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Introduction: Healthcare workers are at the frontline of the COVID-19 pandemic and identified as a priority group for COVID-19 vaccines. We aimed to determine to COVID-19 vaccine acceptance rate and reasons for vaccine refusal in healthcare workers in our hospital. Materials and Methods: A questionnaire consisting of eight questions was applied to healthcare workers working at Ankara City Hospital for 7.5 months after the start of the COVID-19 vaccine in our country, including COVID-19 vaccination, previous years' influenza vaccination, and reasons for vaccine rejection. Results: Six hundred twenty-eight healthcare workers participated in the study. Two hundred fifty-six (40%) of them were doctors. Ninenty-nine of the participants were not vaccinated, the rate of vaccine rejection was 15.7%. The rate of vaccine rejection was the lowest (8.2%) among doctors, and lower among doctors working in the fields of COVID-19 (p= 0.041). While the rates of getting the COVID-19 vaccine were significantly higher in those who had regular or intermittent influenza vaccination every year in the previous years, those who had never had the influenza vaccine did not receive the COVID-19 vaccine either (p= 0.000). The most common reason for vaccine rejection was 'fear of the side effects of the vaccine' (24%), while 'I believe the disease is mild' and `I want to gain immunity naturally' were other common reasons. Conclusion: Vaccination of healthcare workers has gained even more importance in the COVID-19 pandemic, with both risky and severe working conditions and mortality rates. Determining the reasons for vaccine refusal, finding effective solutions, emphasizing the necessity of vaccination with scientific evidence are important for the control of the pandemic. Vaccination of health workers is a guide in community immunization.
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OBJECTIVE: The present study aimed to evaluate and compare the use of 2 different high-dose methylprednisolone posology in treat-ing severe coronavirus disease 2019 pneumonia regarding mortality and recovery time between themselves and against steroidal/ non-steroidal treatment. MATERIAL AND METHODS: Severe coronavirus disease 2019 patients followed up between March 2020 and January 2021 were included. The steroid-free treatment protocol was applied before August 2020 (non-pulse group) and a treatment algorithm containing normal and high doses of methylprednisolone was applied after August 2020 (pulse group). Patients with clinical deterioration under the normal dose of methylprednisolone were administered 250 mg or 1000 mg of methylprednisolone for 3 days. We compared the pulse and non-pulse groups, in addition to pulse subgroups with each other, for clinical outcomes. RESULT(S): A total of 138 patients were included, including 36 patients in the non-pulse group and 102 in the pulse group. In the pulse group, 70 patients received 1000 mg/day and 32 received 250 mg/day of high-dose methylprednisolone therapy. In the comparison of pulse and non-pulse patient groups, mortality rate was lower in the pulse group (P <.001), and the time to discharge without oxygen support was shorter. Although the patients in the 250 mg subgroup were older, there was no difference between the 250 mg and 1000 mg subgroups in terms of end of oxygen requirement, discharge with oxygen support, and mortality. In addition, the required time to reach the oxygen-free period in patients discharged without oxygen support was similar in the 2 subgroups, and the majority of patients in both subgroups reached the oxygen-free period on the 20th day after initiating methylprednisolone. CONCLUSION(S): Since there was no difference in clinical improvement between the use of 250 mg or 1000 mg methylprednisolone in patients with severe coronavirus disease 2019 infection, 1000 mg methylprednisolone was not required.Copyright © 2023, AVES. All rights reserved.
