COVID-19: booster(s) vs. hospitalization and Intensive Care Unit admission.

OBJECTIVE: As the pandemic continues, different vaccine protocols have been implemented to maintain the protection of vaccines and to provide protection against new variants. The aim of this study was to assess hospitalized patients' vaccination status and document the efficacy of boosters. PATIENTS AND METHODS: The patients that were hospitalized due to COVID-19 were enrolled from 28 hospitals in Turkey for five months from September 2021. 5,331 confirmed COVID-19 patients from collaborating centers were randomly enrolled to understand/estimate the distribution of vaccination status in hospitalized patients and to compare the efficacy of vaccination/booster protocols. RESULTS: 2,779 men and 2,552 women of which 2,408 (45.2%) were admitted to Intensive Care Units participated in this study. It was found that the highest risk reduction for all age groups was found in groups that received 4 doses. Four doses of vaccination for every 3.7 people under 50 years of age, for every 5.7 people in the 50-64 age group, and for every 4.3 people over 65 years of age will prevent 1 patient from being admitted to intensive care. Regardless of the type of vaccine, it was found that the risk of ICU hospitalization decreased in those who were vaccinated compared to those who were not vaccinated. Regardless of the type of vaccine, the ICU risk was found to decrease 1.25-fold in those who received 1 or 2 doses of vaccine, 1.18-fold in those who received 3 doses, and 3.26-fold in those who received 4 doses. CONCLUSIONS: The results suggested that the addition of a fourth dose is more effective in preventing intensive unit care even in disadvantaged groups.

Back to the First Days of the Pandemic: How Well Have We Done to Diagnose COVID-19 in Healthcare Workers?

Introduction: Healthcare workers (HCWs) are one of the most vulnerable groups for COVID-19. SARS-CoV-2 PCR was offered to HCWs who had symptoms compatible with COVID-19 or who had a close contact with COVID-19 patient. A rapid antibody test was used to identify the risk of exposure of the HCWs who worked at high-risk units in our hospital during the first month of the pandemic. Herein, we aimed to evaluate the usefulness of this approach. Materials and Methods: The records of the HCWs from a university hospital who were tested by SARS-CoV-2 PCR or rapid antibody test between March 12, 2020 and April 04, 2020 were reviewed retrospectively. Demographic and clinical characteristics of HCWs were extracted from the electronic database. Wards or outpatient clinics that served COVID-19 patients were defined as high-risk units. Results: A total of 599 HCWs were tested for SARS-CoV-2 by PCR and 409 by rapid antibody test. Thirty-seven (6.2%) were found to be PCR positive. Eleven (29.7%) out of 37 HCWs were asymptomatic when they were tested. There was no statistically significant relationship between PCR positivity and occupation or working unit. A positive PCR result was detected in 24 HCWs during the first admission. Eleven out of 114 HCWs who were tested by a second PCR were found to be positive and two out of 17 HCWs who were tested by a third test were reported as PCR positive. Median interval between the first and second PCR was seven days (IQR= 8.5 days) and median interval between second and third PCR test was 4.5 days for the HCWs who were reported as positive at repeated PCR tests. Rapid antibody test was positive in one HCW who did not have a history of COVID-19. Conclusion: Approximately, one third of the SARS-CoV-2 PCR positive HCWs were asymptomatic. In case of increasing incidence of COVID-19 in the community, a regular screening policy for the HCWs regardless of their occupation and contact tracing might help to have a safe environment in hospitals. Screening policy should be based on well validated tests.

Young Female COVID-19 Patient Presenting with Epileptic Seizure

COVID-19 is a new type of coronavirus infection with a wide clinical spectrum, ranging from asymptomatic to severely symptomatic, and that mostly affects the respiratory tract. Although the respiratory tract is the primary area affected by the disease, neurological symptoms such as headache, dizziness and muscle ache have also been reported in some patients since the early stages of the pandemic. COVID-19 symptoms and complications can affect the peripheral and central nervous systems as well as the skeletal muscles, while epileptic seizure is a rare manifestation of COVID-19. We present here the case of a female patient admitted to hospital with epileptic seizure due to COVID-19 encephalopathy.