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1.
Biomed Res Int ; 2021: 1934685, 2021.
Article in English | MEDLINE | ID: covidwho-1594713

ABSTRACT

Background: Cytokine release syndrome can be observed during the course of COVID-19. Tocilizumab is used for treating this highly fatal syndrome. We think that the starting time of tocilizumab is important. In this article, we aimed to discuss the efficacy of tocilizumab and to review the necessity of starting it in the early period and the laboratory values that guide us in determining the time of this early period. Methods: This retrospective study includes a total of 308 patients with a diagnosis of COVID-19 who were treated with tocilizumab, who were hospitalized in the University of Health Sciences, Gazi Yasargil Training and Research Hospital between July 2020 and December 2020. The data of the patients were recorded on the day of hospitalization, the day of taking tocilizumab (day 0), and the 1st day, 3rd day, 7th day, and 14th day after taking tocilizumab. Data included age, gender, underlying diseases, where the patient was followed, duration of symptoms before admission to the hospital, duration of oxygen demand before tocilizumab, fever, saturation, and laboratory values. Patients were divided into the mortality group (group 1) and the survival group (group 2), and all data were compared. Results: The study consisted of 308 COVID-19 patients divided into two groups: the mortality group (group 1, n = 135) and the survival group (group 2, n = 173). The median age of the patients was 60 (min-max: 50-70) years, 75.3% (n = 232) were male, and 56.8% had at least one comorbidity. While 88.9% of group 1 was in the intensive care unit, 26.6% of group 2 received tocilizumab while in the intensive care unit, and there was a statistically significant difference. Median SpO2 values and lymphocyte counts were significantly lower in group 1 than in group 2, both on the day of hospitalization and on the day of the first dose of tocilizumab treatment (p < 0.001 for both). C-reactive protein, d-dimer, and alanine aminotransferase values were higher in the mortal group on the first day of hospitalization, and this was significant (p = 0.021, p = 0.001, and p = 0.036, respectively). In our study, d-dimer was 766.5 ng/mL in the survivor group and 988.5 ng/mL in the mortal group. In our patient group, the mean lymphocyte count was 700 × 103/mm3 in the group that survived the first day of TCZ and 500 × 103/mm3 in the mortal group. In addition, the CRP value was 135.5 mg/L in the survivor group and 169 mg/L in the mortal group. There was no difference between ferritin values. Conclusions: Tocilizumab is still among the COVID-19 treatment options and appears to be effective. But the start time is important. In order to increase its effectiveness, it may be important to know a cut-off value of the laboratory findings required for the diagnosis of cytokine release syndrome. Further studies are needed for this.


Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , COVID-19/drug therapy , Cytokine Release Syndrome/drug therapy , Aged , Cytokine Release Syndrome/prevention & control , Female , Hospitalization , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2/drug effects , Time Factors , Treatment Outcome , Turkey/epidemiology
2.
Dent Med Probl ; 58(4): 433-439, 2021.
Article in English | MEDLINE | ID: covidwho-1579663

ABSTRACT

BACKGROUND: Due to curfew and quarantine practices designed to reduce the spread of coronavirus disease 2019 (COVID­19), social isolation has tested the psychological limits of children. OBJECTIVES: The authors evaluated parent-observed symptoms of anxiety in preschool children with harmful oral habits during the curfew period in Turkey. MATERIAL AND METHODS: The authors prepared a questionnaire with Google Forms that was distributed through social media applications (e.g., WhatsApp) to 405 parents recruited via snowball sampling. To measure children's symptoms and levels of anxiety, the Spence Preschool Anxiety Scale (SPAS) was used. Harmful oral habits that might develop in children during the curfew were investigated. RESULTS: Separation anxiety and physical injury anxiety were reported by the parents more frequently than general anxiety and obsessive-compulsive disorder. Also, the presence of tantrums (p = 0.010), crying attacks (p = 0.010) and aggression (p = 0.010) were reported by the parents in these children. It was observed that the habits of finger sucking (p = 0.010), nail biting (p = 0.040) and lip biting (p = 0.010) that were present before the curfew decreased significantly after the curfew. CONCLUSIONS: Children aged 3-7 years can develop anxiety about physical injuries and about being separated from their parents as well as tantrums and crying attacks. Their harmful oral habits (i.e., finger sucking, nail biting and lip biting) all decreased during the curfew period.


Subject(s)
COVID-19 , Anxiety/epidemiology , Child, Preschool , Communicable Disease Control , Habits , Humans , SARS-CoV-2 , Turkey/epidemiology
3.
J Infect Dev Ctries ; 15(11): 1584-1592, 2021 11 30.
Article in English | MEDLINE | ID: covidwho-1572704

