Evaluation of the frequency, follow-up, and treatment of patients with multisystem inflammatory syndrome related to COVID-19

Aim: Aim of this study is evaluate the clinical features, laboratory values, treatment and follow-up of in children with COVID-19-associated multisystem inflammatory syndrome (MIS-C) disease. Materials and Methods: In this study, patients aged between 2 months and 17 years, who applied to the Inonu University Faculty of Medicine, Department of Pediatrics between March 2020, and February 2021 due to MIS-C related to COVID-19 disease, were reviewed retrospectively. Demographic data, clinical features, laboratory values, treatment and follow-up data of the patients were evaluated. Results: Forty-nine patients diagnosed with MIS-C between March 2020 and February 2021 were included in the study. Thirty-one (72.7%) patients were male and 18 (27.3%) were female. The most common indications for admission were fever (100%), abdominal pain (51.6%), vomiting (42.9%), cough (38.8%), diarrhea (28.8%), shortness of breath, rash, conjunctivitis, and convulsion. Levels of CRP (93.9%), D-dimer (85.7%), fibrinogen (73.4%), interleukin 6 (IL6) (73.4%), procalcitonin (71.4%), NT-proBNP (63.2%) remained at high levels in respective number of patients. The (32.6%) patients were followed up in the intensive care unit. These patients had cardiogenic shock (26.5%), severe pneumonia (18.3%), and acute gastroenteritis (14.3%). It was determined that the mean age of the patients followed up for cardiogenic shock was 12.5 years and relatively higher (p < 0.05). One patient died during follow-up. Conclusion: Although the manifestations of MIS- C due to COVID -19 are seen relatively rarely in children, it constitutes a serious problem and they mostly require hospitalization in intensive care unit, simultaneously involves many organ systems, and leads a serious course with higher risk of mortality. Another problem in these patients is higher rates of cardiac involvement. For this reason, it is important to take necessary precautions to protect children against COVID 19 and its associated MIS-C, and to include them in vaccination programs.

Investigation of Reasons for the Covid-19 Vaccine Hesitancy of Citizens over the Age of 18

Due to the circulation of false information about Covid-19 in our country, Covid-19 vaccination studies are approached with suspicion and the numerical majority of citizens who are hesitant about vaccination draw attention. The aim of this study is to determine the vaccine hesitancy of citizens over the age of 18 and to investigate the Covid-19 vaccine hesitancy in terms of various variables. The population of this descriptive quantitative study consisted of 385 participants, and the sample of citizens over the age of 18 living in Konya. Research data were collected through online platforms. The obtained data was analyzed with SPSS 20.0 statistical program. As a result, individuals who are against the Covid-19 vaccine do not see the coronavirus as a deadly disease;they are against Covid-19 vaccines mostly due to the side effects of vaccines, foreign production of vaccines, insufficient experimental studies, disbelief in protection, storage conditions, vaccine phobia, being against religious belief;It has been seen that most of the participants have partial knowledge about Covid-19 vaccines, and effective sources of information are social media, TV channels, academic publications, health authorities.

SARS-CoV-2 vaccine-associated subacute thyroiditis.

PURPOSE: With coronavirus disease 2019 (COVID-19), subacute thyroiditis (SAT) cases are on the rise all over the world. COVID-19 vaccine-associated SAT cases have also been reported. In this article, we present our data on 11 vaccine-associated SAT cases. METHODS: Eleven patients were included in the study. Type of the vaccines patients received, time to the occurrence of SAT after vaccination, symptoms and laboratory findings, treatment given, and response to treatment were evaluated. RESULTS: The age of patients ranged from 26 to 73. Four of the patients were males, and seven were females. Symptoms of six patients were seen after BNT162b2 Pfizer/BioNTech COVID-19 mRNA vaccine®, and four of them after Coronavac inactivated SARS-CoV-2 vaccine®. In one patient, SAT developed after the first dose of BNT162b2, administered after two doses of Coronavac. The average time to the onset of symptoms was 22 days (15-37) after vaccination. CONCLUSIONS: The fact that both whole virus containing and genetic material containing vaccines cause SAT suggests that the trigger may be viral proteins rather than the whole viral particle. Although corticosteroids are commonly preferred in published vaccine-associated SAT cases, we preferred nonsteroidal anti-inflammatory therapy in our patients for sufficient vaccine antibody response. There is not enough information about whether patients who develop SAT can be revaccinated safely considering the ongoing pandemic. Further research is needed for a conclusion in the treatment and revaccination of these patients.

How was pediatric flexible bronchoscopy implementation affected during COVID-19 era?: A retrospective study

Rationale: As application of flexible bronchoscopy (FB) has a high risk for infection transmission, it is recommended to postpone elective FB procedures during COVID-19 pandemic. We aimed to determine how COVID-19 pandemic affected pediatric FB implementation. Methods: Medical records of patients who underwent FB from March 11, 2015 to September 11, 2020 were examined retrospectively. Records of post-COVID-19 period (March 11, 2020 to September 11, 2020) were compared with records of pre-COVID-19 (consists of each six-month time window from March 11 to September 11 of each year from 2015 to 2019) period in terms of hospitalization status of the patients, with numbers and indications of FB. Some additional measures were taken during FB procedure in post-COVID-19 period. Number of health workers infected during FB procedures in post-COVID-19 period was reviewed. Results: Of total 182 procedures, the least FB was performed in post-COVID-19 period (34, 30, 36, 36, 25 and 21 procedures respectively from 2015 to 2020). Ninetythree (51.1%) patients were male. The median age of the patients was 48 months (range, 1-204 months). Eighty-two (45.0%) patients had chronic diseases. While 62 (34.2%) patients were hospitalized for another reason before FB, 120 (65.9%) patients were outpatient who applied for FB. Three most common indications for FB were atelectasis (n=39, 21.4%), chronic cough (n=32, 17.5%) and stridor (n=27, 14.8 %). While microbiological sampling with bronchoalveolar lavage was the most common indication in post-COVID-19 period, atelectasis was leading in pre-COVID-19 period (p<0.001). In post-COVID-19 period most of the patients were inpatients while outpatient predominance was determined in pre-COVID-19 period (p<0.001) (Table 1). None of the health workers was infected during FB procedure. Conclusion: Postponing elective FB procedures decreased the numbers and affected the indications of procedures in our center during COVID-19 era. Taking additional measures are of great importance and effective to prevent transmission of infection during FB.