MEASURING THE KNOWLEDGE LEVEL OF COVID-19 AND ITS TREATMENT IN PHARMACISTS.

Objective: The aim of this study is to measure the knowledge level of pharmacists working in Turkey about COVID-19 Material(s) and Method(s): The online questionnaire consisting of 16 questions in the form of true-false, developed by the authors after a comprehensive review of the literature, was delivered to pharmacists via social media and professional platforms (such as WhatsApp, Gmail, Instagram, LinkedIn) using the Google form. 364 pharmacists from all over Turkey who filled out the questionnaire were included in the study. Result and Discussion: In this study carried out in Turkey, it was determined that 99.5% of the pharmacists had good knowledge. When the factors affecting the level of knowledge of COVID-19 were examined, in our study, no relationship was found with the independent variables since the level of knowledge was homogeneously high. In the literature, it is reported that age, years of professional experience, having a master's and doctorate education are associated with better knowledge, while the length of experience is associated with the level of knowledge, while in some studies it is stated that no feature is related. However, the fact that it is a cross-sectional study creates a limitation in explaining the cause-effect relationship. Although the number of participants met the sample, it would have been desirable to have more.Copyright © 2022 University of Ankara. All rights reserved.

Analysis of 65 Years Old and Over Patients with Full Dose Vaccination by Inactive Vaccine and without Vaccination Admitted to Hospital with SARS-Cov-2 PCR Positivity

Objective: In this study, we aimed to analyze real-time reverse transcription-polymerase chain reaction (RT-PCR) positive elderly patients (>= 65 years old) admitted to the hospital with symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection regarding their vaccination status.Methods: The study included 151 COVID-19 patients aged >= 65 years old, admitted to the hospital between March 10 and June 30, 2021. The study group was divided into two groups: Group 1 consisted of patients who had two doses of inactive vaccine, administered at four weeks interval, and Group 2 consisted of unvaccinated patients who had no vac-cination at all or got one dose of vaccine or had an infection within 15 days of completion of the vaccination schedule. We compared the two groups based on demographic, clinical, laboratory, and mortality data.Results: Groups 1 and 2 included 78 and 73 patients, respectively. There was no significant difference between groups regarding gender distribution, age, intensive care admission, number of underlying diseases, and laboratory and radio-logical findings. However, the number of comorbidities and mortality showed a significant positive correlation. Also, the presence of desaturation was significantly associated with mortality.Conclusion: In this study, we established that an inactive virus vaccine had no significant protectivity for the severity of disease and mortality in the elderly population.

MEASURING THE KNOWLEDGE LEVEL OF COVID-19 AND ITS TREATMENT IN PHARMACISTS.

Objective: The aim of this study is to measure the knowledge level of pharmacists working in Turkey about COVID-19 Material(s) and Method(s): The online questionnaire consisting of 16 questions in the form of true-false, developed by the authors after a comprehensive review of the literature, was delivered to pharmacists via social media and professional platforms (such as WhatsApp, Gmail, Instagram, LinkedIn) using the Google form. 364 pharmacists from all over Turkey who filled out the questionnaire were included in the study. Result and Discussion: In this study carried out in Turkey, it was determined that 99.5% of the pharmacists had good knowledge. When the factors affecting the level of knowledge of COVID-19 were examined, in our study, no relationship was found with the independent variables since the level of knowledge was homogeneously high. In the literature, it is reported that age, years of professional experience, having a master's and doctorate education are associated with better knowledge, while the length of experience is associated with the level of knowledge, while in some studies it is stated that no feature is related. However, the fact that it is a cross-sectional study creates a limitation in explaining the cause-effect relationship. Although the number of participants met the sample, it would have been desirable to have more.Copyright © 2022 University of Ankara. All rights reserved.

MEASURING THE KNOWLEDGE LEVEL OF COVID-19 AND ITS TREATMENT IN PHARMACISTS.

