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Objective: Although there are a sufficient number of studies on the mental impacts of the COVID-19 pandemic on healthcare workers (HCWs) in the early phase, few studies have evaluated these impacts in the vaccination phase. This study aimed to assess the prevalence of mental disorders and their associated factors among HCWs in the vaccination phase of the COVID-19 pandemic.Methods: A cross-sectional, web-based survey collected demographic data with the structured 25-item questionnaire, COVID-19 infection status and exposure, and mental health measurements between 13 March 2021 and 20 April 2021, in Turkey. Depression, anxiety, insomnia, distress, resilience, and burnout were assessed by the 9-item patient health questionnaire (PHQ-9), the 7-item generalized anxiety disorder questionnaire (GAD-7), the Jenkins sleep scale (JSS), the 10-item perceived stress scale (PSS-10), the brief resilience scale (BRS), and two subscales of the Maslach burnout inventory (MBI): emotional exhaustion (EE) and depersonalization (DP), respectively. Thereafter, binary logistic regression was performed to explore the risk factors of those HCWs with poor mental health outcomes.Results: A total of 573 HCWs completed the survey. Of the 573 responding participants, 309 (53.9%) were medical doctors, 119 (20.8%) were nurses, and 145 (25.3%) were other HCWs. Overall, 37.5%, 31.9%, 36.3%, and 19.2% of all HCWs reported symptoms of depression, anxiety, insomnia, and suicidal ideation, respectively. Moreover, 77% perceived moderate to high-stress, 49.9% described emotional exhaustion, and 11.3% of HCWs expressed depersonalization. A considerable proportion of participants reported exposure to violence (39.4%) and mobbing (38.6%) during the pandemic. We found a positive relation between getting COVID-19 vaccine and anxiety (odds ratio [OR]= 1.80;95%CI, 1.01-3.21;p = 0.046). Being a woman (for depression, OR= 2.26;95% CI, 1.48-3.45;p < 0.001;for resilience, OR= 0.55;95% CI, 0.38-0.80;p = 0.002),working on the frontline (for emotional exhaustion, OR= 1.82;95% CI, 1.26-2.62;p = 0.001), being exposed to mobbing (for anxiety, OR= 2.86;95% CI, 1.93-4.25;p < 0.001;for depression, OR= 3.70;95% CI, 2.55-5.36;p < 0.001), being victim of the violence in the pandemic (for depersonalization, OR= 2.82;95% CI, 1.58-5.03;p < 0.001;for insomnia, OR= 2.03;95% CI, 1.40-2.94;p < 0.001), the loss of a loved one due to COVID-19 (for perceived stress, OR= 2.14;95% CI, 1.22-3.75;p = 0.008), having a mental disorder (for resilience, OR= 0.53;95% CI, 0.30-0.94;p = 0.031) and self-medicating with alcohol (for anxiety, OR= 2.86;95% CI, 1.92-4.25;p < 0.001) were associated with worsened mental health outcomes.Conclusion: COVID-19 is still affecting the mental health of HCWs in the vaccination phase. These findings advance the understanding of risk factors for the poor mental health of HCWs during a pandemic. The results revealed that receiving psychological interventions for occupational mental health during the pandemic is important for HCWs.
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Background and Aim: COVID-19 patients with cardiac involvement have a high mortality rate. The aim of this study was to investigate the echocardiographic features in COVID-19 patients between severe and non-severe groups. Method(s): For this single-center study, data from patients who were treated for COVID-19 between March 25, 2020 and April 15, 2020 were collected. Two-dimensional echocardiography (2DE) images were obtained for all patients. Patients were divided into two groups based on the severity of their COVID-19 infections. 2DE parameters indicating right ventricular (RV) and left ventricular (LV) functions were compared between the two groups. Result(s): A total of 90 patients hospitalized for COVID-19 were included in this study. The mean age of the severe group (n=44) was 63.3+/-15.7 years, and 54% were male. The mean age of non-severe group (n=46) was 49.7+/-21.4 years, and 47% were male. In the severe group, RV and LV diameters were larger (RV, 36.6+/-5.9 mm vs 33.1+/-4.8 mm, p=0.003;LV 47.3+/-5.8 mm vs. 44.9+/-3.8 mm, p=0.023), the LE ejection fraction (LVEF) and the RV fractional area change (RV-FAC) were lower (LVEF, 54.0+/-9.8% vs 61.9+/-4.8%, p<0.001;RV-FAC, 41.4+/-4.1% vs 45.5+/-4.5%, p<0.001), and pericardial effusions were more frequent (23% vs 0%) compared to patients in the non-severe group. A multiple linear regression analysis determined that LVEF, right atrial diameter, high-sensitivity troponin I, d-dimer, and systolic pulmonary artery pressure, were independent predictors of RV dilatation. Conclusion(s): The results demonstrate that both right and left ventricular functions decreased due to COVID-19 infection in the severe group. 2DE is a valuable bedside tool and may yield valuable information about the clinical status of patients and their prognoses.
