The Relationship Between Functional Status and Fatigue After COVID-19 Infection

Introduction: After COVID-19 infection, symptoms last for weeks or months. In this study, it was aimed to examine the relationship between functional status and fatigue and the associated factors in patients with COVID-19. Method(s): Patients with COVID-19 infection who applied to 13 centers were included into the study according to the inclusion criteria. Age, gender, height, body weight, body mass index (BMI), marital status, smoking status and amount, presence, duration of chronic disease, Charlson comorbidity index, regular exercise habit, time of diagnosis with COVID-19, presence of hospitalization,length of hospital stay, intubation status, home oxygen therapy need, participation in PR program, presence of dyspnea, cough, sputum, mMRC score, post-COVID functional status scale, fatigue severity scale, EQ-5D-5L Questionnaire scores were recorded. Result(s): Of the 1095 patients, 603 (55%) were male and 492 (45%) were female. Their mean age was 50+/-14 years. The most common chronic lung disease was COPD (11%), while 266 patients (29%) had non-pulmonary systemic disease. The median time of COVID-19 diagonosis was 5 months ago with 47% hospitalization rate. The median value of post-COVID functional status scale was 1 (0:4), and fatigue severity scale score was 4.4 (1:7). There was a significant correlation between post-COVID functional status and fatigue severity scale (r=0.43, p <0.01). Conclusion(s): Functional status and fatigue were found to be related primarily to quality of life and then patients' age, BMI, presence of chronic and systemic lung disease, regular exercise habits before COVID-19, hospitalization and its duration, home oxygen therapy and symptoms.

CONSUMERS' ACCEPTANCE OF ONLINE GROCERY SHOPPING IN A PANDEMIC SITUATION: AN EXTENDED TECHNOLOGY ACCEPTANCE MODEL PERSPECTIVE

This study aims to understand the mechanisms of consumers' online grocery shopping (OGS) acceptance in the current COVID-19 pandemic. Through this perspective, an extended technology acceptance model is employed by including the fear of COVID-19 factor to reveal the extent of the Turkish consumers' acceptance of OGS. We have tested the proposed research model on 455 survey participants living in various cities of Turkey. Structural equation modeling is employed to test the eleven research hypotheses. The results indicate that perceived ease of use, perceived usefulness, and attitude are valid predictors of OGS acceptance. Besides, the fear of COVID-19 negatively moderates these relationships. By revealing these empirical results, this study provides some useful insights into our understanding of the acceptance mechanisms of OGS processes in a pandemic situation. We hope to pinpoint the underlying reasons for the vast expansion of OGS among Turkish customers in pandemic times. © 2022 The authors.

The Effects of the COVID-19 Pandemic on Clinical and Laboratory Follow-up of Patients Diagnosed With Chronic Hepatitis B: A Multicenter, Prospective, Observational Study

Background: Chronic hepatitis B (CHB) patients who are under the treatment of antiviral agents should be monitored in routine control visits. However, during the COVID-19 pandemic, the visits were interrupted. Objectives: This study aimed to investigate whether these patients were affected regarding clinical, laboratory, and treatment out-comes. Methods: This prospective study consisted of CHB patients aged > 18 who were applied to 3 tertiary centers between 14 February and 30 March 2022. The patients were selected from the ones who regularly applied to outpatient clinics and under the treatment of antiviral agents before the pandemic. The demographic and laboratory values, including serologic, biochemistry, and molecular results, were compared between the 2 groups who came and did not come to control visits. Results: A total number of 220 patients were included. More than half (n = 142, 64.5%) were female. The median age was 44 years (19-73). A hundred and forty-two (64.5%) patients did not come to control visits during the pandemic. The most common reason was anxiety about COVID-19. The tenofovir treatment was replaced with entecavir (ETV) due to osteopenia and with alafenamide due to osteopenia and/or renal failure. The previous agents were re-started in 27 (79.5%) patients who discontinued the treatment. Conclusions: The COVID-19 pandemic negatively impacted the follow-up of CHB patients. In this regard, 15.5% of patients stopped their treatments. The patients who stopped their follow-ups and continued tenofovir disoproxil fumarate (TDF) had proteinuria and decreases in bone mineral density (BMD) and estimated glomerular filtration rate (eGFR) levels. © 2022, Author(s).

