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Objective: There is a positive and significant relationship between severity and viral load in some viral diseases. Studies on the relationship between SARS-CoV-2 viral load at diagnosis and severity of coronavirus disease-2019 (COVID-19) have yielded conflicting results. Therefore, we aimed to evaluate the relationship between viral load and the clinical status of patients with COVID-19.Methods: Data of the patients diagnosed with COVID-19 and admitted to our center between May 01 and June 31, 2020, were retrospectively reviewed. The patients were divided into two groups according to their clinical character-istics as mild-moderate and severe. The demographic, laboratory, clinical, and radiological data were retrieved from electronic folders.Results: The entire cohort included 285 patients;254 had a mild-moderate clinical course, and 31 had a severe course. Statistical analyses revealed that SARS-CoV-2 viral load was not associated with symptom duration and clinical status (p>0.05). According to multivariate logistic regression analysis, only ferritin, C-reactive protein, and lactate dehydro-genase elevations were positively correlated with severe clinical course. (p<0.05).Conclusion: We do not recommend using viral load to predict disease severity in COVID-19. We also found that only ferritin, C-reactive protein, and lactate dehydrogenase accompanied severe clinical course. Keywords: cycle threshold, COVID-19, clinical severity
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Objective: Vitamin D plays an important role in maintaining the integrity of mucosal barriers and in natural and acquired immunity. In the COVID-19 pandemic, the strength of personal immunity is very important in the course of the disease, despite the presence of variants of the virus or vaccination status. Method: In this study, we investigated the relationship between the clinical course and vitamin D levels of outpatient and inpatient follow-up patients admitted to our hospital due to COVID-19. A total of 94 patients, 47 outpatients and 47 inpatients, were included in the study. Results: The mean age and gender distributions of both groups were similar. Vitamin D levels were found to be normal in only 7 of 94 patients who were followed up in our hospital due to COVID-19. Patients with vitamin D levels >= 30 were significantly lower than those with "<10" and "10-29.9" (p<0.01 for each). Hospitalized patients (71%) with vitamin D levels <10 were significantly higher than those (0%) with vitamin D levels >= 30. Additionally, the outpatients (29%) with vitamin D levels <10 were significantly lower than those (100%) with vitamin D levels >= 30. Conclusion: The data showed that vitamin D deficiency may be associated with the severe clinical course of COVID-19, even in patients without comorbidities, and may also be one of the predisposing factors resulting in death in COVID-19. As a result, vitamin D levels in COVID-19 patients may be important for the course of the disease.
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Objective: There is a positive and significant relationship between severity and viral load in some viral diseases. Studies on the relationship between SARS-CoV-2 viral load at diagnosis and severity of coronavirus disease-2019 (COVID-19) have yielded conflicting results. Therefore, we aimed to evaluate the relationship between viral load and the clinical status of patients with COVID-19. Method(s): Data of the patients diagnosed with COVID-19 and admitted to our center between May 01 and June 31, 2020, were retrospectively reviewed. The patients were divided into two groups according to their clinical characteristics as mild-moderate and severe. The demographic, laboratory, clinical, and radiological data were retrieved from electronic folders. Result(s): The entire cohort included 285 patients;254 had a mild-moderate clinical course, and 31 had a severe course. Statistical analyses revealed that SARS-CoV-2 viral load was not associated with symptom duration and clinical status (p>0.05). According to multivariate logistic regression analysis, only ferritin, C-reactive protein, and lactate dehydro-genase elevations were positively correlated with severe clinical course. (p<0.05). Conclusion(s): We do not recommend using viral load to predict disease severity in COVID-19. We also found that only ferritin, C-reactive protein, and lactate dehydrogenase accompanied severe clinical course. Copyright © 2022, DOC Design and Informatics Co. Ltd.. All rights reserved.