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Introduction: Healthcare workers are at the frontline of the COVID-19 pandemic and identified as a priority group for COVID-19 vaccines. We aimed to determine to COVID-19 vaccine acceptance rate and reasons for vaccine refusal in healthcare workers in our hospital. Material(s) and Method(s): A questionnaire consisting of eight questions was applied to healthcare workers working at Ankara City Hospital for 7.5 months after the start of the COVID-19 vaccine in our country, including COVID-19 vaccination, previous years' influenza vaccination, and reasons for vaccine rejection. Result(s): Six hundred twenty-eight healthcare workers participated in the study. Two hundred fifty-six (40%) of them were doctors. Ninenty-nine of the participants were not vaccinated, the rate of vaccine rejection was 15.7%. The rate of vaccine rejection was the lowest (8.2%) among doctors, and lower among doctors working in the fields of COVID-19 (p= 0.041). While the rates of getting the COVID-19 vaccine were significantly higher in those who had regular or intermittent influenza vaccination every year in the previous years, those who had never had the influenza vaccine did not receive the COVID-19 vaccine either (p= 0.000). The most common reason for vaccine rejection was 'fear of the side effects of the vaccine' (24%), while 'I believe the disease is mild' and 'I want to gain immunity naturally' were other common reasons. Conclusion(s): Vaccination of healthcare workers has gained even more importance in the COVID-19 pandemic, with both risky and severe working conditions and mortality rates. Determining the reasons for vaccine refusal, finding effective solutions, emphasizing the necessity of vaccination with scientific evidence are important for the control of the pandemic. Vaccination of health workers is a guide in community immunization.Copyright © 2022 Bilimsel Tip Yayinevi. All rights reserved.
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OBJECTIVE: As the pandemic continues, different vaccine protocols have been implemented to maintain the protection of vaccines and to provide protection against new variants. The aim of this study was to assess hospitalized patients' vaccination status and document the efficacy of boosters. PATIENTS AND METHODS: The patients that were hospitalized due to COVID-19 were enrolled from 28 hospitals in Turkey for five months from September 2021. 5,331 confirmed COVID-19 patients from collaborating centers were randomly enrolled to understand/estimate the distribution of vaccination status in hospitalized patients and to compare the efficacy of vaccination/booster protocols. RESULTS: 2,779 men and 2,552 women of which 2,408 (45.2%) were admitted to Intensive Care Units participated in this study. It was found that the highest risk reduction for all age groups was found in groups that received 4 doses. Four doses of vaccination for every 3.7 people under 50 years of age, for every 5.7 people in the 50-64 age group, and for every 4.3 people over 65 years of age will prevent 1 patient from being admitted to intensive care. Regardless of the type of vaccine, it was found that the risk of ICU hospitalization decreased in those who were vaccinated compared to those who were not vaccinated. Regardless of the type of vaccine, the ICU risk was found to decrease 1.25-fold in those who received 1 or 2 doses of vaccine, 1.18-fold in those who received 3 doses, and 3.26-fold in those who received 4 doses. CONCLUSIONS: The results suggested that the addition of a fourth dose is more effective in preventing intensive unit care even in disadvantaged groups.
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COVID-19 , Male , Humans , Female , Aged , COVID-19/epidemiology , COVID-19/prevention & control , Hospitalization , Intensive Care Units , Hospitals , Critical CareABSTRACT
Introduction: Healthcare workers are at the frontline of the COVID-19 pandemic and identified as a priority group for COVID-19 vaccines. We aimed to determine to COVID-19 vaccine acceptance rate and reasons for vaccine refusal in healthcare workers in our hospital. Materials and Methods: A questionnaire consisting of eight questions was applied to healthcare workers working at Ankara City Hospital for 7.5 months after the start of the COVID-19 vaccine in our country, including COVID-19 vaccination, previous years' influenza vaccination, and reasons for vaccine rejection. Results: Six hundred twenty-eight healthcare workers participated in the study. Two hundred fifty-six (40%) of them were doctors. Ninenty-nine of the participants were not vaccinated, the rate of vaccine rejection was 15.7%. The rate of vaccine rejection was the lowest (8.2%) among doctors, and lower among doctors working in the fields of COVID-19 (p= 0.041). While the rates of getting the COVID-19 vaccine were significantly higher in those who had regular or intermittent influenza vaccination every year in the previous years, those who had never had the influenza vaccine did not receive the COVID-19 vaccine either (p= 0.000). The most common reason for vaccine rejection was 'fear of the side effects of the vaccine' (24%), while 'I believe the disease is mild' and 'I want to gain immunity naturally' were other common reasons. Conclusion: Vaccination of healthcare workers has gained even more importance in the COVID-19 pandemic, with both risky and severe working conditions and mortality rates. Determining the reasons for vaccine refusal, finding effective solutions, emphasizing the necessity of vaccination with scientific evidence are important for the control of the pandemic. Vaccination of health workers is a guide in community immunization.