Does combined usage of FFP2 and Surgical mask against SARS-CoV-2 affect SpO2 values and pulse rates of dental health-care workers?

Background and Aim: Combined use of surgical mask with filtering facepiece (FFP) 2 masks has been popular among the health-care workers. However, the effect of this preference on the vital values of individuals stays as a challenge among the professionals. The present study aimed to assess the effect of FFP2 mask versus combined use of it with surgical mask on the SpO2 values and pulse rates of individuals. Patients and Methods: This study was conducted on 20 health-care workers. The pulse rates and SpO2 values were evaluated by pulse oximeter placed in the index fingers of the participants. The participants were divided into two groups: those using the FFP2 mask and those using FFP2-surgical mask combination. Individuals wearing FFP2 mask were examined for a period of 60 min and the same examination was repeated for another period of 60 min in those using combination of FFP2 with surgical mask. The values were measured at the beginning and at 15, 30, 45, and 60 min intervals, respectively. The examinations were conducted in the rest position to obtain standardization. Results: The observed data showed no statistical difference at all periods in either SpO2 values or pulse rates between FFP2 and FFP2-surgical mask combined groups. The SpO2 values reduced from the initial time to 15 min in the FFP2-surgical mask group. Also, in the FFP2-SM group, statistically significant increase in values was observed between 15 and 45 min and 15 and 60 min. Another increase in SpO2 value was found in the observations made between made 30 and 45 min in the same group (P < 0.05). The pulse rates of the individuals showed no statistical difference in both the groups and at all experimental periods (P > 0.05). Conclusion: According to the present study, wearing only the FFP2 mask or FFP2-surgical mask combination seems not to cause any effect on the SpO2 values and pulse rates of the participants.

Effect of Fluid Therapy on Coagulation in COVID-19 Patients in the Intensive Care Unit

Study Objectives: Several studies have evaluated CT pulmonary angiography of COVID-19 patients and reported a 7%-30% increase in the incidence of pulmonary embolism. In this study, it was aimed to investigate the effect of fluid therapy on coagulation in COVID-19 patients in the intensive care unit. Methods: This retrospective study included 120 patients hospitalized in the COVID-19 Intensive Care Unit for more than one week, between August 2020 and February 2021. Blood prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR), fibrinogen, troponin, D-dimer levels, platelet count measured at the time of admission (T1, baseline) and one week after admission (T2), and the fluid treatments administered during this period were recorded. Patients were divided into the saline solution (SS) group (n=75), 0.45% saline solution group (0.45%, n=30), and combined fluid therapy group (SS+0.45%, n=15). Results: The change in PT was statistically significant for the SS group (p = 0.005), but not for the 0.45% and SS+0.45% groups (p = 0.625, p = 0.262, respectively). In the SS group, the aPTT levels increased posttreatment (p = 0.005). INR levels were significantly different between SS and SS+0.45% groups (p = 0.008). In the SS group, the INR levels increased between T1 and T2 (p = 0.014). In the SS group, the D-dimer levels significantly increased posttreatment. Conclusion: The D-dimer levels were prominent in the follow-up of the COVID-19 patients. Accordingly, using SS for fluid therapy may increase hypercoagulation and the risk of an embolism when compared to the SS, 0.45%, and combined (SS+0.45%) treatment.