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Since late 2020, protests against government measures to contain the Covid‐19 pandemic have swept across Germany. At the forefront of these protests was the Querdenker Movement, a heterogeneous alliance of ordinary citizens, hippies, esotericists, opponents of conventional medicine, Christian fundamentalists, and right‐wing extremists bonded by their shared belief in conspiracy myths. This contribution draws upon the theoretical framework of the studies on the authoritarian personality to dissect the nature of this heterogeneous alliance and the democracy‐endangering potential of conspiracy myths. We present three key insights based on an analysis of representative public opinion surveys conducted by the Leipzig Authoritarianism Study. First, we demonstrate that susceptibility to conspiracy myths in the public mood occurs in waves that coincide with times of crisis. In this regard, the Covid‐19 pandemic is a catalyst of conspiracy myths as it has induced existential and epistemic insecurities amongst many citizens. Second, it is shown that there is an elec-tive affinity between superstition, esotericism, and a conspiracy mentality, which can be cited as one explanation for the heterogeneous alliance during the protests. On the other hand, the nexus between religion and the conspiracy mentality depends on an individual’s interpretation of religion. It is literalist fundamentalism that fosters susceptibility to conspiracy myths. Third, we highlight the democracy‐endangering consequences of a conspiracy mentality. Its manifestations include resentment and hostility toward minorities, an alienation from democracy, an increased likelihood of voting for right‐wing authoritarian parties, and an affinity for violence. © 2022 by the author(s);licensee Cogitatio (Lisbon, Portugal).
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Background: Coronavirus disease 2019 (COVID-19) first appeared in China in December 2019, and has become a global pandemic. Because the clinical progression of the disease is highly variable, better prediction of prognosis and mortality is important. In the present study, we investigated the role of procalcitonin/albumin ratio (PAR) as a new biomarker in predicting mortality in patients with COVID-19 infection. Methods: In this study, patients with COVID-19 diagnosis were enrolled from Sakarya Yenikent State Hospital and Ayancık State Hospital between 09.11.2020 and 04.05.2021. The demographic characteristics, biochemical and hematological parameters such as age, gender, length of hospital stay, and comorbidities of the patients were collected retrospectively from medical records. Results: Of the 105 patients, 51 were mild and 54 were critically ill. Between mild and critical cases, age, lymphocyte count, red cell distribution width, neutrophile count, mean corpuscular volume (MCV), monocyte count, albumin, C-reactive protein, ferritin, procalcitonin, D-dimer, and PAR were statistically different (p<0.001 for all). All patients in the critical group and only 2% of the mild group died. PAR showed the largest area under the curve (0.949) for the prediction of mortality (p<0.001). Conclusion: We report that PAR, a simple, cheap, and easily accessible biomarker, can be used to predict the prognosis in patients with COVID-19 infection.
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As part of the fight against the COVID19 outbreak;an economic health tracking system has been developed (TRL 4-5) that can measure oxygen saturation and heart rate data for patients in the service and send it to a central computer via the existing Wi-Fi network.
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Aim: To investigate the relationship between infection markers (lymphocyte, C-reactive protein, and D-dimer) at the time of diagnosis, and the new scoring system created according to the amount and pattern of pneumonic involvement in recent computed tomography (CT) of patients with Coronavirus disease-2019 (COVID-19) pneumonia Methods: We investigated retrospectively patients diagnosed with COVID-19 with positive reverse transcriptase-polymerase chain reaction on throat swabs between March 17 and May 1, 2020. Eighty-nine cases with COVID-19 pneumonia were divided into two groups according to the level of poor prognostic criteria (blood lymphocyte count <800/µL or C-reactive protein >10x upper limit of normal value or D-dimer >1000 ng/mL). The severity of pulmonary parenchymal findings was scored using two separate scoring systems previously as well as a third separate scoring system, namely the “modified CT severity scoring”. The cut-off point for severe infection was investigated by comparing the scores of the groups with and without severe infection. Results: All three scoring systems were significantly higher in the group with severe infection compared to those without severe infections. A modified CT score above 3.4 accompanies at least one of the poor prognosis findings (sensitivity 77.6%, specificity 61%). Conclusion: In patients with COVID-19 pneumonia, the presence of at least one of the infection markers that are poor prognosis markers at the time of diagnosis indicate that the modified CT severity score of pneumonia will be above 3.4.
