From syringes to dishes: improving food security through vaccination

This paper examines the impact of COVID-19 vaccination on food insecurity in the United States, using data from the Household Pulse Survey. Our primary research design exploits variation in vaccine eligibility across states over time as an instrumental variable to address the endogeneity of vaccination decision. We find that vaccination had a substantial impact on food hardship by reducing the likelihood of food insecurity by 24%, with even stronger effects among minority and financially disadvantaged populations. Our results are robust to alternative specifications and the use of regression discontinuity as an alternative identification strategy. We also show that vaccine eligibility had a positive spillover impact on food assistance programs, specifically by reducing participation in the Supplemental Nutrition Assistance Program (SNAP), which suggests that vaccination policy can be effective in alleviating the fiscal burden of the pandemic on the government. Furthermore, our analysis indicates that vaccinated individuals exhibit increased financial optimism, as measured by expectations about future loss of employment and income as well as ability to make mortgage and debt payments. Based on the point estimates, the implied elasticity of food insecurity with respect to financial optimism is between -0.57 and -0.86. Our findings suggest that the COVID-19 vaccination program has implications that extend beyond the direct health benefits. Taken together, our results underscore the critical role of medical innovations and health interventions in improving economic optimism and food security, especially among vulnerable populations, during public health crises.

Investigation of the effects of N-Acetylglucosamine on the stability of the spike protein in SARS-CoV-2 by molecular dynamics simulations.

A lot of effort has been made in developing vaccine and therapeutic agents against the SARS-CoV-2, concentrating on the Spike protein that binds angiotensin-converting enzyme 2 on human cells. Nowadays, some researches study the role of the N-linked glycans as potential targets for vaccines and new agents. Due to the flexibility and diversity of the N-linked glycans, in this work, we focus on the N-Acetylglucosamine moiety, which is the precursor of nearly all eukaryotic glycans. We performed molecular dynamics simulations to study the effects of the N-Acetylglucosamine on the stability of the spike glycoprotein in SARS-CoV-2. After a 100 ns of simulation on the spike proteins without and with the N-Acetylglucosamine molecules, we found that the presence of N-Acetylglucosamine increases the local stability in their vicinity; even though their effect on the full structure is negligible. Thus; it can be inferred that the N-Acetylglucosamine moieties can potentially affect the interaction of the S protein with the ACE2 receptor. We also found that the S1 domain is more flexible than the S2 domain. We propose which of the experimentally observed glycans found on the spike may be more functional than the others. Detailed understanding of glycans is key for the development of new therapeutic strategies.

Diagnostic and Predictive Role of Platelet/Lymphocyte Ratio (Plr) in Predicting Outcomes in Elderly Covid-19 Patients (a Cross-Sectional Study)

Introduction: In this study, we aimed to investigate the prognostic effects of platelet-to-lymphocyte ratio biomarker in the group of laboratory-confirmed Coronavirus Disease-19 (COVID-19) geriatric patients and compare them with the group of patients under 75 years of age. Material(s) and Method(s): The platelet-to-lymphocyte ratio were recorded for oxidative stress response when it is decided to transfer patients from the emergency room COVID-19/area to the COVID-19 /service, at the time of admission to intensive care unit due to arterial oxygen partial pressure (PaO2 mmHg) to fractional inspired oxygen (FiO2) < 200 mmHg, at the time of discharge from intensive care unit and exitus. Result(s):It was found that the mean age of the survivors was significantly lower than those who had died(p=0,016). In Post-hoc analysis, the platelet-to-lymphocyte ratio values at hospitalization of >=75years old patients who had died were found to be significantly different compared to patients 75<years(p=0.006)who were survived and patients 75>= years who had died(p=0.043).Only hospitalization platelet-to-lymphocyte ratio value and age data were found to be associated with mortality. According to mortality;the cut-off value for platelet-to-lymphocyte ratio at the time of admission to the COVID-19/service in patients 75>= years at the time of admission to ICU in patients 75<years was determined as 411.15 and 216.54, respectively. Conclusion(s): The clinical use of the platelet-to-lymphocyte ratio may be a suitable marker in geriatric patients for determining disease severity and can be used as a predictive factor for determining the poor prognosis. Copyright © 2022, Geriatrics Society. All rights reserved.

