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Background COVID-19 usually cause a mild infection among children with a low fatality rate. On the other hand, increasing evidence suggests that children may have prolonged symptoms related to COVID-19. This study aims to describe the persistence of COVID-19 symptoms up to 12 or more weeks among children and to investigate associated factors including perceived socioeconomic status and parents’ education level. Methods The study group consisted of 759 cases aged <18 years detected as SARS-CoV-2 RT-PCR positive in DEU Hospital between March 2020, and May 2021. Interviews were conducted at 1st 3rd and 6th month of diagnosis. The ongoing self-reported symptoms 12 or more weeks after infection was the dependent variable. Multivariate logistic regression models were used to evaluate associated factors with long COVID, and robust clustering using links algorithm was used to assess long COVID symptoms clusters. Results Among 759 COVID-19 cases, 22 children were hospitalized, and 4 died. 9.6% of the children had at least one symptom related to COVID-19 after 12 weeks of the diagnosis, Symptom duration was minimum 84 days, maximum 344 days (mean±SD: 160±68 days). The most frequent symptoms were fatigue, muscle-joint pain, headache, and loss of smell and/or taste. In multivariate analysis, female gender (OR:2,3 95%CI:1.1-3.6) and symptomatic onset (OR:2,7 95%CI:1.7-20.9) were related to increased risk of long COVID. Age, long-term health conditions, socioeconomic status and mother's education level did not predict the risk of long COVID. No cluster of symptoms was found. Conclusions About 10% of children suffer from symptoms related to COVID-19 for up to six months. Female gender and symptomatic onset of disease increased the risk of prolonged symptoms. Socioeconomic status and mother's education level was not associated with the risk of long COVID, but the evidence of the effect of social determinants of health on the outcomes of COVID-19 among children is still needed. Key messages • One out of ten children may suffer from long COVID represents symptoms such as fatigue, headache, and muscle and joint pain. Girls and children with symptomatic onset have a higher risk of long COVID. • The effects of social determinants on the susceptibility and outcomes of COVID-19, including death, were well studied among the adult population. There is a need for sound evidence for children.
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Background It has been shown that COVID-19 can cause symptoms and diseases such as insomnia, depression, and anxiety. This study aimed to describe prevalence of feeling anxious or depressive among COVID-19 patients in six months of follow-up time and its association with baseline independent factors. Methods This prospective cohort study included patients aged ≥18 years who tested positive for SARS-CoV-2 at Dokuz Eylul University Hospital, Turkey between November 1, 2020 and May 31, 2021. Participants were interviewed by telephone calls on the 1st, 3rd and 6th months after diagnosis. The dependent variable of the study was self-reported moderate or severe anxiety or depression based on EQ-5D-3L general quality of life scale. Generalized estimating equations were used to identify the factors associated with feeling anxious and depressive after SARS-CoV-2 infection. Results In total 5446 patients agreed to participate in the study. Frequency of feeling anxious or depressive at the 1st, 3rd and 6th months after diagnosis were 18.5%, 17.9% and 15.4%, respectively. Older age (≥65 years;odds ratio-OR:1.17, 95% confidence interval-CI: 0.95-1.44), female gender (OR:1.76 (1.58-1.96)), bad economic status (OR: 1.62 (1.34-1.97)), having more symptoms (4-5, OR:1.48 (1.21-1.81);≥5, OR:1.65 (1.35-2.01)), having more underlying health conditions (1-2, OR:1.35 (1.19-1.54);≥3: OR:1.50 (1.13-1.99)), intensive care unit admission (OR: 2.58 (1.70-3.90)) were associated with self-reported anxiety and depression. Conclusions Feelings of anxiety and depression are common in COVID-19 patients and may persist in the long term. Anxiety and depression were associated with gender, economic status and disease severity. Determination of vulnerable groups for anxiety and depression after COVID-19 can be helpful for early diagnosis and initiation of mental care services. Key messages • As a consequence of Covid-19, anxiety and depression in Covid-19 survivors are common generally. It shouldn't be overlooked or underestimated for the public mental well-being. • Covid-19 mental effects on the population have a correlation with social determinants of health. Therefore, determining vulnerable groups is a key to planning mental care services.