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Big Data-driven management system has attracted significant attention worldwide as it provides several capabilities to improve strategic, tactical, and operational decisions to eventually create a notable impact on the COVID-19 pandemic. Monitoring, surveillance, detection, and prevention of the global pandemic cases are provided with simultaneous access and management with big data tools. Bringing the pandemic to a normalization level and taking it under control in the health supply chain could be achieved through big data-driven management which is lifesaving applications. However, the adoption of the management system in the fight against the COVID-19 pandemic includes many obstacles all over the world. Mainly, these are data-related characteristics, technological incompetence, socio-economic structure, and governmental policies. In this scope, the main motivation of this study is determining and evaluating critical criteria by using a Multi-Criteria Decision-Making (MCDM) approach. The Spherical Fuzzy AHP methodology proposed as one of the novel MCDM methods enables to obtain managerial implications by comparing to the significance of criteria. The findings can assist to understand the actual nature of the barriers and potential benefits of big data-driven in COVID-19 pandemic management system and make policy regarding curb the pandemic. Therefore, this study is a contribution to academicians, researchers, and practitioners with a different perspective on COVID-19 pandemic management. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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This study aims to develop a model for location-allocation decisions (LAD) for the different types of hospitals’ during Corona Virus 2019 (COVID-19) pandemic. Long-term hospital LAD are accepted as a long-term strategy and take a long time to reach a decision. However, after the beginning of the COVID-19 pandemic, the decision-makers aim to reach their patients as immediately as possible. Thus, decision-makers are planning to increase the capacity of regional or country-wide health systems by adding new hospitals. However, during LAD processes, the decision-makers face imprecision due to the inherited uncertainty of main parameters that must be paid attention to make decisions applicable. Therefore, the decision-makers must give a decision in a short time in a more imprecise environment. For this purpose, Pythagorean Fuzzy Sets (PFS), which are recognized as generalized intuitionistic fuzzy sets with a broader range of applications, are utilized. PFS is one of the most recent tools for dealing with imprecision and a method for removing uncertainty from decision-making processes. This study is one of the first research on applying PFS and making inferences to increase the accuracy of decisions during the COVID-19 pandemic. To show the usability of the proposed model, a case study is provided assuming each candidate location has different specifications which are shown as PFS. Therefore, the LAD model for short-time hospitals related to COVID-19 pandemic conditions is proposed by using a PFS relation called max–min–max composition to ascertain the suitability of decisions. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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During the Covid-19 outbreak, different types of vaccines have been produced and tested in different countries. However, the produced vaccines have different features from each other, and governments are undergoing a decision process for vaccine selection. Criteria such as side effects of vaccines, supply chain processes, storage conditions, costs and perception on people play a crucial role in decision-making. In this study, vaccine selection is considered in an analytical framework. In this context, we focus on vaccine selection using the interval-valued intuitionistic fuzzy VIKOR method (VIseKriterijumska Optimize Kompromisno Resenje), one of the multi-criteria decision-making methods. In addition, interval valued intuitionistic fuzzy numbers (IVIFN) have been integrated into the VIKOR method to eliminate the uncertainty in decision processes. First, the concept, comparison, and distances of IVIFNs are briefly presented in the first section. The extension classical VIKOR approach is then developed to address vaccine selection problem with IVIFNs, and its significant aspect is that it can completely accept the finite justification of decision-makers as a real progress in decision-making. In this study, the applicability of the interval-valued intuitionistic VIKOR (IVIFV) method to evaluate the vaccines produced for the covid-19 outbreak was discussed. With the IVIFV method, the performances of the vaccines based on various criteria were evaluated and a ranking is represented among the vaccines accordingly. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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OBJECTIVES: The present study aims to investigate whether elementary lesions detected at the time of the diagnosis, their distribution characteristics, and CT scoring can be predictive of a cytokine storm. BACKGROUND: CT might have a prognostic predictive value beyond its diagnostic value. METHODS: Sixty-eight patients, 32 with cytokine storm and 36 without cytokine storm, were included in the study. Four different scoring methods were created according to elementary lesions, distribution and involvement rate. CT scores and demographic findings of the cases were compared in the cytokine storm and non-cytokine storm groups. RESULTS: The mean age of patients was 57.72 (SD: 13.5) and 40 (58.8 %) of them were male. The cytokine storm was significantly more common among male patients and patients of older age (p=0.04). The AUC values of CT score 1, CT score 2, CT score 3, and CT score 4 were as follows; 0.772 (95% CI; 0.651-0.892), 0.766 (95% CI; 0.647-0.885), 0.758 (95% CI; 0.639-8.78), and 0.760 (95% CI; 0.640-0.881), respectively. All CT scores had better predictive values in males. CONCLUSIONS: CT scoring at the time of admission can be used to predict cases that may develop cytokine storm later (Tab. 4, Fig. 2, Ref. 15).