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After the declaration Global Health Sector Strategy on Viral Hepatitis by the World Health Organization in 2016, the Turkish Government defined a national strategy covering 2018-2023 to reach goals by 2030. Following a participatory decision process and a series of workshops, the strategy was built on eight separate subheadings. Apart from the official Prevention and Control Program, two separate road maps for hepatitis B and C were developed to obtain targets accessible with the cooperation of the Viral Hepatitis Society and the Turkish Association for the Study of the Liver in 2018 and 2020, respectively. Up to 2023, achievements and the current situation of the National Viral Hepatitis Prevention and Control Program and the hepatitis B virus and hepatitis C virus road maps were assessed in detail on June 28th, 2022, by the subject matter experts in Turkey. Besides the officially reported achievement rate (42%) of the Program in 2021, participants mentioned undesirable effects of the coronavirus disease-2019 pandemic, unregulated migration, low levels of professional and public awareness, and barriers to access to anti-viral treatment. Recommendations focused on increasing the efficiency of screening and surveillance by integrating the viral carrier identity of individuals into the national health information system, simplifying the drug supplement and treatment initiation process and insisting on education to raise awareness.
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Introduction: We aimed to assess the present knowledge, attitude and anxiety levels of coronavirus disease 2019 (COVID-19) among healthcare workers at Ankara City Hospital. Materials and Methods: The study was implemented in the form of an online survey, based on voluntary participation and conducted on healthcare workers at the Ministry of Health Ankara City Hospital by using convenience sampling and snowball method between 30 May-2 July 2020. There were 28 questions on knowledge and 8 questions on attitude. The Beck Anxiety Inventory (BAI) was used to measure the anxiety level of the participants. The results were analyzed using the SPSS program. Results: Of the participants, 75% were females, 61.25% were nurses/midwives, and mean age was 34.5 ± 10.1 years. A significant portion of the participants (84.50%) had a moderate or adequate level of knowledge. The highest knowledge score in terms of their professions are doctors, followed by nurses/midwives. The most used resource (71.25%) by our participants was the Ministry of Health’s web page, posters and brochures. The knowledge adequacy of those who have a case algorithm is 1.8 times. Of the participants, 61.0 % demonstrated a positive attitude. 25.25% were gauged to have severe and moderate anxiety. Of the participants, 42.39% stated that anxiety causing reason was the future of their family in case of death in our study. The anxiety score of the female participants was higher than that of the men, young people were higher than the other age groups. There was no significant correlation between the level of knowledge and attitude;whereas a negative, weak correlation was identified between the level of knowledge and anxiety, and between attitude and anxiety. Conclusion: Although the knowledge level of the participants was found to be adequate, in-service training on infection control measures, especially on the use of personal protective equipment should be continued using official information, such as algorithms are designed and other sources by the Ministry of Health. Health workers, especially women and young people, should be monitored psychologically, treated and social support for them should be increased during the pandemic. Increasing knowledge and positive attitudes may be contribute to decrease anxiety scores.
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Objectives: Clinical features and risk factors are highly variable for Coronavirus disease-2019 (COVID-19). Researchers investigate for the prediction of people who have high risk of developing severe illness and dying. The aim of this study is to examine the effect of obesity on the course of COVID-19. Materials and Methods: Patients with laboratory confirmed COVID-19 were retrospectively screened between March 11 and April 30. Anthropometric measures including standing height and body weight were measured at admission. Body mass index (BMI) was calculated and patients were classified into three groups as BMI< 25, BMI 25-29.99, and BMI30 according to the guidelines for the diagnosis and treatment of obesity in Turkey.