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Background Investigating the people who suffer from post-COVID health conditions is necessary to accommodate the demand for accessing healthcare. This study aims to describe post-COVID health conditions within six months after diagnosis. Methods This study was conducted at Dokuz Eylul University Hospital, a tertiary care hospital in Ä°zmir-Turkey. Participants aged ≥18 years who were diagnosed as SARS-CoV-2 RNA positive in the hospital from November 1st, 2020 to May 31st were interviewed by phone at one, three and six months after diagnosis. Symptom frequencies were stratified by demographic and clinical characteristics. The dependent variable was having post-COVID condition according to World Health Organization's definition. We estimated logistic regression models to identify associated factors for post-COVID condition in the patients who had symptoms at baseline. Results A total of 5083 people completed the third month's interview. The prevalence of post-COVID condition was 21.8% (n = 1108). Tiredness/fatigue (10.2%), muscle or body aches (7.3%) and dyspnea/difficulty breathing (4.8%) were the most common symptoms. Older age (65-74 aged groups versus 18-24 aged group, odds ratio-OR:1.57, 95% confidence interval: 1.10-2.25), female gender (OR: 1.97, 1.71-2.28), bad economic status (OR: 1.44, 1.13-1.84), having more health conditions (≥3 conditions, OR: 1.82, 1.28-2.55), having more symptoms (>5 symptoms, OR: 2.59, 2.20-3.07) and hospitalization (intensive care unit, OR: 1.98, 1.13-3.37) were found to be associated with reporting of post-COVID condition. Conclusions This study identifies the prevalence and risk factors for post-COVID conditions in a large cohort of patients. The results of the study would guide the healthcare organizations in the planning of post-COVID management strategies. Key messages • The prevalence of post-COVID conditions was 21.8%. Older age, female gender, having more health conditions, disease severity in the acute phase and bad economic status were risk factors. • Clinical management strategies and country-specific healthcare planning should be devised for the post-COVID condition burden.
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Introduction: The management of the patients with COVID-19 is depend on the clinical presentation. We aimed to evaluate the hospitalization rates due to the progression of the illness in the fist month, the mortality and reinfection rates of the patients with mild COVID-19 during the six months follow-up. Materials and Methods: The study with retrospective design included all SARS CoV-2 PCR positive patients presenting with mild disease to our hospital and who were recommended at-home follow-up during the first month of the COVID-19 pandemic. Demographic characteristics, baseline symptoms, laboratory results and the treatments administered were recorded. The patients were called by phone at six months after the diagnosis. Patients were asked to report hospitalisation at first month, hospitalisation due to any reason and possi- ble reinfections and current symptoms at six month. We noted the mortality rates at first month and at six months from hospital records. Results: The study included 210 patients;130 patients were male. The mean age was 42.3 +/- 15.7 (16-96) years. At baseline, 168 patients (80%) were symptomatic. Fifty-two patients (75.2%) had comorbidities. Thorax computed tomography (CT) was congruent with COVID-19 infection in 46 patients (26%). Twenty-seven patients (16.5%) were hospitalised due to the progression of clinical condition and four (2.4%) needed intensive care transmission. In multivariate analysis, those with comorbidity had having 8.2 fold (95%CI 2.2933.12) D-dimer >= 1 ug/mL had 17.8 fold (OR: 17.8, %95 GA: 3.42-113.3), and diffuse infiltrations in thorax CT scan had 5.36-fold (95% CI 1.46-21.76) higher relative risk for post-COVID hospitalisation. Two (4.1%) out of 48 patients younger than 50 years old and with no risk factors and a normal thorax CT needed hospitalisation. There was no mortality at first month. Four patients (1.9%) died due to deterioration of underlying condition during the six-month follow up. Six patients (3.6%) were considered to be reinfected six months after the first episode. Twenty-six patients (15.6%) had current symptoms which they belived had occured after COVID-19 infection. Conclusion: In the case of the presence of comorbidities, high D-dimer value and diffuse infiltration in thorax CT scan in mild COVID-19 patients, hospitalisation may be the optimal approach.