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COVID-19 , Cytokine Release Syndrome , Aged , Female , Humans , Male , Prognosis , Retrospective Studies , SARS-CoV-2 , Tomography, X-Ray ComputedABSTRACT
Shortly after the first cases were reported in late 2019 in Wuhan Province of China, SARS CoV 2 spread all over the world and was declared a pandemic by the World Health Organization on March 12, 2020. In Turkey the first case was in March 10, 2020 and March 25, 2020 in Duzce. Duzce University Faculty of Medicine, Department of Medical Microbiology, PCR laboratory was declared to be "T.C. Ministry of Health Duzce authorized Covid 19 PCR laboratory " in 28.03.2020. Samples are sent to our laboratory from all provincial and district hospitals, private hospitals and public health institutions in Duzce. This is the only Covid 19 center in our city and it works for 7 days a week. In our laboratory, Covid 19 antibody tests are carried out with card tests and ELISA methods. A total of 8500 COVID 19 PCR tests and 2200 anti Covid19 ELISA total antibody tests were studied in our laboratory within three months. Although covid 19 patients are not followed in our hospital, pandemic process continues in our laboratory. In addition, all PCR studies and IFA studies of the hospital are carried out in this laboratory.
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COVID-19 is a major pandemic currently spreading worldwide. There is no specific method for its treat-ment. The aim of this study was to evaluate the effect of convalescent plasma in the treatment of COVID-19 and to compare it with patients not receiving plasma therapy. Between March-May 2020, 21 patients diagnosed with COVID-19 who received convalescent plasma therapy were investigated. For the control group, data of patients with similar clinical characteristics who did not receive plasma therapy were recorded. Plasma receivers received convalescent plasma treatment from donors infected and healed with the SARS-Cov-2 virus. Demographic data, laboratory parameters, oxygen saturations and SOFA scores were evaluated. In addition, the clinical outcomes on mortality and length of hospital stay were compared. The mean age of patients was 64.90±19.12. After convalescent plasma treatment, a significant decrease was detected in the respiratory rate, leukocyte count, ferritin, CRP, procalcitonin, lactate and sedimentation values. It was found that patients who received plasma demonstrated shorter length of hospital stay (P = 0.045), less worsened oxygen status/ex status (P = 0.043) compared to control patients. This study demonstrates that convalescent plasma therapy is well tolerated and can improve the clinical and laboratory results by neutralizing viremia in COVID-19 patients. Further larger prospective studies are needed to better assess the impact of convalescent plasma.
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Objective: The SARS-CoV-2 infection outbreak was given the name Coronavirus Disease 2019 (COVID-19) by the World Health Organization. Meteorological parameters are one of the most important factors affecting infectious diseases. The aim of this study is to analyze the correlation between meteorological parameters and the COVID-19 pandemic. Methods: One hundred ninety-seven COVID-19 patients diagnosed and treated in the Turkish province of Duzce between 29.03.2020 and 04.05.2020 were included in this study. Results: We found the relationship between air quality parameters and COVID-19 case numbers revealed significant negative correlation between positive patient number and air temperature, relative humidity, and NO2, and significant positive correlation with air pressure, but no correlation with PM10, PM2.5, SO2, NO, or CO. Conclusions: Our findings are important as a preliminary study, since interactions between air pollutants and meteorological factors may be involved in the transmission and pathogenesis of COVID-19, and large-scale studies should now be designed for a better understanding of these interactions.
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Shortly after the first cases were reported in late 2019 in Wuhan Province of China, SARS CoV 2 spread all over the world and was declared a pandemic by the World Health Organization on March 12, 2020. In Turkey the first case was in March 10, 2020 and March 25, 2020 in Duzce. Duzce University Faculty of Medicine, Department of Medical Microbiology, PCR laboratory was declared to be "T.C. Ministry of Health Duzce authorized Covid 19 PCR laboratory " in 28.03.2020. Samples are sent to our laboratory from all provincial and district hospitals, private hospitals and public health institutions in Duzce. This is the only Covid 19 center in our city and it works for 7 days a week. In our laboratory, Covid 19 antibody tests are carried out with card tests and ELISA methods. A total of 8500 COVID 19 PCR tests and 2200 anti Covid 19 ELISA total antibody tests were studied in our laboratory within three months Although covid 19 patients are not followed in our hospital, pandemic process continues in our laboratory. In addition, all PCR studies and IFA studies of the hospital are carried out in this laboratory.