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Introduction: High-flow oxygen therapy (HFOT) is used to provide oxygenation and reduce the need for intubation in severe pneumonia cases caused by SARS-CoV-2 virus. In this study, causes of mortality during hospitalization in the intensive care unit (ICU) in patients receiving HFOT therapy were investigated. Method(s): The data of 215 adult patients, who were admitted to ICU of a university hospital between April 2020 and October 2021, with severe COVID pneumonia and received HFOT were enrolled retrospectively in our study. Result(s): Total mortality among patients was 158 (73.4%). The overall mean age was 72 years, 61 in the survivor group and 73 in the mortality group (p < 0.001). It was determined that mortality rates decreased as the length of stay (LoS) in ICU and HFOT duration of the patients increased (p = 0.008 and < 0.001, respectively). The increase in respiratory rate on arrival was found to be significantly associated with increased mortality. Although the goal of HFOT is to improve oxygenation, no significant mortality-related difference was found in terms of pO2, pCO2 and P/F values calculated at the time of admission. The ROC curve was applied to examine the differential effect of Apache-II, SOFA, ROX and Procalcitonin measurements according to the survival. The area under the curve (AUC) and cut-off values were calculated as follows: APACHE-II (63.9%, 5,) SOFA (62.8%, 2), ROX index (66.8%, 4.72), Procalcitonin (65.7%, 0.23) (Fig. 1). Conclusion(s): Unlike reports in literature on mortality in ICU, LoS was found to have a decreasing effect on mortality rate [1]. In addition to the well-known scoring systems such as APACHE-II and SOFA, the ROX index, which is used to predict the success of HFOT, has emerged as a predictive value for mortality at admission to the intensive care unit [2].
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Objective: As approval of one of many coronavirus disease-2019 (COVID-19) vaccines' use for pregnancy is getting closer, vaccine hesitancy may take place in pregnant individuals for this new vaccine. Our study aimed to evaluate vaccine acceptance and factors affecting vaccine acceptance in case of an approved COVID-19 vaccine for pregnant individuals. Material and Methods: Our study was designed as one group, cross-sectional, prospective study. Sample consisted of pregnant individuals who didn't have any chronic illnesses and didn't contract COVID-19 in the last 6 months. In-person style survey was used to collect data about demographics, knowledge about COVID- 19 disease and it's effects on pregnant individuals, vaccine acceptance and reasons for acceptance or refusal. Results were analyzed with descriptive statistics, chi-square test and Shapiro-Wilk test of normality using Number Cruncher Statistical System. Results: Among 250 participants, 183 (73.2%) reported they wouldn't accept COVID-19 vaccination if there was a safe and effective vaccine approved for use in pregnancy. Main reasons of refusal were the belief that vaccine hadn't been studied on humans enough or that it might have adverse effectes on baby and/or pregnant individual. Only factor associated with vaccine acceptance was found to be knowing someone who had severe COVID-19 disease (p=0.022). Conclusion: Our study shows that vaccine hesitancy rates may be high among pregnant individuals when a COVID-19 vaccine is approved for use in pregnancy. The main reason for vaccine hesitancy is safety concerns.
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Objective: COVID-19 (Coronavirus disease 2019) is a global pandemic that affected more than 125 million people all over the world. Vaccines will play a key role in the control of this pandemic. Although inactive vaccine technologies are reliable and being used for a long time, Coronavac is a newly developed vaccine and studies on the side effects of this vaccine are limited. The aims of this study is to evaluate the frequency of possible side effects of Coronovac vaccine and to investigate whether there is a difference between the 1st and 2nd dose vaccines in terms of the frequency of side effects. Methods: This single-center, retrospective descriptive study was carried out in health care workers (HCWs) of Gazi University Hospital who received 2 doses of Coronavac vaccine between January and March 2021. At least 14 days after 2 dose of vaccination, serious advers events, non-serious advers events and possible side effects are collected by the questionnaire forms prepared for the study by the researchers. All data were analyzed by IBM SPSS Statistics version 20.0 (IBM Corp., Armonk, N.Y., USA). The questionnaire forms, prepared for the study, were delivered to volunteer HCWs manually or online by the researchers at least 14 days after 2 dose of vaccination. The data obtained through the questionnaires were transferred to the computing environment and analyzed. Results: 1102 HCWs were enrolled in the study and 392 (35.6 %) had at least one adverse event after the 1st or 2 nd dose Coronavac vaccine. The most common adverse events were: Headache 230 (20.9%), fatigue 225 (20.4 %) and local reactions 193 (17.5%). Serious adverse events occurred in 3 (0.3 %) patients (1 Anaphylaxis,2 Angioedema) after vaccination. The majority of adverse events associated with Coronavac vaccine occured within the first 48 hours. The incidence of adverse events after vaccination is higher in healthcare workers with a known history of vaccine and non-vaccine allergies (42.7% vs. 34.3%, p<0.05, Chi-square test). More frequent side effects were observed after second doses in healthcare workers who developed side effects after the 1st dose of vaccine (70.5% vs. 5.3, p<0.01, Chi-square test) Conclusion: In our study, we found that short-term adverse events of Coronovac vaccine were found to be consistent with phase 1/2 studies and it was observed to be safe for clinical use. However, there is still a need for long-term follow-up in terms of monitoring side effects after administration for the safety of vaccine use.
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Objective: The aim of the study is to compare the differences between COVID-19 pneumonia and other viral pneumonia (OVP) in terms of demographic, clinical and radiological features. Methods: This retrospective cohort study was conducted in Gazi University Hospital between 11 March and 24 May 2020. Patients, admitted to the hospital with suspected COVID-19 infection aged >18 years and those who had pneumonia on chest computed tomography (CT) scan were evaluated. SARS-CoV-2 RT-PCR and multiplex PCR, for other respiratory viruses, were performed. Patients with a positive SARS-CoV-2 PCR were included in "COVID-19 pneumonia" group and those who had a positive result for any other respiratory viruses and two consecutive negative results for SARS-CoV-2 were included in the "OVP" group. Two groups were compared in terms of clinical, laboratory and chest CT findings. Results: Of the 63 patients included in the study, 45 had COVID-19 pneumonia and 18 had OVP. Cough, nasal congestion, sputum production and leukocytosis were more common in the OVP group while leukopenia was more common in the COVID-19 pneumonia (p<0.05). The distribution pattern of parenchymal lesions on chest CT was more likely to be predominantly peripheral and posterior in COVID-19 pneumonia compared to OVP. Bilateral involvement was also more frequent in COVID-19 group compared to OVP (p<0.05). Conclusion: Distinguishing COVID-19 pneumonia from OVP with clinical and laboratory findings is difficult. Chest CT findings such as peripheral and posterior distribution of the parenchymal lesions and bilateral involvement may help to differentiate COVID-19 pneumonia from OVP.