ABSTRACT

INTRODUCTION: This study aims to evaluate the knowledge, attitudes and behavior of people towards COVID-19 and to evaluate compliance with practices such as social isolation, curfews, mask use and hand hygiene. METHODOLOGY: A month after the COVID-19 infection was observed in Turkey, a standard questionnaire link was sent to participants via the online questionnaire platform to determine the knowledge, attitude, and behavior of the public. The survey results of 503 people were evaluated. RESULTS: During the COVID-19 pandemic 81.2% of the participants stayed at home, 79.1% of the participants wore a mask, 74% of the participants expressed to be following social distancing rules, 54.1% confirmed the use of hand sanitizers and 43.9% confirmed the use of gloves (43.9%), which are considered to be personal protective measures. The knowledge of terms such as 'quarantine' and 'isolation' was 94% and 97.4% respectively and 37.2% of the participants were of the opinion that the COVID-19 virus was produced in a laboratory environment. Within the research group, a rate of 65.6% of the participants found their own knowledge of COVID-19 to be sufficient. The participants found the announcements of official institutions more reliable than the announcements on television programs, the internet and social media. CONCLUSIONS: The public information on COVID-19 was found to be sufficient. In order to prevent the spreading of the pandemic, participants were partially compliant to rules such as staying at home, using masks, maintaining hand hygiene and social isolation. Compared to men, women's use of protective equipment was higher.


Subject(s)
COVID-19/prevention & control , Health Knowledge, Attitudes, Practice , SARS-CoV-2 , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Female , Hand Hygiene , Humans , Internet , Male , Middle Aged , Social Isolation , Surveys and Questionnaires , Turkey/epidemiology , Young Adult
4.
J Med Virol ; 94(1): 291-297, 2022 01.
Article in English | MEDLINE | ID: covidwho-1544344

ABSTRACT

Due to current advances and growing experience in the management of coronavirus Disease 2019 (COVID-19), the outcome of COVID-19 patients with severe/critical illness would be expected to be better in the second wave compared with the first wave. As our hospitalization criteria changed in the second wave, we aimed to investigate whether a favorable outcome occurred in hospitalized COVID-19 patients with only severe/critical illness. Among 642 laboratory-confirmed hospitalized COVID-19 patients in the first wave and 1121 in the second wave, those who met World Health Organization (WHO) definitions for severe or critical illness on admission or during follow-up were surveyed. Data on demographics, comorbidities, C-reactive protein (CRP) levels on admission, and outcomes were obtained from an electronic hospital database. Univariate analysis was performed to compare the characteristics of patients in the first and second waves. There were 228 (35.5%) patients with severe/critical illness in the first wave and 681 (60.7%) in the second wave. Both groups were similar in terms of age, gender, and comorbidities, other than chronic kidney disease. Median serum CRP levels were significantly higher in patients in the second wave compared with those in the first wave [109 mg/L (interquartile range [IQR]: 65-157) vs. 87 mg/L (IQR: 39-140); p < 0.001]. However, intensive care unit admission and mortality rates were similar among the waves. Even though a lower mortality rate in the second wave has been reported in previous studies, including all hospitalized COVID-19 patients, we found similar demographics and outcomes among hospitalized COVID-19 patients with severe/critical illness in the first and second wave.


Subject(s)
COVID-19/drug therapy , COVID-19/mortality , Critical Care/statistics & numerical data , Severity of Illness Index , Aged , Amides/therapeutic use , Antibodies, Monoclonal, Humanized/therapeutic use , Azithromycin/therapeutic use , C-Reactive Protein/analysis , COVID-19/epidemiology , COVID-19/pathology , Comorbidity , Drug Combinations , Enoxaparin/therapeutic use , Female , Hospital Mortality , Hospitalization/statistics & numerical data , Humans , Hydroxychloroquine/therapeutic use , Interleukin 1 Receptor Antagonist Protein/therapeutic use , Lopinavir/therapeutic use , Male , Methylprednisolone/therapeutic use , Middle Aged , Pyrazines/therapeutic use , Retrospective Studies , Ritonavir/therapeutic use , SARS-CoV-2 , Treatment Outcome , Turkey/epidemiology
5.
Int J Immunopathol Pharmacol ; 35: 20587384211059677, 2021.
Article in English | MEDLINE | ID: covidwho-1533223

ABSTRACT

Oral booster-single strain probiotic bifidobacteria could be a potential strategy for SARS-CoV-2. This study aims to evaluate the role of oral probiotic Bifidobacterium on moderate/severe SARS-CoV-2 inpatients. In this single-center study, we analyzed data of 44 moderate/severe inpatients with diagnosed COVID-19 in Istanbul Maltepe University Medical Faculty Hospital, 2020 from 1 November 2020 to 15 December 2020. Clinical and medication features were compared and analyzed between patients with or without probiotic. In result, 19 of the 44 patients (43.18%) who were administrated with oral booster-single strain probiotic were discharged with the median inpatient day of 7.6 days which were significantly shorter than those of patients without probiotic. There were significant differences in inpatient days, radiological improvement at day 6 and week 3, and reduction in interleukin-6 levels in those receiving oral probiotic therapy. Although the mortality rate was 5% in the probiotic group, it was 25% in the non-probiotic group. Booster-single strain probiotic bifidobacteria could be an effective treatment strategy for moderate/severe SARS-CoV-2 inpatients to reduce the mortality and length of stay in hospital.