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Objective: The aim of this study is to examine the depression and anxiety levels of the athletes in the Covid-19 pandemic in terms of some variables.
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BACKGROUND: This study aimed to investigate pregnancy frequency and evaluate the factors affecting live births in hemodialysis (HD) patients. METHODS: Female HD patients whose pregnancy was retrospectively reported between January 1, 2014, and December 31, 2019. The duration of HD, primary disease, and the information on whether the pregnancy resulted in abortion, stillbirth, or live birth, whether the HD duration was prolonged after diagnosing the pregnancy and whether it accompanied preeclampsia were recorded. RESULTS: In this study, we reached 9038 HD female patients' data in the study. A total of 235 pregnancies were detected in 145 patients. The mean age was 35.42 (35 ± 7.4) years. The mean age at first gestation was 30.8 ± 6.5 years. The average birth week was 32 (28 -36) weeks. A total of 53.8% (no = 78) of the patients had live birth, 51.7% (no = 70) had at least one abortion in the first 20 weeks, and 13.1% (no = 19) had at least one stillbirth after 20 weeks. The rate of patients' increased numbers of dialysis sessions during pregnancy was 71.7%. The abortion rate was 22.4% in those with increased HD sessions, whereas 79.3% in those not increased HD sessions (p < 0.001). Live birth frequency was 67.2% in the increased HD sessions group and 3.4% in those who did not differ in HD sessions (p < 0.001). DISCUSSION: For the first time, we reported pregnancy outcomes in HD female patients, covering all regions of Turkey. It has been observed that;increasing the number of HD sessions in dialysis patients will decrease fetal and maternal complications and increase live birth rates.
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Background: Although appendicitis is the most common emergency abdominal surgical pathology in the pediatric age group, there are a limited number of publications in the literature on how appendicitis has affected patients during the COVID-19 pan-demic. Objectives: This study examined the effects of fear of being infected with COVID-19 and isolation measures on complications and morbidity in pediatric appendicitis cases. Methods: This study was performed in the Department of Pediatric Surgery, Faculty of Medicine, Health Sciences University, , Si , sli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey. Patients aged 18 years and younger who were operated on for appendicitis between 11 March 2019 and 11 May 2019 were classified as group 1, and patients aged 18 years and younger who were operated on for appendicitis between 11 March 2020 and 11 May 2020 (during the pandemic) were classified as group 2. Both groups were compared in terms of age, gender, symptoms, duration of symptoms, surgical method, duration of operation, length of hospital stay, and postoperative complications. Results: There were 85 patients in group 1 and 49 in group 2. The mean age was 11.5 +/- 3.5 years in group 1 and 12.2 +/- 3.0 years in group 2. While the mean hospital admission time for group 1 was 52.2 +/- 38.5 hours, it was 50.2 +/- 40.0 hours for group 2. The complicated appendicitis rates were 37% and 25% in group 1 and group 2, respectively. In group 1, 94.1% of the operations were completed laparoscopically, whereas, in group 2, this rate was 88.6%. The mean operation time was 64.0 +/- 24.4 minutes in group 1 and 69.0 +/- 33.0 minutes in group 2. The mean length of hospital stay was 2.9 +/- 2.0 days in group 1 and 3.1 +/- 3.40 days in group 2. The complication rate was 8.2% in group 1 and 11.4% in group 2. Conclusions: Despite the isolation measures and the risk of virus transmission, the psychosocial effects of the pandemic did not prevent real emergency cases with appendicitis from visiting hospitals.
