed COVID-19 patients.

COVID-19 in Patients Using RAAS Inhibitors for Hypertension: Evaluating Factors Associated with Lung Involvement, Intensive Care Unit Admission and Mortality

Background and Aim: We investigated the possible relationships between RAAS inhibitor use (for hypertension) and COVID-19-related characteristics such as lung involvement on CT, admission to intensive care unit, and mortality. Method(s): This case-control study was conducted in a single-center with a retrospective and observational design. We included 220 patients from a total of 654 patients admitted with a confirmed diagnosis of COVID-19 infection (by RT-PCR) and who underwent simultaneous Thoracic CT scan. We divided the patients into three groups: patients without a history of hypertension or drug use as the non-HT group (n=74), patients with HT using RAAS inhibitors (ACEIs and ARBs) in the RAAS group (n=72), and patients with HT using CCBs in the CCB group. Result(s): Of the 220 patients, 117 (53.2%) were males and no difference was observed between the groups in term of sex. The overall median age of patients was 63 (21-93) years and the RAAS group was found to have significantly higher mean age, while the non-HT and RAAS groups were similar (66 [24-93] vs. 61 [32-89], 62 [21-88], p= 0.040). No significant difference was observed between the groups in terms of in-hospital mortality, 1-month mortality, mechanical ventilation need, lung involvement and other radiological findings. Albumin (OR=0.250, 95%CI: 0.091-0.690, p = 0.007), WBC (OR=1.000, 95%CI: 1.000-1.000, p = 0.004), platelet count (OR=0.987, 95%CI: 0.979-0.995, p = 0.002), CRP (OR=1.007, 95%CI: 1.001-1.014, p = 0.025) and male gender (OR=3.893, 95%CI: 1.598-9.480, p = 0.003) were determined as factors that were independently associated with ICU admission among hospitalized patients. Also, age (OR=1.095, 95%CI: 1.005-1.194, p = 0.038) and length of stay in ward (OR=0.809, 95%CI: 0.694-0.943, p = 0.007) were found to be independently associated with mortality in patients admitted to the ICU. Conclusion(s): In our study, we showed that patients using RAAS inhibitors for HT, those using CCB, and individuals without a history of HT or other chronic diseases did not differ in terms of lung involvement on CT. We also found that HT presence was not associated with ICU admission and death. Albumin level, CRP level, platelet count, WBC count and male gender are independent predictors of ICU admission;also found that age and length of ward stay days were independent predictors of death in patients hospitalized in the ICU.

Student performance under asynchronous and synchronous methods in distance education: A quasi-field experiment

This study examines student performance under asynchronous and synchronous methods in a microeconomics course during COVID-19 pandemic. We conduct a quasi-field experiment in a state university in Turkey. In the experiment, students were divided into synchronous and asynchronous groups and were taught the same weekly material of microeconomics by the methods respective to their group. At the end of the week, both groups took the same multiple question test. Our results showed that asynchronous group performed significantly better than the synchronous group. While showing the comparative advantage of the asynchronous method, our study also underlines the importance of interaction between instructors and students. We discuss our findings from a socioeconomic perspective, where we argue that the flexibility that the asynchronous method offers might have compensated for the accessibility issues (internet and/or computer) during the COVID-19 outbreak. As a policy recommendation, universities can offer lectures with a recorded option to allow students to interact with the course material multiple times.