Subject(s)
Bifidobacterium , COVID-19 , Interleukin-6/blood , Probiotics , COVID-19/diagnosis , COVID-19/drug therapy , COVID-19/epidemiology , COVID-19/immunology , Female , Hospitalization/statistics & numerical data , Humans , Immunologic Factors/administration & dosage , Immunologic Factors/adverse effects , Length of Stay/statistics & numerical data , Male , Middle Aged , Mortality , Probiotics/administration & dosage , Probiotics/adverse effects , Retrospective Studies , SARS-CoV-2/drug effects , Severity of Illness Index , Treatment Outcome , Turkey/epidemiology
6.
Adv Skin Wound Care ; 34(12): 651-655, 2021 Dec 01.
Article in English | MEDLINE | ID: covidwho-1528177

ABSTRACT

OBJECTIVE: To determine the frequency of hand dermatitis among nurses during the COVID-19 pandemic and factors affecting its prevalence. METHODS: The research sample consisted of 175 nurses working in state hospitals. Research data were collected via Google survey between September and October 2020. The data were collected using a sociodemographic data collection form, and a self-assessment form was used to determine dermatologic symptoms. RESULTS: The frequency of hand dermatitis among nurses was 70.9%. A statistically significant difference was found between sex, allergy history, and increased frequency of handwashing and the frequency of hand dermatitis. No significant difference in terms of the frequency of hand dermatitis was found between nurses who provided care to patients who were COVID-19 positive versus nurses who provided care to patients who were COVID-19 negative. However, the frequency of washing hands and using hand disinfectants and hand creams was found to have increased significantly during the COVID-19 pandemic compared to the prepandemic period. CONCLUSIONS: The frequency of hand dermatitis increased among nurses during the pandemic. The increased frequency of handwashing during the pandemic poses a risk for hand dermatitis among nurses, although this should not discourage nurses from appropriate hygiene.


Subject(s)
Dermatitis/diagnosis , Hand/physiopathology , Nurses/statistics & numerical data , Adult , COVID-19/prevention & control , COVID-19/transmission , Dermatitis/epidemiology , Female , Hand Disinfection , Humans , Infection Control/instrumentation , Infection Control/methods , Male , Middle Aged , Personal Protective Equipment/adverse effects , Personal Protective Equipment/statistics & numerical data , Prevalence , Turkey/epidemiology
7.
Turk J Med Sci ; 51(4): 1665-1674, 2021 08 30.
Article in English | MEDLINE | ID: covidwho-1526879

ABSTRACT

Background/aim: Coronavirus disease 2019 (COVID-19) is a disease with a high rate of progression to critical illness. However, the predictors of mortality in critically ill patients admitted to the intensive care unit (ICU) are not yet well understood. In this study, we aimed to investigate the risk factors associated with ICU mortality in our hospital. Materials and methods: In this single-centered retrospective study, we enrolled 86 critically ill adult patients with COVID-19 admitted to ICU of Dokuz Eylül University Hospital (Izmir, Turkey) between 18 March 2020 and 31 October 2020. Data on demographic information, preexisting comorbidities, treatments, the laboratory findings at ICU admission, and clinical outcomes were collected. The chest computerized tomography (CT) of the patients were evaluated specifically for COVID-19 and CT score was calculated. Data of the survivors and nonsurvivors were compared with survival analysis to identify risk factors of mortality in the ICU. Results: The mean age of the patients was 71.1 ± 14.1 years. The patients were predominantly male. The most common comorbidity in patients was hypertension. ICU mortality was 62.8%. Being over 60 years old, CT score > 15, acute physiology and chronic health evaluation (APACHE) II score ≥ 15, having dementia, treatment without favipiravir, base excess in blood gas analysis ≤ ­2.0, WBC > 10,000/mm3, D-dimer > 1.6 µg/mL, troponin > 24 ng/L, Na ≥ 145 mmol/L were considered to link with ICU mortality according to Kaplan­Meier curves (log-rank test, p < 0.05). The APACHE II score (HR: 1.055, 95% CI: 1.021­1.090) and chest CT score (HR: 2.411, 95% CI:1.193­4.875) were associated with ICU mortality in the cox proportional-hazard regression model adjusted for age, dementia, favipiravir treatment and troponin. Howewer, no difference was found between survivors and nonsurvivors in terms of intubation timing. Conclusions: COVID-19 patients have a high ICU admission and mortality rate. Studies in the ICU are also crucial in this respect. In our study, we investigated the ICU mortality risk factors of COVID-19 patients. We determined a predictive mortality model consisting of APACHE II score and chest CT score. It was thought that this feasible and practical model would assist in making clinical decisions.


Subject(s)
COVID-19/diagnostic imaging , COVID-19/mortality , Critical Care/methods , Hospital Mortality , Intubation, Intratracheal/methods , Tomography, X-Ray Computed/methods , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Intensive Care Units , Intubation, Intratracheal/statistics & numerical data , Lung/diagnostic imaging , Male , Middle Aged , Retrospective Studies , Risk Factors , SARS-CoV-2 , Survival Analysis , Time Factors , Turkey/epidemiology , Young Adult
8.
Public Health Nutr ; 24(18): 6369-6376, 2021 12.
Article in English | MEDLINE | ID: covidwho-1526034