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Objective: Early diagnosis is important for severe diseases in COVID-19. Monocyte/high dansity lipoprotein ratio (MHR) is a new prognostic marker indicating inflammation. We aimed to investigate the relationship between MHR and diseases severity in COVID-19. Methods: Patients with laboratory confirmed COVID-19, were retrospectively analyzed. Clinical symptoms, signs and laboratory data on the first day of hospitalization were obtained from medical records of hospital. The clinical data of 301 patients were included in study. Cases were diagnosed on the basis of interim guidance of World Health Organization (WHO). Patients were classified into two groups as non-severe COVID-19 and severe COVID-19. MHR were calculated with laboratory data on the first day of hospitalization. The relationship between MHR level and COVID-19 severity was evaluated. Statistical analysis of the data was performed by using SPSS 25 (SPSS Inc., Chicago, IL, USA) package program. Statistical significance level was accepted as p<0.05. Results: One hundred ninety-six patients (65.1 %) had non-severe COVID-19,105 patients (34.9 %) had severe COVID-19. In our study, it was found that the mean age was higher in severe patients and comorbid diseases were more common. Although monocyte count values were not statistically significantly different, MHR was significantly higher in severe COVID-19 than non-severe COVID-19. Conclusions: Monocytes are very important to cytokine storm in COVID-19. Dyslipidemia can occur in viral infection because of inflammation. MHR can be used as an inflammatory marker in COVID-19.
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Objective: The coronavirus disease 2019 (COVID-19) has placed huge strains on medical systems. Therefore, it is essential to determine the predictors of the long hospital stay. We sought to investigate whether alterations in left ventricular (LV) geometry in COVID-19 patients are associated with the length of stay (LoS) and a long hospital stay. Materials and Methods: 108 consecutive hospitalized COVID-19 patients were incorporated in the study and 89 patients remained for statistical analysis. All participants underwent standard two-dimensional (2D) and Doppler echocardiographic examinations. Patients were classified according to LV geometry characteristics namely normal geometry (NG), concentric remodeling, concentric hypertrophy and eccentric hypertrophy. Results: Multiple binary logistic regression model adjusted for clinical and laboratory variables yielded significant and independent association of LV mass index (LVMI) (OR: 1.12, 95% CI: 1.06-1.19, p<0.001), 10 g/m(2) increase in LVMI (OR: 3.63, 95% CI: 2.00-6.59, p<0.001), LV geometry patterns (OR: 2.92, 95% CI: 1.46-5.34, p=0.002), and altered geometric patterns compared to NG (OR: 3.97, 95% CI: 1.08-14.5, p=0.037) with long hospital stay. Correlation analysis of LVMI and LoS demonstrated significant and moderate correlation (rho=0.58, p<0.001). Conclusion: LVMI and LV geometric patterns independently predict long hospital stays in COVID-19 patients. The significant correlation between LoS and LVMI underlies the significance of LV geometry in this infection.
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Coronavirus disease-2019 (COVID-19) is a global health problem causing morbidity and mortality. It has a clinical spectrum ranging from an absence of symptoms to acute respiratory distress syndrome. A new COVID-19-related clinical finding is published daily. We report here a patient with COVID-19 and cerebral venous sinus thrombosis and no deep vein thrombosis or any underlying predisposing factors for hypercoagulation.
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Subacute thyroiditis (SAT), is a self-limiting inflammatory disorder which is linked to a viral infection. A few cases of SAT were reported after Severe Acute Respiratory syndrome Coronavirus-2 (SARS-CoV-2) infection. We here reported a case of SAT that occurred two weeks after SARS-CoV-2 infection. A thirty-nine-year-old male with no comorbid diseases applied to our outpatient clinic with the complaints of sore throat, fatigue and subfebrile fever. He had a contact history of his wife who has a positive SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) test. The nasopharyngeal swab was performed and his SARS-CoV-2 RT-PCR test was confirmed positive. He recovered from all symptoms in one week. On the second week of the first diagnosis, he developed neck pain, fatigue, muscle pains, palpitation and tremors. Because his thyroid palpation was painful and he was more symptomatic thyroid function tests were performed. Thyrotropin was suppressed (0.01 mIU/L), free triiodothyronine and free thyroxine levels were high as 11 ng/L and 3.72 ng/dL, respectively. His cervical ultrasound also revealed SAT. He was treated with prednisolone, ibuprofen and propranolol. Within one week, there was a progressive resolution of signs and symptoms. After the third week, his laboratory results returned to normal ranges.