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Background and aim There is limited research on how common the longer-term effects of COVID-19. This study aimed to describe changes in symptoms of COVID-19 patients at the 1st and 3rd months after diagnosis. Methods Patients older than 18-years who tested positive for SARS-CoV-2 RNA in Dokuz Eylül University Hospital-Turkey in December 2020 (n = 1434) were included in this prospective cohort study. Overall, 1029 patients (71.8%) completed the 1st month and 3rd-month follow-up. Data on demographic characteristics, chronic disease history, symptom history and hospitalization were collected via telephone interviews. Based on the relapsing nature of the disease, the presence or absence of any COVID-19 related symptoms within a week before the 1st and 3rd-month interview was questioned. Categorical variables (n, %) were compared using the chi-square test. Results Of the 1029 patients, 92.8% were symptomatic. The most common initial symptoms were muscle or body aches (58.5%), fatigue (57.8%) and loss of smell (53.1%). Among the symptomatic patients, 40.8% and 27.6% reported at least one symptom in the 1st and 3rd months, respectively. Mean number of symptoms was 4.5±2.6 at diagnosis, 2.3±1.7 at the 1st month and 2.5±2.3 at the 3rd month. The most common persistent symptoms by the 1st month were muscle or body aches (11.1%), heart palpitations (6.4%), and shortness of breath (5.8%). Muscle or body aches (9.5%), shortness of breath (4.2%) and fatigue (4.2%) were reported as persistent by the 3rd month. Persistent symptoms up to the 3rd month were more common in women (33.3% vs 21.3%, p < 0.001), in the patients aged >50 years (32.8% vs 25%, p = 0.01) and in the patients with comorbidities (31.8% vs 25.1%, p = 0.03). Conclusions Over a quarter of patients (27.6%) reported persistent symptoms even after 3 months of diagnosis. Rehabilitation and long-term monitoring programs for patients aged >50 years with comorbidities could be useful in responding to this problem. Key messages Over a quarter of patients report persisting symptoms even after 3 months of initial diagnosis. Follow-up programs could be useful in appropriately managing any persistent or emerging long-term sequelae.
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Background There is limited research on children infected with Covid-19 after initial diagnosis. The aim of this study was to describe changes in symptoms in children infected by Covid-19 after 1st and 3rd months of diagnosis. Methods Covid-19 patients age under 18 admitted to the Dokuz Eylul University Hospital, Izmir, Turkey during December 2020 (n = 144) and completed three months follow-up (n = 123) were included in this prospective cohort study. Data on age, sex, parents' educational status, perceived economic status, presence of Covid-19 patient at household, chronic diseases history, initial and existing symptoms and perception of recovery were collected via telephone interviews. Persistent symptom was defined as any symptom reported within a week of the interview. Chi-square and Mann-Whitney U Test were used for univariate analyses. Results Out of 124 patients, 89.3% reported a symptom at time of diagnosis, 21.0% at 1st month and 11.4% at the 3rd-month follow-up. Median number of symptoms was 2 at diagnosis, 0 at 1st and the 3rd month. The most common initial symptoms were fever (52.4%), weakness (40.3%), flu like symptoms (25.8%) and cough (24.4%). The most common persistent symptoms by the 1st month were fatigue (5.7%), cough (4.1%) and gastrointestinal symptoms (4.1%), and by the 3rd month were fatigue (2.4%), weakness (2.4%), respiratory symptoms and chest pain (2.4%). 10.6% of the patients were not fully recovered by the 3rd month. Persistent symptoms at the end of 1st month were more common in children with chronic diseases (36.6% vs 13.3%, p = 0.003) and who were not recovered fully (63.6% vs 15.5%, p = 0.001). Parents' education level, perceived economic status, and presence of Covid-19 patients at household were not associated with persisting symptoms. Conclusions COVID-19 symptoms may persist by three months of infection, especially in children with chronic conditions. Health care providers should consider following up those children with special care. Key messages COVID-19 symptoms may persist by three months of infection, especially in children with chronic conditions. Health care providers should consider following up those children with special care.
