A mass vaccination site selection problem: An application of GIS and entropy-based MAUT approach.

- Coronavirus disease (COVID-19) was recognized in December 2019 and spread very severely throughout the world. In 2022 May, the total death numbers reached 6.28 million people worldwide. During the pandemic, some alternative vaccines were discovered in the middle of 2020. Today, many countries are struggling to supply vaccines and vaccinate their citizens. Besides the difficulties of vaccine supply, mass vaccination is a challenging but mandatory task for the countries. Within this context, determining the mass vaccination site is very important for recovering, thus a five-step approach is generated in this paper to solve this real-life problem. Firstly the mass vaccination site selection criteria are determined, and secondly, the spatial data are collected and mapped by using Geographical Information System (GIS) software. Then, the entropy weighting method (EWM) is used for determining the relative importance levels of criteria and fourthly, the multiple attribute utility theory (MAUT) approach is used for ranking the potential mass vaccination sites. Lastly, ranked alternative sites are analyzed using network analyst tool of GIS in terms of covered population. A case study is conducted in Gaziantep city which is the ninth most population and having above-average COVID-19 patients in Turkey. As a result, the fourth alternative (around the Sehitkamil Monument) is chosen as the best mass vaccination site for the city. It is believed that the outcomes of the paper could be used by city planners and decision-makers.

Persistent Post-COVID Symptoms and the Related Factors.

OBJECTIVE: The recently emerged coronavirus 2019 disease is an infectious disease that predominantly affects the respiratory system. In this study, we aimed to evaluate the persistent post-COVID symptoms and the related factors. MATERIAL AND METHODS: This study was conducted on 396 post-COVID patients. The demographic (age, gender, body mass index, smoking, location and duration of treatment, and date of post-COVID follow-up visit) and clinical (symptoms during and after the infection, comorbidities) data were evaluated by interview and a questionnaire. RESULTS: The mean age of the patients was 50.25 years (min-max: 19-85). There were equal numbers of males (n = 198) and females (n = 198) in the study. The mean body mass index was 27.94 (min-max: 17.90-44.92). The majority of patients (n = 222, 56.1%) had been treated at home, while the rates of patients admitted to ward and intensive care unit were 37.1% (n = 147) and 6.8% (n = 27), respectively. The number of patients with at least 1 persistent symptom during post-COVID follow-up visit was 348 (87.9%). The symptoms during the infection included fatigue (n = 339, 85.6%), cough (n = 373, 68.9%), joint pain (n = 267, 67.4%), appetite loss (n = 234, 59.1%), dyspnea (n = 231, 58.3%), while the persistent post-COVID symptoms were fatigue (n = 222, 56.1%), cough (n = 174, 43.9%), dyspnea (n = 171, 43.2%), and chest pain (n = 171, 43.2%). No significant relationships between post-COVID symptoms and age, body mass index, comorbidity, duration from diagnosis to a follow-up visit, and COVID-19 pneumonia during the infection were found, while a statistically significant relationship regarding gender was found. CONCLUSION: There is still a lack of knowledge about the long-term consequences of coronavirus 2019 disease. Moreover, no standardized method exists for categorizing patients into post-COVID controls.

Instability of Tear Film after Novel Coronavirus Disease: A Noninvasive and No Contact Method by a Scheimpflug-Placido Disc Topographer.

PURPOSE: To compare the topographical tear film break-up time (T-BUT) between individuals recovering from COVID-19 and control subjects using a noninvasive and noncontact technique with a Scheimpflug-Placido disc topographer. METHODS: One-hundred and twenty-two eyes from 61 post-COVID-19 patients and 124 eyes from 62 control subjects were included in this prospective study. All participants underwent detailed ophthalmological examination including best-corrected visual acuity, intraocular pressure measurements, slit lamp examination, and fundoscopy as well as qualitative and quantitative evaluation of the noninvasive first tear film break-up time (NIF-BUT) and noninvasive average tear film break-up time (NIAvg-BUT) with T-BUT measured with a Sirius (CSO - Costruzione Strumenti Oftalmici S. r. l., Italy) corneal topography device. RESULTS: The mean NIF-BUT in post-COVID-19 and control patients was 5.2 ± 3.4 vs. 6.5 ± 3.2 sec, respectively. The mean NIAvg-BUT in the corresponding groups was 7.5 ± 3.5 vs. 8.8 ± 3.0 sec, respectively. Both NIF-BUT and NIAvg-BUT were significantly lower in the post-COVID-19 group than in controls (p = 0.004 vs. 0.020). Topographical tear film break-up at any time during the test (17 sec) was observed qualitatively in 79 eyes (64.8%) in the post-COVID-19 group and 57 eyes (46%) in the control group (p = 0.003). Moreover, temporal quadrant involvement occurred significantly more frequently in the post-COVID-19 group (p = 0.028). CONCLUSION: Tear film stability assessment based on T-BUT showed shorter NIF-BUT and NIAvg-BUT in post-COVID-19 patients as compared to the control group. Our results suggest that post-COVID-19 patients have impaired stability of tear film, and therefore require closer monitoring regarding dry eye. In addition, tear film instability in post-COVID-19 patients can be reliably detected using a noninvasive and noncontact technique that is more comfortable for both patients and physicians.

Evaluation of criteria and COVID-19 patients for intensive care unit admission in the era of pandemic: A multi-criteria decision making approach.

BACKGROUND AND OBJECTIVE: The COVID-19 pandemic results in an intense flow of patients to hospitals especially to the intensive care units (ICUs) to be treated. The ICUs will therefore be confronted with a massive influx of patients (e.g. Spain and Italy). However, if the number of patients is higher than the resources available in ICUs, rationing decisions such as determining and evaluating the criteria for ICU admission becomes essential. In this case, the decision of which patients will be admitted to the ICUs may put significant pressure on healthcare personnel. The goal of this paper is to determine the criteria to be used in the decision of admission of COVID-19 patients to the ICUs. METHODS: A three-step methodology is applied. In the first step, the evaluation criteria are determined, and then the criteria are prioritized using a fuzzy analytical hierarchy process (AHP) in an uncertain and multiple-criteria environment choice. Finally, COVID-19 patients are ranked using the Multi-Objective Optimization Method by Ratio Analysis to find out which patient is more urgent. RESULTS: According to experts' evaluation of ICU admission criteria, "increment of >2 in SOFA score" seems the most dominant factor among others. The proposed methodology is tested on 10 anonymous COVID-19 positive patients being treated in a public hospital and the ICU admission results are discussed. CONCLUSIONS: Obtained priorities and ranking is in line with the hospitals' behavior that potentially depicts the usefulness and validity of the proposed approach.