Evaluation of Patients Presenting to the Pediatric Emergency Department with Seizures during the COVID-19 Pandemic

The coronavirus disease 2019 pandemic has led to significant changes in hospital visits worldwide. The admission rates have remarkably decreased. This study investigates the characteristics of 104 patients (54 girls, 50 boys) who presented to our pediatric emergency department (ED) with seizures during the pandemic between May 2020 and May 2021. Regarding seizure type, 84 generalized and 20 focal seizures had occurred. Tonic, tonic-clonic, clonic, and hypomotor seizures were seen in descending order. Thirty-seven patients were diagnosed with epilepsy, and 32 patients with first afebrile, 25 first febrile, and 10 recurrent febrile seizures. No patients had acute symptomatic seizures. In 85 patients, the seizures had stopped before the ED visit;only one lasted >60 minutes. Benzodiazepines were administered as a first-line drug. Demographical features, electroencephalogram (EEG), and cranial imaging findings, laboratory test results, and distribution by month and by the hour of ED visit were analyzed. Study data was in accordance with the literature by seizure types, seizure management, and cranial imaging rates but differed by distribution in terms of month and the hour of ED visit. The EEG abnormality rate was higher among the first afebrile seizure cases. The number of patients with seizures was 69, that is, 0.3% of emergency admissions, for the 4 months of 2019 before the pandemic, and 104, that is, 0.4% of emergency admissions for the whole initial year of the pandemic thereafter. So, the number of patients with seizures had decreased, but their rate had increased, which could be attributed to a decrease in the number of nonurgent presentations to the ED during the pandemic.

Gastrointestinal Symptoms and Liver Damage in Patients with COVID-19

Introduction: Gastrointestinal and hepatic symptoms may be seen before respiratory symptoms in Coronavirus disease 2019 (COVID19). The purpose of the present study was to evaluate the relationship between liver damage and observed symptoms and laboratory parameters. Materials and Methods: Patients followed-up with diagnoses of COVID-19 between March and August 2020 were included in the study. Clinical characteristics and laboratory parameters were compared according to liver damage status. Results: Four hundred and thirteen COVID-19 cases were included. The prevalence of gastrointestinal symptoms was 19.8%, the most common being nausea/vomiting, abdominal pain, and diarrhea (10.4%, 6.1%, and 2.9%, respectively). CT-confirmed pneumonia, intensive care requirement, and mean length of hospitalization differed significantly depending on liver damage status (p< 0.001, p= 0.006, p= 0.002, respectively). Significant differences were determined between the groups with and without liver damage in terms of all the laboratory parameters examined, apart from white blood cell, neutrophil, lymphocyte, neutrophil:lymphocyte ratio (NLR), total bilirubin, and partial thromboplastin time (PTT) (p< 0.05). Significant associations were present between alanine aminotransferase lev- els and all other laboratory parameters apart from NLR and PTT (p< 0.001). Aspartate aminotransferase (OR: 1.22, CI: 1.16-1.28) and albumin (OR: 2.28, CI: 1.12-4.63) were identified as significant independent risk factors for liver damage in patients with COVID-19. Conclusion: Gastrointestinal symptoms are not uncommon in COVID-19 patients. Liver damage may be associated with progression to intensive care and systemic inflammation.

Determining the Anxiety Levels of Emergency Health Workers in the COVID-19 Pandemic

Aim: This study aimed to determine the anxiety levels of emergency healthcare workers during the coronavirus disease-2019 (COVID-19) pandemic. Materials and Methods: This descriptive and cross-sectional study was conducted using face-to-face interviews with 153 healthcare workers in emergency service clinics who cared for patients suspected of COVID-19. Study data were obtained using a descriptive characteristics questionnaire and the State-Trait Anxiety Inventory (STAI). Results: The mean state anxiety score of emergency healthcare workers was 42.76 +/- 10.06, the mean trait anxiety score was 42.11 +/- 8.22, and the total scale mean score was 84.88 +/- 15.11. No significant relationships were found between STAI scores and participants' descriptive characteristics (i.e., workplace, gender, marital status, age, profession, years of experience, and satisfaction with work conditions). Conclusion: This study revealed that emergency healthcare workers experienced anxiety at the panic level.

Investigation of the usability of CT in clinical decision making by comparing COVID-19 positive and probable patients diagnosed according to CT imaging findings

Aim: In this study, the usability of thoracic computed tomography (CT) in clinical decision making was investigated by comparing laboratory results of patients with probable and definite coronavirus disease 2019 (COVID-19) diagnosis according to CT imaging features. Material and Methods: Within the scope of this single-center retrospective clinical study, data of possible and definite cases of COVID-19 were scanned from the hospital electronic database and patient files. Laboratory and CT imaging results of the patients were obtained. Patients were divided into two groups as positive and negative according to their CT imaging results, and compared. Results: Of the 995 patients included in the study, 57% (n=567) were male, and the mean age was 45.7±20.2 years. It was found that 65.1% (n=648) of the patients had positive CT. Real-time polymerase chain reaction (RT-PCR) test result was found positive in 22.2% (n=144) of the CT positive patients, and 32.0% (n=111) of the CT negative patients, and it was statistically significant (p<0.001). In the logistic regression analysis, it was determined that C-reactive protein (CRP), lymphocyte count, ferritin, procalcitonin, D-dimer, lactate and RT-PCR were statistically significant with CT positivity. Conclusion: In this study, COVID-19 positive and probable patients were compared according to thoracic CT findings and the usability of CT for clinical decision making was investigated. It has been determined that thorax CT can be used to initiate the treatment of COVID-19 in patients with negative RT-PCR test results but positive CT findings and high biochemical parameters such as CRP, D-dimer, ferritin and lactate.