Objective: The aim of this study is to measure the knowledge level of pharmacists working in Turkey about COVID-19 Material(s) and Method(s): The online questionnaire consisting of 16 questions in the form of true-false, developed by the authors after a comprehensive review of the literature, was delivered to pharmacists via social media and professional platforms (such as WhatsApp, Gmail, Instagram, LinkedIn) using the Google form. 364 pharmacists from all over Turkey who filled out the questionnaire were included in the study. Result and Discussion: In this study carried out in Turkey, it was determined that 99.5% of the pharmacists had good knowledge. When the factors affecting the level of knowledge of COVID-19 were examined, in our study, no relationship was found with the independent variables since the level of knowledge was homogeneously high. In the literature, it is reported that age, years of professional experience, having a master's and doctorate education are associated with better knowledge, while the length of experience is associated with the level of knowledge, while in some studies it is stated that no feature is related. However, the fact that it is a cross-sectional study creates a limitation in explaining the cause-effect relationship. Although the number of participants met the sample, it would have been desirable to have more.Copyright © 2022 University of Ankara. All rights reserved.

Nursing students' opinions about the COVID-19 vaccine: a descriptive, cross-sectional study

Objective: This study aims to identify the nursing students' opinions about the COVID-19 vaccine. Materials and Methods: This descriptive, cross-sectional study was realized with 1008 students enrolled in the nursing departments of four universities located in Istanbul. Data were collected online with Information Form. Results: 85.7% of the students did not get a COVID-19 vaccine, and 44.8% of the unvaccinated students did not think about getting a vaccine or were indecisive. The reasons for the students' not thinking about getting the vaccine or their indecisiveness about it were most frequently the vaccine having been produced in a very short time, not trusting the protection or content of the vaccine, not having enough information about the vaccine. A significant difference was found between the students' grade (p= 0.000), type of university (p= 0.000), knowledge level about the COVID-19 illness (p= 0.028) and vaccine (p= 0.000) and their thinking about getting vaccinated. Conclusion: It was found that a tiny part of the students was vaccinated;almost half of the unvaccinated students did not think about getting vaccinated or were indecisive. Understanding the student's perspective on the COVID-19 vaccine can be helpful in planning multidisciplinary education strategies.

Correlation of Rapid Antibody and RT-PCR Tests With Clinical and Radiological Findings in COVID-19 Patients Admitted to an Employee Health Outpatient Clinic

BACKGROUND/AIM: To evaluate the results of simultaneous rapid antibody tests and Real-time polymerase chain reaction (RT-PCR) tests in patients diagnosed with coronavirus disease-2019 (COVID-19) retrospectively, and to evaluate the compatibility rates of these results with clinical and radiological findings. MATERIALS AND METHODS: Between March 31, 2020 and July 31, 2020, simultaneous COVID-19 RT-PCR and COVID-19 rapid antibody assay were applied to the health care personnel who were admitted to a healthcare personnel COVID-19 outpatient clinic with COVID-19 complaints. RESULTS: A total of 1010 healthcare personnel who were admitted to the healthcare personnel COVID-19 outpatient clinic were included in this study. One hundred and sixty-seven of them (16.54%) were doctors, and 363 (35.94%) were nurses or midwives. The most common symptoms were sore throat (27.92%), cough (25.94%) and weakness (14.75%). Throat nasal swab RT-PCR revealed that a total of 989 (98%) personnel had PCR negative, and 21 (2%) had PCR positive results. Sixteen (1.58%) personnel did not have a registered assay result. Rapid antibody test revealed that 1006 (99.6%) personnel had negative, and 4 (0.4%) personnel had positive results. When the assay results were evaluated with simultaneous computed tomography findings, 990 (98%) did not have any signs suggesting COVID-19. CONCLUSION: In serological rapid assays used to diagnose COVID-19, specific antibodies in the "window period" are at undetectable levels in the patient's blood. Therefore, false negative results may be obtained. For this reason, serological tests cannot be used as the basic diagnostic tool for COVID-19 infections.

Evaluation of pediatric patients with COVID-19 in a Turkish university hospital.

