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1.
Exp Gerontol ; 170: 111998, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2086199

ABSTRACT

PURPOSE: While the definitive diagnosis of COVID-19 relies on PCR confirmation of the virus, the sensitivity of this technique is limited. The clinicians had to go on with the clinical diagnosis of COVID-19 in selected cases. We aimed to compare PCR-positive and PCR-negative patients diagnosed as COVID-19 with a specific focus on older adults. METHODS: We studied 601 hospitalized adults. The demographics, co-morbidities, triage clinical, laboratory characteristics, and outcomes were noted. Differences between the PCR (+) and (-) cases were analyzed. An additional specific analysis focusing on older adults (≥65 years) (n = 184) was performed. RESULTS: The PCR confirmation was present in 359 (59.7 %). There was not any difference in terms of age, sex, travel/contact history, hospitalization duration, ICU need, the time between first symptom/hospitalization to ICU need, ICU days, or survival between PCR-positive and negative cases in the total study group and older adults subgroup. The only symptoms that were different in prevalence between PCR-confirmed and unconfirmed cases were fever (73.3 % vs. 64 %, p = 0.02) and fatigue/myalgia (91.1 % vs. 79.3 %, p = 0.001). Bilateral diffuse pneumonia was also more prevalent in PCR-confirmed cases (20 % vs. 13.3 %, p = 0.03). In older adults, the PCR (-) cases had more prevalent dyspnea (72.2 % vs. 51.4 %, p = 0.004), less prevalent fatigue/myalgia (70.9 % vs. 88.6 %, p = 0.002). CONCLUSION: The PCR (+) and (-) cases displayed very similar disease phenotypes, courses, and outcomes with few differences between each other. The presence of some worse laboratory findings may indicate a worse immune protective response in PCR (-) cases.


Subject(s)
COVID-19 , Pneumonia , Humans , COVID-19/diagnosis , SARS-CoV-2 , Myalgia , Hospitalization , Polymerase Chain Reaction , Outcome Assessment, Health Care , Fatigue
2.
Exp Gerontol ; 167: 111907, 2022 10 01.
Article in English | MEDLINE | ID: covidwho-2031280

ABSTRACT

BACKGROUND: While there are substantial reports on the acute phase of Covid-19, the data on post-Covid phase are limited. AIM: To report the data on older post-Covid patients comparatively with the young adults. STUDY DESIGN: Retrospective, single-center study in post-Covid outpatient clinic. Clinical characteristics, laboratory examination, chest imagings were examined. RESULTS: 665 patients were included (median age, 46; 53 %, male; 10.5 %, aged ≥65). We assessed patients at 47th day (median) after recovery. 43.6 % were suffering from one or more ongoing symptomatology. The prevalence of symptoms or physical examination findings were not different between older and younger groups. Most prevalent ongoing symptom was dyspnea (14.3 % and 11.8 % older and younger group, respectively). Most common laboratory abnormality was high pro-BNP (12.2 %, in both age groups). Despite there was no differences regarding imaging findings at acute-phase, there were higher rates of control imaging abnormalities in older subgroup (35.7 % vs 19.4 %; p = 0.006). On admission 28.4 % younger patients had normal imaging, of whom 12.4 % developed some form of sequela; however, in older group, 40.0 % had normal imaging, of whom 25.0 % developed sequela. CONCLUSION: Complaints related to Covid-19 persisted in about half of the patients at about 1.5 months after Covid. More than 1/3 older post-Covid patients displayed pulmonary sequela in the post-acute period which was more prevalent than those in younger adults. Hence, compared to the younger counterparts, the clinicians should be alert in follow-up of older adults for subsequent pulmonary sequela, even among those that had normal imaging finding on initial presentation.


