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1.
American Journal of Blood Research ; 12(2):54-59, 2022.
Article in English | EMBASE | ID: covidwho-1935125

ABSTRACT

Objective: Severe acute respiratory syndrome (SARS) coronavirus 2 (SaRS-Cov-2) associated respiratory disease (COVID-19), announced as a pandemic, is a multisystem syndrome. SARS-CoV-2 directly infects and damages vascular endothelial cells, which leads to microvascular dysfunction and promotes a procoagulant state. Dipyridamole (DP) acts as a reversible phosphodiesterase inhibitor and is used mainly as an antiplatelet agent. It is hypothetised that it has possible activities in COVID-19. Design and Methodology: We report our retrospective, real-world results of DP added to low-molecular weight heparin (LMWH) in the treatment of 462 clinically diagnosed and hospitalized COVID-19 patients. We compared anticoagulation with and without DP addition with no administration of anticoagulation in the same time frame. The primary outcome was proven or highly suspected coagulopathy within 30 days of hospitalization. Results: Definitive coagulopathy has been diagnosed in 3 (3.5%) of 85 LMWH administered patients and 7 (2.13%) of 328 DP + LMWH received patients (P=0.456). Five cases with definitive coagulopathy were not initiated any anticoagulation at the time of the event. The multivariate analysis showed that DP addition to the anticoagulant approach did not have any impact on the risk of demonstrated coagulopathy and highly-suspected coagulopathy. Conclusion: We think that our clinical experience is valuable in showing the real-life results of DP + LMWH treatment in COVID-19. This approach did not affect the coagulopathy rate. Our data did also not document an additive effect of DP in the COVID-19 outcome. Prospective controlled trials would give more convincing results regarding the role of DP in COVID-19 endothelial dysfunction and clinical outcome.

2.
Istanbul Tip Fakultesi Dergisi ; 85(1):1-8, 2022.
Article in English | Scopus | ID: covidwho-1876446

ABSTRACT

Objective: In this study, we aimed to analyze the demographic characteristics, symptoms, and comorbidities of 504 patients hospitalized for COVID-19. We also sought to describe the relationship between these features and intensive care unit (ICU) admission and mortality. Materials and Methods: This study is a descriptive study involving 504 COVID-19 patients hospitalized between 16.03.2020 and 07.05.2020 at Istanbul Universitys’ Istanbul Faculty of Medicine Hospital. Information about the patients was obtained from the hospital automation system and evaluated retrospectively. Results: The average age of the 504 patients was 56±15.14, and 59.1% of them were male. The proportion of the patients admitted into ICU 11.9% and for 8.52% of them the disease resulted in death. Real time polymerase chain reaction (RT-PCR) test results were positive for 60.5% of the patients. The median time spent in the hospital was eight days. Fifty six percent of the patients had at least one accompanying comorbid disease, with hypertension (39.3%) and diabetes (20.8%) being the most common. Being 65 years old or older (p<0.001), days spent in the hospital (p<0.001), presence of at least one comorbidity (p=0.009), hypertension (p=0.003), coronary artery disease (p=0.004), congestive heart failure (p=0.005) and dyspnea (p<0.001) were all factors found in those admitted to ICU. Conclusion: COVID-19 infection leading to high morbidity-mortality rates and an increased requirement for ICU admission is mainly seen among older patients and those who have dyspnea. During the process of analyzing patients suspected of COVID-19 who are admitted to hospital, it is crucial to consider both the patient’s age and any respiratory symptoms. Such a clinical evaluation is crucial for a better understanding of the course of the disease. © 2022 Istanbul University Press. All Rights Reserved.

3.
Asthma Allergy Immunology ; 19(3):174-182, 2021.
Article in English | EMBASE | ID: covidwho-1856522

ABSTRACT

Objective: The clinical features of COVID-19 range from asymptomatic disease to severe pneumonia or even death. Therefore, many researchers have investigated the factors that could affect the severity of COVID-19. We aimed to assess the impact of aero-allergen sensitization and allergic diseases on the severity of COVID-19. Materials and Methods: We included 60 adult patients with symptomatic COVID-19 and allocated them into two groups equal in number as having severe and non-severe COVID-19. We evaluated the demographic features and allergic diseases in addition to clinical, laboratory and radiological findings of COVID-19. Skin prick tests (SPTs) with common aero-allergens, serum total IgE levels and blood eosinophil counts were evaluated 3 months after the patient's recovery from COVID-19. Results: The mean age of the patients was 52 ± 11 years and 73.3% of the patients were male. There was no significant difference between the two groups in terms of age, gender, smoking habits, obesity and comorbidities. Although the frequency of sensitization to aeroallergens and the allergic diseases were similar, the history of allergic diseases in the family was higher in the severe group (p<0.001). The polysensitization in SPTs was associated with the presence of a cytokine storm during the infection (p=0.02). Total IgE levels and blood eosinophil counts were not significantly different between the two groups. Conclusion: The presence of atopy or allergic diseases does not seem to be related to the severity of COVID-19. However, polysensitization and a family history of allergic diseases are more prominent in those having a cytokine storm and severe COVID-19, respectively.

