Health-related quality of life in long COVID-19 in context of symptom type

Aim: Coronavirus disease 2019 (COVID-19) is complex multisystem disease. After 4 weeks of persistent symptoms, it is termed as Long COVID-19. Long COVID-19 causes a decrease in health-related quality of life (HRQoL). In this study, it was aimed to determine which symptoms were associated with lower HRQoL in Long COVID-19 in this study. Material(s) and Method(s): This cross-sectional study was conducted in a tertiary research hospital. Patients who have positive RT-PCR results at least 28 days and at most 180 days ago were selected for the study. Online survey was applied to 266 patients who had positive PCR test results for COVID-19. The EuroQoL 5D-3L scale was used to measure the HRQoL as a dependent variable. Socio-demographic features and symptoms were assessed by the survey as independent variables. Due to heteroscedasticity, a robust standard error regression analysis was conducted to make inferences on the effects of persistent symptoms on HRQoL. Result(s): Of the total 266 participants, 163 were females (63.3%). The mean age was 41.2 +/- 11.8 years. One hundred forty-two patients (53.3%) did not report any ongoing symptom. Female gender and lower education level as socio-demographic variables, visual problems and myalgia as persistent symptoms were identified as risk factors for reduced HRQoL in Long COVID-19 patients. Discussion(s): Long COVID-19 patients experience lower levels of HRQoL, especially those with visual problems and/or myalgia. Interventions to raise the HRQoL of Long COVID-19 patients should first target visual problems and myalgia.Copyright © 2023, Derman Medical Publishing. All rights reserved.

Evaluation of maternal serum and umbilical cord brain-derived neurotrophic factor (BDNF) levels in COVID-19-infected pregnancies.

OBJECTIVE: COVID-19 is a disease that affects and damages the neurological system. The aim of this study was to evaluate the fetal neurodevelopmental status through maternal serum and umbilical cord BDNF levels. PATIENTS AND METHODS: In this prospective study, 88 pregnant women were evaluated. Demographic and peripartum characteristics of the patients were recorded. Samples were collected from pregnant women for maternal serum and the umbilical cord BDNF levels during delivery. RESULTS: In this study, 40 pregnant women hospitalized with COVID-19 formed the infected group and 48 pregnant women without COVID-19 formed the healthy control group. Demographic and postpartum characteristics were similar in both groups. Maternal serum BDNF values were significantly lower in the COVID-19 infected group (1597.0 ± 337.3 pg/ml) than in the healthy group (1783.2 ± 394.1 pg/ml) (p=0.019). Fetal BDNF levels were 1794.9 ± 440.3 pg/ml in the healthy group and 1691.0 ± 368.6 pg/ml in COVID-19 infected pregnant women group and statistically similar between groups (p=0.232). CONCLUSIONS: Results showed that while maternal serum BDNF levels decreased in the presence of COVID-19, there was no difference in umbilical cord BDNF levels. This may be an indication that the fetus is not affected and is protected.

An Insidious Clinical Picture: Optic Nerve Involvement in Patients with COVID-19

Objective: Many neurological symptoms due to central nervous system, peripheral nervous system and musculoskeletal system damage have been reported in more than a third of patients with coronavirus disease-2019 (COVID-19). Although optic neuritis has been reported in patients with COVID-19, they are extremely rare. The aim of this study was screening optic nerve involvement in COVID-19 with visual evoked potential (VEP) in asymptomatic patients without a history of visual impairment. Materials and Methods: Pattern reversal VEP measurements were made in 101 adult patients with COVID-19 without a history of visual impairment after they completed COVID-19 treatments and the quarantine period. VEPs were recorded with the 4-channel electromyography-evoked device in a dark room. P100 latencies and amplitudes were analyzed by the same neurologist. Results: A total of 34 (33.7%) patients had P100 latency prolongation. There was no significant difference in terms of gender, age or outpatient/inpatient treatment status. There was no significant correlation between the time of polymerase chain reaction diagnosis and VEP values. Conclusion: Contrary to previous studies, asymptomatic optic nerve involvement after COVID-19 was detected by VEP measurements. Prolongation of P100 latency shows the probable linkage between COVID-19 virus and angiotensin converting enzyme 2 receptors in human eyes.

