Unexpected Severe Bocavirus Infections among Hospitalized Children during the COVID-19 Pandemic

Objective: Acute respiratory tract infections are one of the leading causes of morbidity and mortality in children. Although human bocavirus (HBoV) infections are not as common as other seasonal respiratory viruses, children who are infected with HBoV are more likely to suffer from a variety of respiratory conditions, including the common cold, acute otitis media, asthma exacerbations, bronchiolitis pneumonia, some of the affected children require pediatric intensive care unit stay. Here, we aimed to evaluate pediatric bocavirus (HBoV) cases presenting with severe respiratory tract symptoms during the coronavirus disease 2019 (COVID-19) pandemic. Method(s): This retrospective study evaluated the medical records of children diagnosed with respiratory infections, followed up at the Faculty of Medicine, Eskisehir Osmangazi University between September 2021 and March 2022. In this study, patients with HBoV identified using nasopharyngeal polymerase chain reaction (PCR) were considered positive. Cases were analyzed retrospectively for their clinical characteristics. Result(s): This study included 54 children (29 girls and 25 boys) with HBoV in nasopharyngeal PCR samples. The cases ranged in age from 1 month to 72 months (median 25 months). At the time of presentation, cough, fever, and respiratory distress were the most prevalent symptoms. Hyperinflation (48%), pneumonic consolidation (42%), and pneumothorax-pneumomediastinum (7%) were observed on the chest X-ray;54% of the children required intensive care unit stay. The median length of hospitalization was 6 days. Bacterial coinfection was detected in 7 (17%) children, while HBoV and other viruses were present in 20 (37%) children;57% of children received supplemental oxygen by mask, 24% high-flow nasal oxygen, 7% continuous positive airway pressure, and 9% invasive mechanical ventilation support. Antibiotics were given to 34 (63%) cases, and systemic steroid treatment was given to 41 (76%) cases. Chest tubes were inserted in three out of the four cases with pneumothorax-pneumomediastinum. All patients were recovered and were discharged from the hospital. Conclusion(s): The COVID-19 pandemic changed the epidemiology of seasonal respiratory viruses and the clinical course of the diseases. Although it usually causes mild symptoms, severe respiratory symptoms can lead to life-threatening illnesses requiring intensive care admission.Copyright © 2023. The Author(s).

Unexpected Severe Bocavirus Infections among Hospitalized Children during the COVID-19 Pandemic

Objective Acute respiratory tract infections are one of the leading causes of morbidity and mortality in children. Although human bocavirus (HBoV) infections are not as common as other seasonal respiratory viruses, children who are infected with HBoV are more likely to suffer from a variety of respiratory conditions, including the common cold, acute otitis media, asthma exacerbations, bronchiolitis pneumonia, some of the affected children require pediatric intensive care unit stay. Here, we aimed to evaluate pediatric bocavirus (HBoV) cases presenting with severe respiratory tract symptoms during the coronavirus disease 2019 (COVID-19) pandemic.Methods This retrospective study evaluated the medical records of children diagnosed with respiratory infections, followed up at the Faculty of Medicine, Eskisehir Osmangazi University between September 2021 and March 2022. In this study, patients with HBoV identified using nasopharyngeal polymerase chain reaction (PCR) were considered positive. Cases were analyzed retrospectively for their clinical characteristics.Results This study included 54 children (29 girls and 25 boys) with HBoV in nasopharyngeal PCR samples. The cases ranged in age from 1 month to 72 months (median 25 months). At the time of presentation, cough, fever, and respiratory distress were the most prevalent symptoms. Hyperinflation (48%), pneumonic consolidation (42%), and pneumothorax-pneumomediastinum (7%) were observed on the chest X-ray;54% of the children required intensive care unit stay. The median length of hospitalization was 6 days. Bacterial coinfection was detected in 7 (17%) children, while HBoV and other viruses were present in 20 (37%) children;57% of children received supplemental oxygen by mask, 24% high-flow nasal oxygen, 7% continuous positive airway pressure, and 9% invasive mechanical ventilation support. Antibiotics were given to 34 (63%) cases, and systemic steroid treatment was given to 41 (76%) cases. Chest tubes were inserted in three out of the four cases with pneumothorax-pneumomediastinum. All patients were recovered and were discharged from the hospital.Conclusion The COVID-19 pandemic changed the epidemiology of seasonal respiratory viruses and the clinical course of the diseases. Although it usually causes mild symptoms, severe respiratory symptoms can lead to life-threatening illnesses requiring intensive care admission.

Prognosticating poor outcome in COVID-19

We have read the article titled "Comparison of liver biomarkers with N/L ratio, CRP, d-dimer in Covid 19 pneumonia and its effect on mortality” prepared by Haydar et al. with great interest. We thank the editorial board and the authors for publishing this successful and informative manuscript. We also would like to mention a few important points about prognosticating mortality in COVID-19 to contribute to the discussion of the study. © 2023 Ondokuz Mayis Universitesi. All rights reserved.

Medical management during the pandemic period

We read with great interest the article titled "Diagnostic Accuracy of Clinical Gestalt of Doctors with Different Experiences in COVID-19 Suspected Patients" prepared by Özkan and published in the third issue of your journal in 2022. Thanks to the author and editorial board for this interesting and informative article. In addition, we would like to briefly touch on the parameters used in the perception of triage and patient management during the pandemic process. © 2023 Ondokuz Mayis Universitesi. All rights reserved.

