Clinical and Laboratory Evaluations of Patients Diagnosed as Having Multisystem Inflammatory Syndrome Associated with Coronavirus Disease 2019 in Children: A Single Center Experience from Konya

Objective Multisystem inflammatory syndrome in children (MIS-C), characterized by fever, inflammation, and multiorgan dysfunction, was newly defined after severe acute respiratory syndrome coronavirus 2 infection. The clinical spectrum of MIS-C can be classified as mild, moderate, and severe. We aimed to evaluate demographics, clinical presentations, laboratory findings, and treatment modalities of patients with MIS-C according to clinical severity.Methods We performed a retrospective study of patients who were diagnosed as having MIS-C between September 2020 and October 2021 in the Necmettin Erbakan University Meram Faculty of Medicine, Turkey.Results A total of 48 patients (24 females and 24 males) with a median age at diagnosis of 10.3 years (range: 42 months-17 years) were enrolled, the most common clinical severity of MIS-C was moderate. The common presentations of patients were fever (97%), nonpurulent conjunctivitis (89.6%), rashes (81.3%), fatigue (81.3%), strawberry tongue (79.2%), and myalgia (68.8%). The most common laboratory findings were lymphopenia (81.2%), thrombocytopenia (54.1%), elevated D-dimer levels (89.5%), C-reactive protein (CRP;100%), procalcitonin (97%), erythrocyte sedimentation rate (87.5%), ferritin (95.8%), interleukin 6 (IL-6) (86.1%), and probrain natriuretic peptide (pro-BNP) (97%). High levels of CRP, procalcitonin, pro-BNP, and urea were associated with the severity of MIS-C ( p < 0.05). Fifteen of the patients were found to have pulmonary involvement. Ascites were the most common finding on abdominal ultrasonography (11 patients) and were not seen in a mild form of the disease. During the study period, two patients died.Conclusion It is important to make patient-based decisions and apply a stepwise approach in treating patients with MIS-C due to the increased risk of complications and mortality.

Serum Vitamins A, D, and Zinc Levels in Children with Coronavirus Disease 2019 and Multisystem Inflammatory Syndrome in Children

Objective Vitamin D, due to its immunomodulating effect, zinc, and vitamin A, which affect cellular and humoral immunity, are thought to affect the clinical severity of coronavirus disease 2019 (COVID-19) infection. The present study evaluates the association between vitamin A, D, and zinc deficiencies and disease severity in pediatric patients with COVID-19 infections. Methods The levels of vitamin A, D, and zinc at the time of diagnosis of 123 pediatric patients who presented to our hospital and were diagnosed as having hospitalized, nonhospitalized COVID-19 infection group, and multisystem inflammatory syndrome in children (MIS-C) were evaluated. The correlations of the measured levels with the disease severity and the need for intensive care or hospitalization were analyzed. Results Among the 123 patients, 21.1% (n = 26), 42.2% (n = 52), and 36.7% (n = 45) had a diagnosis of MIS-C, belonged to the hospitalized COVID-19 infection group, or belonged to the nonhospitalized COVID-19 infection group, respectively. Zinc levels were significantly lower in the MIS-C group than in the nonhospitalized group (p < 0.05). Vitamin A levels were found to be significantly lower in the MIS-C group than in the nonhospitalized group (p < 0.01) and significantly lower in the hospitalized group when compared with the nonhospitalized group (p < 0.001). Deficiencies in vitamin A, vitamin D, and zinc levels were found to be most common in the MIS-C group (42.3%) and in hospitalized COVID-19 group (15.3%). In the nonhospitalized COVID-19 group, it was found to be the lowest at 6.6%. Conclusion Based on the results of the present study and a literature review, it can be said that vitamin A, D, and zinc deficiencies may associate with the severity of COVID-19, although more studies are required to clarify this subject further.

Assessment of the opinions and experiences of anatomy educators regarding the distance anatomy education in medical facilities under the effect of COVID-19 in Turkey.

PURPOSE: Aim of this research is to assess the perceptions and views of the anatomy lecturers (educators) of the medical faculties in Turkey on undergraduate distance anatomy education during the COVID-19. METHODS: Anatomy educators nationwide were invited to the online questionnaire developed by the authors. Ninety-one anatomy educators participated in the questionnaire. Views of the participants were evaluated by Likert-type questions and open-ended questions. Distance anatomy education experiences of the participants between March and July 2020 were evaluated. RESULTS: Participants found face-to-face education more beneficial than distance education courses conducted with video recordings. They also reported that they agreed synchronous lessons were more beneficial than asynchronous lessons. They agreed that time management was a positive result. However, they were concerned about the adverse effects of the interruption of formal anatomy education regarding quality. The experience of distance anatomy education applied during the COVID-19 pandemic has revealed the demand for distance theoretical anatomy education supported by video recordings and face-to-face practical anatomy education methods (blended) for the post-pandemic period. CONCLUSION: There is much research focusing on the students regarding the effects of the COVID-19 pandemic on anatomy education. The experiences and the suggestions of the anatomy educators are also important. The findings of the current research have revealed the positive approach to distance theoretical anatomy education and face-to-face practical anatomy education methods (blended) for the post-pandemic period.

Evaluation of views and perceptions of the medical faculty students about distance anatomy education during the COVID-19 pandemic.

PURPOSE: This study aimed to investigate the students' opinions about the distance anatomy education given in our faculty at the COVID-19 pandemic and present our department's experiences. METHODS: An online questionnaire designed for medical faculty students. The questionnaire was applied to 355 volunteer medical faculty students. The questionnaire consisted of demographics, five-point Likert items, and open-ended questions. The questionnaire was applied between August and September 2020. Distance anatomy education activities were evaluated during March and July 2020. RESULTS: Results showed face-to-face theoretical anatomy education was found to be more effective than distance anatomy education conducted with recorded lecture videos. Even though the positive aspects of distance anatomy education stand out in topics, such as time management, it has been stated that cadaver and laboratory education has been disrupted. Most of the students agreed that they spent more time on supplementary resources during distance anatomy education. CONCLUSION: The COVID-19 pandemic has provided an unexpected experimental environment. The demand for a blended method, which consists of distance (supported by video recordings) theoretical anatomy education and face-to-face practical anatomy education for the post-pandemic period comes to the fore. Distance anatomy education brings some problems with it due to its nature, and it is essential to seek unique solutions to them. Evaluating the perceptions of the parties will play an essential role in solving the problems of distance anatomy education and in the formation of future anatomy education styles.