ABSTRACT
BACKGROUND AND AIM: Obstructive sleep apnea (OSA), having an increased inflammatory state due to an imbalance between sympathetic and parasympathetic activity, intermittent hypoxia, and increased cytokines, may aggravate the immune response for COVID-19 infection. Our aim was to evaluate the effect of OSA upon inflammatory response and length of stay in patients with favorable outcomes. METHODS: Patients admitted to an outpatient clinic after being hospitalized for treatment of COVID-19 were included consecutively in this cross-sectional multicenter observational study. STOP-Bang Questionnaire and a cut-off value of 3 points were used to identify patients with a high risk of OSA. RESULTS: Study population consisted of 201 patients with a median STOP-Bang score of 2.0 (1.0-4.0) points. According to the cut-off value of 3 points, 94 (46.8%) patients were classified as high-risk OSA patients. High-risk OSA patients were older, had many comorbidities such as hypertension, coronary artery disease, and diabetes mellitus, had higher serum D-dimer, ferritin, C-reactive protein, and procalcitonin measurements, and had a longer hospital stay. Possible risk factors associated with length of stay were age, lymphocyte count, and total STOP-Bang score. Multivariable analysis revealed that a 1 point increase in STOP-Bang score results in a 0.43 day longer hospital stay. CONCLUSIONS: Prevalence of OSA within COVID-19 patients with favorable outcomes is similar to the general population. However, the length of stay is related to the presence of high-risk OSA. Our study, therefore, suggests that OSA is related to delayed improvement of COVID-19 infection.
ABSTRACT
AIM: The COVID-19 (SARS-CoV-2) infection that emerged in 2019 has caused difficult conditions for healthcare workers. The aim of this study was to evaluate the situation of employees in the Respiratory Function Tests (PFT), polysomnography (PSG) and Bronchoscopy laboratories, which are among the most risky units in terms of droplet infection, in terms of their exposure to COVID-19 infection. METHODS: Permission was obtained from the Scientific Research Board of TC. Ministry of Health. The study is a multicenter, cross-sectional survey study. The questionnaire form was sent to the participants by e-mail by the Turkish Thoracic Society. The study was limited to healthcare professionals working in PFT, PSG and bronchoscopy laboratories, and the data obtained were compared using the chi-square test. RESULTS: 156 employments (71 PFT, 52 PSG and 33 bronchoscopy laboratories) participated. The mean age was 37±8.6 (23-60), 47 (30%) were male. The vaccination rate was 91%, and 14 (9%) participants were not vaccinated voluntarily. Of the 48 (30.8%) participants who had COVID-19, 36 (75%) were diagnosed only with PCR, 3 (1%) only radiologically, and 9 (19%) with both tests. Before vaccination, 36 (73%) people had COVID-19. Two people got COVID-19 right after the first dose of vaccine, 12 (25%) people got COVID-19 after the second dose of vaccine. 4 of them were hospitalized and one person was taken to intensive care. Full compliance with the personal protective equipment of laboratory staff (goggles/visor, N95/FPP2.2 mask, gloves, overalls) is 62%. When the conditions of the laboratories were questioned, 7 (10%) laboratories did not meet any requirements for clean air. When those who had COVID-19 were asked about the sources of transmission, 61.2% answered as hospital/patient, 16.3% family contact, 14.3% social environment, 8.2% did not express an opinion. CONCLUSION: A higher number of COVID-19 infections were detected in PFT and Bronchoscopy units compared to PSG workers. Although they have been educated about health and have taken various preventive measures;The incidence of COVID-19 in those working in this laboratory was found to be 30.6%. This rate is TC. According to the data of the Ministry of Health (3 July 2021, 8%), it is significantly higher than the general population. In a meta-analysis conducted by examining 25 articles and 168,200 healthcare workers in total, the average seroprevalence was shown to be 8%. This value is higher than our findings. Reasons for this may include intense contact with patients, inadequate laboratory conditions, and inadequate personal precautions. This cross-sectional study is a starting point for more extensive and detailed research on this subject. Additional measures should be taken to protect both patients and employees from infection.
ABSTRACT
On 31 December 2019, the Wuhan Municipal Committee of Health and Healthcare (Hubei Province, China) reported that there were 27 cases of pneumonia of unknown origin with symptoms starting on the 8 December. On 7 January 2020, the Chinese authorities identified that the agent causing the outbreak was a new type of virus of the Coronaviridae family, temporarily called 'new coronavirus, 2019-nCoV'. On January 30th, 2020, the World Health Organisation (WHO) declared the outbreak an international emergency and described it as a pandemic in March 2020. While it was previously referred to as 2019-nCoV by WHO, on February 11, 2020, the disease was named as severe acute respiratory syndrome-coronavirus2. The disease was confirmed to have reached Turkey on 11 March 2020, after a patient who had returned to Turkey from Europe, tested positive. The most appropriate treatment approach to treating COVID-19 remains unclear. Current treatment protocols are based on limited data and are evolving rapidly as clinical data emerge. A large volume of data and publications from randomized controlled trials, observational cohorts, and case series are emerging promptly, some in peer-reviewed journals, others as manuscripts that have not yet been peer reviewed. The Republic of Turkey Ministry of Health invited the specialties societies to prepare a clinical protocol for the management of COVID-19. The Turkish Pandemic Working Group prepare the present recommendations with the evidence available at the time of preparing them. It is aimed to summarize the treatment management of COVID-19 in line with the current treatment recommendations in national and international guidelines. Keywords: COVID-19;pandemic;treatment.