ABSTRACT
Objective: The objective of this study was to evaluate how the coronavirus disease 2019 pandemic affected the profile of patients admitted to the electromyography (EMG) laboratory and the types of neurophysiologic evaluations. Method(s): We included patients who were admitted to our EMG laboratory in the first 6 months of the pandemic period (Period 1) and the same 6 months of the previous year (Period 2). In view of changes in health-care strategies, lockdown, and disease awareness during the pandemic, each group was divided into 3-month periods (early and late). Demographic and clinical characteristics and electrophysiologic data were evaluated retrospectively and compared between the groups. Result(s): In Period 1, there were 1872 studies of 1829 patients, and in Period 2, there were 625 studies of 607 patients. Electrodiagnoses for cranial neuropathies were more frequent during the pandemic when compared with before the pandemic (P = 0.018). The subgroup analysis revealed that the ratio of segmental anterior horn involvement decreased in the early pandemic period (P = 0.003), myopathies decreased in the late pandemic period (P = 0.001), and cranial neuropathies increased in the late pandemic period (P = 0.005) compared with the same periods in the previous year. Conclusion(s): During the pandemic, there have been changes in clinical practice approaches in the electrophysiology laboratory. More cranial neuropathies seemed to be diagnosed in the EMG laboratory during the pandemic, including new-onset facial neuropathies, which was the most significant finding of our study.Copyright © 2023 AVES. All rights reserved.
ABSTRACT
Introduction: In the post-acute phase, COVID-19 survivors may have persistent symptoms, lung function abnormalities and sequela lesions on thorax CT. This new entity is defined as post-COVID Interstitial Lung Disease (ILD) or a residual disease. Aim(s): To investigate the characteristics and clinical significance of post-COVID-19 ILD. Method(s): Patients with persistent respiratory symptoms after recovery were evaluated by a team including two pulmonologists and a radiologist. Pulmonary function tests, 6-minute walking test, thorax HRCT were performed. Post-COVID ILD was defined as presence of all the followings: respiratory symptoms, hypoxemia, restrictive lung functions and interstitial changes on follow-up HRCT. Result(s): A total of 375 post-COVID-19 patients were evaluated on average 91 days after recovery and 262 of them were included. 17.9 % of the patients were non-hospitalized with mild COVID-19;10.8 % of the patients had received high flow nasal oxygen, of 17.5 % had required non-invasive mechanical ventilation, of 8.8 % had been intubated. The most prevalent symptoms were dyspnoea, exercise intolerance and fatigue. The mean mMRC score was 1.82, oxygen saturation was 94.1, 6-minute walking distance was 374 meters. Pulmonary functions (percentage of mean predicted value +/- SD) were as follows;FEV1:79+/-19, FVC: 73+/-19, FEV1/FVC: 87+/-9, DLCO: 64.5+/-21.8. On CT, GGOs, fibrotic bands, and a combination of them were detected. The mean CT score was 13.5. Discussion(s): The presence of symptoms and functional defects in addition to radiological parenchymal lesions requires the definition of this new entity is post-COVID-19 ILD which could be seen even in non-hospitalised patients with mild COVID-19.
ABSTRACT
Introduction: Post-COVID-19 Interstitial Lung Disease (ILD) is controversial and need for treatment is unclear. Aim(s): To investigate the efficacy of methylprednisolone in the treatment of post-COVID-19 ILD. Method(s): This multicentre, prospective, randomized controlled clinical trial, included post-COVID ILD patients (ClinicalTrials.gov, NCT:04988282). Post-COVID ILD was defined as the presence of respiratory symptoms, hypoxemia, restrictive lung functions and parenchymal infiltrates on thorax HRCT. 262 post-COVID-19 patients were randomly assigned to one of two arms: the steroid group (n:135) or control group (n:127). For 4 weeks, the steroid group received oral methylprednisolone at a dose of 0.5 mg/kg/day (maximum dose: 48 mg/day). At the end of the study, thorax HRCT, 6-minute walking test and lung function tests were re-evaluated. A good response was defined as a mMRC score of 0, a FVC percentage greater than 80% and absence of hypoxemia at rest or during exercise, greater than 90% resolution of lesions on CT. Result(s): Good clinical and functional response rates were higher in steroid group compared to the control group (62.9% vs 33.3%;54.1% vs 33.7%, p<0.001, respectively). Patients with a radiological response in steroid group tend to be higher than control group, but not statistically significant (61.1 % vs 51.1 %, p=0.159). The increase in oxygen saturation, FVC, and 6-minute walking distance were significantly higher in the steroid group compared to the control. Discussion(s): Systemic corticosteroids improves clinical and functional characteristics and increases oxygen saturation, FVC, and exercise capacity in post-COVID ILD patients compared to the natural course of the disease.
