Impact of the COVID-19 Pandemic on Frailty in Older Adults

Objective: This study examines the effects of the Coronavirus disease-2019 (COVID-19) pandemic on frailty in a group of older adults at the end of the first year of the pandemic. Materials and Methods: The cross-sectional study was conducted at the end of the first year of the pandemic. Our study included 394 older adults who were contacted at primary care health centers. The FRAIL scale, the coronavirus fear scale and the scale of adjustment to measures in respiratory disease outbreaks in the Elderly were used. Results: The average age of the 394 individuals who participated was 70.38±5.68 years. Overall, 33% of the individuals have been infected with COVID-19. It was found that the prefrail and frail older populations increased by 2.7% and 13.8%, respectively, in the first year of the COVID-19 pandemic. The pandemic was found to have a moderate effect on the frailty scores. The risk of frailty was found to be 2 [odds ratio (OR)=2.04, confidence interval (CI) (95%)=1.28-3.23] times higher in individuals that tested positive for COVID-19. The fear of coronavirus increased the risk of frailty by 1.08 times [OR=1.08, CI (95%)=1.03-1.13]. The risk of frailty was reduced by 1.03 [OR=0.96, CI (95%)=0.94-0.99] times in the older adults who complied with the precautions. Conclusion: COVID-19 and the fear of COVID-19 it causes increase the risk of frailty among the older adults. Compliance with the recommended measures reduces the risk of frailty. © Copyright 2022 by the Academic Geriatrics Society / European Journal of Geriatrics and Gerontology published by Galenos Publishing House.

A cross-sectional study of post-COVID syndrome at a tertiary care center in Turkey

Objective: To investigate long-term symptoms after acute COVID-19, the link between symptoms and respiratory function, radiological changes in the post-COVID period, and risk factors for post-COVID syndrome. Method(s): In this cross-sectional study, 123 participants who were admitted within the first 3 months were categorized as group 1, and those who applied after 3 months were categorized as group 2. According to thoracic imaging and pulmonary function tests, patients were split into 3 groups as mild, moderate and severe. Result(s): At least one symptom was present in 91.9% and 61.8% in acute and post-COVID period, respectively. Pulmonary function tests were normal in 60 (70.6%) in the first three months, and 30 (78.9%) in 91-days to 1-year period after acute COVID-19 infection. After 3 months, 22.4% of chest X-rays and 7.9% of computerized tomography revealed progression. Patients who developed acute complications (OR 9.91, 95% Cl 1.93-50.87), had 2 or more symptoms at admission (OR 7.73, 95% CI 2.56-23.33), had 1% to 14% CT involvement (OR 3.05, 95% CI 1.06-8.79), or had 50% or more CT involvement (OR 14.68, 95% CI 1.24-172.55) had a higher risk of developing post-COVID syndrome. Conclusion(s): COVID-19 symptoms can last for long time. Severity of symptoms, acute complications, and the extent of radiological involvement may all contribute to elevated risk of post-COVID syndrome. As a result, patients with COVID-19 should be checked for long-term clinical difficulties on regular basis. Copyright © 2022 Asian Pacific Journal of Tropical Medicine Produced by Wolters Kluwer Medknow.

The Bad Bug is Back: Acinetobacter Baumannii Bacteremia Outbreak during the COVID-19 Pandemic in an Intensive Care Unit.

Background: Epidemiology of nosocomial infections may show variability because of under-estimation of infection control measures (ICMs) in coronavirus disease 19 (COVID-19) outbreak. Aim: To investigate the Acinetobacter bacteremia outbreak developed in an intensive care unit (ICU) between March 20 to May 15, 2020, examine the risk factors, and re-evaluate ICM retrospectively. Material and Methods: A retrospective cohort analysis was conducted to determine the risk factors, pulsed field gel electrophoresis (PFGE) was performed for analysis of the outbreak, ICM practices were observed by a team, and infection control interventions were undertaken. Results: Acinetobacter bacteremia developed in 17 patients (21.5%) within 79 COVID-19 patients included in the study. The mean age of the bacteremic patients was 67.3 (SD = 14.82) years, and 82.4% of them were male; of these, 15 died, leading to 88.2% mortality. The bacteremia rate was higher compared with a 14-month period preceding the COVID-19 pandemic (17/79 versus 12/580 patients, respectively). PFGE revealed that the outbreak was polyclonal. On multi-variate analysis, the bacteremia development rate was 13.7 and 5.06 times higher with central venous catheter (CVC) use and in patients with chronic obstructive pulmonary disease (COPD), respectively. The mortality rate was higher in bacteremic patients (p = 0.0016). It was observed that ICMs were not followed completely, especially change of gloves and hand hygiene. Contamination of A. baumannii was observed in 38% of the gloves. Conclusion: COPD and CVC use were determined as risk factors for Acinetobacter bacteremia development, and failures in ICM may have led to cross-contamination of endemic A. baumannii. The outbreak could be controlled within 3 weeks of interventions.