Background: Although COVID-19 has a milder course in pediatric patients than in adults, it can have a severe and fatal course in children with an underlying disease (UD). Aims: In this study, we aimed to evaluate the demographic, clinical, laboratory, and radiological characteristics, treatment methods, and prognosis of pediatric patients diagnosed with COVID-19. Patients and Methods: The files of patients aged 0-18 years diagnosed with COVID-19 were retrospectively evaluated. Clinically and radiologically suspicious cases were accepted as confirmed cases if SARS-CoV-2 PCR positivity was found in nasopharyngeal swab samples. The severity of the disease was defined as asymptomatic, mild, moderate, and severe according to clinical, laboratory, and radiological features. Results: A total of 322 pediatric patients, 51.2% male and 48.8% female, were included in the study. The median age of the patients was 12.08 years (1 month-18 years). Of the 322 patients, 81 (25.1%) were asymptomatic. Disease severity was as follows: 218 were (67.7%) mild, 14 were (4.3%) moderate, and 9 (2.7%) were severe. 35.7% of the patients were hospitalized. Six percent were admitted to the intensive care unit, and three (0.93%) patients died. The mortality rate in patients with the UD was 3.3%. Conclusion: In our study, we determined that the disease had a more severe course in patients with initial procalcitonin, D-dimer, troponin increase, and thrombocytopenia. Although COVID-19 has a mild course in children, this is unfortunately not true for children with an UD.

Disinfectants Used Against COVID-19 and Their Toxic Effects

Coronavirus Disease 2019 (COVID-19) emerged in Wuhan, China in December 2019, and then spread rapidly all over the world. Although the main transmission route of the pandemic is through the transfer of respiratory droplets among peo-ple, it is known that the virus can survive for days on contact surfaces and is also transmitted from body parts and contaminated surfaces. Therefore, disinfectants have increasingly become a part of daily use. However, prolonged exposure to these chemical agents at high concentrations may cause significant toxic effects that threaten human health and the environment. Therefore, it is of great importance to inform the public about the correct use of disinfectants and possible toxic effects. Informing the healthcare personnel and public about the toxic effects of disinfectants has of great importance for protecting public health. Precautions should be taken against the potential health hazards of disinfectants when used separately or in combination. In this review, the possible toxic effects of disinfectants that are frequently used during COVID-19 pandemic will be discussed. © 2021, Hacettepe University, Faculty of Pharmacy. All rights reserved.

Analysis of 65 Years Old and Over Patients with Full Dose Vaccination by Inactive Vaccine and without Vaccination Admitted to Hospital with SARS-Cov-2 PCR Positivity

Objective: In this study, we aimed to analyze real-time reverse transcription-polymerase chain reaction (RT-PCR) positive elderly patients (≥ 65 years old) admitted to the hospital with symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection regarding their vaccination status. Methods: The study included 151 COVID-19 patients aged ≥ 65 years old, admitted to the hospital between March 10 and June 30, 2021. The study group was divided into two groups: Group 1 consisted of patients who had two doses of inactive vaccine, administered at four weeks interval, and Group 2 consisted of unvaccinated patients who had no vaccination at all or got one dose of vaccine or had an infection within 15 days of completion of the vaccination schedule. We compared the two groups based on demographic, clinical, laboratory, and mortality data. Results: Groups 1 and 2 included 78 and 73 patients, respectively. There was no significant difference between groups regarding gender distribution, age, intensive care admission, number of underlying diseases, and laboratory and radiological findings. However, the number of comorbidities and mortality showed a significant positive correlation. Also, the presence of desaturation was significantly associated with mortality. Conclusion: In this study, we established that an inactive virus vaccine had no significant protectivity for the severity of disease and mortality in the elderly population.

Detection and molecular characterization of canine Coronavirus in dogs with lower respiratory tract infection

