ABSTRACT
Aims: Rheumatological disease flares may occur after many infections. However, our knowledge of the post-Coronavirus disease-2019 (COVID-19) axial spondyloarthritis (SpA) flares and related factors is limited. Methods: We retrospectively assessed the axial SpA patients who had COVID-19. Demographic and clinical data were collected from the medical records. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was applied via telephone for pre- and post-COVID-19 SpA symptoms. An increase of 2 points in the BASDAI score or any new extra-articular manifestations were defined as SpA flares and SpA patients were grouped as flares and no-flare. Factors predicting SpA flare were also analyzed. Results: A total of 48 axial SpA patients were included in the study [age, mean+or-standard deviation (SD): 42.3+or-8.6 years;male: 65%]. Post-COVID-19 SpA flare was identified in 19 patients (40%), and new extra-articular manifestations were recorded in 6 patients (13%). Although the diagnosis of inflammatory bowel disease was more common in the flare group, the difference was not significant compared with that of the no-flare group. Other features of SpA and COVID-19 disease severity were similar between the flare and no-flare groups. In the flare group, the frequency of back pain (84% vs. 62%, p=0.091) and diarrhea (53% vs. 28%, p=0.080), and headache (84% vs. 52%, p=0.021) were higher than the no-flare group. No risk factor for a post-COVID-19 SpA flare could be identified. Conclusions: Post-COVID-19 flare was common in the axial SpA, and even new extra-articular manifestations could be reported. Although some clinical manifestations of COVID-19 were more common in patients with a flare, any predictive factor could not be identified among the study variables.
ABSTRACT
Aim: Coronavirus disease 2019 (COVID-19) has caused thrombotic disease. In this study, we aimed to determine the demographic and clinical characteristics of acute coronary syndrome (ACS) patients infected with COVID-19 and to investigate whether they differ from patients with ACS without COVID-19 in terms of these characteristics. Material(s) and Method(s): The study was designed as a single-center retrospective study. Thirty-three COVID-19 infected ACS patients (Group 1) and 100 ACS patients without COVID-19 infection (Group 2) were included in the study. Result(s): The groups were compared in terms of coronary angiographic data. Twenty-eight (84.8%) patients in Group 1 and 74 (74%) patients in Group 2 were presented as non-ST elevation myocardial infarctus. Patients were compared in terms of baseline Thrombolysis in Myocardial Infarctus (TIMI) flow, thrombus stage, myocardial blush (end), using of thrombus aspiration catheter, stent thrombosis, and TIMI flow after percutaneous coronary intervention, and it was observed that there was no statistical difference between the groups (p> 0.05). Discussion(s): COVID-19 infection can cause plaque rupture, myocardial damage, coronary spasm and cytokine storm by triggering the coagulation and inflammation process. The fact is that we did not encounter an increased thrombus load in this study.Copyright © 2022, Derman Medical Publishing. All rights reserved.
ABSTRACT
Background and Aim: This study aims to determine the demographic, clinical and angiographic characteristics of patients with acute miyocardial infarction (AMI) and coronavirus (COVID-19) and compare these findings with AMI patients without COVID-19. Method(s): The study was designed as a single center retrospective study. The patients who had been hospitalized due to acute myocardial infarction to our hospital were included. Patients with COVID-19 and AMI were included in Group 1 (n=33) and Group 2 consisted of the rest of the patients (n= 100). In these two groups, demographic, clinical presentation, angiography findings and prognosis were compared. Result(s): The average age of Group 1 and Group 2 were 65.9 years and 59.75 respectively(p>0.05).Five patients (15.2%) in Group 1 and 26 patients (26%) in Group 2 were presented with STEMI (p > 0.05).The heart rate and Tp-e / QTc ratio were higher and corrected QT and Tpeak-end were longer in Group 1 (p = 0.000;0.014;0.000, respectively).There was no statistical difference between the groups in terms of baseline Thrombolisis in myocardial infarctus (TIMI) flow, thrombus stage, final myocardial blush, frequency of using thrombus aspiration catheter, stent thrombosis, and final TIMI flow (p > 0.05).These two groups were also similar in terms of hospital mortality and the composite end point in the first month (p > 0.05). Conclusion(s): The main findings of our study suggest that AMI patients with COVID-19 do not have a significantly increased risk of mortality compared to those with AMI without COVID-19.In addition to that, this study shows that clinical and angiographic characteristics are similar.