ABSTRACT
Background: Healthcare workers (HCWs) face work-related psychosocial risks. The ongoing pandemic is causing widespread concern in a variety of ways, including COVID-19 fear and anxiety. Objective(s): We aimed to evaluate mental health, quality of life, COVID-19 fear and related factors in Turkish HCWs practicing in pandemic hospitals. Method(s): The data were collected in 13 provinces between 27 September and 11 November 2021 by researchers from the Early Career Task Force of the Turkish Thoracic Society. The study survey included sociodemographic, health- and work-related characteristics, the General Health Questionnaire-12 (GHQ-12) evaluating mental health, the World Health Organization Quality of Life-BREF (WHOQoL-BREF) questionnaire and the Fear of COVID-19 Scale (FCV-19S). Result(s): Of 1,556 participants, 522 (33.5%) reported a need for mental health support (MHS) in the previous year. The FCV-19S weakly correlated with the GHQ-12 (r=0.234, p<0.001) and WHOQoL-BREF domains (r=-0.245 for physical health, r=-0.182 for psychological health, r=-0.141 for social relationships and r=-0.183 for environmental health domains;p<0.001). The need for MHS was the common significant variable for all scale scores in univariate analyses and multiple linear regression. After multiple linear regression, the FCV-19S score was significantly related to the GHQ-12 and all WHOQoL-BREF domain scores. Conclusion(s): Our results indicate a remarkable level of need for MHS. The need for MHS and COVID-19 fear are related to mental health and quality of life in Turkish HCWs. The self-reported need for MHS may serve as an alarming characteristic for HCWs' psychosocial burden.
ABSTRACT
Background: Coronavirus (COVID-19) infection has made restrictions on every sports level, from the audience to athletes worldwide. Volleyball players' life were affected by COVID-19 infection, the layout of training, and competitions. This study aims to show the effect of COVID-19 infection on the performance of volleyball players. Methods: Nineteen volleyball players aged 15-20 in the same volleyball club and infected with COVID-19 in the first league of their country were included in the study. Weight, height, fat percentage, muscle mass, countermovement jump, Squat jump, Spike jump tests, and agility T-tests records were compared before (1 and 2 measures) and after the COVID-19 infection (3 and 4 measures). The team physician asked and recorded the players' feelings about changes in their sports performance after the COVID-19 infection. Results: The mean number of PCR (+) days was 13.4 +/- 2.6. All the median differences of the vertical jump tests had a statistically significant increase at every measure except for the Countermovement jump and squat jump' last two measures, squat jump' first two measures, and spike jump' between twice and third measures. The median differences between the first and last agility T-tests were not statistically significant (p = 0.277). The feeling of volleyball players about the sports performance level was decreased by 57.9%, increase 10.5%, no change 31.6%. Conclusions: Volleyball players' vertical jump performance was getting better despite the COVID-19 infection in our study. Inactivity might be more harmful than COVID-19 infection on sports performance.
ABSTRACT
Objectives: Our study aimed to evaluate the eating patterns of children as well as parental anxiety on virus transmission along with associated factors in the first month of the Coronavirus disease-2019 (COVID-19) pandemic and to compare the results to pre-epidemic patterns. Materials and Methods: This study was planned as a multi-center (n=8), cross-sectional study. Informed consent forms and questionnaires were sent to the parents of the children between the ages of 6 and 18 years who applied to the study centers and accepted study participation via e-mail or instant messaging applications.
ABSTRACT
Background: Coronavirus (COVID-19) infection has made restrictions on every sports level, from the audience to athletes worldwide. Volleyball players' life were affected by COVID-19 infection, the layout of training, and competitions. This study aims to show the effect of COVID-19 infection on the performance of volleyball players. Methods: Nineteen volleyball players aged 15-20 in the same volleyball club and infected with COVID19 in the first league of their country were included in the study. Weight, height, fat percentage, muscle mass, countermovement jump, Squat jump, Spike jump tests, and agility T-tests records were compared before (1 and 2 measures) and after the COVID-19 infection (3 and 4 measures). The team physician asked and recorded the players' feelings about changes in their sports performance after the COVID-19 infection. Results: The mean number of PCR (+) days was 13.4 +/- 2.6. All the median differences of the vertical jump tests had a statistically significant increase at every measure except for the Countermovement jump and squat jump' last two measures, squat jump' first two measures, and spike jump' between twice and third measures. The median differences between the first and last agility T-tests were not statistically significant (p = 0.277). The feeling of volleyball players about the sports performance level was decreased by 57.9%, increase 10.5%, no change 31.6%. Conclusions: Volleyball players' vertical jump performance was getting better despite the COVID19 infection in our study. Inactivity might be more harmful than COVID-19 infection on sports performance.