Investigation of the clinical course of Covid-19 patients according to blood groups

The aim of this study is to evaluate the effect of blood groups (BGs) on Covid-19 contraction and prognosis and to reveal the coefficients. Patients who referred to Covid-19 outpatient clinics and had an established diagnosis of Covid-19 were included in the study. Their BGs, previous diagnoses and blood examination findings were retrospectively analyzed. Duration of hospitalization, clinical course and survival were recorded. The mean age of 365 subjects, 210 female and 155 male, was 45,5 years. Subjects with BG A developed Covid-19 at significantly higher rates (p = 0.001), while BG O was found associated with lower rates (p = 0.005). Lymphocyte count was found lower (p = 0.035) and rate of lung parenchymal involvement was higher (p = 0.003) in patients with Rh antigen. It was found that a higher percentage of patients with B BG required treatment in the intensive care unit (ICU) compared to other ABO BGs (p = 0.015). These results suggest a higher risk of Covid-19 contraction in the population with BG A and lower risk for BG O population while indicating poorer prognosis for patients with BG B. Copyright © 2022 Ondokuz Mayis Universitesi. All rights reserved.

Analysis of laboratory parameters in patients with COVID-19: Experiences from a pandemic hospital Laboratory parameters of COVID-19

Aim: This study aimed to determine the analysis of the laboratory parameters in patients infected with SARS-CoV-2 during the early pandemic period in Turkey. Material and Methods : This retrospective descriptive study was conducted at a pandemic hospital. All hospitalized patients and outpatients with a positive RT-PCR assay for SARS-CoV-2 were included In the study. Demographics, clinical characteristics, vital parameters on admission, laboratory findings, and drugs used for SARS-CoV-2 infection were obtained from the computer-based patient data system of the hospital and analyzed. The primary outcome of the study was the laboratory parameters of patients with COVID-19. The secondary outcome was 30-day all-cause mortality following emergency department admission. Results: A total of 2,012 patients were included in study. The rates of hospitalization and 30-day mortality were 24% and 2%, respectively. The most common symptom was cough, and the most common comorbidity was hypertension. The neutrophil count, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio values were elevated in the non-survivor group compared to the survivor group (P = 0.001, P < 0.001, and P = 0.020, respectively). The lymphocyte and platelet counts were elevated in the survivor group compared to the non-survivor group (P = 0.001 and P < 0.001, respectively). As predictors of mortality, the cut-off value for the neutrophil, lymphocyte and platelet counts, and the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios were 5.68, 1.42, 195, 3.09, and 141.8, respectively, and the AUC was determined as 0.704, 0.714, 0.727, 0.745, and 0.610, respectively (P < 0.001, P < 0.001, P < 0.001, P < 0.001, and P = 0.023, respectively). Discussion: The results of the study demonstrated that the neutrophil count, lymphocyte count, platelet count, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are useful in determining prognosis in SARS-CoV-2 Infection.

Analysis of laboratory parameters in patients with covid-19: Experiences from a pandemic hospital

Aim: This study aimed to determine the analysis of the laboratory parameters in patients infected with SARS-CoV-2 during the early pandemic period in Turkey. Material and Methods: This retrospective descriptive study was conducted at a pandemic hospital. All hospitalized patients and outpatients with a positive RT-PCR assay for SARS-CoV-2 were included in the study. Demographics, clinical characteristics, vital parameters on admission, laboratory findings, and drugs used for SARS-CoV-2 infection were obtained from the computer-based patient data system of the hospital and analyzed. The primary outcome of the study was the laboratory parameters of patients with COVID-19. The secondary outcome was 30-day all-cause mortality following emergency department admis-sion. Results: A total of 2,012 patients were included in study. The rates of hospitalization and 30-day mortality were 24% and 2%, respectively. The most common symptom was cough, and the most common comorbidity was hypertension. The neutrophil count, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio values were elevated in the non-survivor group compared to the survivor group (P = 0.001, P < 0.001, and P = 0.020, respectively). The lymphocyte and platelet counts were elevated in the survivor group compared to the non-survivor group (P = 0.001 and P < 0.001, respectively). As predictors of mortality, the cut-off value for the neutrophil, lymphocyte and platelet counts, and the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios were 5.68, 1.42, 195, 3.09, and 141.8, respectively, and the AUC was determined as 0.704, 0.714, 0.727, 0.745, and 0.610, respectively (P < 0.001, P < 0.001, P < 0.001, P < 0.001, and P = 0.023, respectively). Discussion: The results of the study demonstrated that the neutrophil count, lymphocyte count, platelet count, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are useful in determining prognosis in SARS-CoV-2 infection.

COVID-19 strategy in organizing and planning orthopedic surgery in a major orthopedic referral center in an area of Italy severely affected by the pandemic: experience of the Department of Orthopedics, University of Padova.

BACKGROUND: According to the required reorganization of all hospital activities, the recent COVID-19 pandemic had dramatic consequences on the orthopedic world. We think that informing the orthopedic community about the strategy that we adopted both in our hospital and in our Department of Orthopedics could be useful, particularly for those who are facing the pandemic later than Italy. METHODS: Changes were done in our hospital by medical direction to reallocate resources to COVID-19 patients. In the Orthopedic Department, a decrease in the number of beds and surgical activity was stabilized. Since March 13, it has been avoided to perform elective surgery, and since March 16, non-urgent outpatient consultations were abolished. This activity reduction was associated with careful evaluation of staff and patients: extensive periodical swab testing of all healthcare staff and swab testing of all surgical patients were applied. RESULTS: These restrictions determined an overall reduction of all our surgical activities of 30% compared to 2019. We also had a reduction in outpatient clinic activities and admissions to the orthopedic emergency unit. Extensive swab testing has proven successful: of more than 160 people tested in our building, only three COVID-19 positives were found, and of over more than 200 surgical procedures, only two positive patients were found. CONCLUSIONS: Extensive swab test of all people (even if asymptomatic) and proactive tracing and quarantining of potential COVID-19 positive patients may diminish the virus spread.