Gastrointestinal Symptoms in Patients with COVID-19: A Single-Center Experience

Objective: Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus, the first cases of which were reported in Wuhan, China in December 2019. The disease often presents with major respiratory symptoms. In addition, gastrointestinal (GI) symptoms are observed. They may be the first or even the only symptoms of the disease. The aim of this study is to demonstrate the presentation of GI symptoms and their relationship to other symptoms, the clinical course and prognosis of patients with COVID-19. Methods: Included in this study were patients over 18 years of age who had been hospitalised for treatment in clinics and intensive care units due to COVID-19 between March and June 2020. The symptoms reported by the patients at the time of admission and the data collected as a result of the clinical follow-up were evaluated. Results: Out of the 1,045 patients with COVID-19, 140 patients (13.4%) had GI symptoms. The complaints of these 140 patients were nausea (53.6%), vomiting (32.1%), abdominal pain (11.4%), diarrhea (45.7%), anorexia (43.6%) and loss of taste (5.6%). In 3.2% of the patients, only GI symptoms were present, without any respiratory symptoms. Conclusion: Gastrointestinal symptoms were present at the time of admission in 13.4% of the patients with COVID-19. The most common GI symptom in the patients was nausea. Length of stay in hospital and mortality rate were higher in patients with only GI symptoms. Therefore, GI symptoms should be considered in patients with suspected COVID-19.

A Tertiary Care Hospital Experience During the COVID-19 Pandemic

Introduction: Early detection of the severity of COVID-19 disease is important for patient prognosis and effective use of hospital capac- ity. Early detection of critical patients and providing supportive treatment is the main goal of disease management. In this study, we evaluated demographic, clinical, laboratory and radiological findings in COVID-19 patients and aimed to find risk factors associated with poor prognosis. Materials and Methods: A total of 579 cases hospitalized with the diagnosis of COVID-19 were evaluated retrospectively. The diagnosis of COVID-19 was confirmed by polymerase chain reaction (PCR) positivity or typical clinical, laboratory and radiological findings. The study population was divided into groups according to the World Health Organization (WHO) COVID-19 disease severity classification. Significant risk factors associated with severe disease and mortality were investigated by comparing the demographic, clinical, labora- tory and radiological data of these groups. Results: Mean age of the 579 cases was 54 +/- 18.25, and 321 of them (55.4%) were male. Severe disease was detected in 131 (22.6%) patients and mortality rate was %8.29. The most common comorbidities were hypertension (31.8%), diabetes mellitus (18.5%) and coronary artery disease (17.8%), respectively. The most common symptoms at the time of admission to the hospital were cough (40.7%), fever (38 degrees C;33.6%) and shortness of breath (26.3%). Age, coronary artery disease and shortness of breath, neutrophil count, urea, CRP, ferritin, Pro-BNP, fibronogen, IL-6 values were found to be predictive variables for severe disease. Age, presence of shortness of breath, urea, ferritin and Pro-BNP values were found to be independent predictive variables for severe disease, and the cut-off points were calculated for these variables (age 59.5, urea 33.5 mg/dL, ferritin 50.8 mu g/L and Pro-BNP 881 pg/mL). Conclusion: Some predictive factors were demonstrated to detect severe disease in COVID-19 patients. It is important to predict poor prognosis based on these factors. It provides early detection of critical patients and it will be a guide for reducing mortality rates in these patients with effective treatment.

Classroom Management Problems Encountered By Teachers In Virtual Classes During Covid-19 Pandemic

This study aims to reveal classroom management problems that teachers face in virtual classrooms during COVID-19 pandemic. Convergent design, which is one of the mixed methods research models was used in this study. Both quantitative and qualitative data were gathered from 381 teachers via an online form that was developed by researchers. Descriptive statistics was used for the analysis of closed-ended questions, content analysis for open-ended ones. The findings of the study showed that the classroom management problems were mostly associated with hardware, software and evaluation problems in the virtual classrooms. Some of the classroom management problems were related to background noise, internet connection, access to the course, lack of digital content, lack of interaction, short class time, voice transmission, privacy and security, and inappropriate use of software. Based on the findings of the study, some implications for practitioners and researchers were suggested. © 2020, Milli Egitim. All Rights Reserved.