Coronaviruses in the family Coronaviridae cause digestive and respiratory system infections in humans and animals. There are two subtypes of canine coronaviruses (CCoV), which are included in the alfacoronavirus, as CCoV I and CCoV II. CCoV-II is divided into two genotypes, CCoV-IIa and IIb. Although CCoV affects dogs of all ages and all diets, newborn puppies can be particularly susceptible and severely affected. According to the literature research, no molecular studies have been found in our country for the detection of canine coronavirus, especially in lower respiratory tract infections. In this study, it was aimed to detect and molecular characterization of CCoV un shelter dogs with lower respiratory tract infection. For this purpose, Bronchoalveolar Lavage (BAL) fluids taken from 40 shelter dogs with lower respiratory tract infections were examined. CCoV was detected in 3 of the BAL fluids of 40 dogs tested. A phylogenetic tree was constructed with the sequences obtained after the sequence analysis. It was determined that 2 of the 3 positive samples in the phylogenetic tree were CCoV-I and one sample was CCoV-II. In conclusion, this study revealed that CCoV-I and CCoV-II may play a role in lower respiratory system disorders of shelter dogs. In addition, the detection of two different CCoVs in different animals in the same shelter has been considered as an important data, and the detection of both types in dogs housed in crowded environments such as shelter conditions shows that the possibility of new variants or subtypes that may occur in the future should not be ignored.

Are the illness severity and treatment efficacy of the patients followed in the child psychiatry inpatient service during the pandemic period different from the "normal" period?

Objective: COVID-19 pandemic poses a serious threat to health systems and inpatient treatment units. With the increase in the size of the pandemic, it has become a difficult process to carry out routine treatment services. In this study we aimed to compare the clinical profile, illness severity and length of hospitalization of the patients who were hospitalized in the child psychiatry inpatient service during the normal and the pandemic period. Method: The patients who were treated in the child psychiatry inpatient service during the the pandemic period (n=19), and previously normal period (n=149) were compared in terms of clinical profile, illness severity and length of hospitalization. Psychiatric diagnoses were assessed using the K-SADS-PL (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version). The Clinical Global Impressions-Severity scale (CGI-S) was applied to all patients in both groups at hospitalization and discharge point. Results: We found that median level of CGI-S hospitalization scores in pandemic period was significantly higher than normal period. A significant negative correlation was found between CGI-S discharge scores and length of hospitalization during pandemic period. In addition, a significant difference was found between the groups in terms of the rate of anxiolytic drugs used. Discussion: Anxiety levels of people may increase in disasters such as pandemics, wars, earthquakes. During the pandemic period, patients with higher clinical severity of illness are treated in inpatient treatment units. In these cases, it is important to continue inpatient management without interruption, along with infection-preventive measures.

Child and Adolescent Forensic Psychiatry Experiences During the COVID-19 Pandemic

Objective: Coronavirus disease-2019 (COVID-19) changed the status-quo in psychiatric interview with the advent of telemental health practices, save for a select group of patients;forensic psychiatric interviews among them. The present study aimed to identify the predictors of completing forensic psychiatric evaluations mandated by the judicial authorities in the hospital setting during the COVID-19 outbreak. Method: Twenty-six patients who had completed an initial forensic psychiatric assessment and were required to complete a child and adolescent forensic psychiatry board interview during the height of the COVID-19 pandemic were recruited. Their records were retrospectively examined, sociodemographic data, Beck Depression Inventory (BDI), the Screen For Child Anxiety Related Disorders (SCARED), and Wecshler Intelligence Scale for Children-revised scores were recorded and analyzed. Results: Statistical analysis revealed an association between conduct disorder and concomitant substance use with missed appointments, and maternal employment and completed interviews. BDI and SCARED total scores showed no difference between the patients who missed or completed their mandatory forensic psychiatry board assessment. BDI individual items of loss of pleasure (item 4), suicidality (item 9), and loss of interest (item 12) were associated with missed appointments. Conclusion: The results of this study support the established relationship between conduct problems and depressive symptoms, and this demographic group may be among the most affected by the limitation of access to mental health services during the COVID-19 pandemic, as they are already less likely to seek help overall.

