ABSTRACT
Objective: The aim of this study was to determine the clinical course and treatment outcomes of patients with hereditary angioedema (HAE) after infection with coronavirus disease 2019 (COVID-19). Materials and Methods: Thirty-nine patients with HAE were included in this study. These patients were regularly followed up over phone calls since the first COVID-19 case was seen in our country. Patients were asked to visit the hospital if there was a history of contact with a confirmed COVID-19 patient or if the patient developed clinical symptoms of COVID-19. Results: There were 21 (54%) patients with type I HAE, and 18 (46%) with type II HAE. All patients received treatment for angioedema attacks (C1-inhibitor [C1-INH], icatibant), and seven (20%) received long-term prophylaxis (danazol). Treatment for attacks was continued for all patients during the pandemic. Patients taking danazol were switched to long-term prophylaxis using the C1-INH concentrate. Eleven (28%) patients with HAE developed COVID-19 during this study. Only one patient had severe COVID-19. Six patients (54.5%) were diagnosed with type II HAE, and five (45.5%) were diagnosed with type I HAE. The most common COVID-19 symptoms were fever (7/11;64%) and myalgia (6/11;55%). Mild angioedema attacks were experienced by 36% (4/11) of the HAE patients diagnosed with COVID-19. Icatibant was used in all patients. Conclusion: Agents used for HAE block the kallikrein-kinin system and may be useful in the treatment of COVID-19. Considering their beneficial effects on COVID-19, it is recommended that HAE patients should continue the use of agents blocking the kallikrein-kinin system.
ABSTRACT
Objective: The effect of the COVID-19 pandemic on mental health in the long term is unclear. We evaluated severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)–related transmission fear and mental-health disorders in populations at high risk for COVID-19. Materials and Methods: Healthcare workers and patients with primary immunodeficiency disorders (PIDs), severe asthma, malignancy, cardiovascular disease, hypertension, and diabetes mellitus were included in the study. The hospital anxiety and depression scale (HADS) and Fear of Illness and Virus Evaluation (FIVE) scales were applied during face-to-face interviews. Results: There was a total of 560 participants, 80 per group;306 (55%) were female. The FIVE and HADS-A scale scores of health care workers were significantly higher than the other groups (p = 0.001 and 0.006). The second-highest scores were in patients with PID. There was no significant difference between the groups in HADS-D scores (p = 0.07). There was a significant positive correlation between FIVE scale scores and anxiety (r = 0.828;p < 0.001) and depression (r = 0.660;p < 0.001). The FIVE scale had significant discriminatory power for anxiety (AUC = 0.870, 95% confidence interval [CI] = 0.836–0.904;p < 0.0001) and depression (area under the curve = 0.760, 95% CI = 0.717–0.803;p < 0.0001). Conclusion: During the COVID-19 pandemic, mental-health disorders may develop in patients with comorbidities, especially healthcare workers. They should be referred to mental-health centers.
ABSTRACT
Purpose: Electrocardiography (ECG) is the first-line diagnostic tool to evaluate cardiac involvement in any disease and COVID-19 patients. The objective of this study is to investigate the ventricular arrhythmia forming effect of COVID-19 and to guide the treatment. Materials and Methods: A total of 74 patients (mean age 52.63 +/- 17.85 years) under follow-up for asymptomatic COVID-19 and 74 healthy volunteers (mean age 50.71 +/- 6.02 years) were enrolled in the study. Heart rate, QRS duration, QT distance, T-wave morphology (Tp-e interval), Tp-e/QT ratio, and index of c ardioelectrophysiological balance (iCEB) were analyzed and compared to both groups. Results: The heart rate was higher, and the QT interval was shorter on ECG in the COVID-19 group. QTc interval, Tp-e intervals, and Tp-e/QT ratio were not different between groups. Furthermore, iCEB and iCEB-c values were not different between groups. A significant positive but weak correlation was observed between CRP and troponin values in patients with COVID-19. Moreover, there was no correlation between troponin levels and Tp-e/QT ratio and iCEB in patients with COVID-19. Conclusion: The chronic cardiac effects of the COVID-19 have not been elucidated. Prospective clinical trials with long-term and a high number of patient populations are needed to reveal this. Notably, patients with significantly elevated troponin values should be followed up for long-term development of cardiomyopathy and arrhythmias.