ABSTRACT
Background: Rheumatological disease fares may be seen after many infections. However, our knowledge for the post-COVID axial spondyloarthritis (SpA) fares and its related factors is limited. Objectives: We aimed to evaluate disease activity and factors that may be associated with disease activity in axial SpA patients in post-COVID period. Methods: We retrospectively assessed the axial SpA patients who have had COVID-19 disease confrmed by a positive SARS-CoV-2 polymerized chain reaction (PCR) test result. Demographics, comorbid diseases, active medical treatments for SpA and information regarding COVID-19 clinical courses were collected from medical records. PCR positive patients were reached via telephone and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scored for pre-and post-COVID SpA symptoms. An increase of ≥2 points in the BASDAI score was defned as fare, and SpA groups with and without fare were compared. Factors predicting SpA fare were also analyzed by the logistic regression analysis. Results: A total of 48 axial SpA patients were included in our study, 65% of them male and the mean±SD age was 42.3±8.6 years. Post-COVID SpA fare was seen in 38% patients. Demographic, clinical, medical features of the SpA patients and COVID-19 disease severity were similar between Flare and No fare groups. In comparison of the COVID-19 symptoms, although most of the COVID-19 related symptoms were similar between two groups, the frequency of the back pain and diarrhea were higher in the Flare group than No fare group. But in multivariate analysis, only history of the infammatory bowel disease had an increased risk for post-COVID SpA fare (Table 1). Conclusion: The presence of infammatory bowel disease statistically signifcant related post-COVID SpA fares. In addition, diarrhea and back pain symptoms in COVID-19 disease may be stimulating factors for SpA fares but we found no effect of rheumatological therapies.
ABSTRACT
Background: Compared to biologic-agents, little is known about effects of sul-fasalazine used for axial spondyloarthritis(AxSpA) on COVID-19 outcomes. Objectives: So, we aimed to understand the impact of sulfasalazine on COVID-19 in AxSpA patients. Methods: This was a retrospective study from a single center which included 2344 AxSpA patients. We analyzed 219 of 406 confrmed COVID-19 patients from March 2020 to July 2021. The primary outcome was COVID-19 severity in terms of COVID-19 pneumonia, hospitalization rate and length of hospitalization. Analyses were stratifed according to use of sulfasalazine and/or biologic-agents. Results: Most of the patients were male(59%) with a mean age of 45.0 years. Peripheral arthritis was present in 35% and uveitis in 15%. In total, sulfasalazine was used in 42% and biologic-agent in 42%. COVID-19 pneumonia detected in 16%, hospitalization required in 14% and median(IQR) duration of hospitalization was 10(8) days. Two patients died due to COVID-19. The sulfasalazine users had higher age, more frequent COVID-19 pneumonia, hospitalization and longer hospitalization. After biologic-agent users were excluded, the sulfasalazine group had again longer hospitalization. When patients regrouped as sulfasalazine mon-otherapy, sulfasalazine+biologic and biologic monotherapy, in pairwise comparisons, sulfasalazine monotherapy group had a higher frequency of COVID-19 pneumonia than biologic monotherapy group(p=0.008). Conclusion: Although sulfasalazine seemed to be related with increased rates of COVID-19 pneumonia and hospitalization, this impact diminished after exclusion of biologic-agent users. Sulfasalazine monotherapy and sulfasalazine+bio-logic therapy might be associated with development of COVID-19 pneumonia, compared to biologic monotherapy. Our results imply sulfasalazine may be related with worse disease course AxSpA patients with COVID-19.
