Favipiravir Experience in COVID-19 Patients at a Tertiary Center Intensive Care Unit

Objectives The aim of this study was to compare intensive care unit (ICU) and overall hospital mortality in patients treated with favipiravir and lopinavir-ritonavir for COVID-19. Methods Data were collected retrospectively between March 10 and May 10, 2020, from patients’ records admitted to ICU due to COVID-19. Laboratory data, clinical characteristics, ICU and hospital mortality, ICU and hospital length of stay were compared in patients treated with favipiravir and lopinavir-ritonavir. Results A total of 100 patients’ data were investigated. Favipiravir was used as the treatment for 85% of patients, with the rest treated with lopinavir-ritonavir. Clinical and laboratory data of both antiviral treatment groups were similar. Length of hospital stay was 16 (9–24) days with favipiravir and 8.5 (5–12.5) days with lopinavir-ritonavir (p=0.002). Length of ICU stay for favipiravir and lopinavir-ritonavir groups were 8 (5–15) days and 4 (3–9) days, respectively (p=0.011). ICU mortality was 65.9% for the favipiravir and 80% for lopinavir-ritonavir (p=0.002). Hospital mortality for favipiravir and lopinavir-ritonavir was 67.1% and 80%, respectively (p=0.001). Conclusion The mortality in patients treated with favipiravir was less than patients treated with lopinavir-ritonavir. Favipiravir needs more attention and trials for its effect to be confirmed.

The Effect of Diabetes Mellitus on Mortality in Patients Hospitalized Intensive Care Unit in Covid-19 Pandemic.

Backgorund and aim: There are many studies on the effects of Diabetes Mellitus on the clinical course in COVID-19 patients. Factors that increase the risk of contracting COVID-19 disease and increase disease progression have been caused, and diabetes mellitus is one of them. We aimed to evaluate the incidence of Diabetes Mellitus in patients treated in the intensive care unit in respiratory failure due to COVID-19 pneumonia, and the effect of Diabetes Mellitus on the length of stay in intensive care and mortality. METHODS: Our study is a single-center retrospective study. The study includes patients hospitalized in our COVID intensive care unit between March 16, 2019, and May 16, 2020 Patients over 18 years of age with and without a history of Diabetes Mellitus were compared in 2 groups. Demographic data of the patients, length of stay in the intensive care unit, respiratory support methods, presence of other comorbid diseases, effects of Diabetes Mellitus to mortality in ICU were recorded. RESULTS: The information of 150 patients was obtained in the COVID-19 intensive care units of our hospital. Diabetes Mellitus was detected in 49 of the patients hospitalized in intensive care. 34.7% of these patients were female and 65.3% were male. There was no significant difference in survival in both groups (p = 0.942). The BMI of the patients with Diabetes Mellitus was 27.07 ± 2.55, significantly higher (p = 0.005). Intensive care stay periods were similar in both groups. The presence of hypertension was significantly higher in those with Diabetes Mellitus (p = 0.000). There was no statistically significant difference between respiratory support methods. CONCLUSIONS: Diabetes Mellitus did not affect the duration of stay in the intensive care unit and mortality in patients who were followed up and treated in the intensive care unit due to COVID-19 pneumonia.

Effectiveness of inactivated SARS-CoV-2 vaccine (CoronaVac) on intensive care unit survival.

This study compared the course of coronavirus disease 2019 (COVID-19) in vaccinated and unvaccinated patients admitted to an intensive care unit (ICU) and evaluated the effect of vaccination with CoronaVac on admission to ICU. Patients admitted to ICU due to COVID-19 between 1 April 2021 and 15 May 2021 were enrolled to the study. Clinical, laboratory, radiological parameters, hospital and ICU mortality were compared between vaccinated patients and eligible but unvaccinated patients. Patients over 65 years old were the target population of the study due to the national vaccination schedule. Data from 90 patients were evaluated. Of these, 36 (40.0%) were vaccinated. All patients had the CoronaVac vaccine. Lactate dehydrogenase and ferritin levels were higher in an unvaccinated group than vaccinated group (P = 0.021 and 0.008, respectively). SpO2 from the first arterial blood gas at ICU was 83.71 ± 19.50% in vaccinated, 92.36 ± 6.59% in unvaccinated patients (P = 0.003). Length of ICU and hospital stay were not different (P = 0.204, 0.092, respectively). ICU and hospital mortality were similar between groups (P = 0.11 and 0.70, respectively). CoronaVac vaccine had no effect on survival from COVID-19. CoronaVac's protective effect, especially on new genetic variants, should be investigated further.