THE EFFICACY OF LUCILIA SERICATA LARVAE SECRETION AGAINST SARS-COV-2: A QUANTITATIVE PCR STUDY

Background: The lack of information about the novel coronavirus (SARS-CoV-2) makes it difficult to fight against it. The research about potential molecules that can be used to treat the SARS-CoV-2 continues all over the world. This study aimed to make a preliminary research on the possible effects of Lucilia sericata (L. sericata) larval secretion on the SARS-CoV-2, which has been used to treat chronic or infected wounds and shown to have antiviral effects. Methods: L. sericata larval secretion was applied to the pharyngeal swab samples of the SARS-CoV-2 positive patients, and the specimens were analyzed with the quantitative PCR method. The average Relative Fluorescence Unit (RFU) and Cycle Threshold (Ct) values were compared to the control group of positive specimens from the same patients without the application of larval secretion. Results: SARS-CoV-2 remained positive in the samples of the control group, while all samples in the experimental group were found to be negative. The difference between the average RFU and Ct values were found statistically significant (Control group: 752, Larvae group: 0) indicating that L. sericata larval secretion caused the lysis of SARS-CoV-2 and its RNA molecules. Conclusion: Revealing the antiviral effect of L. sericata larval secretion on SARS-CoV-2 can provide a basis for conducting further cell-culture studies, which might lead to developing an inexpensive substance that can help to fight against SARS-CoV-2.

EFFECT OF SURGICAL MASK USE ON BREATHING AIR QUALITY AND OXYGEN SATURATION: A QUASI-EXPERIMENTAL MODEL

This study aimed to investigate the effect of surgical masks (SM), which are widely used in the community in the fight against COVID-19, on breathing air quality and blood oxygen saturation among healthy people. This study included 45 healthy individuals. At rest and indoor conditions: blood oxygen concentrations and heart rates were recorded, while simultaneous oxygen (O-2), carbon monoxide (CO), sulphur dioxide (SO2), nitrogen oxides (NOx), VOC (volatile organic compounds) concentrations, and humidity and temperature were measured both in the mouth-nose area (MNA) in the indoor area before the mask was worn, and in MNA inside the mask (in-mask) after the mask was worn. The mean age of 45 healthy participants was 36.06 with a male to female ratio of 53.3% to 46.7%. When the indoor room air values in MNA without SM were compared with in-mask MNA values;in-mask O-2 saturation was observed to decrease, CO to increase in smokers, and VOC, humidity and temperature to significantly increase in all participants. SM wearing was observed not to significantly alter simultaneously measured peripheral blood O-2 saturation and resting heart rate. The (measured) effect of SM wearing on O-2 saturation and heart rate was found to be very small. Wearing a surgical mask was found not to impair blood O-2 saturation in healthy individuals at rest. Further studies can be recommended to support the results in this study.