ABSTRACT

OBJECTIVE: The massive increase in COVID-19 cases led to the implementation of nationwide lockdown in Turkey. While enforced lockdown is an effective strategy to abate the transmission of the virus, it causes significant lifestyle changes in every part of the community. This study aims to assess the changes in eating habits, sleeping behaviour and physical activity status of final-year medical students (interns) whose education was suspended during the pandemic. DESIGN: In this cross-sectional epidemiological study, an online questionnaire was created. Interns were asked questions regarding socio-demographic status, eating habits, sleeping behaviour and physical activity status before and during COVID-19 pandemic. Changes in dietary habits and sleep quality were evaluated under the guidance of Turkey Dietary Guidelines, Determination of Nutritional Status Report, Turkey National Nutrition and Health Survey and Pittsburgh Sleep Quality Index. SETTING: Hacettepe University Faculty of Medicine - Ankara, Turkey. PARTICIPANTS: Among 536 students, a total of 340 students (63·4 %) answered the questionnaire. RESULTS: After the beginning of lockdown, an increase in BMI was observed in both female (P = 0·002) and male students (P = 0·013). Students having healthy dietary habits increased by 18·8 % and unhealthy dietary habits decreased by 3·2 % during lockdown (P < 0·001). Overall, 63·2 % of students reported a decrease in physical activity, and 33·6 % reported a reduction in sleep quality, whereas 38·6 % reported an improvement in sleep quality. There was no significant difference in sleep quality between genders (P = 0·075). CONCLUSIONS: This study indicated that medical school suspension and enforced lockdown led to significant changes in interns' eating behaviour, physical activity and sleeping habits.


Subject(s)
COVID-19 , Students, Medical , Communicable Disease Control , Cross-Sectional Studies , Exercise , Feeding Behavior , Female , Humans , Male , Pandemics , SARS-CoV-2 , Sleep , Surveys and Questionnaires , Turkey/epidemiology
9.
Turk J Gastroenterol ; 32(10): 879-887, 2021 10.
Article in English | MEDLINE | ID: covidwho-1524376

ABSTRACT

BACKGROUND: The Coronavirus-2019 disease (COVID-19) pandemic has markedly restricted endoscopic and clinical activities in gastroenterology (GI), with a negative impact on trainee education. We aimed to inve stigate how and to what extent has GI trainees in Turkey are affected by the current pandemic in terms of general, psychological, and educational status. METHODS: We conducted a web-based survey sent electronically to 103 official GI trainees in Turkey from 37 centers. The 32-item survey included questions to capture demographic (5-questions), endoscopic (7-questions), personal protective equipment (PPE) (3-questions), psychological and general well-being (11-questions), and educational (6-questions) data. RESULTS: Ninety-six (93.2%) trainees completed the survey, of which 56.3% (n = 54) reported a decrease in independently performed endoscopic procedures. Due to pandemic, 91.7% of standard diagnostic endoscopic procedures, 57.2% of standard therapeutic procedures, and 67.7% of advanced endoscopic procedures were decreased. Out of 96 respondents, we detected signs of anxiety in 88.5%, exposure concern in 92.7%, concerns for prolongation of training period in 49%, loss of concentration and interest in 47.9%, and burnout syndrome in 63.5%. Female gender (odds-ratio: 3.856, 95% confidence interval: 1.221-12.174, P = .021) was the only independently associated factor with pandemic-related anxiety. CONCLUSIONS: COVID-19 pandemic has led to high amounts of anxiety and non-negligible rates of burnout syndrome among GI trainees, with a significant reduction in endoscopic activities. More effort and novel strategies are required to deliver sufficient competence and general-psychological well-being to GI trainees.


Subject(s)
COVID-19 , Endoscopy/statistics & numerical data , Fellowships and Scholarships , Gastroenterology/education , Pandemics , Adult , Education, Medical, Graduate , Female , Humans , Male , Middle Aged , Prospective Studies , SARS-CoV-2 , Surveys and Questionnaires , Turkey/epidemiology
10.
J Infect Dev Ctries ; 15(10): 1415-1425, 2021 10 31.
Article in English | MEDLINE | ID: covidwho-1518652

ABSTRACT

INTRODUCTION: We aimed to evaluate clinical and laboratory findings of hospitalized asthma and chronic obstructive pulmonary disease (COPD) patients with COVID-19 and demonstrate that they have different symptoms and/or laboratory results and outcomes than COVID-19 patients with comorbidity (CoV-com) and without comorbidity (CoV-alone). METHODOLOGY: The data of the demographic, clinical, laboratory findings of hospitalized CoV-alone, asthma, COPD patients with COVID-19 (CoV-asthma, CoV-COPD, respectively), and CoV-com were analyzed. RESULTS: Out of 1082 patients hospitalized for COVID-19, 585 (54.1%) had CoV-alone, 40 (3.7%) had CoV-asthma, 46 (4.3%) had CoV-COPD and 411 (38%) had CoV-com. Cough, shortness of breath, fever and weakness were the most common four symptoms seen in all COVID-19 patients. Shortness of breath, myalgia, headache symptoms were more common in CoV-asthma than the other groups (p < 0.001, p < 0.01, p < 0.05 respectively). Sputum was more common in CoV-COPD than other groups (p < 0.01). COPD group most frequently had increased values, different from the other groups with CRP>5ng/mL in 91.3%, D-dimer > 0.05mg/dL in 89.1%, troponin > 0.014micg/L in %63.9, INR>1.15 in 52.2%, CK-MB>25U/L in 48.5%, PT>14s in 40.9% of patients (p < 0.05, p < 0.001, p < 0.001, p < 0.001, p < 0.05, p < 0.001, respectively). NT-ProBNP was found to have the highest AUC value and the best differentiating parameter for CoV-asthma from CoV-alone. Typical CT findings were present in 44.4% of CoV-alone, 57.5% of CoV-asthma, 28.3% of CoV-COPD and 38.9% of CoV-com groups. CoV-COPD and CoV-com patients died more frequently than other groups (17.8%, 18.5%). CONCLUSIONS: CoV-asthma and CoV-COPD patients might have different symptoms and laboratory parameters than other COVID-19 patients which can guide the physicians.


