RESUMO
Objective: This study aimed to evaluate the development of adjustment disorder according to the ADNM-20 (Adjustment Disorder New Module-20) scale in participants who were followed up for Covid-19 infection. Methods: A cross-sectional survey was conducted from September to November 2020. After sample size calculation, we aimed to reach minimum 170 people out of 1290 people who applied to the hospital for Covid-19 disease treatment. Participants were selected from the patients admitted to the hospital using a simple stratified random sampling method. We reached 182 people after treating the patients who were followed up with Covid-19 infection in a University Hospital in Istanbul, Turkey. A questionnaire and the Adjustment Disorder New Module-20 scale were applied via phone / mail at the end of the 6th month after Covid-19 related hospital admission by researchers. Results: Adjustment disorder was found in 28.8% (n=42) of the participants disorder according to the ADNM-20 scale. While the rate of development of adjustment disorder due to Covid-19-related stress was 26.7% (n=39);the rate of development of adjustment disorder due to non-Covid-19 stress was found to be 2.1% (n=3). With the increase in stress load, the development of adjustment disorder increased significantly. The frequency of developing Covid-19-related stress-related adjustment disorder was statistically significantly increased with the duration of exposure to stress. Conclusion: We have found out that one out of every four people who apply to the hospital for healthcare services due to Covid-19 infection may develop an adjustment disorder. Assessment of the adjustment disorder more frequently and making early interventions may contribute to the prevention of progressive mental disorders.
RESUMO
OBJECTIVE: Several studies have investigated the association between cardiac biomarkers and short-term prognosis in the COVID-19 infection. However, the data on the predictive value of cardiac biomarkers to predict long-term prognosis in COVID-19 infection are limited. We aimed at determining the relationship between N-terminal brain-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin I (hs-TnI) as cardiac biomarkers and in-hospital/long-term outcomes in COVID-19 infection. PATIENTS AND METHODS: The study included a total of 916 patients with confirmed COVID-19 infection. The primary outcome was in-hospital and 1-year mortality. The secondary outcome was intensive care need at admission or the need to be transferred to the intensive care unit later on. RESULTS: The study included 498 (54.4%) males and 418 (45.6%) females with a mean age of 55.1±18.5 years. The patients with known heart failure (HF), COVID-19-related HF, acute renal failure (ARF), chronic kidney disease (CKD), diabetes mellitus, hypertension, coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD)/asthma, high CO-RADS score (≥ 4), lower EF, higher hs-TnI, and NT-proBNP levels had increased in-hospital and 1-year mortality. After multivariate analysis, NT-proBNP, hs-TnI, CKD, ARF, diabetes mellitus, and CAD were independent predictors of in-hospital and 1-year mortality. After ROC analysis, NT-proBNP cut-off levels of 1022.50 (sensitivity 87.5%, specificity 87.1%) and 1008 (sensitivity 88.6%, specificity 88.0%) were found to predict in-hospital and 1-year mortality, respectively. Hs-TnI cut-off levels of 49.6 (sensitivity 88.6%, specificity 88.9%) and 34.10 (sensitivity 83.8%, specificity 84.1%) were found to predict in-hospital and 1-year mortality, respectively. CONCLUSIONS: The current study suggests that NT-proBNP and hs-TnI can be used as valuable cardiac biomarkers to predict short-term and long-term parameters in COVID-19 infection.