A retrospective evaluation of people with COVID-19 in Northwest Syria

Aim: In our study, in Northwest Syria, where healthcare is provided with humanitarian support, with investigating the demographic and clinical characteristics of people who has been detected Coronavirus disease-2019 (COVID-19), we investigated their situation in the pandemic. Materials and Methods: The demographic and clinical characteristics of people whose COVID-19 polymerase chain reaction (PCR) tests were studied and found positive in the World Health Organization supported assistance coordination unit laboratories in Northwest Syria, were retrospectively investigated. All patients except healthcare workers were included in the study between 01/05-22/12/2020. Results: 17,070 non-healthcare workers who were positive for COVID-19 PCR were included in the study. 6.368 (37.3%) of the participants were female and 10,702 (62.7%) were male. The average age of the participants was 37.7+or-16.4 years. The data obtained that there were 1.090 (6.4%) people hospitalized or undergoing isolation. When comorbid diseases were investigated, hypertension was found in 435 (2.5%), diabetes in 426 (2.5%), and heart disease in 139 (0.8%) people. When evaluated in terms of prognosis, 56% (n=9584) of the patients showed complete recovery, 41.8% (n=7141) recovered and their symptoms persist, but 345 (2%) patients died of COVID-19, including 106 of them are women (female crude death rate: 1.6%) and 239 of them are men (crude death rate: 2.23%). Conclusion: In our study, we presented a cross-sectional analysis of almost all people with COVID-19 in the last half of the 2020 by investigating the demographic and clinical characteristics of people with COVID-19 in Northwest Syria. COVID-19 diagnoses were evaluated according to the PCR test result.

Can 4C score predict mortality due to COVID-19 pneumonia in Syria? An observational study

INTRODUCTION: The aim of this study was to investigate the patients treated for COVID -19 in pandemic hospitals in northwestern Syria. METHODS: The study evaluated all patients hospitalized for COVID -19 by the pandemic emergency departments of hospitals in northwestern Syria between July 1, 2020 and December 01, 2020. Demographic, clinical, laboratory, and imaging characteristics, 4C mortality index scores treatments, and progressions of all patients hospitalized for COVID -19 were retrospectively reviewed. RESULTS: A total of 991 patients admitted to hospitals in northwestern Syria by pandemic emergency services for treatment and follow-up were included. 114 patients from Afrin Hospital, 251 from Al-Bab Hospital, 527 from Azez Vatan Hospital, and 99 from Jarablus Hospital were included in the study. When comparing the mortality and hospitalization rates of the patients according to the 4C Mortality Score, it was found that the patients with high-risk score in Azez and Jarabulus hospitals and those with very high-risk score in El Bab hospital had significantly higher mortality and hospitalization rates in the ICU (p<0.05). DISCUSSION AND CONCLUSION: The data that can be obtained from studies evaluating the approach to the COVID -19 epidemic in this and similar regions are important for the development of health services in disadvantaged regions. We believe that our study will make an important contribution to the literature, as it is the first and only data reflecting hospitalized patients with COVID -19 in this region.

Rhino-orbital mucormycosis after COVID-19 in the emergency department

Rhino-orbital mucormycosis (ROM) is an acute and fulminant infection. The number of ROM cases developing after coronavirus disease 2019 (COVID-19) is increasing. A 62-year-old male patient was admitted to the emergency department in northern Syria complaining of new-onset vision loss, swelling, and severe swelling of the left eye. It was noted that a 3-day course of prednisolone 250 mg was given to treat COVID-19. We found that he had a history of diabetes mellitus (DM) for 10 years. Physical examination revealed ptosis, proptosis, and ocular movement restriction in all directions in the left eye. All other systemic examinations were normal. A cranial and orbital magnetic resonance imaging scan performed after hospitalization for further evaluation and treatment showed an increase in the density of the sphenoid, ethmoid, and frontal sinus walls in the left orbit. Despite antifungal and surgical treatment, the patient died on day 14. The use of steroids in treatment and the presence of concomitant DM are the main predisposing factors. The prognosis of this disease, which has a high mortality and morbidity, is adversely affected in geographic regions where health care is inadequate.

