ABSTRACT
Introduction: We aimed to compare the COVID-19 outcomes in unvaccinated and CoronaVac vaccinated older adults. Material(s) and Method(s): In this single-center study, patients aged >=65 years who were hospitalized for COVID-19 were retrospectively analyzed in two groups: unvaccinated and vaccinated. Result(s): A total of 742 patients were included. The mean age was 76.6+/-7.6 years. Of these, 46.1% (n=342) were male, 76.0% (n=564) were vaccinated. Among patients who were transferred to the intensive care unit (n=217), 206 (27.8%) received invasive mechanical ventilation support and 194 (26.1%) were died. In the multivariate analysis, advanced age (OR=1.03, 95%CI=1.01-1.06, p<0.01) and a high Charlson Comorbidity Index (OR=1.24, 95%CI=1.12-1.38, p<0.01) were predictors of mortality, while being vaccinated (OR=0.75, 95%CI=0.62-0.91, p<0.01) was associated with survival. Vaccination reduced the need for intensive care by 26.5% and mortality by 24.9 %. When the vaccinated group was evaluated, high Charlson Comorbidity Index (OR=1.428, 95%CI=1.14-1.64, p<0.01) was an independent predictor for mortality. However, booster vaccination in the last 130 days was the only protective factor that reduced mortality (p=0.04, 95%CI=0.43-0.99, OR=0.66) in multivariate analysis. Booster dose vaccination in the last 130 days reduced mortality by 33.8%. Conclusion(s): CoronaVac vaccination improved survival in hospitalized older adult patients (>=65 years old) with COVID-19. However, delaying the booster dose for more than 130 days were significantly associated with decreased survival. Therefore, older adults who completed their primary vaccination series with CoronaVac should not delay their booster dose to reduce the risk of death. Copyright © 2022, Geriatrics Society. All rights reserved.
ABSTRACT
Introduction: Neurological symptoms in SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infected patients and the course of COVID-19 in patients with neurological findings are determined. Material and methods: Inpatient cases aged =18 years, followed-up in clinical services for COVID-19 diagnosis are studied. Patients were visited on 04.20.2020 and examined for central nervous system (CNS), peripheral nervous system (PNS) manifestations and muscular injury, from onset of symptoms to hospitalization. Risk factors associated with the severity of COVID-19 and the comparison of variables in terms of existence of neurological findings including CNS and PNS findings were performed. Results: Overall, 133 (54%) of the 242 patients of the study were male, mean age was 56.82±16.35 (18-91) years. Of these, 128 (52%) cases were defined as severe COVID-19. Outstanding symptoms at the onset were cough (62.8%), fever (46.7%), dyspnea (45.9%), and tiredness (31%). Further, 82 (33.9%) cases showed neurological findings at the first admission. Of those with neurological symptoms, 25.6% had CNS, 16.1% had PNS, 1.7% had muscular symptoms. In patients with CNS manifestations, the most common symptoms were headache (20.6%) and dizziness (7.4%). Impaired taste was the most common manifestation of PNS (11.2%). Neurological symptoms showed no significant difference between severe and non-severe COVID-19 groups except impaired taste (significantly higher in non-severe group). During follow-up, 17 (7%) patients needed intensive care unit. Nine (3.6%) patients died. Conclusion: Frequency and variety of neurological findings in COVID-19 cases is too high to underestimate. Early diagnosis of these findings may prevent spread of COVID-19.
ABSTRACT
Introduction: It was aimed to assess the economic burdens of inpatients with Coronavirus disease 2019 (COVID-19) to the social security institution. Materials and methods: Patients, who were 18 years and older, diagnosed with COVID-19 by the laboratory (PCR test) or clinical and radiological (by the computed tomography of the thorax or a chest X-ray) findings and received treatment for at least 24 hours in clinics or intensive care unit (ICU) of Taksim Training and Research Hospital, Istanbul, Turkey that serves with 250 beds at clinics and 38 beds at ICU, between 17 March and 11 May 2020, were included in the study. Results: In the study, the invoices of 393 (76%) clinical patients (CPs) and 66 (24%) intensive care unit patients (ICUPs), consisting of the 255 (58%) males and 178 (42%) females, were analyzed. The mean hospitalization days of CPs were 8.97±4.64 days (Range 1-49 days). The mean cost per CP was $ 881.75±667.31 (Range: $45.07 - $7584.81). The mean cost per one-day for one CP was $ 101.2 ± 75.95 (Range: $6.58 - $1264.14). The mean hospitalization days of ICUPs were 14.74±13.19 days (Range: 1-61 days). The mean cost per ICUP was $2924 ± 2347.14 (Range: $223.01- $9681.88). The mean cost per one-day for one ICUP was $231.9±92.53 (Range: $22.3 - $480.73). Conclusion: The encouragement of domestic production of medical materials and medicines, the implementation of lowest drug price policy as a result of negotiations with pharmaceutical companies, the construction of medical care settings in less time and the settlement of medical care systems through previous experiences and achievements, and the deceleration of incident rates with restrictions were the main factors in the reduction of financial burden of COVID-19.