ABSTRACT
Hypocalcemia prolongs the QTc interval. Total calcium (TCa) measurement can be misleading in cases where the concentration of albumin is abnormal. We aimed to investigate which calcium level —ionized calcium (iCa) or TCa—may be more closely related to the QTc interval in COVID-19 patients in whom hypocalcemia and hypoalbuminemia are observed frequently. Adult patients hospitalized for COVID-19 were included in this study. ICa levels were obtained from the venous blood gas sample examined during the emergency department admission, and the TCa levels were obtained from the biochemistry results on admission. The pH-adjusted iCa (Corrected-iCa) and albumin-adjusted TCa (corrected-TCa) were calculated. The QT interval was measured from the admission ECG and corrected for heart rate using the Bazett formula. Hundred and thirty-two patients were included in the study. The mean age was 50±19 years, and 62 (47%) patients were female. Median iCa level was 1,13 mmol/L (1,08-1,18 interquartile range (IQR)), median TCa level was 2.13 mmol/L (2.02-2.22 IQR). 76 patients (57%) had hypocalcemia (iCa<1,16 mmol/L). The median QTc interva l was 431 ms (414-450 IQR). In the multivariable linear regression analysis, a significant relationship was observed between the QTc interval and iCa and corrected-iCa levels (β=-2.22, standard error (SE) =27.839, p=0.028, β=-2.16, SE=29.407, p=0.033), but no significant relationship was observed between TCa and corrected-TCa levels (β=-1.02, SE=3.959, p=0.312, β=-0.44, SE=4.635, p=0,650). A significant relationship was observed between iCa levels and the QTc interval, which was longer in patients with hypocalcemia, but there was no significant relationship observed with TCa levels.
ABSTRACT
Background and Aim: Experimental Hydroxychloroquine (HCQ)/Azithromycin (AZT) combination treatment is a widely accepted experimental treatment for COVID-19 and concerns stated about the potential lethal ventricular arrhythmias (VA). Corrected QT, Tpeak-Tend interval (Tp-e) and QT dispersion have been accepted as novel markers for the assessment of myocardial repolarization and VA. We aimed to evaluate the effects of HCQ±AZT treatment on ECG repolarization parameters among patients treated for COVID-19 and their association with the with poor prognos. Methods: All consecutive adult patients diagnosed with COVID-19 and hospitalized for treatment with HKK± AZT in participating centers were evaluated. Exclusion criteria: structural heart disease, Class I/III antiarrhythmic use, complete-bundle-branch-block, high-grade-AV-block, non-sinus rhythms and acute coronary syndrome in follow-up. Bazett qtc corrected tpte "Poor clinical outcome (PCO)" is defined as a combined definition for any of the following clinical features as in hospital death/>7 days of hospitalization/endotracheal entubation and/or ICU stay. Results: Of 312 cases, 296 patients (153 females, 56±21 years) were included for analysis. 136 patients also received AZT in addition to HCQ (46% of population, male%:female% 48.5:44 p=0.44). Mean follow up time was 8±5 days (Min-Max 1-35 days). In hospital death was observed in 14 patients (4.7%, 78±17 years) and all were due to multi-organ failure in intensive care unit. PCO occurred in 88 patients (29.7%, mean±SD 64±20 years which was significantly older, p<0.001). Female mortality rate=5.2% while male=4.2% non significant trend for females p=0.7. No lethal VA or any dysrhythmic death was observed in the follow up. QT/QTc intervals and QTdisp were significantly prolonged at the end of the treatment protocol with HCQ±AZT (mean±SD ms change from baseline to the end of the protocol in both sexes = QTc 422±30 to 431±32, p<0.001, QT dispersion-C median ± SEM ms 26±1.4 to 27±1.5 p=). 7.4% (17 cases) >50 ms Delta QTc and. TpTe, TpTe-c, QTd, QTdc and TpTe/QT parameters did not significantly prolong throughout the protocol. However, delta QTc was found to be correlated with and delta QTc >50 ms significantly predicts PCO [(OR 3.8 (95% CI 1.2-12) (p=0.02)]. Presence of prolonged long QT features on ECG at the end of the protocol (p=0.04) and QTdc >50 ms (p=0.04) were significantly associated with PCO. Conclusions: HCQ/AZT treatment prolongs QTc interval while seemingly exerting no profound effects on surface ECG repolarization parameters. This might be hypothesized as one of the reasons of observed low dysrhythmic events in our cohort of COVID-19 patients. More homogenous transmural repolarization prolongation without evident dispersion of repolarization on human myocardium obsrerved in our cohort with the HCQ use might be protective against the expected deleterious effects of ordinary QT prolonging drugs.
ABSTRACT
This article examines the World Health Organization (WHO), which plays the biggest role in combating the current COVID-19 pandemic. The WHO likewise provides for International Health Regulations as its most important normative regulatory measure for confirming and controlling pandemics. In the first section, the historical background leading to the establishment of the WHO and its organs and their powers that are established by the constitution is explained. In the second section of this article, the WHO's powers and responsibilities and the member states' obligations for pandemics are analyzed in the context of International Health Regulations. The last section considers some criticism leveled against the WHO for handling the current pandemic. It shall also discuss possible international legal consequences that may arise from the same.