Transmission of SARS-COV-2 and prevention strategies

The main transmission routes of SARS-CoV-2 are through respiratory droplets and close contact with the index case but other possible routes are also reported. Although the virus may spread during aerosol-generating procedures, the probability of airborne transmission in other circumstances is controversial. Experimental studies demonstrated that SARS-CoV-2 remained viable in aerosols and on fomite surfaces up to 72 hours. However, no reports directly demonstrated transmission from the fomites. SARS-CoV-2 RNA was isolated in various biological specimens but currently, there is no report demonstrating direct transmission of SARS-CoV-2 apart from respiratory secretions except for two cases of vertical transmission. The type, time, and duration of exposure, application of preventive measures, and the amount of the virus are among the most important predictors of the risk of transmission. Infectiousness begins approximately 3 days before symptom onset and peaks on the day of onset. The risk of transmission remains high in case of exposure to the index case within 5 days of symptom onset and is thought to continue until to10-20 days depending on the severity of the disease and presence of underlying immunosuppressive diseases. Although the preventive measures may differ according to public and healthcare settings the main strategy is to accept everyone as potential COVID-19 patients. In public settings, everyone should be encouraged to wear a facemask, maintain social distance, apply hand hygiene, avoid touching mouth, nose, and eyes, keep clean high touch areas, and obey isolation rules in case of illness or contact with COVID-19 patient. Every healthcare center should redesign the structuring of its facility to maintain the physical distance and isolate COVID-19 patients. The administration should consider making arrangements regarding surgical and invasive procedures, outpatient and inpatient clinics in terms of COVID-19. Patients and visitors should wear a facemask. Healthcare workers who care for patients with suspected or confirmed COVID-19 should wear personal protective equipment. © 2021 Nova Science Publishers, Inc.

Medical Faculty Students' Attitudes, Behaviors and Beliefs About Covid-19 Pandemic

Objective: The aim of this study is to evaluate the attitudes, behaviors, and beliefs of medical faculty students about the covid-19 pandemic. Methods: Between 29/03/2020 and 04/13/2020 a total of 1,332 students had been questioned in three Turkish speaking countries (Turkey, Azerbaijan, Turkish Republic of Northern Cyprus). Results: The average age of the students were 20.1 +/- 1.6. Among all 895 (67.7%) of them were female and 427 (32.3%) were male. 1020 (77.2%) of the studens were in Turkey, 195 (14.8%) were in Azerbaijan and 107 (8.1%) were in the TRNC. 104 of the students (7.9%) had a chronic disease. It was found that number of alcohol and cigarette users decreased significantly during the pandemic. (p <0.001, p <0.001). Anxiety levels of those who quit or reduced smoking were found to be higher than those who increased or did not change their amount of smoking (p=0.034). It was found that the most benefited sources were "their faculty lecturers" (n=453, 34.3%), "Worldometer (R) website" (n= 449, 34%) and "Youtube videos" (n=396, 30%). Conclusion: Longitudinal studies are needed on the effects of pandemic on alcohol and tobacco use. It is important to educate future physicians in social media literacy, interpretation and responsibilities for social media posts. In this way, perhaps we can contribute to minimize the public's erroneous beliefs and maladaptive behaviors regarding the pandemic and reduce stigmatizing attitudes towards physicians, elders and Asians.

ALTERED MOLECULAR PATHWAYS OBSERVED IN NASO-OROPHARYNGEAL SAMPLES OF SARS-CoV-2 PATIENTS (preprint)

COVID-19 or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appeared throughout the World and currently affected more than 3.6 million people and caused the death of around 252,000 people. The novel strain of the coronavirus disease is transmittable at a devastating rate with a high rate of severe hospitalization even more so for the elderly population. Currently around 50,000 patients are in a seriously critical situation. Although 1.2 million patients recovered from the disease there are still more than 2.1 Million active cases. Naso-oro-pharyngeal swab samples as the first step towards detecting suspected infection of SARS-CoV-2 provides a non-invasive method for PCR testing at a high confidence rate. Furthermore, proteomics analysis of PCR positive and negative naso-oropharyngeal samples provides information on the molecular level which highlights disease pathology. Samples from 15 PCR positive cases and 15 PCR negative cases were analyzed with nanoLC-MS/MS to identify the differentially expressed proteins. Proteomic analyses identified 207 proteins across the sample set and 17 of them were statistically significant. Protein-protein interaction analyses emphasized pathways like Neutrophil degranulation, Innate Immune System, Antimicrobial Peptides. Neutrophil Elastase (ELANE), Azurocidin (AZU1), Myeloperoxidase (MPO), Myeloblastin (PRTN3), Cathepsin G (CTSG) and Transcobalamine-1 (TCN1) were found to be significantly altered in naso-oropharyngeal samples of SARS-CoV-2 patients. The identified proteins are linked to alteration in the innate immune system specifically via neutrophil degranulation and NETosis.