Subject(s)
COVID-19 , Aged , Female , Humans , Lung/diagnostic imaging , Male , Retrospective Studies , SARS-CoV-2
3.
COVID-19 PANDEM&Iacute ; SÍNDE HASTANE VE EVDE KONTROLLÜ HASTA YÖNETÍMÍ SAĞLAYAN ENTEGRE BÍR MODEL: TELESAĞLIK.; 85(1):9-14, 2022.
Article in English | Academic Search Complete | ID: covidwho-1663006

ABSTRACT

Objective: In this study, we aimed to present the details of a successfully implemented telehealth model in a university hospital during the COVID-19 pandemic. Materials and Methods: Istanbul Faculty of Medicine is a university hospital where the first confirmed case of COVID-19 in Turkey was detected. In IFM, patients who were diagnosed with COVID-19 and received outpatient or inpatient treatment were followed up by telehealth for 21-28 days after leaving the hospital. The distinguishing features of this service are the provision of remote outpatient clinical monitoring personally by physicians and the use of web-based IP information technologies. Results: Between March 15 and July 1, 2020, 1,042 individuals were followed up at least once, 860 patients for 21 days or more by the 26 physicians providing the telehealth service. A total of 11,736 calls were made by the physicians and 7,342 of those calls were answered and a total of 1,086 calls were made by patients. The median number of calls per patient was 4 (1-23). The median duration of the completed calls was 2.8 min (<1–50 min). During these follow-ups patients were informed about the importance of isolation. Most of the patients expressed their satisfaction with these follow-ups by thanking the calling physician. Conclusion: In a pandemic such as COVID-19, telehealth services may increase adherence to treatment and isolation precautions among patients with diseases that require follow-up without hospitalization after diagnosis. Telehealth will facilitate early recognition of symptoms that may require hospitalization, ensuring these patients receive the care they need. Therefore, this approach should be widely adopted. (English) [ FROM AUTHOR] Amaç: Bu makalede bir üniversite hastanesinde COVID-19 pandemisi sırasında başarıyla uygulanmış olan telesağlık modelinin anlatılması amaçlanmıştır. Gereç ve Yöntem: Ístanbul Tıp Fakültesi (ÍTF), Türkiye’de ilk doğrulanmış COVID-19 vakasının tespit edildiği bir üniversite hastanesidir. ÍTF’de COVID-19 tanısı almış ve ayaktan veya yatarak tedavisi düzenlenen hastaların hastaneden ayrılışından itibaren 21-28 günlük bir telesağlık izlemi yapılmıştır. Bu hizmetin örneklerinden farkı bizzat hekim tarafından uzaktan poliklinik izlemi olarak sunulmasıdır ve web-tabanlı, IP bilgi-iletişim teknolojisi kullanılmıştır. Bulgular: 15 Mart-1 Temmuz 2020 tarihleri arasında tele-sağlık hizmeti ile 1.042 kişinin en az bir izlemi yapılmış olup 860 hastanın ise 21 gün ve üzerinde izlemi 26 hekim tarafından gerçekleştirilmiştir. Hekimler tarafından bu süreçte toplam 11.736 çağrı yapılmış ve bu çağrıların 7.342’si cevaplanmıştır. Ayrıca hastalar tarafından da toplam 1.086 arama yapılmıştır. Hasta başına medyan arama sayısı 4 (1-23) ve tamamlanan aramaların medyan süresi 2,8 dakika olarak saptanmıştır (<1-50 dakika). Bu izlemlerde hastalar izolasyonun önemi hakkında da bilgilendirilmiştir. Hastaların çoğu bu takiplerden memnuniyetini arayan hekime teşekkür ederek ifade ettiler. Sonuç: COVID-19 gibi bir pandemide telesağlık hizmetinin tanı sonrası hastaneye yatış olmaksızın takip edilebilecek hastalarda tedavi ve izolasyon önlemlerine uyumu arttıracağı söylenebilir. Telesağlık, hastaneye yatış gerektirebilecek semptomları erken fark edip bu hastaların ihtiyaç duydukları bakımı almalarını sağlayacaktır. Tüm bu durumlar göz önüne alındığında bu yaklaşım daha yaygın olarak benimsenmelidir. (Turkish) [ FROM AUTHOR] Copyright of Istanbul Tip Fakültesi Dergisi is the property of Istanbul Tip Fakultesi Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

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