ABSTRACT
Objectives: Clinical features and risk factors are highly variable for Coronavirus disease-2019 (COVID-19). Researchers investigate for the prediction of people who have high risk of developing severe illness and dying. The aim of this study is to examine the effect of obesity on the course of COVID-19. Materials and Methods: Patients with laboratory confirmed COVID-19 were retrospectively screened between March 11 and April 30. Anthropometric measures including standing height and body weight were measured at admission. Body mass index (BMI) was calculated and patients were classified into three groups as BMI< 25, BMI 25-29.99, and BMI30 according to the guidelines for the diagnosis and treatment of obesity in Turkey.
ABSTRACT
Objective: Early diagnosis is important for severe diseases in COVID-19. Monocyte/high dansity lipoprotein ratio (MHR) is a new prognostic marker indicating inflammation. We aimed to investigate the relationship between MHR and diseases severity in COVID-19. Methods: Patients with laboratory confirmed COVID-19, were retrospectively analyzed. Clinical symptoms, signs and laboratory data on the first day of hospitalization were obtained from medical records of hospital. The clinical data of 301 patients were included in study. Cases were diagnosed on the basis of interim guidance of World Health Organization (WHO). Patients were classified into two groups as non-severe COVID-19 and severe COVID-19. MHR were calculated with laboratory data on the first day of hospitalization. The relationship between MHR level and COVID-19 severity was evaluated. Statistical analysis of the data was performed by using SPSS 25 (SPSS Inc., Chicago, IL, USA) package program. Statistical significance level was accepted as p<0.05. Results: One hundred ninety-six patients (65.1 %) had non-severe COVID-19,105 patients (34.9 %) had severe COVID-19. In our study, it was found that the mean age was higher in severe patients and comorbid diseases were more common. Although monocyte count values were not statistically significantly different, MHR was significantly higher in severe COVID-19 than non-severe COVID-19. Conclusions: Monocytes are very important to cytokine storm in COVID-19. Dyslipidemia can occur in viral infection because of inflammation. MHR can be used as an inflammatory marker in COVID-19.
ABSTRACT
Aim: To investigate clinical implications of antineutrophil cytoplasmic antibody (ANCA) positivity detected in COVID-19 patients during follow up. Materials & methods: A retrospective survey in a hospital database was carried out to detect COVID-19 patients in which ANCAs had been tested. Clinical, laboratory and imaging data were collected from this hospital database and compared between ANCA-negative and-positive patients. Results: ANCAs were tested in 87 COVID-19 patients. Eight had positivity in at least one ANCA test. COVID-19 symptoms on admission and rate of pulmonary involvement were similar. Acute phase reactant levels were higher in ANCA-positive patients. Rate of mortality was higher in the ANCA-positive group without statistical significance. Conclusion: ANCA positivity detected during COVID-19 in patients without a prior diagnosis of any rheumatic condition may be related with worse outcomes.
ABSTRACT
BACKGROUND: Aim of this study is to investigate COVID-19 outcomes in patients with antiphospholipid syndrome (APS). METHODS: A retrospective cohort was formed from APS patients. Patients were screened for a record of positive SARS-CoV 2 PCR. In PCRpositive patients, clinical data and information regarding COVID-19 outcomes were collected from medical records. RESULTS: A positive PCR test was detected in 9/53 APS patients, while 66.7 %, 33.3 % and 11.1 % of APS patients with COVID-19 were under hydroxychloroquine, LMWH or warfarin, and acetylsalicylic acid, respectively. There were 3/9 patients found to be hospitalized and one died. No new thrombotic event was reported in any of the patients during COVID-19 infection. CONCLUSION: Baseline use of hydroxychloroquine, antiaggregants and anticoagulants may be associated with an absence of new thrombotic event (Tab. 2, Ref. 33).