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BACKGROUND AND AIMS: There is not enough data on the post-COVID-19 (coronavirus disease 2019) period for peritoneal dialysis (PD) patients affected from COVID-19. We aimed to compare the clinical and laboratory data retrospectively obtained in the follow-up of PD patients after COVID-19 with a control PD group. METHOD: This study, supported by the Turkish Society of Nephrology, is a national multicenter retrospectively case-control study involving adult PD patients with confirmed COVID-19, using data collected from 21 April 2021 to 11 June 2021. A control PD group was also formed from each PD unit, from patients with similar characteristics but who did not have COVID-19. Patients in the active period of COVID-19 were not included. Data at the end of the first month and within the first 90 days, as well as other outcomes, including mortality, were investigated. RESULTS: A total of 223 patients (COVID-19 group: 113, control group: 110) from 28 centers were included. The duration of PD in both groups was similar [median (IQR):3.0 (1.88-6.0) years and 3.0 (2.0-5.6)], but the patient age of the COVID-19 group was lower than the control group [50 (IQR:40-57) years and 56 (IQR:46-64) years, P < 0.001]. PD characteristics and baseline laboratory data were similar in both groups, except serum albumin and hemoglobin levels on Day 28, which were significantly lower in the COVID-19 group. In the COVID-19 group, respiratory symptoms, rehospitalization, lower respiratory tract infection, change in PD modality, UF failure and hypervolemia were significantly higher on the 28th day. There was no significant difference in laboratory parameters at Day 90. Only one (0.9%) patient in the COVID-19 group died within 90 days. There was no death in the control group. Respiratory symptoms, malnutrition and hypervolemia were significantly higher at Day 90 in the COVID-19 group. CONCLUSION: Mortality in the first 90 days after COVID-19 in PD patients with COVID-19 is not different from the control PD group. However, some of these patients continue to experience significant problems, especially respiratory system symptoms, malnutrition, and hypervolemia.
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BACKGROUND AND AIMS: Although existing data suggest an increased mortality rate, data about the course of coronavirus disease 2019 (COVID-19) in peritoneal dialysis (PD) patients, its short-and long-term effects on the patient and technique survival are limited. Moreover, specific factors associated with increased risk of death have not been clearly defined yet. Therefore, we aimed to study the characteristics of PD patients with COVID-19, determine the short-term mortality and other medical complications, and delineate the factors associated with COVID-19 outcome. METHOD: This national multicenter study included all PD patients who had confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection based on positive reverse transcriptase-polymerase chain reaction testing of a nasopharyngeal swab recorded in this database from the attending 27 PD centers. The demographic data, comorbidities, medications used, PD-related data were recorded as well as clinical, laboratory and radiological findings of COVID-19 and outcomes at the end of the first month were recorded. RESULTS: We enrolled 142 COVID-19 patients (median age: 52 years). A total of 58.2% of patients had mild disease at diagnosis, lung involvement was detected in 60.8% of patients. A total of 83 (58.4%) patients were hospitalized, 31 (21.8%) patients were admitted to intensive care unit and 24 needed mechanical ventilation. A total of 15 (10.5%) patients were switched to hemodialysis and hemodiafiltration was performed for 4 (2.8%) patients. Persisting pulmonary symptoms (n = 27), lower respiratory system infection (n = 12), rehospitalization for any reason (n = 24), malnutrition (n = 6), hypervolemia (n = 13), peritonitis (n = 7), ultrafiltration failure (n = 7) and in PD modality change (n = 8) were reported in survivors. During the 1 month from the diagnosis of COVID-19, 26 patients (18.31%) died. The non-survivor group was older and comorbidities were more prevalent. Fever, dyspnea, cough, serious-vital disease at presentation, bilateral pulmonary involvement and pleural effusion were more frequent among non-survivors. Age (OR:1.102;95% CI: 1.032- 1.117;P:0.004), moderate-severe clinical disease at presentation (OR:26.825;95% CI: 4.578-157.172;P < 0.001) and CRP levels (OR:1.008;95% CI;1.000-1.016;P:0.040) were associated with increased first-month mortality in multivariate analysis. CONCLUSION: Early mortality rate and medical complications are quite high in PD patients with COVID-19. Age, clinical severity of COVID-19 and baseline CRP level are the independent parameters associated with mortality.