The Effect of the COVID-19 Pandemic on Elbow Trauma in the Pediatric Population

BACKGROUND/AIMS: The coronavirus disease-2019 (COVID-19) pandemic has had significant effects on children's daily activities. Changes in the patterns of pediatric trauma injuries were inevitable. Therefore, we aimed to identify the effects of lockdown during the COVID-19 pandemic on the etiology and epidemiology of pediatric elbow injuries.MATERIALS AND METHODS: A retrospective analysis was performed on pediatric patients admitted to the emergency room with elbow trauma during the first 3 months of the pandemic (11th, March, 2020 to 11th, June, 2020) and for the same periods in 2019 and 2018. Age, sex, etiology and type of injury (distal part of humerus, proximal radius and ulna, nursemaid's elbow and soft tissue injuries) were analyzed and compared between the periods.RESULTS: A total of 152 patients, 61 in 2018, 56 in 2019 and 35 in 2020 were included. There were 42.7% and 37.5% decreases in the number of patients during the pandemic compared to 2018 and 2019, respectively. A younger age group was more commonly affected during the pandemic (p=0.01). The most common type of injury was supracondylar humerus fracture followed by soft tissue injury in both periods, before and during the pandemic. During the pandemic, the rates of injuries at home, in the playground and by vehicles (car, bicycle, scooter) increased while outside injury decreased significantly (50.4%, p<0.05).CONCLUSION: The COVID-19 pandemic caused a decline in the frequency of pediatric elbow injuries but the increase in injuries at home and vehicle accidents have shown the necessity for health-care to be prepared for these specific conditions.

Chest Image Staging and Prevalence of Current Smoking Among Hospitalized COVID-19 Patients in Turkey

Objective: Novel coronavirus disease is a new infectious agent of the respiratory tract characterized by severe acute respiratory syndrome. For this disease, there are limited data with regard to the clinical characteristics of the patients and prognostic factors. Methods: We collected data from 213 patients who were hospitalized into COVID-19 isolation with positive PCR test results. We recorded various patient values, including blood test results. We also noted age, gender, additional diseases, duration of discharge, whether they live or die, whether they smoke, and their radiological staging. Results: In CT imaging with a staging of maximum 4 points and minimum 0 points, the mean value resulted in 1.95. The average radiological stage of the dead patients' group was reported as 2.56. There was a correlation between the radiological predictor and the outcome status (P = .002). The number of smokers was 14 (6.5%). Of the 26 patients who died, 3 were smokers and 23 were non-smokers. Conclusion: Fourteen patients in the study were smokers. While in COVID-19 isolation service, only a small rate of smoking was observed. That supports the theory that smoking has no negative impact on COVID-19 development. There was also a correlation between the radiological predictor and the outcome status. It seems that an elevated radiological stage is a predictor of death.

Investigation of descriptive characteristics of randomized controlled trials of COVID-19 vaccines

INTRODUCTION: The aim of this study was to examine the descriptive characteristics of randomized controlled trials published in PubMed on COVID-19 vaccines until May 30, 2021. METHODS: Seventy three articles reached by scanning the keywords "vaccine" and "COVID 19" in the PubMed database were reviewed by researchers, 33 randomized controlled trials (RCTs) related to COVID 19 vaccines were included in the study. According to the 17-item questionnaire created by the researchers, the descriptive features of included studies were examined. RESULTS: The total number of investigative authors in 33 RCT articles published in approximately one and a half years from the outbreak of the pandemic was 946, and the average number of authors per article was 28.67+or-18.56.39.3% of the articles were published in The Lancet and 27.2% in The New England Journal of Medicine. Of the vaccines used in the studies, 36.3% mRNA vaccine, 21.2% Inactivated vaccine, 18.1% Recombinant adenovirus vaccine, 12.1% Chimpanzee adenovirus-based vector vaccine, 6% BCG vaccine. 22.5% of vaccines are Phase 1, 12.9% Phase 2, 19.3% Phase 3, 3.2% Phase 4, 32.3% Phase 1-2, 9%,6 of them are Phase 2-3 studies. DISCUSSION AND CONCLUSION: The majority of randomized controlled trials on COVID-19 vaccines are phase 1 and phase 2 trials for mRNA vaccines and inactivated vaccines. Studies have generally been conducted on the adult age group and studies are needed to evaluate the effect of vaccines on the pediatric age group. In studies, the safety of vaccines has been examined more, and there is limited information on efficacy and effectiveness of vaccines.

