Do the physical and psychosocial symptoms post-COVID constitute a syndrome? A cross-sectional patient survey

COVID-19 also has long-term health implications. The number of reports of people having persisting symptoms is increasing, but the characteristics of a COVID-19 syndrome are unknown. The aim is to assess the presentation of physical and psychological symptoms post-COVID in patients who experienced mild to moderate COVID-19, and to investigate to which extent these constitute a syndrome. A cross-sectional survey, distributed via social media groups of long-COVID sufferers, was conducted. The eligibility criteria were: aged 18 years or older, a history of COVID-19 and the first symptoms of COVID-19 had to be older than 6 weeks. Primary outcome measures are the prevalence of persisting symptoms 3 and 6 months after a COVID-19 infection to identify a post-COVID syndrome. A secondary outcome measure are the patient characteristics associated with persisting symptoms 3 months post-COVID. 787 respondents consented and 539 completed the survey. 471 (87%) participants are female and 259 (49%) are between the age of 36 and 50 years. The most frequently reported symptoms after 6 months are fatigue (52%), decreased concentration and cognitive function (42%), muscle complaints (42%), dyspnoea (39%), sleeping problems (35%), mood swings (20%), depressed mood (19%) and anxiety (18%). A post-COVID syndrome cannot be described. Only the female gender is associated with an increase in the number of symptoms post-COVID. We see a high prevalence of persistent symptoms 3 and 6 months post-COVID. However, despite the high prevalence of symptoms, our analyses do not identify a post-COVID-19 syndrome. Copyright © 2022 Tijdschrift voor Geneeskunde en Gezondheidszorg. All rights reserved.

BEING STRONGER IN NEW GLOBAL SUPPLY CHAIN AFTER THE PANDEMIC: SEEKING TO INCREASE FOREIGN TRADE VOLUME AND EMPLOYMENT SIMULTANEOUSLY IN TURKEY ECONOMY

This study is intended to discuss turning a broken global supply chain into an opportunity by Turkey in post-COVID-19 period and the possibility to be an alternative to China in the sectors in which Turkey is more advantageous and solution seeking to repair the employment structure which has been damaged in pandemic process. Partial direct backward linkages coefficients of both countries were calculated and Leontief similarity test and Spearman correlation test were applied to the obtained coefficients, and the results of both tests were evaluated together. As a result of the analysis, sectors having the advantage of Turkey's foreign trade is as follows: "manufacture of food products", "manufacture of textiles", "manufacture of other non-metalic mineral products", "construction" "manufacture of articles of straw and plaiting materials" and "manufacture of computer, electronic and optical products, manufacture of electrical equipment". The activities of the first 4 of these sectors are among the 6 activities which were published by TOBB and they were most affected by the Covid-19 outbreak and closed down.electronic and optical products, manufacture of electrical equipment".

Weight adjusted prophylactic to intermediate dosed thromboprophylaxis in COVID-19

Background : COVID-19 is frequently associated with venous thromboembolism (VTE), and the use of thromboprophylaxis has been suggested to improve hospitalized patients ' outcomes. We, therefore, intensified our thromboprophylactic protocol starting March 31st. Aims : We aimed to validate the implementation of an intensified thromboprophylactic protocol by reporting VTE incidence and safety while awaiting randomized controlled trials. Methods : On March 31st, 2020, we implemented an intensified thromboprophylactic protocol based on weight and disease severity (50 IU anti-Xa LMWH/kg, once daily at the ward, twice daily at the intensive care unit (ICU)). ICU patients were monitored daily with anti-Xa serum levels. Full therapeutic doses were restricted to patients with a prior indication for therapeutic anticoagulation or confirmed VTE. As early reports demonstrated high VTE incidence, screening with duplex ultrasound became standard of care in our center as soon as logistically possible. We excluded patients with a prior indication for therapeutic anticoagulation and incidental findings of COVID-19 for analysis. The ethical committee has approved this observational study. Results : We analyzed 412 symptomatic and confirmed Covid-19 cases, of which 116 were admitted to the ICU. All symptomatic VTE cases were reported, and 20% of all patients (38% of ICU patients) received screening with venous ultrasound. In 219 patients who received the standard dose of LMWH, 16 patients (7.3%) had VTE, 10 of which were symptomatic (4.6%) (Figure 1). In 193 patients who received intensified thromboprophylaxis, there were no symptomatic VTE cases, three incidental DVT cases (1.6%), and one incidental pulmonary embolism (0.5%). Interestingly, rates of major bleeding were low (Figure 2). Conclusions : In a large cohort of hospitalized patients with COVID-19, we report no symptomatic VTE after implementing systematic thromboprophylaxis with weight-adjusted prophylactic (ward) to intermediate (ICU), but not therapeutic doses of LMWH. This strategy was associated with a low risk of major bleeding.