Levels of peripheral IL-6 and CD4+and CD8+T cells and their prognostic significance in COVID-19

OBJECTIVE: Chemotherapy -related adverse reactions have been steadily in-creasing in recent years. In patients who develop oxaliplatin-induced hypersensitivity reactions (HSRs), prognosis and quality of life are adversely affected. Proper management of cancer patients enables them to safely receive first-line treatments. This study aimed to assess the risk factors in oxaliplatin-induced HSRs and the effectiveness of the rapid desensitization protocol.PATIENTS AND METHODS: In the study, 57 patients treated with oxaliplatin between October 2019 and August 2020 in the Medical Oncology Department of Elazig City Hospital were retrospectively evaluated. We analyzed patients' clinical histories to reveal any associations with the development of oxaliplatin-induced HSRs. Moreover, we re-evaluated 11 patients with oxaliplatin-induced HSRs through infusion time or desensitization procedures.RESULTS: Of 57 patients treated with oxaliplatin, 11 (19.3%) had HSRs. Patients with HSRs were younger and had higher peripheral blood eosinophil counts than those without HSRs (p=0.004, p=0.020, respectively). Prolongation of the infusion time was effective in the re -ad-ministration of oxaliplatin in six of the hyper-sensitive patients. Rapid desensitization proto-col was performed for a total of 11 cycles in four patients with recurrent HSRs, and their chemo-therapy regimens were successfully completed.CONCLUSIONS: This retrospective study has revealed that younger ages and higher peripheral eosinophil counts could be predictive for oxaliplatin-induced HSR. Furthermore, the study confirms that prolongation of the infusion time and rapid desensitization protocol are effective in patients with HSRs.

Financial Factors, Corporate Governance and ESG during Covid-19 Pandemic: Malaysian Evidence

This study investigated the factor that influences the Environment, Social and Governance (ESG) Disclosure of public listed companies in Malaysia, particularly before and during the Covid-19 Pandemic outbreak. Using 62 Public Listed Companies in Malaysia and 248 years of observation from the year 2018 to the year 2021, it found that profitability, growth of the company, company's size, board size, gender diversity, auditor tenure, and ESG disclosure highest during the Covid-19 pandemic outbreak period. It also discovered that profitability and independent board members had positively related to ESG disclosure before and during the Covid-19 pandemic outbreak.

Meaning-making following loss among bereaved spouses during the COVID-19 pandemic (the CO-LIVE study).

This study investigates how individuals construe, understand, and make sense of experiences during the first wave of the COVID-19 pandemic. Seventeen semi-structured interviews were conducted with bereaved spouses focusing on meaning attribution to the death of their partner. The interviewees were lacking adequate information, personalized care, and physical or emotional proximity; these challenges complicated their experience of a meaningful death of their partner. Concomitantly, many interviewees appreciated the exchange of experiences with others and any last moments together with their partner. Bereaved spouses actively sought valuable moments, during and after bereavement, that contributed to the perceived meaning.

Two uncommon complications of COVID-19 in same patient: MINOCA and pneumothorax

COVID-19 has several clinical manifestations in the respiratory system and the cardiovascular system. Pneumothorax and myocardial infarction with nonobstructive coronary arteries (MINOCA) are two different clinical complications in COVID-19. However, pneumothorax and MINOCA have not been described yet in the same patient until now. A COVID-19 patient was admitted due to respiratory distress. He had pneumothorax and MINOCA. We report how we proceeded with diagnosis and treatment of pneumothorax and MINOCA. Respiratory and cardiovascular system manifestations of COVID-19 have made numerous clinical appearances. MINOCA and pneumothorax are rare clinical appearances, but they can be seen in COVID-19 as shown in our case. Copyright © 2022 Czech Society of Cardiology Z.S. All rights reserved.