COVID-19 Pandemisinden

The purpose of this study is to investigate how engagement in leisure time activities influences subjective well-being via perceived leisure satisfaction, as well as the moderating role of perceived severity of COVID-19 in these associations. The data for the analysis were collected using a convenience sampling method from 405 people working in various areas of Turkey via an online survey. Regression analysis, mediating effect analysis, and conditional process analysis were used to examine the hypotheses. The mediation analysis result reveals that leisure time satisfaction plays a mediating role in the relationship between leisure time activities' participation level and subjective well-being. The results of the conditional process analysis demonstrate that the perceived severity of COVID-19 has a conditional influence on the direct and indirect relations between the variables in the conceptual model of the research.

Evaluation of electrocardiographic changes in patients under COVID-19 treatment regimes

Background and Aim: Awareness of electrocardiographic (ECG) changes is crucial in patients who receive coronavirus disease 2019 (COVID-19) treatment. In this study, we aimed to evaluate ECG parameters in patients under COVID-19 therapy and their relationship with the severity of lung involvement and the disease on the basis of thoracic computerized tomography (TCT) findings and laboratory parameters. Material(s) and Method(s): Of 350 patients hospitalized due to COVID-19 between March 2020 and June 2020, 300 patients with available data were retrospectively analyzed. Blood analysis, electrocardiographic, and clinical findings were evaluated. Six-month follow-up data were also recorded. Result(s): The patients were categorized into two groups: Survivor (n = 206, 68.7%, Group 1) and nonsurvivor patients (n = 94, 31.3%, Group 2). The mean total follow-up period was 125.39 +/- 73.09 days. The mean age was similar in both groups. In multivariate regression analysis that aimed to predict COVID-19 disease severity, it was found that besides increased C-reactive protein and D-dimer levels, and >=50% lung involvement in TCT, which are well known as bad prognostic factors, the corrected QT interval duration (QTc) prolongation >=60 miliseconds (msn) during hospitalization was associated with worse prognosis in COVID-19 patients during follow-up. Conclusion(s): Our study is the first study that demonstrated that the presence of >=60 msn QTc prolongation during hospital stay was found to be the most valuable ECG parameter to predict the prognosis and had a significant association with >=50% lung involvement in TCT in patients under anti-COVID therapy. Close monitoring of this ECG parameter is important both in terms of treatment planning and interpretation of disease progression. Copyright © 2022 Society of Cardiovascular Academy. All rights reserved.

Rhino-Orbital Mucormycosis After Covid-19 In the Emergency Department

Rhino-orbital mucormycosis (ROM) is an acute and fulminant infection. The number of ROM cases developing after coronavirus disease 2019 (COVID-19) is increasing. A 62-year-old male patient was admitted to the emergency department in northern Syria complaining of new-onset vision loss, swelling, and severe swelling of the left eye. It was noted that a 3-day course of prednisolone 250 mg was given to treat COVID-19. We found that he had a history of diabetes mellitus (DM) for 10 years. Physical examination revealed ptosis, proptosis, and ocular movement restriction in all directions in the left eye. All other systemic examinations were normal. A cranial and orbital magnetic resonance imaging scan performed after hospitalization for further evaluation and treatment showed an increase in the density of the sphenoid, ethmoid, and frontal sinus walls in the left orbit. Despite antifungal and surgical treatment, the patient died on day 14. The use of steroids in treatment and the presence of concomitant DM are the main predisposing factors. The prognosis of this disease, which has a high mortality and morbidity, is adversely affected in geographic regions where health care is inadequate.