Decline in public interest for most but not all of the spinal diseases in the era of COVID-19 pandemic

Introduction: The COVID-19 pandemic significantly changed public behaviors. Spinal disorders can affect the health care system through patients of all ages and social statuses. Most people are asked to stay at home. However, it is unknown how the public will respond. The purpose of this study was to evaluate the COVID-19 pandemic’s impact on the Turkish population on spinal conditions by using Google Trends. Materials and methods: Common spine-related conditions were categorized into 4 subgroups including pain (neck, back, and low back pain), deformity (scoliosis, kyphosis), degenerative conditions (spinal stenosis, disc herniation, spondylolisthesis), and trauma (vertebra fractures, spinal cord injury). These terms were translated into the Turkish local language. The Google Trends analysis was used to collect the data of all subgroups that were searched within “Turkey” from January 1, 2019, to December 31, 2020, at the “all categories” filter in “google web research”. Results: For 2019, “disc herniation” and for 2020, “low back pain” had the highest mean value of search volume. The most decline of the mean of search interest volume (SIV) was seen in “scoliosis” by %58,3 followed by 35,5% decline in back pain, 11,7% decline in “disc herniation”. There was an increase in the mean rank of SIV for “vertebrae fracture” by 42,6% and “kyphosis” by 6,3%. Conclusion: Public interest in most spine disorders decreased during the COVID-19 pandemic. However there were increases for trauma and kyphosis in the era of pandemic. © 2021 A. CARBONE Editore. All rights reserved.

The effects of distance education applied due to covid-19 on clinical neurology education

Objective: The aim of this study was to compare distance and face-to-face learning models applied in neurology clinic education during the coronavirus disease-2019 (COVID-19) pandemic. Materials and Methods: Medical faculty students who received clinical neurology education in the 2019-2020 academic years were included in the study. The online questionnaire used in the study consisted of three parts. The first part contained questions on students’ sociodemographic data and education;in the second part, questions were asked on the students’ competence level in meeting the cognitive and practical learning objectives of clinical neurology education;and in the third part, the medical school students’ attitudes toward online learning scale was included. Results: The average passing grades of the 45 students (84.3) who took the clinical neurology education face to face were lower than those of the 40 participants (91.1) who received distance education. In 30 of the 40 cognitive goals and 39 of the 40 practical goals, the group averages of the students who received face-to-face training were higher than those of the distance education group. There was no correlation between passing grades and total scores on cognitive and practical goals. There was a significant correlation between the cognitive and practical total scores of the students and attitude scale toward distance/online learning scale score in the distance education group. Conclusion: Distance education was started for clinical neurology education in the COVID-19 pandemic. The proficiency levels declared by students regarding their learning goals after distance education were lower. The results achieved with distance education, especially in practical goals, were worse. Conversely, student grades were higher in the distance education group. These results show that there are serious difficulties in measurement and evaluation methods in distance education. It is necessary to review the experiences gained from the pandemic to eliminate deficiencies and improve clinical neurology education.