Subject(s)
Asthma/epidemiology , COVID-19/epidemiology , Pulmonary Disease, Chronic Obstructive/epidemiology , Adult , Aged , Asthma/diagnostic imaging , COVID-19/diagnostic imaging , Comorbidity , Cross-Sectional Studies , Female , Hospitalization/statistics & numerical data , Humans , Lung/diagnostic imaging , Lung/pathology , Male , Middle Aged , Pulmonary Disease, Chronic Obstructive/diagnostic imaging , Retrospective Studies , SARS-CoV-2/genetics , SARS-CoV-2/pathogenicity , Tomography, X-Ray Computed , Turkey/epidemiology
11.
BMC Fam Pract ; 22(1): 226, 2021 11 15.
Article in English | MEDLINE | ID: covidwho-1518258

ABSTRACT

BACKGROUND: The COVID-19 pandemic has had a negative impact on resident training in different branches and affected the physical and mental health of frontline residents adversely. This nationwide cross-sectional survey aimed to investigate the effects of the COVID-19 pandemic on family medicine residents in Turkey, including the levels of depression and burnout. METHODS: An anonymous online survey was distributed to all family medicine residents via e-mail and a web link between 28.11.2020 and 12.12.2020. Information on sociodemographic data and the residency programme were evaluated, and factors associated with depression and burnout were examined using the Patient Health Questionnaire-9 (PHQ-9) and the Burnout Measure-Short Version (BMS) respectively. RESULTS: Although the weekly average working hours of the 477 respondents increased significantly during the pandemic (p < 0.05), the average weekly working time in the Family Medicine (FM) outpatient clinic decreased. The greatest concern of 58.3% of the residents was fear of transmitting COVID-19 to their family members. 90.2% of the residents stated that training programmes were negatively or very negatively affected. According to PHQ-9 scores, 15.7% of residents had moderately severe, and 14.9% severe depression. The BMS scores of the residents demonstrated that 24.1% had a very severe burnout problem, and 23.3% should seek professional help as soon as possible. Being single, having no children, female gender, lack of personal protective equipments and increased contact time with COVID-19 patients were associated with higher scores in the depression and burnout scales (p < 0.05). CONCLUSIONS: The COVID-19 pandemic has had a negative impact on training programmes for FM residents, who are at the forefront of the pandemic in Turkey, and this situation is closely related to depression and burnout. Due to the unpredictability of the pandemic, long-term plans should be made for the training needs of residents in order to protect their physical and mental health.


Subject(s)
Burnout, Professional , COVID-19 , Internship and Residency , Burnout, Professional/epidemiology , Cross-Sectional Studies , Family Practice , Female , Humans , Mental Health , Pandemics , SARS-CoV-2 , Surveys and Questionnaires , Turkey/epidemiology
12.
Rev Bras Ginecol Obstet ; 43(10): 765-774, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1517657

ABSTRACT

OBJECTIVE: To investigate depression and sexual function among pregnant and non-pregnant women throughout the COVID-19 pandemic. METHODS: A total of 188 women, 96 pregnant and 92 non-pregnant were included. The Beck Depression Inventory (BDI) and the Arizona Sexual Experience Scale (ASEX) were applied to the participants after obtaining sociodemographic data. RESULTS: The depression scores of pregnant and non-pregnant women were similar (p = 0.846). We found that the depression scores were significantly higher among the group of participants who have lower economic status (p = 0.046). Moreover, the depression score was significantly higher among women who lost their income during the pandemic (p = 0.027). The score on the ASEX was significantly higher, and sexual dysfunction was more prevalent among women who have lower levels of schooling and income (p < 0.05). Likewise, the ASEX scores were significantly higher (p = 0.019) among the group who experienced greater income loss throughout the pandemic. Upon comparing the pregnant and non-pregnant groups, we detected that sexual dysfunction had a significantly higher rate among pregnant women (p < 0.001). CONCLUSION: In times of global crisis, such as the current pandemic, low-income families have an increased risk of experiencing depression and sexual dysfunction. When we compared pregnant women with non-pregnant women, depression scores were similar, but pregnant women were at a 6.2 times higher risk of developing sexual dysfunction.