Sigara Kullanımının Yoğun Bakım Ünitesindeki COVID-19 Hastalarında Sağkalıma Etkisi

Amaç: Bu çalışmada yoğun bakım ünitemizde (YBÜ) sigara içme sıklığı/ yaygınlığının (prevalansının), sigara kullanımına bağlı kalış süresinin ve COVID-19 mortalitesi üzerine etkilerini görmeyi amaçladık. Gereç ve Yöntem: 16 Mart-16 Mayıs 2020 tarihleri arasında COVID19 hastaları üzerinde yoğun bakım ünitesinde yapılan retrospektif tek merkezli bir çalışmadır. Demografik veriler, komorbidite durumları, kabul edildikleri birimler, klinik semptomlar, solunum desteği, hastaların sigara içme sıklığı/prevalansı, yoğun bakımda kalış süreleri ve mortaliteleri kaydedilmiştir. Sigara içen ve içmeyen olarak iki grup vardı. 1.100 COVID19 hastası vardı ve bunlardan 150’si yoğun bakım ünitesinde tedavi gördü. Doksan beş hastanın verilerine ulaşıldı. Bulgular: Hiç sigara içmemiş hastalar %64,2’di. Bu hastaların %5,3’ü daha önce sigara içmiş, %30,5’i ise aktif içici idi. Sigara içen gruptaki hastaların yaş ortalaması içmeyenlere göre daha az olmuştur. Sigara içenlerde kronik obstrüktif akciğer hastalığı insidansı daha yüksek olmuştur. Sigara içme durumu, yoğun bakımda kalış süresi ve sağkalım arasında ilişki bulunamamıştır. Sigara kullanımı, COVID-19 hastalığında solunum yetmezliğine kadar ilerleyebilen ve ölümle sonuçlanabilen agresif sürece neden olan faktörler arasında yer almaktadır. Sonuç: Bazı araştırmalar da sigaranın koruyucu olabileceğini iddia etmektedir. Bu konu hakkında henüz bir netlik yoktur. COVID-19 pnömonisine bağlı solunum yetmezliği olan YBÜ’de tedavi edilen hastalarda sigara içmenin yoğun bakımda kalış süresi ve mortalite üzerinde etkisi olmadığı ortaya konmuştur. (Turkish) [ FROM AUTHOR] Copyright of Turkish Journal of Intensive Care 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.)

Anxiety and burnout in anesthetists and intensive care unit nurses during the COVID-19 pandemic: a cross-sectional study.

BACKGROUND: This study aimed to measure the levels of anxiety and burnout among healthcare workers, including attending physicians, residents, and nurses in intensive care units during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This is a cross-sectional survey analysis of healthcare workers in our institution. Data were collected on demographic variables, COVID-19 symptoms and test, disease status, anxiety level (assessed by the Beck Anxiety Inventory), and burnout level (measured by the Maslach Burnout Inventory). Subscales of the burnout inventory were evaluated separately. RESULTS: A total of 104 participants completed the survey. Attending physicians, residents, and nurses constituted 25%, 33.7%, and 41.3% of the cohort, respectively. In comparison to untested participants, those tested for COVID-19 had a lower mean age (p = 0.02), higher emotional exhaustion and depersonalization scores (p = 0.001, 0.004, respectively), and lower personal accomplishment scores (p = 0.004). Furthermore, moderate to severe anxiety was observed more frequently in tested participants than untested ones (p = 0.022). Moderate or severe anxiety was seen in 23.1% of the attending physicians, 54.3% of the residents, and 48.8% of the nurses (p = 0.038). Emotional exhaustion, personal accomplishment, and depersonalization scores differed depending on the position of the healthcare workers (p = 0.034, 0.001, 0.004, respectively). CONCLUSION: This study revealed higher levels of anxiety and burnout in younger healthcare workers and those tested for COVID-19, which mainly included residents and nurses. The reasons for these observations should be further investigated to protect their mental health.