COVID-19 Symptoms at First Admission to Hospital

Objective: The aim of this study is to profile the complaints in the disease application using a symptom survey in patients presenting with the suspicion of COVID-19 disease and to determine the disease-specific and descriptive characteristics of the initial symptoms in those who were diagnosed with the disease. Methods: In this cross-sectional study, symptoms at first admission were questioned in adult patients who applied to the Covid Outpatient Clinic between 21 December 2020 - 22 January 2021. A total of 43 complaints were analyzed in PCR test positive and negative patients. Results: 273 (62.0%) first application and 167 (38.0%) control applications were included in the study. The PCR test was positive in 16.5% of the first admissions. The most common complaints in the first admissions with positive PCR test were fatigue (73.0%), headache (64.9%), pain (32.2%), cough (56.8%), sore throat (51.4%), loss of appetite (45.9%) while 15.9% of them were asymptomatic. Odd's rates of significant complaints for PCR positivity were calculated as 2.607 for fever, 2.724 for anorexia, 2.051 for cough, 2.594 for loss of smell, and 2.243 for loss of strength. Conclusions: COVID-19 is a disease that affects many organs and systems. Comparing the admission symptoms with the PCR test results will contribute to the recognition of the disease at the initial stage. Fever, anorexia, cough, loss of smell and loss of strength were found to be the distinguishing complaints of PCR positivity in our study.

Use of Social Media as a Health Seeking Behaviour: Looking Into Covid-19 Related Social Media Posts on Facebook During The Measures of Isolation, Lockdown and Social Distance

The study aims to demonstrate how health seeking is reflected in users' posts and comments in Covid-19-themed groups on Facebook as a social media platform, under the conditions of isolation, lockdown and social distance in the Covid-19 process. In this scope, the study examined Facebook groups: The Coronavirus (Covid-19) Information Exchange and Cooperation-Turkey, The Covid-19 Information Sharing Platform, and The Information and Solidarity Platform for Those Diagnosed with Covid-19 Turkey. 600 posts and comments were selected using the random sampling technique and analysed using descriptive method content analysis technique. This was conducted through a coding layout developed by the researchers based on field research (92.95% reliability) and showed that the participants mainly shared emotional support posts and comments that included good wishes/consolation/prayer/thanks (35.3%) and asked questions about the Covid-19 experience/treatment (41.3%) process for information. The posts differed by gender and 86.3% of them received comments. Finally, a word cloud was created using Python, and the overall distribution of the posts and comments was determined. The study demonstrates that digital channels and social networks are used for emotional support and as a source in seeking health information despite having problems such as causing the paradox of fear, issues of confidentiality, and a low confidence level.

An investigation of fear of COVID-19 status in university student athletes from different sports associated with contact

Background and Study Aim The aim of this research is to (i) examine the COVID-19 fear scales according to the contact rate of the sports branch of the athletes and (ii) examine the COVID-19 fear scales according to some demographic variables of the athletes. Material and Methods Sport Sciences Faculty students athletes (n=176) in sports with different levels of contact voluntarily participated in the current study. The fear of COVID-19 scale consisting of a total of 7 items and demographic information form and a single sub-dimension were applied online via Google (R) forms to individuals who participated in the study voluntarily. The data obtained from the study were analyzed using IBM SPSS 25.0 statistics package program. Due to the normal distribution of the data, sample t-test independent of parametric tests and one-way analysis of variance tests were used in the statistical analysis of the data. Bonferroni test, one of the multiple comparison tests, was used in order to determine which groups had significance according to the results of the one-way analysis of variance test. The results were tested at a significance level of p <0.05. The Cronbach Alpha reliability coefficient for the COVID-19 fear scale was found to be 0.88. Results Statistically significant difference was found between the fears of catching COVID-19 according to the gender of athletes in different branches (p = 0.01). No statistically significant difference was found between the fears of catching COVID-19 according to the educational status of the athletes (p = 0.31). No statistically significant difference found between the fears of catching COVID-19 according to the contact included in the specialty sports of the athletes in different branches (p = 0.56). Statistically significant difference was found between the highest level (professional) and intermediate level (amateur) groups) in terms of fear of catching COVID-19 (p = 0.02). No statistically significant difference found between the fears of catching COVID-19 (p = 0.08) of the athletes in different branches according to their sports experience. Statistically significant difference was found in terms of fear of catching COVID-19 between the 4-6 years and 7-9 years groups with sports experience (p = 0.02). In addition, it has been revealed that the average scores of COVID-19 fear scales (20.05 +/- 4.79) of female athletes are higher than the average scores of male athletes (17.67 +/- 6.75). Conclusions: As a result, this research has revealed that the fear of COVID-19 does not differ relative to the contact levels of a specific sports branch. In addition, it has shown that the fear of COVID-19 is greater in female athletes compared to male athletes and lower performance levels and less competition experiences are in fact causing an increase in fear of COVID-19.