Mental Health Problems in Renal Nurses During Novel Coronavirus Disease of 2019 Pandemic

Objective: The most important factor in facing the pandemic is to ensure the physical and mental health status of the healthcare workers. Studies have found serious stressors experienced by the hemodialysis incharge-nurses but report less burnout than the other nurses. Determining the mental distress of the hemodialysis incharge-nurses during the pandemic is important in determining the necessary precautions. The objective of this study is to determine the psychological complaints of the hemodialysis incharge-nurses during the pandemic. Methods: The participants of the study are hemodialysis incharge-nurses who work in different provinces of Turkey. The data of the study were collected from April to June 2020. Beck Anxiety Inventory was used to measure the frequency of anxiety symptoms experienced by the individuals. Beck Depression Inventory was used to measure the behavioral manifestations of depression. Maslach Burnout Inventory was used to measure burnout in the workplace. The Perceived Trauma Coping Scale was used to evaluate the perception of coping-up with a traumatic life. Results: In our study, we found Beck Anxiety Inventory mean score was 13.42 +/- 11.28, Beck Depression Inventory mean score was 11.88 +/- 9.57, Maslach emotional exhaustion mean score was 15.74 +/- 8.19, Maslach depersonalization mean score was 4.96 +/- 3.70, and Maslach personal failure mean score was 8.95 +/- 4.50, respectively. Finally, the mean Perceived Trauma Coping Scale trauma score was 63.05 +/- 12.78, the mean Perceived Trauma Coping Scale future score was 36.34 +/- 8.65, and the mean Perceived Trauma Coping Scale elasticity score was 71.94 +/- 17.67, respectively. Conclusion: The findings of the study show the importance of the improvements to be made in reducing the depression and burnout levels of the nurses.

MEASURING THE KNOWLEDGE LEVEL OF COVID-19 AND ITS TREATMENT IN PHARMACISTS

Objective: The aim of this study is to measure the knowledge level of pharmacists working in Turkey about COVID-19 Material and Method: The online questionnaire consisting of 16 questions in the form of true-false, developed by the authors after a comprehensive review of the literature, was delivered to pharmacists via social media and professional platforms (such as WhatsApp, Gmail, Instagram, LinkedIn) using the Google form. 364 pharmacists from all over Turkey who filled out the questionnaire were included in the study. Result and Discussion: In this study carried out in Turkey, it was determined that 99.5% of the pharmacists had good knowledge. When the factors affecting the level of knowledge of COVID-19 were examined, in our study, no relationship was found with the independent variables since the level of knowledge was homogeneously high. In the literature, it is reported that age, years of professional experience, having a master's and doctorate education are associated with better knowledge, while the length of experience is associated with the level of knowledge, while in some studies it is stated that no feature is related. However, the fact that it is a cross-sectional study creates a limitation in explaining the cause-effect relationship. Although the number of participants met the sample, it would have been desirable to have more. © 2022 University of Ankara. All rights reserved.

The impacts of COVID-19 pandemic on children with neurodevelopmental disorder

Objective: In this study, we aimed to evaluate the impact of Covid-19 pandemic on children with neurodevelopmental disorders through Tele-Medicine system. Method: Children aged between 7-18 years old with neurodevelopmental disorders were evaluated. On the routine control visit day, they and their parents were called by phone via the Tele-Medicine system and a questionnaire prepared by the researchers was applied to evaluate the compliance process to the pandemic. The disease severity of the cases was evaluated by the Clinical Global Impression Scale. Results: In our study, 17.6% of the cases were girls and 82.4% were boys. The average age is 11.66 +/- 3.46 years. In this study 51% of the cases were diagnosed with Autism Spectrum Disorder;47.1% with Intellectual Disability and 17.6% with Special Learning Disorder. The comorbidity of Attention Deficit and Hyperactivity Disorder was found to be 49%. Increased anxiety is reported by 25.5% of the cases, appetite and nutritional problems by %37.3 and sleep pattern changes by 62.7%. Pre-pandemic score of Clinical Global Impression Scale was evaluated as 3.82 +/- 0.81, and the score during the pandemic as 4.09 +/- 0.87. Discussion: It was found that, in the early period of the Covid-19 pandemic, the most common problems of the cases with neurodevelopmental disorder were the sleep pattern changes, appetite and nutritional problems and increased anxiety. It is thought that our findings will guide psychosocial support interventions for children and adolescents with developmental problems during the pandemic.