6.
European Journal of Immunology ; 51:345-345, 2021.
Article in English | Web of Science | ID: covidwho-1717530
7.
European Journal of Immunology ; 51:113-113, 2021.
Article in English | Web of Science | ID: covidwho-1717315
8.
European Journal of Immunology ; 51:358-358, 2021.
Article in English | Web of Science | ID: covidwho-1717167
9.
European Journal of Immunology ; 51:135-135, 2021.
Article in English | Web of Science | ID: covidwho-1717025
10.
European Journal of Immunology ; 51:362-362, 2021.
Article in English | Web of Science | ID: covidwho-1716882
11.
European Journal of Immunology ; 51:378-378, 2021.
Article in English | Web of Science | ID: covidwho-1716746
12.
SSRN;
Preprint in English | SSRN | ID: ppcovidwho-326109

ABSTRACT

This paper presents a comprehensive analysis of the impact of COVID-19 on debt, puts recent debt developments and prospects in historical context, and analyzes new policy challenges associated with debt resolution. The paper reports three main results. First, even before the pandemic, a rapid buildup of debt in emerging market and developing economies-dubbed the "fourth wave" of debt-had been underway. Because of the sharp increase in debt during the pandemic-induced global recession of 2020, the fourth wave of debt has turned into a tsunami and become even more dangerous. Second, five years after past global recessions, global government debt continued to increase. In light of this historical record, and given large financing gaps and significant investment needs in many countries, debt levels will likely continue to rise in the near future. Third, debt resolution has become more complicated because of a highly fragmented creditor base, a lack of transparency in debt reporting, and a legacy stock of government debt without collective action clauses. National policy makers and the global community need to act rapidly and forcefully ensure that the fourth wave does not end with a string of debt crises in emerging market and developing economies as earlier debt waves did. Keywords: fiscal balance, Global recessions, Government Debt, private debt, Resolution

13.
Journal of Istanbul Faculty of Medicine-Istanbul Tip Fakultesi Dergisi ; 0(0):8, 2021.
Article in English | Web of Science | ID: covidwho-1579348

ABSTRACT

Objective: In this study, we aimed to analyze the demographic characteristics, symptoms, and comorbidities of 504 patients hospitalized for COVID-19. We also sought to describe the relationship between these features and intensive care unit (ICU) admission and mortality. Material and Methods: This study is a descriptive study involving 504 COVID-19 patients hospitalized between 16.03.2020 and 07.05.2020 at Istanbul University's Faculty of Medicine Hospital. Information about the patients was obtained from the hospital automation system and evaluated retrospectively. Results: The average age of the 504 patients was 56 +/- 15.14, and 59.1% of them were male. The proportion of the patients admitted into ICU 11.9% and for 8.52% of them the disease resulted in death. Real time polymerase chain reaction (RT-PCR) test results were positive for 60.5% of the patients. The median time spent in the hospital was eight days. Fifty six percent of the patients had at least one accompanying comorbid disease, with hypertension (39.3%) and diabetes (20.8%) being the most common. Being 65 years old or older (p<0.001), days spent in the hospital (p<0.001), presence of at least one comorbidity (p=0.009), hypertension (p=0.003), coronary artery disease (p=0.004), congestive heart failure (p=0.005) and dyspnea (p<0.001) were all factors found in those admitted to ICU. Conclusion: COVID-19 infection leading to high morbidity-mortality rates and an increased requirement for ICU admission is mainly seen among older patients and those who have dyspnea. During the process of analyzing patients suspected of COVID-19 who are admitted to hospital, it is crucial to consider both the patient's age and any respiratory symptoms. Such a clinical evaluation is crucial for a better understanding of the course of the disease.