Subject(s)
Antiphospholipid Syndrome , COVID-19 , Antibodies, Antiphospholipid , Anticoagulants/therapeutic use , Antiphospholipid Syndrome/complications , Heparin, Low-Molecular-Weight , Humans , Retrospective Studies , SARS-CoV-2ABSTRACT
Aim: Since blood types first appeared, their association with diseases caused by microorganisms has been further investigated with several studies for many years. The bond of blood groups described as A, B, AB, and O with coronavirus has been the research subject in many countries.We aimed to elucidate whether there was a relationship between blood types and Rh factor and contracting COVID-19 disease and disease severity. Methods: The study was designed as a retrospective case-control study. Between March 2020-February 2021, 1110 patients were included (538 cases, 572 controls). Disease severity was classified according to where patients were treated: those who were outpatients considered as “mild disease”, hospitalized in a hospital ward considered as “moderate disease”, and treated in the intensive care unit were considered as “severe disease”. Results: The number of people with blood type A was 447 (40.3%), blood type B was 197 (17.7%), blood type AB was 90 (%8), and blood type O was 376 (33.9%). There was no significant difference between the case and control groups according to the blood types. A 3.93 times increase of developing mild illness was detected compared to the control group in Rh-positive individuals. The rate of developing a severe disease was higher in females with blood type A than a mild disease, and A blood type caused the disease to be severe compared to other blood groups in females. Conclusion: We concluded that blood type A caused more severe disease than other blood types in females, and females with B blood type survived the disease as outpatients. Our study can shed light on pathophysiological investigation of the relationship between COVID-19 disease causing a pandemic with high mortality and virulence and blood types. © 2021, Eurasian Society of Family Medicine. All rights reserved.
ABSTRACT
Aim: Coronavirus disease 2019 (COVID-19) has caused thrombotic disease. In this study, we aimed to determine the demographic and clinical characteristics of acute coronary syndrome (ACS) patients infected with COVID-19 and to investigate whether they differ from patients with ACS without COVID-19 in terms of these characteristics. Material and Methods: The study was designed as a single-center retrospective study. Thirty-three COVID-19 infected ACS patients (Group 1) and 100 ACS patients without COVID-19 infection (Group 2) were included in the study. Results: The groups were compared in terms of coronary angiographic data. Twenty-eight (84.8%) patients in Group 1 and 74 (74%) patients in Group 2 were presented as non-ST elevation myocardial infarctus. Patients were compared in terms of baseline Thrombolysis in Myocardial Infarctus (TIMI) flow, thrombus stage, myocardial blush (end), using of thrombus aspiration catheter, stent thrombosis, and TIMI flow after percutaneous coronary intervention, and it was observed that there was no statistical difference between the groups (p>0.05). Discussion: COVID-19 infection can cause plaque rupture, myocardial damage, coronary spasm and cytokine storm by triggering the coagulation and inflammation process. The fact is that we did not encounter an increased thrombus load in this study.
ABSTRACT
This study examines the high-risk group of individuals age 65 and over who most frequently experience the negative consequences of Covid-19. We review their communicative needs and expectations, knowledge and information sources, and risk information and knowledge patterns. We conducted semi-structured interviews with 47 people aged 65 and over residing in Ankara. We evaluated our results in the context of The Social Amplification of Risk Framework, considering the major communication stations disseminating risk information. We found that during the Covid-19 pandemic, individuals aged 65 and over accessed risk information through new media and traditional media, and interpersonal communication, especially with close family and children, served as a primary information source during the pandemic. The trust factor, particularly regarding medical expertise, was an essential criterion in evaluating information. The communicative needs and expectations changed for this high-risk group. The need for improved digital communication capabilities become apparent during the pandemic crisis. Suggestions that consider public perspectives and risk perceptions while incorporating the relationship between risks and communication processes may contribute to structuring impactful risk communication activities.