A Retrospective Evaluation of People with COVID-19 in Northwest Syria

Aim: In our study, in Northwest Syria, where healthcare is provided with humanitarian support, with investigating the demographic and clinical characteristics of people who has been detected Coronavirus disease-2019 (COVID-19), we investigated their situation in the pandemic. Materials and Methods: The demographic and clinical characteristics of people whose COVID-19 polymerase chain reaction (PCR) tests were studied and found positive in the World Health Organization supported assistance coordination unit laboratories in Northwest Syria, were retrospectively investigated. All patients except healthcare workers were included in the study between 01/05-22/12/2020. Results: 17,070 non-healthcare workers who were positive for COVID-19 PCR were included in the study. 6.368 (37.3%) of the participants were female and 10,702 (62.7%) were male. The average age of the participants was 37.7 +/- 16.4 years. The data obtained that there were 1.090 (6.4%) people hospitalized or undergoing isolation. When comorbid diseases were investigated, hypertension was found in 435 (2.5%), diabetes in 426 (2.5%), and heart disease in 139 (0.8%) people. When evaluated in terms of prognosis, 56% (n=9584) of the patientsshowed complete recovery, 41.8% (n=7141) recovered and their symptoms persist, but 345 (2%) patients died of COVID-19, including 106 of them are women (female crude death rate: 1.6%) and 239 of them are men (crude death rate: 2.23%). Conclusion: In our study, we presented a cross-sectional analysis of almost all people with COVID-19 in the last half of the 2020 by investigating the demographic and clinical characteristics of people with COVID-19 in Northwest Syria. COVID-19 diagnoses were evaluated according to the PCR test result.

Detection of humoral and cellular responses to SARS-CoV-2 in COVID-19 convalescents

Introduction: The emergence of SARS-CoV-2 virus, which causes COVID-19, is a major global health hazard. Therefore, a comprehensive characterization of the humoral and cellular immune responses to this virus is essential to combat the COVID-19 pandemic. Our goal was to develop reliable methods and tools for the analysis of humoral and cellular B- and T- cell responses, which will facilitate scientific research for prediction of disease progression, long-term immunity and will support vaccine development. Methods: Plasma samples and PBMCs of COVID-19 convalescent and healthy donors were obtained. For the detection of SARS-CoV-2 specific antibodies and identification of antigen-specific B cells, we manufactured recombinant mono-biotinylated protein variants of the Spike (S), Receptor Binding Domain (RBD) and Nucleoprotein (N). To identify antigen-reactive T cells, SARS-CoV-2 peptide pools were synthetized for the S, N and Membrane (M) antigens and used for stimulation. The peptide pools consist of mainly 15-mer peptides having an 11-mer amino acid overlap and thereby overspan a whole protein sequence. Results: To determine the presence of SARS-CoV-2 reactive antibodies a flow-based bead assay using recombinant, mono-biotinylated SARS-CoV-2 antigens loaded onto Streptavidin (SAV)-coated-PMMA beads was set up. The beads were incubated with plasma samples and fluorochrome conjugated anti-human isotype specific antibodies for flow cytometric analysis. All the antigens tested were shown to be suitable for the detection of antibodies to SARS-CoV-2 in COVID-19 convalescent plasma. To assess the feasibility of recombinant antigens for the detection and isolation of antigen-specific B cells, the mono-biotinylated Spike and RBD antigens were tetramerized on fluorochrome-conjugated SAV. These tetramers were used for staining, magnetic enrichment and flow cytometric sorting of B cells specific to SARS-CoV-2 antigens. We were able to demonstrate that our recombinant antigens can be used to assess the presence and enable the phenotyping and isolation of rare antigen-specific B cells. For further characterization of the SARS-CoV-2 reactive T cell immunity PBMCs were short term stimulated with the S, M and N peptide pools. After intracellular staining of IFNg, TNFa, IL-2 and CD154, reactive T cells were detected using flow cytometry. We could demonstrate T cell reactivity towards each peptide pool. However, strengths of T cell responses towards the S, M and N peptide pools were heterogeneous between different COVID-19 convalescent individuals. Conclusion: To support and improve current research activities for the identification and characterization of SARS-CoV-2 reactive humoral and cellular B- and T- cell responses, potent tools and assays were developed. Described here research solutions offer the opportunity to successfully address and contribute to the investigation on healthy and dysfunctional immune reactions towards SARS-CoV-2.