The impacts of COVID-19 pandemic on children with neurodevelopmental disorder

Objective: In this study, we aimed to evaluate the impact of Covid-19 pandemic on children with neurodevelopmental disorders through Tele-Medicine system. Method: Children aged between 7-18 years old with neurodevelopmental disorders were evaluated. On the routine control visit day, they and their parents were called by phone via the Tele-Medicine system and a questionnaire prepared by the researchers was applied to evaluate the compliance process to the pandemic. The disease severity of the cases was evaluated by the Clinical Global Impression Scale. Results: In our study, 17.6% of the cases were girls and 82.4% were boys. The average age is 11.66±3.46 years. In this study 51% of the cases were diagnosed with Autism Spectrum Disorder;47.1% with Intellectual Disability and 17.6% with Special Learning Disorder. The comorbidity of Attention Deficit and Hyperactivity Disorder was found to be 49%. Increased anxiety is reported by 25.5% of the cases, appetite and nutritional problems by %37.3 and sleep pattern changes by 62.7%. Pre-pandemic score of Clinical Global Impression Scale was evaluated as 3.82±0.81, and the score during the pandemic as 4.09±0.87. Discussion: It was found that, in the early period of the Covid-19 pandemic, the most common problems of the cases with neurodevelopmental disorder were the sleep pattern changes, appetite and nutritional problems and increased anxiety. It is thought that our findings will guide psychosocial support interventions for children and adolescents with developmental problems during the pandemic. © 2021 ANP Publishing. All rights reserved.

The Effect of The Covid-19 Pandemic On The Adaptation Process and Psychiatric Symptoms of Children Aged 7-12: A Telemedicine Study

Objective: The aim of the presented study is to evaluate the adaptive process and psychiatric symptoms in the 7-12 age group followed-up with telemedicine interviews during the height of the pandemic. Method: Patients between the ages of 7-12 who were followed up in our outpatient clinic were called by telemedicine service at the appointment date. The questionnaire prepared by the researchers in order to investigate the adaptation process to the pandemic was administered, the answers provided by the patients and their families were recorded in the case data form together with Clinical Global Impression (CGI) Scale score appraised by the interviewing psychiatrist. Medical records pertaining to each patient were also reviewed, their psychiatric diagnoses, according to DSM 5 criteria and CGI scores recorded in their last face-to-face interviews during the pandemic period, were included in the case data form. Results: Fifty patients were included in the study. The mean age of the participants was 9.14 +/- 1.61 years. Attention deficit hyperactivity disorder (60%) was the most common psychiatric diagnosis detected in the participants before the pandemic, followed closely by anxiety and related disorders (20%) and specific learning difficulty (16%). The CGI scores of the cases before, and during the pandemic were 2.72 +/- 0.75, and 2.92 +/- 0.94, respectively. The difference between the mean scores was statistically significant (p=0.024). Conclusion: Our study emphasizes the importance of follow-up by telemental health practices in cases where face-to-face psychiatric interviews are not applicable, i.e., due to the risk of transmission of COVID-19 disease during the current pandemic.