Stability analysis and numerical simulation of dynamic and fractional SEIRD models for spread of nCOVID-19 in Turkey

There are various mathematical models that have been designed for forecasting the future behavior of coronavirus spreading, which helps to rapidly control the process while there is no treatment and vaccines. The main aim of this study is to describe COVID-19 dynamics in Turkey by using a Susceptible-Exposed-Infected-Recovered-Deceased (SEIRD) model. For this purpose, a new SEIRD model of nCOVID-19 and its fractional-order version are designed. The basic reproduction number is calculated with the generation operator method. All possible equilibria of the dynamic model are investigated in terms of the basic reproduction number. Further, stability conditions are obtained through the Routh-Hurwitz and Lyapunov stability theories. Finally, some numerical simulations of the dynamic system and its fractional version are given based on the data from the number of nCOVID-19 cases in Turkey. These results provide to implicate the theoretical findings corresponding to the model. © 2022 World Scientific Publishing Company.

iLIVE Project Volunteer Study: Using a Newly Developed European Core Curriculum (Ecc) To Develop and Implement End-Of-Life-Care Volunteer Services Within 5 Hospitals Across 5 Countries

Background: Across Europe palliative and end-of-life-care volunteer services (EOLC-VS) in the hospital setting are relatively uncommon, particularly for patients in the last weeks of life. The iLIVE Volunteer Study, one of 8 work-packages within the iLIVE Project, conducted an international Delphi study to develop a European Core Curriculum for EOLC-VC's, including associated training manuals. The ECC was designed to empower Volunteer Coordinators (VC's) to develop and implement EOLC-VS's in 5 hospitals in 5 countries, adapted to local cultural and organisational contexts. A case study to providing in-depth assessment of the facilitators and barriers in one hospital in the Netherlands has been undertaken (results reported elsewhere). Aim: To support Volunteer Coordinators (VC's) to initiate EOLC-VS's in 5 hospitals across 5 European countries. Methods: VC's attended a 3-day International Training Programme to examine and adapt the ECC implementation and training manuals to their individual organisational and cultural contexts. Due to COVID-19, virtual resources for support were engaged, including international networking sessions between EOLC volunteers and VC's. Structured feedback from VC's were collected at the 3-day training programme and throughout development, training of volunteers, and implementation of EOLC-VC's. Results: The ECC provided VC's with a practical guide to design and implement EOLC-VC's within the complex environment of a hospital. The supportive resources gave VC's an opportunity to share learning, facilitating a deeper understanding of the ECC, as well as enable the sharing of practical experiences during service development and implementation using the ECC. Conclusions: The ECC, with supportive resources, enabled successful implementation of hospital EOLC-VC's volunteer services across 5 countries. Further research to assess the use and experience of these services is now underway as part of the iLIVE Volunteer Study.

Comparing Autopsy Thoracic Injury Patterns between In-Hospital CPR Patients Receiving LUCAS Device vs Manual Chest Compressions

Background: Current research comparing CPR-associated injuries between those receiving LUCAS device and manual CPR has primarily focused on patients who suffered out-of-hospital cardiac arrest. During the SARS-CoV-2 pandemic, more hospitals leveraged mechanical CPR devices to provide distant yet high quality chest compressions for in-hospital cardiac arrest (IHCA) patients. We sought to investigate autopsy thoracic injury patterns in in-hospital non-traumatic cardiac arrests, comparing traditional manual compressions with the mechanical LUCAS device compressions. Design: Autopsies were screened for a history of in-hospital cardiopulmonary resuscitation in the absence of prior traumatic injuries at a single, large quaternary care center from 1/1/2018 to 06/30/2021. 20 received LUCAS compressions and 40 received manual compressions. Student's T-Tests were used to compare means for continuous variables, while chi-squared and Fischer's exact tests were used for categorical variables. An alpha of 0.05 was chosen as the threshold for statistical significance. Results: A statistically significant decrease in the rate of sternal fractures and rate of multiple sternal fractures during mechanical CPR was found. A statistically significant increase in other soft tissue injuries, such as pleural wall or lung injuries was seen in mechanical CPR cases, while an increased rate of bilateral rib fractures was noted in manual compression cases. Conversely, no difference in the number or laterality of rib fractures were noted. There was no significant difference in age, biological sex, or rate of scoliosis or kyphosis between cohorts. Results are listed in table 1. (Table Presented) Little research has looked at the injury patterns of mechanical CPR in the IHCA patient population. These results point to a potential difference in thoracic injury patterns from manual compressions when compared to LUCAS device compressions. The statistically significant decrease in sternal fractures with mechanical compressions is noteworthy. Conversely, the increase in other soft tissue injury demands further examination. The decrease in bilateral rib fractures with LUCAS use suggests that placement of the device may play a role in the epidemiology of rib injuries, but not in the number of ribs injured. Further research should examine rib injuries in more detail, and quantify additional comorbidities in both survivors and non-survivors of cardiac arrest.