Prognostic significance of Tp-e interval and Tp-e/QTc ratio in patients with COVID-19

OBJECTIVE: Ventricular arrhythmias were the most frequent manifestations in patients with COVID-19. Both the natural course of the disease and the treatment drugs used have effects on ventricular repolarization. The objective of this study was to evaluate the effects of repolarization parameters obtained from surface electrocardiography (ECG) on prognosis. PATIENTS AND METHODS: Participants were 205 consecutive patients hospitalized with COVID-19 diagnosis. The 12-lead surface ECG was obtained from each patient on admission. The ECG results were evaluated against the patients' clinical characteristics and outcomes by experienced cardiology specialists. RESULTS: The mean age was higher in the non-survivor group compared to the survivor group (57.4 +/- 15.7 vs. 65.6 +/- 16.6;p = 0.001). The demographical characteristics were similar between the survivor and non-survivor groups. Multivariate analyses demonstrated that age (OR: 1.041;p = 0.009), D-dimer (OR: 1.002;p = 0.031), high-sensitivity troponin I (hs-TnI) (OR: 1.010;p = 0.041), pneumonia on computed tomography (CT) (OR: 4.985;p < 0.001), the peak-to-end interval of the T wave (Tp-e) (OR: 3.421;p < 0.001), and Tp-e/QTc ratio (OR: 1.978;p = 0.013) were statistically significant independent predictors in terms of determining mortality. CONCLUSIONS: Prolonged Tp-e interval and increased Tp-e/QTc ratio on admission are decent predictors and linked with mortality. ECG is a practical study to evaluate prognosis and potential arrhythmias, as well as initiating suitable treatment.

Perceived stress levels in patients in novel corona virus infection pandemic: prospective single-center study

Aim: In the progression of the diseases, the psychological and stress levels of the patients affect the course of the disease. This situation is also important and should be analyzed in the follow-up of COVID-19 patients. In this study, it was aimed to investigate the stress levels of COVID-19 patients in our hospital isolation services. Materials and Methods: A prospective cross-sectional study is conducted in our isolation services where possible/definite COVID-19 patients older than 18 years old are followed. According to the patients' swap test results, patients are divided into two groups;group 1: COVID-19 possible, and the group 2: COVID-19 definitive groups. The demographic properties of the patients investigated, and the "Perceived Stress Scale", was applied to all groups the day after the swap test results were completed, and the outputs were analyzed.

Evaluation of Childhood COVID-19 Cases: A Retrospective Analysis

Objective This study aims to evaluate the demographic, epidemiological, and clinical features of novel coronavirus disease 2019 (COVID-19) cases aged between 0 and 18 years Methods The demographic characteristics of the patients, admission symptoms, contact and travel histories, clinical onset duration, symptoms, treatments, laboratory findings, radiological images, and polymerase chain reaction (PCR) negation times were evaluated in a retrospective manner Thirty-eight children (19 boys and 19 girls) were included in the study Discussion The mean age of the patients was 1036 ± 559 years The average admission times of the patients after the onset of the symptoms was determined as 184 ± 202 days Thirteen (342%) patients were observed as asymptomatic The most common identified symptoms were fever, cough, and fatigue (552, 342, and 132%, respectively) Febrile convulsions, myalgia, dizziness, and diarrhea were the least common symptoms Also, 25-hydroxyvitamin D3 (vitamin D3) levels were low and aspartate aminotransferase (AST) values were higher in the moderate group than the mild group and the relationships were statistically significant (p = 0044and 0027) Ferritin levels of the patients with ground glass opacity (GGO) were found statistically and significantly higher than the patients without GGO (p = 0,031) There was more than one lobe and segment involvement in five patients, the average number of affected lobes and segments was 38 and 88, respectively High-resolution computed tomography of the 24 patients showed that;GGO in five (208%), consolidation + GGO (mixed) in three (125%), consolidation (alone) in one, subpleural linear opacities in three (125%), and pavement stone opacities in one (42%) patient COVID-19, which is seen less frequently in children, may pose a risk in infants and young children Conclusion Especially high ferritin levels may present with lung involvement and low vitamin D levels may worsen the aggravation of the lung involvement There is a great need for further research on this subject. © 2021 Hogrefe Verlag GmbH & Co. KG. All rights reserved.