How did covid-19 pandemic affect the older patients? Comparison of clinical features in older versus younger patients

Íntroduction: COVID-19 infection may be atypically presented in the older adults with a poor prognosis. In this study, we aimed to investigate the clinical and laboratory differences of COVID-19 course in older patients. Materials and Method: The demographic, clinical, laboratory and radiological data of the patients hospitalized with COVID-19 infection were compiled retrospectively. A randomized control group was created from younger patients. Chest tomography of the patients were examined and scored. Results: Data of 100 older and 127 younger patients with COVID-19 infection, and 80 non-COVID older patients were evaluated retrospectively. While the mean CRP, fibrinogen, procalcitonin, urea, LDH, INR, PT, Troponin-I, CK-MB and total radiological lung score were significantly higher in older patients;the mean hemoglobin, hematocrit and d-dimer were significantly higher in younger patients. Lymphopeniawasmore common and themortality ratewas higher in the older adults. Lymphopenia, presence of comorbidity, being over the age of 75, and radiological lung involvement were identified as mortality risk factors in older patients. The cut-off values for mortality were as follows;age≥77 years, lymphocyte#≤ 700x103 cells/µL, CRP≥108.71 mg/L, d-dimer≥2.25 mg/L, fibrinogen≥383 mg/L, INR≥1.05, PT ≥12.5 seconds, aPTT≥31 seconds, Troponin-I≥19.1 pg/mL, total lung score≥6 points. COVID-19 did not increase mortality much more than other hospital-requiring clinical events in older adults (17% vs 26.25%). Conclusion: The older adults require special attention in COVID-19 pandemic. Those with comorbidities, lymphopenia, high d-dimer levels, and extensive lung involvement in the initial tomography should be followed-up closely.

Effects of the COVID-19 pandemic on eating and meat consumption habits of Turkish adults

Animal originated proteins have great importance in meeting the daily protein need in a healthy and balanced diet due to their high protein content, amino acid pattern and good digestibility. Also, when included in a diet, they play an important role in the protection of individuals' health and improving the life quality with their vitamin and mineral content. The aim of this study is to investigate the changes in meat and meat products consumption habits of people and whether they are concerned about reaching meat and meat products during the COVID-19 pandemic. For that purpose, a 24-question survey of 1000 people from several cities of Turkey was carried out. The majority of the participants stated that their consumption of red meat (77%), poultry meat (81%) and fish (66%) did not change due to the COVID-19 pandemic, while 10%, 8%, and 3% of the participants said their red meat, poultry meat and fish consumption increased, respectively. In addition, 13%, 11%, and 31% of the participants said there was a decrease in their red meat, poultry meat and fish consumption, respectively. The major reason for the decrease in red and white meat consumption was economic reasons, however, the reason for the decrease in consumption of fish was difficulties in reaching. During the COVID-19 pandemic, until the date that the survey was done, 12% of the participants had concerns about reaching meat and meat products. The main cause of their concern was being unemployed or losing their job after the COVID-19 pandemic.

Normal chest ct prevalence in coronavirus disease 2019 (covid-19) patients: A report of 791 cases

Introduction: In this study, we aimed to better understand the role of chest CT as an initial workup tool among all COVID-19 patients admitted to a tertiary hospital. Materials and Methods: We retrospectively evaluated the data of patients that were suspected for COVID-19. All patients who had both noncontrast chest CT scan with RT-PCR test results included in the study. Symptomatic patients were divided into four groups according to time between the onset of symptoms and chest CT;4 days, 5-8 days, 9-13 days, and 14 days. Chest CT findings according to symptom status, duration, and RT-PCR positivity were evaluated. Results: Data for a total of 791 patients were evaluated. The mean patient age was 51.7 19.7 years. 459 (58%) patients were male, and 332 (42%) were female. 55.1% of patients had positive and 44.9% negative RT-PCR tests. Typical, indeterminate, atypical and negative chest CT findings were seen in 241 (30.5%), 131 (16.6%), 154 (19.5%), and 265 (33.5%) patients, respectively. Among 355 patients with negative RT-PCR results, 152 (42.8%) had typical or indeterminate chest CT findings. Asymptomatic patients had a 91.9% of RT-PCR positivity. Only 123 (61.5%) patients had typical or indeterminate CT findings among symptomatic and RT-PCR positive cohort. Conclusion: The greatest value of our study is in demonstrating the value of chest CT in both patients that had symptoms but had negative RT-PCR test results and insignificance of chest CT in asymptomatic but had suspected contact with COVID-19 patients.