14.
Selcuk Universitesi Edebiyat Fakultesi Dergisi-Selcuk University Journal of Faculty of Letters ; 46:337-354, 2021.
Article in English | Web of Science | ID: covidwho-1576757

ABSTRACT

According to official statistics, there are approximately eight million higher education students in Turkey. In other words, one-eighth of Turkey's population continues to higher education in Turkey. In this study, the digital divide in distance education in terms of the physical and social environment of higher education students is discussed. When the first COVID-19 cases were recorded in Turkey in the second week of March 2020, formal education was immediately stopped with distance education until finishing 2020-2021 education year and 2021-2022 higher education year started with partly (approximately %40) distance education. This paper focusses on undergraduate (BA) and postgraduate students (both MA and PhD) from Ankara Yildirim Beyazit University (AYBU) in Turkey to compare the function of living in the urban area or rural area during the COVID-19 pandemic. After finishing literature review and getting ethical approval for collecting original data, Phone and Skype interviews between June and September 2020 has done with thirty-four students. Then, the datasets analyzed with the NVivo program with regards to emerged main themes (e.g., location, urban and rural areas, and distance education). In this study, students living in the city center stated that they experienced more psychological, social and economic difficulties in order to overcome this pandemic. Students who live in rural or suburban areas and can access educational materials and facilities with secure internet access have been found to be more independent, safe and productive during the COVID-19 pandemic.

15.
Istanbul Tip Fakultesi Dergisi / Journal of Istanbul Faculty of Medicine ; 84(3):301-306, 2021.
Article in English | CAB Abstracts | ID: covidwho-1560118

ABSTRACT

Objective: This study aimed to examine the preoperative, perioperative, and postoperative colorectal surgery experience during the initial stage of the pandemic outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) later named COVID-19 disease in Turkey and to assess conditions and needs. Material and Method: Seven early cases of colorectal disease patients are described and lessons learned from these cases are reported. All patients' preoperative workup included two nasopharyngeal polymerase chain reaction (PCR) swabs for SARS-CoV2 taken at a three-day interval preoperatively and a thorax computerized tomography scan taken on a preoperative day.

16.
Research and Practice in Thrombosis and Haemostasis ; 5(SUPPL 2), 2021.
Article in English | EMBASE | ID: covidwho-1509134

ABSTRACT

Background : Covid-19 appeared quaint with evolving hyperinflammation phase, vasculoendothelial dysfunction, and a distinct coagulopathy. Aims : We present our experience regarding coagulopathy predictive factors in hospitalized Covid-19 patients just after pandemic declaration. Methods : The data were obtained retrospectively by screening the institution's electronic data system between March and May 2020. The treatment protocol based on Health Ministry guidelines, includes hydroxychloroquine, azithromycin, favipiravir, low-molecular-weight heparin, dipyridamole, and anti-cytokine agents on the hyperinflammation phase. We stratified 3 groups, patients with proven coagulopathy, highly suspected coagulopathy, and patients without coagulopathy. Highly suspected coagulopathy encompasses clinical deterioration with sudden and inconsistent D-dimer elevation. Results : A total of 511 patients were screened. Forty-nine of them were excluded due to accompanying conditions resulting in high D-dimer levels. The median age of the remaining patients was 56 years with a male/female ratio of 284/178. Proven coagulopathy as documented thrombosis developed in 3.2% with a male predominance (60%). Highly suspected coagulopathy was decided in 10.1% of patients. Among predictive factors for coagulopathy, the risk factors at admission were being over 65-year-old, having coronary artery disease, dyspnea, severe lymphopenia (<500/μl), monocytopenia (<300/ μl), and elevated LDH. For highly suspected coagulopathy, in addition to these having more than 3 comorbidities, high initial ferritin (>1000 ng/ml) and d-dimer levels as greater than 3600 U/ml were also predictive. The clinical pictures in the proven coagulopathy group included 5 myocardial infarctions, 4 disseminated intravascular coagulation (DIC), 2 deep vein thrombosis, 1 catheter-related venous thrombosis, 1 catheter-related venous thrombosis, and pulmonary embolism, 1 lower extremity arterial thrombosis, 1 stroke. All DIC cases had gram-negative bacterial sepsis. Conclusions : Our data suggest coagulopathy is not directly correlated with inflammation severity but patients in hyperinflamation phase should be pursued for possible proven coagulopathy.