Subject(s)
COVID-19/epidemiology , COVID-19/psychology , Depression/epidemiology , Pandemics , Pregnant Women/psychology , Sexual Dysfunctions, Psychological/epidemiology , Adolescent , Adult , Cross-Sectional Studies , Economic Factors , Female , Humans , Middle Aged , Pregnancy , SARS-CoV-2 , Sexual Behavior , Turkey/epidemiology , Unemployment/psychology , Young Adult
13.
Jpn J Infect Dis ; 74(5): 458-464, 2021 Sep 22.
Article in English | MEDLINE | ID: covidwho-1497875

ABSTRACT

We aimed to determine the predictors of intensive care unit (ICU) admission or death in patients with coronavirus disease 2019 (COVID-19) pneumonia. This retrospective, single-center study included patients aged ≥18 years who were diagnosed with COVID-19 pneumonia (laboratory and radiologically confirmed) between March 9 and April 8, 2020. The composite endpoint was ICU admission or in-hospital mortality. Univariate and multivariate logistic regression analyses were performed to evaluate the factors associated with the composite endpoint. A total of 336 patients with COVID-19 pneumonia were evaluated. The median age was 54 years (interquartile range: 21), and 187 (55.7%) were men. Fifty-one (15.2%) patients were admitted to the ICU. In-hospital mortality occurred in 33 patients (9.8%). In the univariate analysis, 17 parameters were associated with the composite endpoint, and procalcitonin had the highest odds ratio (odds ratio [OR] = 36.568, confidence interval [CI] = 5.145-259.915). Our results revealed that body temperature (OR = 1.489, CI = 1.023-2.167, P = 0.037), peripheral capillary oxygen saturation (SpO2) (OR = 0.835, CI = 0.773-0.901, P < 0.001), and consolidation (> 25%) on chest computed tomography (OR = 3.170, CI = 1.218-8.252, P = 0.018) at admission were independent predictors. As a result, increased body temperature, decreased SpO2, a high level of procalcitonin, and degree of consolidation on chest computed tomography may predict a poor prognosis and have utility in the management of patients.


Subject(s)
COVID-19/epidemiology , Hospitalization/statistics & numerical data , Intensive Care Units/statistics & numerical data , Adult , Aged , COVID-19/diagnosis , COVID-19/mortality , Female , Hospital Mortality , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2 , Turkey/epidemiology
14.
Turk J Ophthalmol ; 51(5): 269-281, 2021 10 26.
Article in English | MEDLINE | ID: covidwho-1497595

ABSTRACT

Objectives: To investigate the effect of the novel coronavirus disease 2019 (COVID-19) pandemic on the clinical practice of ophthalmologists in our country. Materials and Methods: A questionnaire consisting of 22 questions was delivered to 250 ophthalmologists via e-mail and a smartphone messaging application. A total of 113 ophthalmologists completed the survey. The questions included the participants' demographic data (age, years in practice, institution, and city), changes in their working conditions and institutional preventive measures implemented during the pandemic, their personal COVID-19 experiences, the prevalence of telemedicine applications, and their attitudes toward these practices. Results: Nearly half (47.8%) of the 113 ophthalmologists were 36 to 45 years old. In terms of years in practice, the largest proportion of respondents (28.3%) had 6-10 years of experience. Most of the participants worked in private/foundation universities (37.2%), while 22.1% worked in education and research clinics. Participants working at public universities most often reported that they or a close contact had to work in COVID wards (89.5%). Triage was performed in 51.5% of ophthalmology outpatient clinics, with 88.0% of these participants reporting that patients with fever, cough, or dyspnea were directed to the pandemic clinic without ophthalmological examination. All participants working in public hospitals, education and research clinics, and public university hospitals had postponed elective surgeries, whereas 12.5% of those working in private practice and 20.5% of those working in private/foundation universities reported that they continued elective surgeries. While 80.8% of the participants did not conduct online interviews or examinations, 40.4% stated that they considered telemedicine applications beneficial. Seventy-seven percent of participants expressed concern about a decrease in their income during the pandemic, with this being especially common among participants working in private practice (87.5%) and private/foundation university hospitals (85.7%). Conclusion: Ophthalmologists across our country have been affected by this pandemic at a level that will change their clinical approach. We think that ophthalmologists impacted by the difficulty of providing personal protective equipment and economic concerns should be supported more during the pandemic.


Subject(s)
COVID-19/epidemiology , Ophthalmologists/statistics & numerical data , Ophthalmology/trends , Practice Patterns, Physicians'/statistics & numerical data , SARS-CoV-2 , Adult , Aged , Delivery of Health Care , Elective Surgical Procedures/statistics & numerical data , Female , Health Surveys , Hospitals, Private , Hospitals, Public , Humans , Male , Middle Aged , Ophthalmologists/psychology , Patient Care , Personal Protective Equipment/statistics & numerical data , Surveys and Questionnaires , Telemedicine , Turkey/epidemiology
15.
Int J Psychiatry Med ; 56(4): 240-254, 2021 07.
Article in English | MEDLINE | ID: covidwho-1495823

