PENTRAXIN 3 LEVELS CORRELATE WELL WITH DISEASE SEVERITY AT ADMISSION IN COVID-19 PATIENTS.

Pentraxin 3 (PTX3), a long pentraxin, is not only released from dendritic cells and neutrophils but also from epithelial and endothelial cells such as alveolar epithelium. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) initially activates the innate immune system, causing a complex immune response. Clinical and experimental studies suggest that PTX3, a locally and systemically secreted marker, can be used as a predictor of the severity and mortality in respiratory infections. In the current study, serum PTX3 levels in patients hospitalized with COVID-19 were found to be significantly increased at admission and showed significant association with the disease severity.

Comparison of Pneumonia Severity Indices, qCSI, 4C-Mortality Score and qSOFA in Predicting Mortality in Hospitalized Patients with COVID-19 Pneumonia.

This is a retrospective and observational study on 1511 patients with SARS-CoV-2, who were diagnosed with COVID-19 by real-time PCR testing and hospitalized due to COVID-19 pneumonia. 1511 patients, 879 male (58.17%) and 632 female (41.83%) with a mean age of 60.1 ± 14.7 were included in the study. Survivors and non-survivors groups were statistically compared with respect to survival, discharge, ICU admission and in-hospital death. Although gender was not statistically significant different between two groups, 80 (60.15%) of the patients who died were male. Mean age was 72.8 ± 11.8 in non-survivors vs. 59.9 ± 14.7 in survivors (p < 0.001). Overall in-hospital mortality was found to be 8.8% (133/1511 cases), and overall ICU admission was 10.85% (164/1511 cases). The PSI/PORT score of the non-survivors group was higher than that of the survivors group (144.38 ± 28.64 versus 67.17 ± 25.63, p < 0.001). The PSI/PORT yielding the highest performance was the best predictor for in-hospital mortality, since it incorporates the factors as advanced age and comorbidity (AUROC 0.971; % 95 CI 0.961-0.981). The use of A-DROP may also be preferred as an easier alternative to PSI/PORT, which is a time-consuming evaluation although it is more comprehensive.

Risk factors and the impact of vaccination on mortality in COVID-19 patients.

INTRODUCTION: The novel coronavirus disease (COVID-19) pandemic has had a profound global impact economically, socially, and in many other areas. As vaccines are developed and introduced, their effect on the disease on both, the global and individual scale is a subject of intense curiosity. This study aimed to evaluate the relationship between risk factors for hospitalization, disease severity, and vaccination status in COVID-19 inpatients in a pandemic hospital. METHODOLOGY: Patients hospitalized for COVID-19 between June and September 2021 were retrospectively analyzed in three groups: unvaccinated, incompletely vaccinated, and fully vaccinated. Disease severity was classified as moderate, severe, or critical according to World Health Organization criteria, and mortality risk factors and the prognostic effect of vaccination were analyzed. RESULTS: The study included 486 patients, 228 women (46.9 %) and 258 men (53.1 %), with a mean age of 55.4 ± 16.5 years. Of these, 264 patients (54.3 %) were unvaccinated, 147 (30.2 %) were incompletely vaccinated, and 75 (15.4 %) were fully vaccinated. Older age, higher Charlson Comorbidity Index, greater disease severity, and being unvaccinated or incompletely vaccinated were associated with higher mortality. CONCLUSIONS: The results of our study indicate that age, disease severity, comorbidities, and vaccination status were factors affecting COVID-19 mortality. Our findings support that full vaccination reduces COVID-19 -related mortality rates, disease severity, and length of hospital stay. However, large-scale studies with larger patient populations are needed (Tab. 2, Ref. 22).

Prevalence and Associated Risk Factors of COVID-19 Infection Among Healthcare Workers in a Pandemic Hospital