17.
Journal of Istanbul Faculty of Medicine-Istanbul Tip Fakultesi Dergisi ; 84(3):301-306, 2021.
Article in English | Web of Science | ID: covidwho-1389971

ABSTRACT

Objective: This study aimed to examine the preoperative, perioperative, and postoperative colorectal surgery experience during the initial stage of the pandemic outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) later named COVID-19 disease in Turkey and to assess conditions and needs. Material and Method: Seven early cases of colorectal disease patients are described and lessons learned from these cases are reported. All patients' preoperative workup included two nasopharyngeal polymerase chain reaction (PCR) swabs for SARS-CoV-2 taken at a three-day interval preoperatively and a thorax computerized tomography scan taken on a preoperative day. Results: COVID-19 infection occurred before and after surgery despite all measures taken, including isolation. It became complicated to manage surgical complications such as stoma complication, surgical site infection, and small bowel obstruction. Nonetheless, while patients with underlying health conditions have a high mortality rate from COVID-19 infection, no death was observed in this small case series. Conclusion: Medical centers must be well organized to perform colorectal surgery under pandemic conditions. Patients may initially test negative or become positive for COVID-19 at any stage during this disease outbreak. Multidisciplinary teamwork with the infectious disease department and anesthetists can prevent mortality from COVID-19 infection during colorectal surgery and subsequent hospitalization.

18.
Annals of the Rheumatic Diseases ; 80(SUPPL 1):191-192, 2021.
Article in English | EMBASE | ID: covidwho-1358821

ABSTRACT

Background: COVID-19 runs a severe disease associated with acute respiratory distress syndrome in a subset of patients, and a hyperinflammatory response developing in the second week contributes to the worse outcome. Inflammatory features are mostly compatible with macrophage activation syndrome (MAS) observed in other viral infections despite resulting in milder changes. Early detection and treatment of MAS may be associated with a better outcome. However, available criteria for MAS associated with other causes have not been helpful. Objectives: To identify distinct features of MAS associated with COVID-19 using a large database enabling to assess of dynamic changes. Methods: PCR-confirmed hospitalized COVID-19 patients followed between March and September 2020 constituted the discovery set. Patients considered to have findings of MAS by experienced physicians and given anakinra or tocilizumab were classified as the MAS group and the remaining patients as the non-MAS group. The MAS group was then re-grouped as the cases with exact-MAS and borderline-MAS cases by the study group. Clinical and laboratory data including the Ct values of the PCR test were obtained from the database, and dynamic changes were evaluated especially for the first 14 days of the hospitalization. The second set of 162 patients followed between September-December 2020 were used as the replication group to test the preliminary criteria. In the second set, hospitalization rules were changed, and all patients required oxygen support and received dexamethasone 6mg/day or equivalent glucocorticoids. Daily changes were calculated for the laboratory items in MAS, borderline, and non-MAS groups to see the days differentiating the groups, and ROC curves and lower and upper limits (10-90%) of the selected parameters were calculated to determine the cutoff values. Results: A total of 769 PCR-confirmed hospitalized patients were analysed, and 77 of them were classified as MAS and 83 as borderline MAS patients. There was no statistically significant difference in the baseline viral loads of MAS patients compared to the non-MAS group according to the Ct values. Daily dynamic changes in the MAS group differed from the non-MAS group especially around the 6th day of hospitalization, and more than a twofold increase in ferritin and a 1.5-fold increase in D-dimer levels compared to the baseline values help to define the MAS group. Twelve items selected for the criteria are given in Table 1 below. The total score of 45 provided 79.6% sensitivity for the MAS (including borderline cases) and 81.3% specificity around days 5 and 6 in the discovery set, and a score of 60 increased the specificity to 94.9% despite a decrease in sensitivity to 40.8%. The same set provided a similar sensitivity (80.3%) in the replication, but a lower specificity (47.4-66% on days 6 to 9) due to a group of control patients with findings of MAS possibly masked by glucocorticoids. Conclusion: This study defined a set of preliminary criteria using the most relevant items of MAS according to the dynamic changes in the parameters in a group of COVID-19 patients. A score of 45 would be helpful to define a possible MAS group with reasonable sensitivity and specificity to start necessary treatments as early as possible.

20.
Journal of Nutrition, Health and Aging ; 2021.
Article in English | EMBASE | ID: covidwho-1269182

ABSTRACT

Two unrelated tables have interfered with our article. There are two Table 1 and Table 2 in the original publication. We request readers to disregard “Table 1. General characteristics of the subjects by sex” and age and “Table 2. Parameters of the ROC analysis for the diagnostic performance of SPPB in identifying high risk for frailty phenotype and geriatric syndromes for community-dwelling older adults by sex”. The correct Table 1 and Table 2 is found in the manuscript as “Table 1. Baseline demographic and clinical characteristics of the hospitalized Covid-19 patients stratified by age” and “Table 2. Laboratory and radiological findings of the hospitalized Covid-19 patients at hospital admission stratified by age. We apologize to the readers for this error on proof stage ”

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