Application of Fractional SIQRV Model for SARS-CoV-2 and Stability Analysis

Throughout history, infectious diseases have been the cause of outbreaks and the deaths of people. It is crucial for endemic disease management to be able to forecast the number of infections at a given moment and the frequency of new infections so that the appropriate precautions can be taken. The COVID-19 pandemic has highlighted the value of mathematical modeling of pandemics. The susceptible–infected–quarantined–recovered–vaccinated (SIQRV) epidemic model was used in this work. Symmetrical aspects of the proposed dynamic model, disease-free equilibrium, and stability were analyzed. The symmetry of the population size over time allows the model to find stable equilibrium points for any parameter value and initial conditions. The assumption of the strong symmetry of the initial conditions and parameter values plays a key role in the analysis of the fractional SIQRV model. In order to combat the pandemic nature of the disease, control the disease in the population, and increase the possibility of eradicating the disease, effective control measures include quarantine and immunization. Fractional derivatives are used in the Caputo sense. In the model, vaccination and quarantine are two important applications for managing the spread of the pandemic. Although some of the individuals who were vaccinated with the same type and equal dose of vaccine gained strong immunity thanks to the vaccine, the vaccine could not give sufficient immunity to the other part of the population. This is thought to be related the structural characteristics of individuals. Thus, although some of the individuals vaccinated with the same strategy are protected against the virus for a long time, others may become infected soon after vaccination. Appropriate parameters were used in the model to reflect this situation. In order to validate the model, the model was run by taking the COVID-19 data of Türkiye about a year ago, and the official data on the date of this study were successfully obtained. In addition to the stability analysis of the model, numerical solutions were obtained using the fractional Euler method. © 2023 by the authors.

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.

SARS-CoV-2 seroprevalence in health care workers in a third level hospital in Turkey

Objective: The aim of this study is to investigate the previous four months (March-July 2020) SARS-CoV-2 infection rate, seroprevalence and the variables affecting these in HCWs in a university hospital.

INACTIVATED COVID-19 VACCINE CAN INDUCE REACTIVE POLYARTHRITIS IN OLDER PATIENTS: REPORT OF TWO CASES

Reactive arthritis is an acute, sterile, non-suppurative and inflammatory arthropathy that usually follows infection process. Gastrointestinal, genitourinary and respiratory tract infections generally provoke reactive arthritis. Also, reactive arthritis can be seen after vaccination. Reactive arthritis cases have been reported after tetanus, combined diphteria-poliomyelitis-tetanus toxoid, hepatitis B or influenza vaccination. Although reactive arthritis is more common in youngs, healthcare workers should be aware of the development of post inactivated COVID-19 vaccine reactive arthritis in older patients. We present two cases with ReA induced by inactivated coronavirus 2019 (COVID-19) vaccination (CoronaVac, Sinovac). Both patients in our study were over 70 years old and presented with polyarthritis that developed after vaccination. Rheumatoid factor and anti-nucleer antibody were negative and patients responded well to short-term steroid therapy, arthritis were not resistant.

EVALUATION OF THE FREQUENCY and INTENSITY OF COVID-19 IN PATIENTS WITH ANKYLOSING SPONDYLITIS UNDER ANTI-TNF THERAPY

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Being a caregiver in the palliative care unit in the pandemic: who can do it better?

Background: During the Coronavirus Disease-2019 (COVID-19) pandemic, palliative care units and nursing homes became risky in terms of infection transmission. The measures that are taken in the general population have also been strictly applied for caregivers. However, to achieve success, the personal compliance of the caregivers is as important as setting the rules. Objectives: This study aimed to evaluate the demographic characteristics, knowledge levels, and attitudes towards the measures taken for pandemics of the caregivers who were caring for their patients in the palliative care unit. It was also attempted to evaluate the relationship between these parameters and their quality of life (QOL). Methods: The level of knowledge and the level of agreement with the measures with questions prepared by three physicians working in the palliative care unit were assessed in this study. The QOL was also evaluated using the 3-level version of EQ-5D (EQ-5D-3L). Results: Education, employment, smoking, as well as parental and marital status, were found to be related to a high level of knowledge. It has been shown that the level of knowledge is higher in female caregivers and those who were caregiving for less than three years. The caregivers of Alzheimer's disease patients were also revealed to know more about the COVID-19 pandemic. Single, male, employed, smoking, and experienced less than three years caregivers were seemed to have a higher level of agreement with the measures. In addition, it was concluded that the QOL was positively correlated with the level of knowledge and negatively correlated with the compliance of the measures. Conclusion: It is essential to know the characteristics and beliefs of the caregivers in pandemic management in palliative care;accordingly, more studies should be conducted on this issue.

Tocilizumab did not reduce mortality in severe COVID-19 patients but caused thrombocytosis

Background: TCZ is a monoclonal antibody against Interleukin-6 receptor (IL-6R) which is used for relieving inflammation and reducing mortality in COVID-19 patients. Safety and efficacy of Tocilizumab (TCZ) in Covid-19 pneumonia is uncertain yet. In this study, we aimed to determine clinical outcomes in patients treated with TCZ. Objectives: In this study we aimed to share our retrospective results which we had obtained from patients with COVID-19 diagnosis received TCZ. Methods: We performed a retrospective case control study between May and August 2020 in Turkey. We compared outcomes in patients who received TCZ with those who did not. Death in hospital and intensive care unit (ICU) requirements were evaluated as endpoints. Demographic data, comorbidities, additional treatment, treatment side effects, laboratory and clinical results were retrospectively assessed. There are no significant differences between groups according to age, gender and Charlson Comorbidity Index (CCI). Results: 12 (27.3%) patients died in standard group and eight (18.6%) patients died in TCZ group (p=0.150).Days of staying in the hospital were eight days in standard treatment group and 12 days in TCZ group (p=0.03). 10 of 43 patients in TCZ group were admitted to ICU. MV support was needed in 8 of these patients. 18 of 44 patients (40.9%) within the standard group were admitted to ICU and 12 patients (27.3%) were intubated (p=0.125,p=0.480). Significant IL-6 decrease was not observed post treatment in TCZ group according to pretreatment period (p=0.60). Significant decreases were examined in CRP and ferritin values through TCZ treatment. However, D-dimer and thrombocyte values increased. Conclusion: TCZ may not be an effective treatment for reducing ICU requirement, to prevent intubation or death, for shortening period for staying in hospital. The patients should be followed up closely for possible thrombosis because of increased D-dimer and thrombocytes with TCZ treatment.