Introduction: This study aimed to investigate the prevalence of Coronavirus disease-2019 (COVID-19) infection among healthcare workers in our hospital with the risk factors affecting the transmission and course of the disease and to determine the control measures. Methods: Medical records of healthcare workers diagnosed with COVID-19, confirmed by polymerase chain reaction (PCR) between 11 March and 30 April 2020, were retrospectively analyzed in our hospital in the center of Ístanbul, the city with the highest number of cases in our country. Real-time PCR detection was used to verify the diagnosis of the healthcare workers. A rapid diagnostic test kit for COVID-19 immunoglobulin M (IgM) and IgG antibodies was used in seroconversion analysis. Results: In our hospital, 4,177 COVID-19 cases confirmed by the laboratory between March 11 and April 30 2020 were followed. Of the 4177 cases, 165 (3.95%) were healthcare workers. The majority of healthcare workers with positive test results were nurses (36.3%), and 118 (71.5%) of the healthcare workers worked 40 h or more per week. Thoracic tomography examinations were performed in all infected healthcare workers, and 69 (41.8%) were diagnosed with pneumonia by the detection of ground patchy lesions. Conclusion: During the epidemic, early training of healthcare workers on the disease, use of personal protective equipment, and infection control are extremely important to reduce the risk of infection among healthcare workers. Periodic screening of asymptomatic healthcare workers can also help protect patients and hospital staff and prevent loss of workforce. (English) [ FROM AUTHOR] Amaç: Bu çalışmada, hastanemizde görev yapan sağlık çalışanlarının Koronavirüs hastalığı-2019 (COVID-19) enfeksiyonu prevalansı ile hastalığın bulaşını ve seyrini etkileyen risk faktörlerinin araştırılması ve kontrol önlemlerinin belirlenmesi amaçlanmıştır. Yöntemler: Ülkemizde olguların en fazla olduğu şehir olan Ístanbul'un merkezinde olan hastanemizde 11 Mart-30 Nisan 2020 tarihleri arasında polimeraz zincir reaksiyon (PCR) ile konfirme edilmiş COVID-19 tanısı alan sağlık çalışanlarının tıbbi kayıtları retrospektif olarak incelenmiştir. Sağlık çalışanlarının tanıları gerçek zamanlı PCR tespit yöntemi ile konulmuştur. Serokonversiyon incelemesi için hızlı test tanı kiti COVID-19 immünoglobulin M (IgM) ve IgG kullanılmıştır. Bulgular: Hastanemizde 11 Mart-30 Nisan 2020 tarihleri arasında laboratuvar tarafından konfirme edilmiş 4.177 COVID-19 olgusu takip edilmiştir. Toplam 165'i (%3,95) sağlık çalışanıydı. Pozitif olanların çoğunluğunu hemşireler (%36,3) oluşturmakta ve sağlık çalışanların 118'i (%71,5) haftada 40 saat ve üzerinde çalışmaktadır. Enfekte sağlık çalışanın tümüne toraks tomografisi çekilmiş olup 69'unda (%41,8) yamasal lezyonlar saptanarak pnömoni tanısı konulmuştur. Sonuç: Salgın sırasında sağlık çalışanlarının hastalıkla ilgili bilgilendirilme, kişisel koruyucu ekipman kullanımı ve enfeksiyon kontrolü ile ilgili eğitimlerinin erken dönemde yapılması sağlık çalışmalarında enfeksiyon riskini azaltma açısından son derece önemlidir. Asemptomatik sağlık çalışanlarının da düzenli aralıklarla taranmasının hastaların ve hastane personelinin korunması açısından faydalı olacağı ayrıca iş gücü kaybının da önüne geçileceği açıktır. (Turkish) [ FROM AUTHOR] Copyright of Istanbul Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The Importance of Healthcare Workers to Comply with Infection Prevention and Control Instructions During COVID-19 Outbreak-A Survey Study