Evaluation of endothelial function patient infected with SARS-CoV-2 virus

Background and Aim: Vascular endothelium is an active organ with paracrine, autocrine, and endocrine functions that is vital for regulation of vascular tone and the maintenance of vascular homoeostasis. Endothelial dysfunction is the primary factor of microvascular dysfunction characterized by vasoconstriction and subsequent organ ischemia, inflammation associated with tissue edema, and pro-coagulant state. SARS-CoV-2 infects the host using the angiotensin converting enzyme 2 (ACE2) receptor, which is expressed in several organs, including the lung, heart, kidney, and intestine. ACE2 receptors are also expressed by endothelial cells. Endothelial cell infection and endotheliitis were currently demonstrated histologically in COVID-19 patients. Whether vascular derangements in COVID-19 are due to endothelial cell involvement by the virus is currently unknown.In this study we investigated early-mid term effect of SARS-CoV-2 viruse on endothelial functions in patient with COVID-19 infection. Methods: We included 51 COVID-19 patient (27 symptomatic, 24 asymptomatic) and 54 healthy controle in this study. Endothelial function was assessed by measuring endothelial-dependent flow-mediated vasodilatation (FMD %) and nitroglycerin-mediated dilatation (NMD %) in the brachial artery. We enrolled COVID-19 patients in the study after three negative PCR test and median duration from PCR negativity was 40.4±13.4 days. Results: Age and gender distribution were well matched between groups (38.2±8.4 vs 38.1±11.4;p=0.95). Although controle patient have higher BMI than COVID patients, BSA was similar in both groups. Whilst hyperlipidemia and smoking habitus were similar between the groups, there were more hypertensive patient in controle group. Plasma CRP (2.19±1.83 vs. 0.63±1.17 p=0.001), Total cholesterol (206.9±38.8 vs. 181.1±49.2 p=0.005) and LDL cholesterol (127.9±37.7 vs. 109.2±40.9, p=0.015) levels were found significantly high in patient with COVID-19 infection. In patients who have had COVID-19 infection, FMD% was significantly impaired compared to patients with controle (8.5±3.27 vs.10.4±2.77, p=0.002), however no significant difference was observed in NMD% (11.7±2.36 vs. 12.0±2.52, p=0.55). Conclusions: In this study we found that endothelial function assessed by endothelium-dependent vasodilation was significantly impaired in patients who have had COVID-19 infection before average 40 days ago. We determined that abnormalities in arterial function may persist for at least 6 weeks after COVID-19 infection. These could help to explain in part the earlier reported increase in cardiovascular risk during the first weeks after COVID-19 incfection. In the current situation because of little known about long term residual adverse effect of COVID-19 on arterial endothelial function and cardiovascular system, more comprehensive and long-term studies are needed in this area.

The effect of disease severity on cardiac autonomic functions in COVID-19

Background and Aim: The new coronavirus (SARS-COV-2) pandemic has rapidly spread to many countries and caused morbidity and mortality all over the world. Central nervous system (CNS) can be affected in this disease because of the coronavirus capability to invade brainsteam. Olfactorial neurons blame to be entry for neuroinvasion and the spread the infection to the brainsteam via transneural route. Medulla oblangata contains cardiac, respiratory and vasomotor centers. A quarter of admitted COVID-19 complain from anosmia (loss sense of smell) and which may be indicator of CNS involvement. Heart rate variability (HRV) has long been associated to be a surrogate markers of cardiac autonomic tone. Inflammatory bowel disease (IBD) has effects on neural cardiovascular control mechanisms the effect of IBD disease status on cardiovascular autonomic functions by measuring (HRV) parameters with 24-hour holter electrocardiogram (ECG) recording. The aim of this study was to evaluate the heart rate variability (HRV) in a patient with coronavirus disease 2019 (COVID-19) as a marker disease severity and CNS involvement. Methods: A prospective analytical case control study was conducted in Health Science University, Tepecik Education and Research Hospital Izmir, Turkey. We enrolled 50 patients with COVID-19 and 54 matched control subjects in the study. All participants underwent a 24-hour Holter recording to assess HRV parameters. Firstly, we design two groups as patient and controle group. Than the study population was separated into 3 groups of symptomatic disease, asymptomatic disease and control group to analyse the effect of disease severity on the HRV parameters. Results: Age and gender distribution were well matched between groups (38.5±8.46 vs 39.9±15.3;p=0.95). Disease duration was 10.46±4.67 and %26.5 of patient complained from lost sense of smell and taste. %50 of the COVID-19 patient had symptomatic disease on admission. Control patient have higher BMI (26.2±3.34 vs. 28.1±4.0;p=0.02) than COVID patients. Plasma CRP (2.88±4.2 vs. 0.63±1.12 p=0.003) levels were found significantly high in patient with COVID-19. No difference was determined between the COVID-19 and control groups in respect of any HRV parameters (Table 2). Significant differences were found both between the symptomatic patients and the control group and between symptomatic and asymptomatic patients in terms of the HRV measurements of SDANN5, RMSSD, CCVLF, LF/HF (Table 3). Conclusions: The results of this study demonstrated for the first time that the disease severity and symptom status in COVID-19 patients is associated with cardiac autonomic abnormalities compared to both a control groups and asymptomatic COVID-19 patients. Patients who have had symptomatic COVID-19 infection appear to be at risk for arrhythmia, particularly patient with sign of CNS involvement. Further research is needed to clarify long term effect of COVID-19 infection on HRV.