Specialty-Training Program During COVID-19 Pandemic: A Single Center Survey on over 300 Trainees and Trainers

Objective: COVID-19 pandemic caused significant modifications in education of trainees who are in medical speciality training programs. Limiting the number of residents in the clinics, cancelling elective surgical procedures, stopping face to face practical education, and transforming theoretical education into distance learning platforms resulted in alterations in the curriculum. Limited number of studies in the literature surveyed the impact of the COVID-19 pandemic on specialty training in various medical disciplines. Methods: We addressed to assess the situation of trainees' education using an online questionnaire from the trainees' and directors' perspective during the pandemic. The survey platform SurveyMonkey® was used to distribute the survey and to collect responses. We generated a list of multiple-choice questions about how social distancing affected the delivery of medical education, potential compromise in core training and difficulties in conducting clinical research for the thesis. Results: A total of 364 trainees among 552 (65.9%) under training at our university hospital and 90% of the directors (37 of 41) responded the survey. Almost 78 percent of the trainees claimed that they have been negatively affected during the pandemic. Although majority of the trainees (60.3%) reported that extension of their education program is not necessary, most of the program directors were in tendency of extending the duration of the speciality training period. The participants predominantly considered that online training would keep on being a part of the training program after the pandemic. Conclusion: Education programs are negatively affected during pandemics. However, authorities should manage this deficiency by a new perspective since present trainees are familiar to use technology-driven virtual sources for their education. After the pandemic, computer-assisted online learning and webbased programs should be integrated into educational curriculum. (English) [ FROM AUTHOR] Amaç: COVID-19 pandemisi tıpta uzmanlık eğitimi alan uzmanlık öğrencilerinin eğitim programında belirgin değişikliklere neden olmuştur. Kliniklerde asistan sayıları azaltılmış, elektif ameliyatlar ertelenmiş, yüz yüze pratik eğitim sonlandırılmış ve teorik eğitim uzaktan eğitime dönüştürülerek müfredat düzenlenmiştir. COVID-19 pandemisinin farklı tıp dsiplinlerinde uzmanlık eğitimini nasıl etkilediğine ait çalışma sayısı sınırlıdır. Yöntemler: Pandemi döneminde eğitimin sorgulanması için uzmanlık öğrencilerine ve anabilim dalı başkanlarına yönelik "online" bir anket hazırlanmıştır. Anket "SurveyMonkey®" programında hazırlanmış ve dağıtılmıştır. Sosyal mesafe kurallarının tıp eğitimini nasıl etkilediği, çekirdek eğitim müfredatının nasıl yürütüldüğü, tez çalışmalarının ve klinik araştırmaların durumunu sorgulayan çoktan seçmeli sorular hazırlanmıştır. Sonuçlar: Üniversite hastanemizde eğitim alan toplam 552 uzmanlık öğrencisinden 364'ü (%65.9) ve anabilim dalı başkanlarının %90'ı (41'den 37'si) anketi cevaplandırmıştır. Uzmanlık öğrencilerinin %78'si pandeminin eğitimlerini olumsuz yönde etkilediğini bildirmiş, ancak, çoğunluk (%60.3) uzmanlık eğitim süresinin uzamasını istememiştir. Tersine, anabilim dalı başkanlarının çoğunluğu sürenin uzatılması gerektiğini bildirmiştir. Katılımcıların çoğu uzaktan "online" eğitimin pandemiden sonra da eğitim programına dahil edilmesi gerektiğini bildirmiştir. Tartışma: Pandemi döneminde eğitim olumsuz etkilenmiştir. Ancak, eğitim sorumluları günümüz uzmanlık öğrencilerinin teknolojinin kullanıldığı uzaktan eğitim modellerine daha yatkın olmalarından yararlanarak, eğitim sistemlerini yeni bir bakış açısı ile güncellemelidir. Pandemi sonrasında, bilgisayar temelli eğitim kaynakları uzmanlık eğitim müfredatına yerleştirilmelidir. (Turkish) [ FROM AUTHOR] Copyright of Gazi Medical Journal is the property of Gazi Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Prognostic value of semi-quantitative CT-based score integrated with cardiovascular risk factors during the first peak of the COVID-19 pandemic: A new score to predict poor outcome.

PURPOSE: Predicting the clinical course of COVID-19 pneumonia is of high clinical importance and may change treatment strategies. This study aimed to compare the semi-quantitative CT score (radiological score), mCHA2DS2-VASc score (clinical score), and R-mCHA2DS2-VASc score (clinical and radiological score) to predict the risk of ICU admission and mortality in COVID 19 pneumonia. METHODS: This study retrospectively evaluated 901 COVID-19 pneumonia cases with positive PCR results. The mCHA2DS2-VASc score was calculated based on clinical risk factors. CT images were evaluated, and the semi-quantitative CT scores were obtained. A new scoring method (R-mCHA2DS2-VASc score) was developed by combining these scores. The performance of the mCHA2DS2-VASc score, semi-quantitative CT score, and a combination of these scores (R-mCHA2DS2-VASc score) was evaluated using ROC analysis. RESULTS: The ROC curves of the semi-quantitative CT, mCHA2DS2-VASc, and R-mCHA2DS2-VASc scores were examined. The semi-quantitative CT, mCHA2DS2-VASc, and R-mCHA2DS2-VASc scores were significant in predicting intensive care unit (ICU) admission and mortality (p < 0.001). The R-mCHA2DS2-VASc score performed best in predicting a severe clinical course, and the cut-off value of 8 for the R-mCHA2DS2-VASc score had 83.9% sensitivity and 91.6% specificity for mortality. CONCLUSIONS: The R-mCHA2DS2-VASc score includes both clinical and radiological parameters. It is a feasible scoring method for predicting a severe clinical course at an early stage with high sensitivity and specificity values. However, prospective studies with larger sample sizes are warranted.

The prognostic role of neopterin in COVID-19 patients.

In Coronavirus disease-2019 (COVID-19) cases, hyper inflammation is associated with the severity of the disease. High levels of circulating cytokines were reported in severe COVID-19 patients. Neopterin produced by macrophages on stimulation with interferon-gamma, which is an important cytokine in the antiviral immune response, hence it can be used to predict the severity of disease in COVID-19 cases. In this study, it was aimed to determine the prognostic value of the neopterin for the prediction of severe disease in patients with COVID-19. This single-center, prospective study was conducted in hospitalized COVID-19 patients and healthy volunteers. Severe and mild COVID-19 cases were compared in terms of clinical and laboratory findings as well as serum neopterin levels on hospital admission. To assess the prognostic utility of neopterin between the severe and mild COVID-19 groups, a receiver-operating characteristic (ROC) curve was generated, and the area under the curve (AUC) was calculated. The median serum neopterin level was four times higher in COVID-19 patients than the healthy controls (46 vs. 12 nmol/L; p < .001). The AUC value of serum neopterin was 0.914 (95% confidence interval, 0.85-0.97). The sensitivity and specificity of serum neopterin for the cut-off value of 90 nmol/L to identify severe COVID-19 cases were 100% and 76%, respectively. Serum neopterin levels on hospitalization were significantly higher in severe COVID-19 disease than mild COVID-19 patients. Neopterin levels can be used as an early prognostic biomarker for COVID-19 on admission.