What has changed in orthopaedic emergency room during covid - 19 pandemic: A single tertiary center experience

Introduction: During COVID- 19 pandemic, changes and restrictions in daily life activities brought many differences in mechanism of injury presented to orthopedic emergency. The purpose of this study was investigation the effect of COVID-19 pandemic on incidence and characteristic features of patients with presented to orthopaedic emergency room. Materials and methods: Patients with consulted orthopedic emergency room between 11 March – 11 May 2020 and the same time window in 2019 were selected for study. Medical records of patients were retrieved retrospectively and analyzed for demographic features (Age and gender), mechanism of injury and pattern of bones fractured. Patients were divided into three groups based on age: 0-18, 18-64, ≥65 years. Mechanism of injury included trauma, destructive and metabolic. Results: 1108 patients were evaluated with consulted orthopedic emergency room between 11 March and 11 May in 2020 and 2019. Falling was the most seen injury type in both seasons. There was decrease in falling from height 66.7% for adult but increase 25% for pediatric group. Hit by car injury was decreased 72% in pandemic season compared to normal season in all age groups. Bicycle accident was also increased 100% in both pediatric and adult groups during pandemic season. In adult group punching injury was increased 44,4% during pandemic season compared to normal season. Other injuries (soft tissue injury, foreign bodies, implant insufficiency, dog bites, destructive and metabolic were decreased naturally in pandemic period. Conclusion: There were 51,1% decrease in fracture during pandemic season. In both seasons falling low – energy was the most common injury mechanisms. New rules in social life for pandemic increased the percentage of personal vehicle accidents, home accidents, punching injury and soft tissue injuries while decreased the percentage of work accidents, out of car accidents and falling from height. © 2021 A. CARBONE Editore. All rights reserved.

Ventricular repolarization indexes in patients treated with hydroxychloroquine - azithromycin combination for COVID-19.

BACKGROUND: Combination of hydroxychloroquine and azithromycin for the treatment of coronavirus disease 2019 (COVID-19) carries increased risk of corrected QT (QTc) prolongation and cardiac arrhythmias. OBJECTIVE:  To characterize the ventricular repolarization indexes which are associated with malignant ventricular arrhythmias in patients treated with hydroxychloroquine and concomitant azithromycin for COVID-19. METHOD: A total of 81 patients who had hydroxychloroquine and azithromycin combination therapy because of possible or  reverse-transcription polymertase chain reaction (RT-PCR) confirmed diagnosis of COVID-19 were included in the study. Baseline and control electrocardiograms (before and after treatment) were analyzed retrospectively. Tp-e interval, Tp-e/QT and Tp-e/QTc ratios, which are ventricular repolarization indexes, were calculated. RESULTS: While there was no significant increase in QTc interval in patients receiving combination therapy, there was a significant increase in ventricular repolarization indexes. CONCLUSION: The increase in ventricular replarization indexes is associated with the risk of arrhythmia. In patients using QTc prolonging medication for COVID-19 treatment, QTc monitoring alone may not be sufficient to follow-up for arrhythmia. Even if there is no prolongation in QTc, an increase in ventricular repolarization indexes may be seen (Tab. 5, Ref. 37).