WHAT BOTHERED PATIENTS WITH PARKINSON DISEASE DURING THE COVID-19 LOCKDOWN? AN ANALYSIS OF TELEPHONE RECORDS

Introduction: It has been suggested that patients with Parkinson's disease are more susceptible to the negative consequences of restrictions for Coronavirus pandemic regulations. We evaluated whether the lockdown caused a change in the subjective complaints of the Parkinson's disease patients. Material and Methods: Telephone records of the Parkinson's disease patients in the 2.5 months of the lockdown in 2020 were categorized and compared to the records of the same period of 2018 and 2019. Results: In total, 666 complaints/questions were categorized from 625 telephone calls of 391 patients. The percentage of motor-related complaints did not differ significantly across the years. In 2020, calls about administrative issues increased significantly compared to 2018 (OR= 3.7 95% CI:1.5-9.3;p= 0.004) and 2019 (OR= 2.1, 95% CI:1.0-4.5;p= 0.044). Moreover in 2020, the odds of calling due to behavioral/psychotic symptoms increased by at least 3 times compared to 2018 (OR=3.7, 95% CI:1.3-10.8 p= 0.014) and 2019 (OR=3.0, 95% CI:1.2-7.4 p= 0.018). Anxiety was also more frequent but only compared to 2019. Conclusions: The results highlight the necessity of taking urgent action to improve the organizational and psychosocial needs of Parkinson's disease patients in times of humanitarian crises.

Frontal QRS/T angle can predict mortality in COVID-19 patients

Aims: fQRS-T angle was investigated from general population including healthy people to patients who has hearth failure. It can predict mortality of myocarditis, ischemic cardiomyopathy, non-ischemic cardiomyopathy, idiopathic dilated cardiomyopathy and chronic heart failure in general population. There is no study in the literature that has been investigated for COVID-19 patients. The purpose of this retrospective multi-center study is to evaluate fQRS angle of COVID-19 patients for in-hospital mortality and need mechanical ventilation. Methods and results: ECG was enrolled in 327 COVID-19 patients during admission and the fQRS angle calculated. Mechanical ventilation was needed for 119 patients and 110 of them died in hospital. Patients were divided into two groups according to their fQRS angle as fQRs>90° and fQRS≤90°. Percentages of mortality and need of MV according to fQRS angle were found 67.8% and 66.1% respectively in fQRs>90° group and 26.1%, 29.9% in fQRS≤90°group. Heart rate, SO2, fQRS, eGFR and CRP only were predictors for mortality in multivariable analysis. Mortality risk was increased 2.9-fold in univariate analysis and 1.6-fold in multivariate analysis for fQRS>90 patient group in respect to fQRS≤90 group. Conclusion: In conclusion, a wide fQRS angle (>90°) was found as a predictor for mortality in-hospital and associated with the need for mechanical ventilation in COVID-19 patients. (Figure Presented).