Could smell and taste dysfunction in COVID-19 patients be a sign of the clinical course of the disease?

Background: It could be of great benefit to determine smell and taste dysfunction in COVID-19 patients and to investigate the relationship between these symptoms and clinical characteristics as the determination of points requiring attention during the clinical course of the disease. Method: Evaluations of patients diagnosed with COVID-19 were made using a questionnaire method. Those with smell and taste dysfunction completed a visual analog scale (VAS) to determine severity. The patients were evaluated at the end of 1 and 2 months. Results: Evaluation was made of a total of 105 patients with a mean age of 55.9 +/- 17.6 years. Smell and taste dysfunction was present in 56 (53.3%) patients with a mean age of 48.7 +/- 17.6 years and the 49 (46.7%) patients with no smell and taste dysfunction had a mean age of 64 +/- 13.6 years. It was determined that as age increased, the complaints of smell and taste dysfunction decreased. Full recovery was determined in 31 (55%) patients after 1 month, and in 16 (28%) patients, smell and taste dysfunction continued at the end of the second month. The symptoms of smell and taste dysfunction were determined to last longer in patients with no comorbidities, no symptoms of fever or shortness of breath, and those treated as outpatients (p=0.043, p=0.031, p=0.034, p=0.028, respectively). In the older age patient group, the VAS scores were observed to be higher and the time to recovery was shorter (p=0.007, p=0.018, respectively). Conclusion: Smell and taste dysfunction in COVID-19 patients is seen more as age decreases and recovery takes longer. Smell and taste dysfunction is seen more in patients with symptoms of cough, nasal obstruction, and headache and lasts longer in patients without symptoms of fever and shortness of breath, with no comorbidities and in those treated as outpatients.

Evaluation of demographic and clinical characteristics of healthcare professionals with COVID-19 in Northwest Syria Region

Objective: In our study, we aimed to investigate the demographic and clinical characteristics of healthcare workers with COVID-19 in Northwest Syria during the pandemic, which is a vulnerable area in terms of public health. Methods: In this study, the demographic and clinical characteristics of the healthcare workers who had COVID-19 infection and applied to the ACU (Assistance Coordination Unit) laboratories that were supported by the World Health Organization in the Northwestern Syria Region were retrospectively 40 investigated. Results: F2596 healthcare workers were included into the study. 38.5% (n=1000) of the participants were female and 61.5% (n=1596) were male. The average age of the participants was 33.4∓8.9. According to the profession, the majority of them were nurses (n=1037). In addition, among all, there were 380 (14.6%) doctors, 335 (12.9%) community health workers and 196 (7.6%) cleaners. In Northwest Syria, 953 health workers from Aleppo Region and 1643 from Idlib Region were included in our study. COVID-19 infected healthcare workers were identified as 277 people in Azez, 214 people in Al Bab and 206 people in Afrin located in the Aleppo Region;770 people in Idlib center and 675 people in Harim ocated in the Idlib Region. Among those included in the study, 275 (10.6%) were asymptomatic and 2321 (89.4%) were symptomatic. Most of them (n=2235, 86.1%) had mild symptoms. The most common symptoms were fever (n=1702, 65.6%), dry cough (n=1435, 55.5%) and fatigue (n = 1230, 47.4%). Conclusion: In our study, we have presented a cross-sectional analysis of almost all COVID-19 infected healthcare workers in northwest Syria in the second half of 2020. In the light of the data of our study, in Northwest Syria, where the internal turmoil continues;insufficient physical conditions of the places where the healthcare services are provided, uncontrolled movement of the crowded population, the failure to comply with isolation measures and the insufficient number of healthcare workers may have paved the way for the high infection rate among the healthcare workers. Among the limitations of our study, we can mention the fact that the diagnosis of COVID-19 infection was evaluated according to the results of the PCR test, but the data of the employees with COVID-19 positive findings in lung CT scans are not available in the digital database. © 2021. All rights reserved