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BACKGROUND AND AIMS: Haemodialysis (HD) patients are at increased risk for adverse short-term consequences of COVID-19. In this study, we investigated the characteristics of chronic HD patients in the post-COVID-19 period and compared them with the control group. METHOD: We conducted a national multicentre observational study involving adult chronic HD patients recovering from COVID-19. The control HD group was selected from patients with similar characteristics who did not have COVID-19 in the same center. SARS-CoV-2 RT-PCR negative patients and patients in the active period of COVID-19 were not included. RESULTS: A total of 1223 patients (635 COVID-19 groups, 588 control groups) were included in the study from the data collected from 47 centres between 21 April 2021 and 11 June 2021. The patients' baseline demographics, comorbidities, medications, HD characteristics and basic laboratory tests were quite similar between the groups (Table 1). 28th-day mortality and between 28th day and 90th day mortality were higher in the COVID-19 group than in the control group [19 (3.0%) patients and 0 (0%) patients;15 (2.4%) patients and 4 (0.7%) patients, respectively]. Presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection and A-V fistula thrombosis were significantly higher in the COVID-19 group in the first 28 days of illness and between 28 and 90 days. Mortality was significantly associated with preexisting COVID-19, age, current smoking, use of tunneled HD catheter, persistence of respiratory symptoms, rehospitalization, need for home oxygen support, presence of lower respiratory tract infection within 28 days and persistence of respiratory symptoms. CONCLUSION: In the post-COVID-19 period, mortality, rehospitalization, respiratory problems and vascular access problems are higher in maintenance HD patients who have had COVID-19 compared to control HD patients. (Table Presented).
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Objective: This cross-sectional study was carried out to investigate the vaccination status of children with rheumatic disease and the reasons why children were not vaccinated.
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BACKGROUND AND AIM: Anticoagulant treatment reduces mortality rates in COVID-19 patients. aPTT is measured to be prolonged in many Covid-19 patients and is associated with the presence of lupus anticoagulant (LA). Our aim in the study is to emphasize that LA should be considered in the evaluation of anticoagulant therapy and prolonged aPTT status due to the increased risk of thrombosis in LA-positive with COVID-19 patients. METHODS: Patients who LA test performed between November-2020 and April-2021 were grouped as positive and negative according to the COVID-19 PCR test results. Confirmed COVID-19 patients were evaluated for thromboembolic event and thrombosis laboratory. The data were obtained retrospectively from the laboratory information management system. RESULTS: The LA test of 806 patients were performed during the time interval, and 52 patients also confirmed positive COVID-19 PCR results. While LA was positive in 25% of PCR (-) patients, this rate increased to 50% in COVID-19 patients (p=0.003). Also, mean prothrombin time and aPTT were measured to be prolonged in LA positive COVID-19 patients compared to those with PCR(-) (p=0.02). Although thrombosis was observed in the COVID-19 group with LA positivity, no thromboembolic event was found in the negative group, but this situation is not statistically significant. CONCLUSIONS: LA positivity is associated with an increased risk of thrombosis. We recommend adding the LA test to the coagulation panel and using it especially for patients with high aPTT values in the follow-up of the disease against the increased risk of thrombosis.
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Objectives: There is limited data about coronavirus disease-19 (COVID-19) characteristics and results in peritoneal dialysis (PD) patients. This study aimed to investigate the characteristics and outcomes among PD patients and compare them with matched hemodialysis (HD) patients and a control group without kidney disease. Methods: We included 18 PD patients and consecutive age- and gender-matched 18 HD and 18 patients without kidney disease (control group) registered into the Turkish Society of Nephrology database including 1301 COVID-19 patients. We compared demographic, clinical, radiological, laboratory data, and outcomes namely intensive care unit (ICU) admission, mechanical ventilation, mortality, and composite outcome (death and/or ICU admission). Results: ICU admission, mechanical ventilation, and mortality rates in PD patients (27.8%, 22.2%, and 22.2%, respectively) and the HD group (16.7%, 11.1%, and 16.7%, respectively) were higher than the control group (11.1%, 11.1%, and 5.6%, respectively), but intergroup comparison did not reveal difference. A total of 11 (20.3%) patients had composite outcome (6 PD patients, 3 HD patients, and 2 patients in the control group). In Cox regression analysis, higher age and higher CRP level were related to increased risk of composite outcome. Adjusted rate of composite outcome in PD group was significantly higher than the control group (P =.050). This rate was similar in HD and control groups (P =.30). Conclusions: Combined in-hospital mortality and/or ICU admission of PD patients with COVID-19 was significantly higher than the control patients. There is a need for careful surveillance of PD patients for infection signs and prompt treatment of COVID-19.