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BACKGROUND: Healthcare workers (HCWs) have an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection due to occupational exposure. Strict measures generally focus on the patient-to-HCW contacts. However, interactions between the HCWs also pose a high risk for SARS-CoV-2 exposure. AIMS: This study was aimed to investigate the effect of social contacts on the level of SARS-CoV-2 exposure risk among workers by broadening the current risk assessment algorithm. METHODS: Contact tracing records of the workers in a large university hospital between 19th March and 31st December 2020 were analysed. Multivariate conditional logistic regression models were estimated to evaluate factors associated with high-risk exposure for contacts among workers. RESULTS: Of the 329 exposed clusters, 260 (79%) were HCW-to-HCW contacted clusters. High-risk exposure was higher in the HCW-to-HCW contacts (44%), when compared to the patient-to-HCW contacts (5%) (P < 0.001). A total of 1827 HCWs contacted a laboratory-confirmed COVID-19-positive co-worker. Among the HCW-to-HCW contacts, high-risk exposure was higher in the support staff (49%, P < 0.001), in non-patient care settings (47%, P < 0.001) and in the social contacts (57%, P < 0.001). Social contacts between workers increased the high-risk exposure (adjusted odds ratio: 3.50, 95% confidence interval 2.62-4.69) in multivariate analysis. CONCLUSIONS: A significant association between social contacts among workers and high-risk exposure of SARS-CoV-2 was observed. The results of the study emphasize the need for policies regarding the improved protection of HCWs in social settings in addition to patient care services.
Subject(s)
COVID-19 , Occupational Exposure , Health Personnel , Humans , Occupational Exposure/adverse effects , Risk Assessment , SARS-CoV-2ABSTRACT
Objective: It is important to put forward the characteristics of the COVID-19 cases to fight the disease effectively. The aim of this study is to determine the epidemiological characteristics of COVID-19 cases in Turkey. And also to determine the risk factors associated with intensive care unit (ICU) admission and death. Methods: In this cross-sectional study, the characteristics of the confirmed COVID-19 cases who applied to a University Hospital in Turkey between March 19th and June 11th, 2020, were analyzed. Variables such as epidemic trend, case fatality rate, need for hospitalization, ICU admission rate, and ICU mortality were calculated. In addition, risk factors affecting ICU admission and death were determined by logistic regression analysis. Results: 19.8% of 654 cases participating in the study were asymptomatic at admission. ICU admission rate was 7.6% and case fatality rate found to be 7.8%. Age, male gender, and cancer were associated with ICU admission. Each 1-unit increase in age increased ICU admissions by 8% (OR: 1.08;CI: 1.06-1.10). Men had a 2.71 times higher risk of ICU admission (OR: 2.71;CI: 1.37-5.39);and cancer patients showed 3.72 (OR: 3.72;CI: 1.35-10.20) times more ICU admissions (p<0.05). Age, cancer, and ICU admission were associated with death. Each 1-unit increase in age increased the risk of death by 10% (OR: 1.10;CI: 1.06-1.15). The risk of death was found to be 5.22 times higher in cancer patients (OR: 5.22;GA: 1.09-24.89) and 87.42 times higher in those admitted to ICU (OR: 87.42;GA: 30.15-153.46) (p<0.05). Conclusions: It was revealed that the course of the disease worsens, and deaths increase with age. Male gender has been associated with the increased need for intensive care. Cancer was significantly associated both with ICU admission and death. Attention should be paid to the groups of elderly, men and those with a comorbidity. More detailed studies with larger samples are of critical importance in fighting against the pandemic. © 2021, DOC Design and Informatics Co. Ltd.. All rights reserved.