ABSTRACT
Introduction: There is no known specific treatment for Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2). Our retrospective study evaluates the effectiveness of steroid treatment and the factors affecting treatment in patients with severe Coronavirus disease-2019 (COVID-19) pneumonia that received favipiravir treatment. Materials and Methods: This study included patients older than 18 years with severe COVID-19 pneumonia who received favipiravir treatment in a training and research hospital between March 1 and May 31, 2020. It retrospectively evaluated respiratory rate <30/min and/or severe respiratory distress and oxygen saturation > 90 and typical thoracic computerized tomography findings: Bilateral lobular, peripheral lesions, and the presence of ground-glass opacities were determined as the criteria for severe pneumonia. For 82 cases of SARS-CoV-2 polymerase chain reaction positive, age, gender, symptoms, comorbidities, steroid use, and mortality rates were examined. Results: Eighty-two patients with confirmed COVID-19 diagnosed with severe pneumonia were included in the study. Of these cases, 63% were males. The median patient age was 64±16.98 (21-97, minimum-maximum) years. The mortality in women was 23%, and the mortality in men was 30%. The correlation between gender and mortality was statistically significant (p=0.04). Advanced age, chronic renal failure, and confusion on hospital admission were associated with mortality (p=0.04, p=0.02, p=0.02, respectively). Methylprednisolone was given to 12 patients as an additional treatment. The mortality of the patients who received steroid treatment was significantly lower than those who did not (p=0.017). There was no bacterial infection in these 12 patients, who received steroid treatment and the procalcitonin level was not high. Conclusion: In confirmed COVID-19 patients without concomitant bacterial infections, steroid treatment can lower mortality and long-term morbidities. Similar to prospective randomized studies, our study showed that steroid use reduces mortality in patients with severe COVID-19 pneumonia.
ABSTRACT
Introduction: There is no known specific treatment for Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2). Our retrospective study evaluates the effectiveness of steroid treatment and the factors affecting treatment in patients with severe Coronavirus disease-2019 (COVID-19) pneumonia that received favipiravir treatment. Materials and Methods: This study included patients older than 18 years with severe COVID-19 pneumonia who received favipiravir treatment in a training and research hospital between March 1 and May 31, 2020. It retrospectively evaluated respiratory rate >30/min and/or severe respiratory distress and oxygen saturation <90 and typical thoracic computerized tomography findings: Bilateral lobular, peripheral lesions, and the presence of ground-glass opacities were determined as the criteria for severe pneumonia. For 82 cases of SARS-CoV-2 polymerase chain reaction positive, age, gender, symptoms, comorbidities, steroid use, and mortality rates were examined.
ABSTRACT
The Canadian banking system, like its Australian counterpart, is often credited for weathering the 2007/8 financial crisis effectively. The oligopolistic rent is overlooked, as a necessary price for the resiliency of the system. In this paper, the authors discuss that the resilience was due to the banks’ ability to pass on the cost of the crisis and the following regulations to the end users of their products and services, and their ability to alter products and services to maximise profitability. In a competitive market, positive economic profit is supposed to erode over time, especially following major events such as the 2007/8 crisis. This did not happen for Canadian banks;therefore, arguably, there was an ‘implicit bailout’ in Canada whose cost was not borne by the taxpayers (as in the case of an explicit bailout) but by the end users of the banking services and products (the payers of the oligopolistic rent). This may reoccur in the aftermath of the COVID crisis, and the perceived resilience may win out over competition. The authors also theorise the diversification benefit vs the systemic risk trade-off with an increasing bank size. The diversification benefit can increase, but at a decreasing rate as a bank grows, whereas systemic risk increases at an increasing rate. Therefore, there exists a point where the systemic risk outweighs the diversification benefit as a bank continues to grow. The authors find that the standardised capital regime not only diminishes the banks’ competiveness against their internal ratings-based (IRB) counterparts but also forces them into the riskier segments of the market and diminishes their ability to diversify. The authors make a case that a banking environment that promotes competition is desirable to increase the utility of the system without sacrificing safety and soundness. As a matter of fact, increased competition can increase stability while reducing the undesired implicit public subsidy of private enterprise. © Henry Stewart Publications.