ABSTRACT

OBJECTIVE: We aimed to evaluate the relationship between perceived social support, coping strategies, anxiety, and depression symptoms among hospitalized COVID-19 patients by comparing them with a matched control group in terms of age, gender, and education level. METHOD: The patient group (n = 84) and the healthy controls (HCs, n = 92) filled in the questionnaire including the socio-demographic form, Hospital Anxiety Depression Scale, Multidimensional Perceived Social Support Scale, and Brief Coping Orientation to Problems Experienced through the online survey link. RESULTS: The COVID-19 patients had higher perceived social support and coping strategies scores than the HCs. However, anxiety and depression scores did not differ significantly between the two groups. In logistic regression analysis performed in COVID-19 patients, the presence of chest CT finding (OR = 4.31; 95% CI = 1.04-17.95) was a risk factor for anxiety and the use of adaptive coping strategies (OR = 0.86; 95% CI = 0.73-0.99) had a negative association with anxiety. In addition, the use of adaptive coping strategies (OR = 0.89; 95% CI = 0.79-0.98) and high perceived social support (OR = 0.97; 95% CI = 0.93- 0,99) had a negative association with depression symptoms. CONCLUSIONS: Longitudinal studies involving the return to normality phase of the COVID-19 pandemic are needed to investigate the effects of factors such as coping strategies and perceived social support that could increase the psychological adjustment and resilience of individuals on anxiety and depression.


Subject(s)
Adaptation, Psychological , Anxiety Disorders/epidemiology , COVID-19/epidemiology , Depressive Disorder/epidemiology , Inpatients/psychology , Social Support , Adult , Anxiety Disorders/psychology , COVID-19/psychology , Comorbidity , Cross-Sectional Studies , Depressive Disorder/psychology , Female , Hospitalization , Humans , Inpatients/statistics & numerical data , Male , Pandemics , Risk Factors , SARS-CoV-2 , Surveys and Questionnaires , Turkey/epidemiology
16.
Mikrobiyol Bul ; 55(4): 648-655, 2021 Oct.
Article in Turkish | MEDLINE | ID: covidwho-1478368

ABSTRACT

Candida auris is a species of fungus that has gained importance in recent years owing to its ability to cause hospital infections and epidemics, resistant to antifungal agents and disinfection processes and frequently misidentified by commercial systems. Hospital outbreaks caused by C.auris have been reported from some countries. It has been determined that C.auris has lower virulence than Candida albicans; however, it is associated with high mortality rates in immunocompromised individuals. An increase in the incidence of invasive fungal infections which can lead to serious complications and death, has been identified in severe coronavirus-2019 (COVID-19) patients or immunocompromised individuals with underlying disease. Studies demonstrated an increase in the frequency of C.auris isolation in COVID-19 patients with candidemia. In this report, the first case of COVID-19 positive C.auris fungemia detected in Turkey was presented. A 71-year-old male patient with a history of myocardial infarction, diabetes mellitus, donation of a single kidney and lobectomy surgery due to lung cancer was hospitalized in the pandemic thoracic surgery service due to the findings consistent with viral pneumonia on thoracic computed tomography. Favipiravir 2 x 600 mg and intravenous dexamethasone 1 x 6 mg therapy was administered. The patient tested positive for SARS-CoV-2 polymerase chain reaction, and severe involvement of the left lung was detected in the following days. Antibiotics were administered, followed by insertion of a right jugular vein catheter and initation of tocilizumab. The patient was transferred to the intensive care unit due to increased respiratory distress. Yeast growth was detected in the patient's hemoculture. The yeast strain could not be identified using API ID 32C (bioMerieux, France) (Sacchromyces kluyveri, Candida sake, unacceptable profile), but was identified as C.auris using the VITEK MALDI TOF MS (bioMerieux, France) (99.9%) system and confirmed by sequencing. The minimum inhibitor concentration values were detected as 3 µg/ml for amphotericin B; > 256 µg/ml for fluconazole; 0.19 µg/ml for voriconazole; 0.19 µg/ml for itraconazole; 0.016 µg/ml for posaconazole; 1 µg/ml for caspofungin and 0.094 µg/ml for anidulafungin by using the antibiotic gradient method. The patient's initial treatment comprised meropenem 3 x 1 g, vancomycin 2 x 1 g, caspofungin 1 x 70 mg, and continued as caspofungine 1 x 50 mg after the loading dose, and vancomycin 1 x 1 g/48 hours from the third day of treatment. The patient died on the ninth day after developing candidemia. The present case is the first case of fungemia caused by C.auris in a COVID-19 positive patient in Turkey, and it emphasizes the need of caution for fungemia due to C.auris in intensive care units in our country which has a high COVID-19 incidence.


Subject(s)
COVID-19 , Candidemia , Fungemia , Aged , Antifungal Agents/pharmacology , Antifungal Agents/therapeutic use , Candida , Candidemia/diagnosis , Candidemia/drug therapy , Candidemia/epidemiology , Fungemia/drug therapy , Humans , Male , Microbial Sensitivity Tests , SARS-CoV-2 , Turkey/epidemiology
17.
Medicina (Kaunas) ; 57(10)2021 Oct 11.
Article in English | MEDLINE | ID: covidwho-1463753