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Background: Vitamin D is recognized to be an immune regulator. Also, it is known to have antiviral effects by several mechanisms, including reducing inflammatory cytokines. Objectives: To examine the 25-hydroxyvitamin D (25(OH) D) status for assessing the severity of COVID-19. Methods: This study consisted of 596 patients confirmed as SARS-CoV-2 infection and 59 healthy individuals. The cases separated into non-severe group, severe survival, and severe non-survival group. 25(OH)D and other laboratory parameters were evaluated retrospectively. Results: In all COVID-19 groups 25(OH)D levels were low compared to controls (p<0.05). 25(OH)D concentrations were lowest in patients in severe non-survival groups than those in other SARS-CoV-2 infection groups (p<0.05). Multivariate regression analysis exhibited that decreasing 25(OH)D was associated with an increased likelihood of non-severe, severe survival and severe non-survival disease. There were significant associations between 25(OH)D and certain inflammatory and hemostatic parameters (p<0.05, for all). Conclusions: 25(OH)D deficiency was observed among patients with COVID-19. Declined steadily 25(OH)D levels make a huge contribution to the scale of the progression of the disease. Correlations support that 25(OH)D may be a substantial tool for utilizing the severity of the disease and estimating the survival. Also, supplementation of 25(OH)D might slow down the course of the COVID-19.
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Objectives: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is isolated as the cause of coronavirus disease-2019 (COVID-19). Middle ear and mastoid air cells are covered with the airway mucosa. In COVID-19, an involvement occurs in the airway mucosa;however, although the involvement of eustachian tube covered with this mucosa, middle ear, and mastoid is not known, there can be an intervention. The aim of the study is to investigate the findings of temporal tomography and evaluate the middle ear and mastoid in COVID-19. Materials and Methods: A retrospective observational study was planned. Patients with a positive polymerase chain reaction (PCR) test for SARS-CoV-2 and diagnosed with COVID-19 were included in the study. COVID-19 patients, who had temporal bone tomography scans (CT), were evaluated. One hundred twenty-nine COVID-19 patients with positive PCR, who also had temporal bone scans, were included in the study. A grading system was used to evaluate the effusion in the middle ear and mastoid cells. According to this grading system, left and right middle ear and mastoid were evaluated separately. In the grading system, the scores were evaluated as 0=no effusion, 1=partial effusion, and 2=100% effusion. The maximum score was accepted as 8. Bilateral tympanic membranes of all the patients were normal.
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Background and Aim: The inflammatory response plays a critical role in coronavirus disease 2019 (COVID-19) and inflammatory cytokine storm increases the severity of COVID-19. Epicardial adipose tissue serves as a source of inflammatory cytokines and mediators. This study aimed to investigate the association between epicardial fat volume (EFV), inflammatory biomarkers and clinical severity of COVID-19. Methods: This retrospective study included 101 patients hospitalized with COVID-19 between March 11 and April 21, 2020. Laboratory findings, treatment and complications were recorded. The serum inflammatory biomarkers including C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT) and ferritin levels were measured. Computed tomographic images were analyzed and semi-automated measurements for EFV were obtained. The primary composite endpoint was admission to intensive care unit (ICU) or death. Results: The primary composite endpoint occurred in 25.1% (n=26) of patients (mean age 64.8±14.8 years, 14 male). A total of 10 patients died (mean age 71.9±14.3, 6 male). EFV (115.1±44.0 cm3 vs 94.3±45.5 cm3, respectively, p=0.037), CRP, PCT, ferritin and IL-6 levels were significantly higher in ICU patients. Moreover, a positive correlation between EFV and CRP (r=0.494, p<0.001), PCT (r=.287, p=0.005), ferritin (r=0.265, p=0.01) and IL-6 (r=0.311, p=0.005) was determined. At receiver operating characteristic analysis, patients with EFV >102 cm3 were more likely to have severe complications. Conclusions: Epicardial fat volume and the serum levels of CRP, IL-6, PCT and ferritin can effectively assess disease severity and predict outcome in patients with COVID-19.