Dying in the era of COVID-19: Experiences of bereaved relatives on end-of-life care in different settings in the netherlands (the co-live study)-an online questionnaire study

Background: The COVID-19 pandemic and restricting measures may have affected end-of life care, including experiences of relatives who lost a loved one. Aims: To describe experiences of bereaved relatives with end-of-life care for a loved one who died at home, in a hospital, nursing home or hospice during the pandemic, and to examine how restricting measures influenced their evaluation of care. Methods: Bereaved relatives completed an open observational online questionnaire about their evaluation of end-of-life care as provided to a loved one who died between March and July 2020. Results: The questionnaire was filled out by 393 bereaved relatives whose loved ones died at home (n=68), in a hospital (n=114), nursing home (n=176) or hospice (n=35). Patients who had died were more often men (49% vs 47%), aged 75 years or older (72%), and had COVID- 19 (57%). Patients who died in a hospital more often had COVID-19 (76%) than patients in nursing homes (62%), hospices (43%) or at home (18%). Bereaved relatives were mostly women (81%), aged 45 years or older (82%), and a child (55%) of the patient. Bereaved relatives of patients who died in a hospital most often evaluated medical (79%), nursing (75%) and personal care (72%) as sufficient, whereas medical (55%) and personal care (62%) in nursing homes and nursing care at home (66%) were least often evaluated as sufficient. Hospitals, nursing homes and hospices had implemented visiting restrictions in the majority of cases (76%, 90%, 71%, respectively). These restrictions were negatively associated with bereaved relatives' evaluation of medical and personal care in nursing homes, and medical care in hospitals. Conclusion: End-of-life care during the COVID-19 pandemic was evaluated most favourably in hospitals and least favourably in nursing homes. Our study suggests that visiting restrictions had a major impact, especially in nursing homes.

One year of the pandemic - how European endocrinologists responded to the crisis: a statement from the European Society of Endocrinology.

Changes that COVID-19 induced in endocrine daily practice as well as the role of endocrine and metabolic comorbidities in COVID-19 outcomes were among the striking features of this last year. The aim of this statement is to illustrate the major characteristics of the response of European endocrinologists to the pandemic including the disclosure of the endocrine phenotype of COVID-19 with diabetes, obesity and hypovitaminosis D playing a key role in this clinical setting with its huge implication for the prevention and management of the disease. The role of the European Society of Endocrinology (ESE) as a reference point of the endocrine community during the pandemic will also be highlighted, including the refocusing of its educational and advocacy activities.

COVID-19 and endocrine and metabolic diseases. An updated statement from the European Society of Endocrinology.

BACKGROUND: COVID-19 has completely changed our daily clinical practice as well as our social relations. Many organs and biological systems are involved in SARS-Cov-2 infection, either due to direct virus-induced damage or to indirect effects that can have systemic consequences. Endocrine system is not only an exception but its involvement in COVID-19 is so relevant that an "endocrine phenotype" of COVID-19 has progressively acquired clinical relevance. AIM: We have been appointed by the European Society of Endocrinology (ESE) to update with the current statement ESE members and the whole endocrine community on the emerging endocrine phenotype of COVID-19 and its implication for the prevention and management of the disease. CONCLUSIONS: Diabetes has a major role in this phenotype since it is one of the most frequent comorbidities associated with severity and mortality of COVID-19. Careful management including treatment modifications may be required for protecting our patients rather with known diabetes from the most dangerous consequences of COVID-19 or hospitalized with COVID-19, but also in patients with SARS-CoV-2 induced newly onset diabetes. Obesity increases susceptibility to SARS-CoV-2 and the risk for COVID-19 adverse outcome. Adequate nutritional management needs to be granted to patients with obesity or undernourishment in order to limit their increased susceptibility and severity of COVID-19 infection. Lack of vitamin D, hypocalcemia and vertebral fractures have also emerged as frequent findings in the hospitalized COVID-19 population and may negatively impact on the outcome of such patients. Also, in patients with adrenal insufficiency prompt adaptation of glucocorticoid doses may be needed. Moreover, in this updated statement role of sex hormones as well as peculiar pituitary and thyroid aspects of COVID-19 have been included. Finally, in view of the mass vaccination, potential implications for endocrine patients should be considered.