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For this reason, instead of holding the education activities of students in the hospital environment and in person, the method of distance education started to be preferred, and online virtual classrooms have been created. [...]students have been given projects in the scope of distance education, and the use of interactive course methods has been provided. According to the calculation, 306 students were reached within a 95% confidence interval. According to these results, the stress levels of the students in the range of 0-5 were considered as low, and those in the range of 6-10 were considered as high levels of stress. [...]of the post hoc chi-squared analysis that was conducted, it was determined that the difference was caused by the students at or over the age of 31 and those in their 3rd course semester (X2: 54.550 p=0.00, X2: 13.228 p=0.01).
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Purpose/Background: The massive inflow of patients with COVID-19 requiring urgent care has overloaded hospitals and impacts the management of other patients. It is indeed not simple as thought to be to reduce emergency surgery without resulting in a loss of the patient. Acute appendicitis is a very unique situation and the frequency of this disease leads us to appraise this particular disease within the scope of COVID-19 crisis. On the other hand, patients seem to hesitate in admission to hospital as often as before because of the concern of getting infected by the virus. In this study, our aim is to demonstrate the clinical features of the patients diagnosed and underwent appendectomy before and after the pandemic. Methods/Interventions: 116 patients included in this study which underwent appendectomy for acute appendicitis. Group-1 (44 patients) consists of the patients which operated before the first case diagnosed for Covid-19 in Turkey (January,1,2020 - March,18.2020);and Group-2 (72 patients) consisted of the patients which operated after Covid-19 spread (March,19,2020 - May,31,2020). Patients evaluated in respect of Alvarado scores;Ultrasonographic findings as positive or negative for appendicitis and postoperative histopathological reports along with demographic features. Results/Outcome(s): Mean Alvarado scores of Group-2 was significantly higher than Group-1 (p<0.005). Positive reporting rate on Ultrasonography for Group-2 was significantly higher then Group-2;furthermore positive surgical exploration of Group-2 was also significantly higher than Group-1. Postoperative pathological reports revealed the significantly higher rates of perforation/microperforation of Group-2 as well. Conclusions/Discussion: In the light of the outcomes of the current study, we can suggest that the anxiety of people for avoidance from the virus can lead the delayed diagnose and treatment of acute appendicitis which is highly associated with postoperative serious surgical complications.
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Online shopping has been a method in which consumers shop intensively, especially in the Covid-19 process. There are two main motivation motives in shaping the shopping behavior of consumers. The first is hedonic motivations and the other is utilitarian motives. In this study, it was investigated whether motivational impulses that direct consumers to online shopping vary according to their effect levels and demographic variables. For this purpose in Turkey online (online) was obtained as a poll carried out and 448 valid. As a result of the analyzes, it was observed that consumers participated in the proposals that they offer the most product variety and different payment opportunities. In age, profession and economic status assessment options;It was determined that there was no statistically significant difference between the averages of the utilitarian motivation dimensions. According to gender;convenience, adaptability and payment services;in terms of the level of education, the availability of information and payment services;In terms of monthly income level, there was a statistically significant difference in desire for control, lack of social interaction and privacy dimensions. © 2020 by Advance Scientific Research.
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Throughout human history, many pandemics have broken out and caused great numbers of deaths. As the technological development made quite a huge advancement by the twentieth century, the medical treatment armamentarium had widened its facilities and resources. This brought with sophisticated and competent health care services for people which provided the medical practitioners with higher success rates when fighting against diseases and improved recovery and survival rates. However, during the COVID-19 pandemic, the high transmission rate of the novel SARS-Cov-2 virus has led to the paralysis of the health system and running out of the resources and healthcare workers. Thus, local government healthcare service regulators have begun building up plans to create management algorithms to use the limited resources more efficiently. This paper presents preliminary practical instructions for healthcare providers as a basic foundation for COVID-19 and potential future pandemics.