Objective: Taking precations to prevent contamination and developing prevention programs play a key role in the outbreak. For this purpose, the use of personal protective equipment (PPE) of healthcare workers (HCWs) and their compliance with hand hygiene were investigated in the current Coronavirus disease-19 (COVID-19) outbreak. Methods: In study, 117 HCW, who were diagnosed with COVID-19 between 11 March and 18 May 2020, and 117 HCW, who did not meet the case definition, 234 HCW were included in the study, A survey consisting of 28 questions was applied to obtain the research data. The survey consisted of multiple choice questions and was prepared by the researchers using the knowledge of the literature. Results: It was determined that 65.8% of the participants were women, 41.9% were nurses, 82.1% did not have additional diseases and 62.8% did not smoke. Positivity was significantly higher in young patients aged 20-30 (p=0.05). In the use of PPE, the use of gloves as "always recommended" was found higher in infected HCW with 77.8% (p=0.012). The use of overalls/ gowns was found to be statistically significantly lower in infected healthcare workers (p=0.01). In terms of the hand hygiene application variable after touching the patient between the groups, compliance was found to be low in healthcare workers diagnosed with COVID-19 (p=0.005). Conclusion: It was observed that the risks of healthcare workers getting COVID-19 decreased significantly if the infection control measures were followed. It is thought that it would be beneficial to investigate new methods to ensure that protective measures are fully implemented by HCW. (English) [ABSTRACT FROM AUTHOR] Amaç: Salgın sürecinde sağlık çalışanlarında (SÇ) bulaşmayı önlemek açısından önlemlerin alınması ve önleme programlarının geliştirilmesi anahtar role sahiptir. Bu amaçla, halen yaşanmakta olan Koronavirüs hastalığı-19 (COVÍD-19) salgınında, SÇ'nin kişisel koruyucu ekipmanları (KKE) kullanımı ve el hijyenine uyumu araştırılmıştır. Yöntemler: Çalışmamızda 11 Mart-18 Mayıs 2020 tarihleri arasında laboratuvar tarafından doğrulanmış COVÍD-19 tanısı alan 117 sağlık çalışanı ile olası olgu tanımını karşılamayan 117 sağlık çalışanı olmak üzere 234 sağlık çalışanı çalışmaya dahil edildi. Araştırma verilerini elde etmek için 28 sorudan oluşan anket uygulanmıştır. Anket, çoktan seçmeli sorulardan oluşmuş ve araştırmacılar tarafından literatür bilgisinden yararlanılarak hazırlanmıştır. Bulgular: Katılımcıların %65,8'inin kadın, %41,9'unun hemşire olduğu, %82,1'inin ek hastalığının olmadığı, %62,8'inin sigara kullanmadığı saptanmıştır. Yirmi-30 yaş arası genç hastalarda pozitiflik anlamlı oranda yüksek saptanmıştır (p=0,05). KKE "her zaman önerildiği gibi" şeklinde eldiven kullanımı %77,8 ile enfekte SÇ'lerde daha yüksek bulunmuştur (p=0,012). Özellikle tulum/önlük kullanımı enfekte SÇ'lerinde istatistiksel açıdan anlamlı olarak düşük saptanmıştır (p=0,01). Gruplar arasında hastaya dokunduktan sonra el hijyeni uygulama değişkeni açısından COVÍD-19 tanılı SÇ'lerinde uyumun düşük olduğu saptanmıştır (p=0,005). Sonuç: Enfeksiyon kontrol önlemlerine uyulduğu takdirde SÇ'lerin COVÍD-19'a yakalanma risklerinin anlamlı olarak düştüğü gözlenmiştir. Buna rağmen, COVÍD-19 pandemisi sürecinde, SÇ'lerin KKE kullanımındaki eksikliklerini görmek, KKE protokollerini iyileştirmek ve eğitimlerini yenilikçi yöntemler kullanarak geliştirmek için detaylı araştırmalara ihtiyaç vardır. (Turkish) [ABSTRACT FROM AUTHOR] Copyright of Bezmialem Science is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The mortality rate of COVID-19 was high in cancer patients: a retrospective single-center study.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has quickly turned into a global pandemic with close to 5 million cases and more than 320,000 deaths. Cancer patients constitute a group that is expected to be at risk and poor prognosis in COVID pandemic. We aimed to investigate how cancer patients are affected by COVID-19 infection, its clinical course and the factors affecting mortality. METHODS: In our single-center retrospective study, we included cancer patients with laboratory confirmed COVID-19 in our hospital. Demographic, clinical, treatment, and laboratory data were obtained from electronic medical records. Logistic regression methods were used to investigate risk factors associated with in-hospital death. RESULTS: In the hospital, 4489 patients were hospitalized with COVID infection and 77 were cancer patients. The mean age of cancer patients was 61.9 ± 10.9 and 44 of them were male (62%). While the mortality rate in non-cancer patients was 1.51% (n = 68), this rate was significantly higher in cancer patients, 23.9% (n = 17). The stage of the disease, receiving chemotherapy in the last 30 days also lymphopenia, elevated troponin I, D-dimer, CRP, and CT findings were associated with severe disease and mortality. Severe lung involvement (OR = 22.9, p = 0.01) and lymphopenia (OR = 0.99, p = 0.04) are the most important factors influencing survival in logistic regression. CONCLUSIONS: The disease is more severe in cancer patients and mortality is significantly higher than non-cancer patients. These data show that it may be beneficial to develop dynamic prevention, early diagnosis and treatment strategies for this vulnerable group of patients who are affected by the infection so much.

Hydroxychloroquine Use on Healthcare Workers Exposed to COVID-19-A Pandemic Hospital Experience

Objective: As healthcare professionals play a role in combating the COVID-19 outbreak, the risk of disease exposure and illness increases. In our study, we aimed to measure the effectiveness of post-contact use in order to protect the healthcare professionals who work very intensively during the outbreak. Method: A total of 208 healthcare workers who applied to Employee Health Unit section between the dates 25 March-25 April 2020 with a history of contact with COVID-19 patients were included in the study. Employees were evaluated in low, moderate and high risk groups according to the Contact Risk Algorithm included in the Evaluation of Healthcare Workers Guidelines with COVID-19 theme. Three-day hydroxychloroquine treatment was initiated to 138 healthcare professionals who were considered as high risk. The treatment regimen was arranged as 2x400 mg on the first day and 2x200 mg on the 2nd and 3rd days. The COVID-19 positivity rates were analyzed according to the contact risk groups Results: There was a statistically significant difference between occupational groups according to contact risk groups (p<0.01);the rate of contact risk of nurses in the middle, and the doctors in the high risk groups was found to be significantly higher. When the COVID-19 positivity rates were analyzed according to the contact risk groups, the COVID-19 positivity rates were 9.4% in the high-, 16.3% in the moderate and 14.3% in the low-risk groups. The contact was found to be related to the COVID-19 test, and the positivity rate from contact with the patient was found to be significantly high (p<0.01). Conclusion: Recommendations about hydroxychloroquine for postexposure prophylaxis vary. Hydroxychloroquine can be a possible effective agent in postexposure prophylaxis. We think that conducting similar studies on larger samples can provide significant benefits to individuals and public health.