ABSTRACT

Background and Objectives: Due to the specific working conditions dental professionals represent a group of high risk of infection and COVID-19 pandemic in many ways have influenced their working environment. The aim of this study was to evaluate effects of COVID-19 pandemic on working conditions of dentists in Poland and Turkey. Materials and Methods: The study was an anonymous online questionnaire conducted among thedentists in two countries: Poland and Turkey. The survey consisted of general questions, COVID-19 pandemic infection and working history as well as working conditions before and during pandemic. Chi-square test, Fisher's Exact test, Fisher Freeman Halton test and Continuity (Yates) Correction were used to compare qualitative data. Results: The study was conducted with a total of 400 participants, 162 (40.5%) men and 238 (59.5%) women, aged between 23 and 67. The mean age of the participants was 42.39 ± 9.99 years. Positive COVID-19 test results among dentists in Poland were found to be significantly higher than in Turkey. Time of dental procedures during the COVID-19 pandemic in Poland and Turkey was significantly increased. The usage of N95/FFP2 or N99/FFP3 masks and surgical gowns during COVID-19 pandemic compared to pre-COVID-19 periods was clearly higher (p < 0.05). Reusable full-face and half-face elastomeric respirators are increasingly used in Turkey. During the COVID-19 pandemic a 25% decrease in dentists' income in Poland (81%) was significantly high than in Turkey (47.5%). Conclusions: COVID-19 pandemic has influenced working conditions of dentists. Many dentists got infected during the pandemic, dental procedures' time has increased, and protective equipment usage has become higher. Further studies analyzing the working conditions of dentists during COVID-19 pandemic should be conducted for better planning of future decisions taken by governments and authorities.


Subject(s)
COVID-19 , Pandemics , Adult , Aged , Dentists , Female , Humans , Male , Middle Aged , Poland/epidemiology , SARS-CoV-2 , Surveys and Questionnaires , Turkey/epidemiology , Young Adult
18.
Work ; 70(1): 21-29, 2021.
Article in English | MEDLINE | ID: covidwho-1463453

ABSTRACT

BACKGROUND: COVID-19 has affected many countries in the world and has been known as one of the fast-spreading viruses in recent history. OBJECTIVE: Our aim is to reveal the level of anxiety and burnout, attitudes, thoughts, and behaviors of healthcare professionals about COVID-19 in Turkey. METHODS: The individuals included in the study answered seven questions containing demographic information, 27 questions determining their views and perspectives on COVID-19. Anxiety level was measured by Beck Anxiety Scale (BAI), and State Anxiety Inventory (SAI); burnout was measured by Maslach Burnout Inventory (MBI). RESULTS: We included 66 health staff (50 female, 16 male) whose mean age was 31.71±5.18 years (22-46 ranged). Twenty-two (33.3%) of the participants worked on the COVID-19 frontline while 44 (66.6%) of them worked on usual wards.We found that participants' anxiety was at a moderate level in BAI (mean: 14.00±12.66). The mean of the SAI was 49.93±13.06. MBI subscales were low. We found that there was a significant difference in BAI between COVID-19 frontline healthcare professionals and those who worked on the usual wards (p = 0.01). CONCLUSIONS: It is important to consider the level of anxiety and burnout in all healthcare professionals and to help them to protect their mental health.


Subject(s)
Burnout, Professional , COVID-19 , Adult , Anxiety/epidemiology , Burnout, Professional/epidemiology , Delivery of Health Care , Female , Humans , Male , Pandemics , SARS-CoV-2 , Turkey/epidemiology
19.
Tuberk Toraks ; 69(2): 242-246, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1444456

ABSTRACT

COVID-19, caused by severe acute respiratory syndrome coronavirus-2, typically presents with respiratory symptoms and fever, but still a variety of clinical presentations have been reported. In this study, it was aimed to report a case of COVID-19 with an atypical presentation and an atypical course. As well, the recovery phase was complicated with GBS and consequently cytomegalovirus infection. It should be kept in mind that patients with COVID-19 severe disease need to be followed for neurological and other complications which may arise during the course of critical illness.


Subject(s)
COVID-19/diagnosis , Guillain-Barre Syndrome/diagnosis , SARS-CoV-2 , Aged , COVID-19/epidemiology , Diagnosis, Differential , Guillain-Barre Syndrome/virology , Humans , Male , Pandemics , Turkey/epidemiology
20.
J Nerv Ment Dis ; 209(10): 727-733, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1440682

ABSTRACT

ABSTRACT: The aim of this study was to determine the frequency of anxiety, depression, and irritability symptoms in children during the COVID-19 outbreak and to investigate the associated factors of these symptoms. This study was conducted with 1071 children aged 6 to 17. Results showed that 49.9% of the participants had anxiety symptoms, 29.5% had depression symptoms, and 51.4% had irritability symptoms. Low age was a potential risk factor for anxiety symptoms. Female sex was a potential risk factor for anxiety and depression symptoms. A COVID-19 death in the family or environment was a potential risk factor for depression and irritability symptoms. Exposure to COVID-19 information on television and on the internet was a potential risk factor for anxiety, depression, and irritability symptoms. In conclusion, this study revealed that the COVID-19 outbreak may have serious effects on the mental health of children, and the study highlighted potential risk factors.


Subject(s)
Anxiety/epidemiology , Depression/epidemiology , Irritable Mood , Adolescent , Anxiety/psychology , COVID-19/epidemiology , Child , Cross-Sectional Studies , Depression/psychology , Female , Humans , Internet , Life Change Events , Male , Mass Media , Pandemics , Risk Factors , SARS-CoV-2 , Surveys and Questionnaires , Turkey/epidemiology
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