Objective- To determine the prevalence of peripartum depression (PPD) and anxiety during the COVID-19 pandemic, any differences between COVID-infected and non-infected mothers and its risk factors. Study design- Cross-sectional study. Setting- Tertiary care maternity hospital Population- Pregnant and postpartum women Methods- Questionnaire based direct interview. EPDS (Edinburgh postnatal depression scale) score, COVID-19 anxiety scale (CAS) was used. Outcome measures- Possible PPD (EPDS13), Probable PPD (EPDS14), Peripartum anxiety (EPDS anxiety sub score4), COVID-19 related anxiety and risk factors of PPD. Results- Out of 842 eligible subjects, 142 were confirmed COVID-19 positive and 670 patients were without the infection. The mean age was 25±3.9 years and 571 (67.8%) subjects were postpartum. Among the subjects, 383 (45.5%) had possible depression, 317 (37.6%) had probable depression. Peripartum anxiety was observed among 763(90.6%) subjects and the median CAS score was 15(8-28). While there was no significant difference in the prevalence of PPD, peripartum anxiety was higher among COVID non-infected subjects (91.6% vs 86.6%, p=0.04). The CAS score was higher among COVID-19 infected compared to the non-infected [17(10-28) vs 15(8-25), p=0.00]. In multivariate analysis, history of psychiatric illness [OR- 4.2(95% CI- 1.82-9.93), p=0.001], domestic violence [OR-2.4(95% CI-1.16-5.10), p=0.019] and past obstetric complications [OR-1.5(95%CI-1.01-2.27), p=0.042] were significant risk factors for PPD. Conclusion- High prevalence of PPD was observed during COVID-19 pandemic without any significant difference between COVID-19 infected and non-infected subjects. COVID-19 infected patients had higher COVID related anxiety. Funding- None taken Keywords- peripartum depression; EPDS; COVID-19 anxiety scale.

Objective: Cytokine storm and Coagulopathy have been implicated as major causes of morbidity and mortality in COVID-19 patients. A black yeast Aureobasidium pullulans AFO-202 strain produced beta 1,3-1,6 glucan has been reported to offer potential immune enhancement and metabolism balancing, as well as mitigation of coagulopathy risks. The N-163 strain produced beta glucan is an efficient anti-inflammatory immune modulator. In this pilot clinical study, we report the beneficial effects of these two beta glucans on the biomarkers for cytokine storm and coagulopathy in COVID-19 patients. Methods: A total of 24 RT-PCR positive COVID-19 patients were recruited (Age range: 18~62; 17 males and 7 females). Patients were randomly divided into three groups (Gr): Gr. 1 control (n=8); Gr. 2: AFO-202 beta glucan (n=8); and Gr. 3, a combination of AFO-202 and N-163 beta glucans (n=8). All three groups received the standard care while groups 2 and 3 received additional supplementation of beta glucans for 30 days. In addition to basic clinical parameters, we periodically evaluated D-Dimer, IL-6, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), the neutrophil to lymphocyte ratio (NLR), the lymphocyte to CRP ratio (LCR) and the leukocyte-CRP ratio (LeCR). Results: The duration of hospital stay for all three groups was nearly equivalent. There was no mortality of the subjects in any of the groups. Intermittent oxygen was administered from day of admission for up to four to five days with mask (two to four Lpm) to two subjects in Gr. 2 and one subject in Gr. 3. None of the subjects required ventilation. The D-Dimer values in Gr. 1, which was on average 751 ng/ml at baseline, decreased to 143.89 ng/ml on day 15, but increased to 202.5 ng/ml on day 30, which in groups 2 and 3 decreased on day 15 and continued to remain at normal levels until day 30. IL-6 levels decreased on day 15 from an average of 7.395 pg/ml to 3.16 pg/ml in the control, 26.18 pg/ml to 6.94 pg/ml in Gr. 2 and 6.25 pg/ml to 5.22 pg/ml in Gr. 3. However, when measured on day 30, in Gr. 1, the IL-6 increased to 55.37 pg/ml while there was only slight marginal increase in Gr. 2 but within normal range, and the levels further decreased to less than 0.5 pg/ml in Gr. 3. The same trend was observed with ESR. LCR and LeCR increased significantly in Gr. 3. NLR decreased significantly in groups 2 and 3. There was no difference in CRP within the groups. Conclusion: In this exploratory study, consumption of Aureobasidium pullulans produced beta glucans for thirty days, results in a significant control of IL6, D-Dimer and NLR, a significant increase in LCR, LeCR and marginal control of ESR in COVID-19 patients. As these beta glucans are well known food supplements with decades of a track record for safety, based on these results, we recommend larger multi-centric clinical studies to validate their use as an adjunct in the management of COVID-19 and the ensuing long COVID-19 syndrome.

Objective: To assess the impact of the Covid-19 pandemic on the diagnosis and treatment of patients at tertiary hospital in Poland. Design, setting, participants: This was a retrospective review of head and neck cancer patients presented to the multidisciplinary tumour board (MTB) during the 12-month period from March 2020 through February 2021 and compared to patients presented to the MTB during the prior, pre-pandemic 12-month period from February 2019 to March 2020. Main outcomes and measures: Patient demographic and clinical variables were compared: sex; age at diagnosis; distance from hospital; date of first visit, radiological diagnosis, pathology specimen, MTB meeting, and initiation of primary and adjuvant treatment Results: The number of patients presented to the MTB increased by 22% (278 to 340) from the pre-pandemic to the pandemic period. The mean time from MTB presentation to treatment initiation increased significantly from 17.1 to 21.7 days. The mean time from first visit to treatment start increased from 44.7 to 54.4 days. The proportion of patients with early-stage oropharyngeal cancer who underwent primary surgery rose from 47.3% to 86.6%. The percentage of patients who received palliative radiotherapy increased from 20.5% to 32.9%. The proportion of patients who received best supportive care rose from 1.8% to 6.2%. Conclusion: One of the most notable findings of this study was the increased time from first visit to treatment initiation, which could negatively impact patient outcomes. The differences in the treatment received in these two periods should be further evaluated to determine their influence on survival

Background Wearing face shields and masks, which used to have very limited public use before the Covid-19 outbreak, has been highly recommended by organizations, such as CDC and WHO, during this pandemic period. The aim of this prospective study is to scrutinize the dynamic changes in vital parameters, change in end tidal CO2 levels, the relationship of these changes with taking a break, and the subjective complaints caused by respiratory protection while healthcare providers are performing their duties with the N95 mask. Methods The prospective cohort included 54 healthcare workers (doctors, nurses, paramedics) who worked in the respiratory unit of the emergency department (ED), performed their duties by wearing valved N95 masks, face shields. The vital parameters and end-tidal CO2 levels were measured at 0-4th-5th-and 9th hours of the work-shift. Results Only the decrease in diastolic BP between 0-9 hours was statistically significant (p=0.038). Besides, MAP values indicated a significant decrease between 0-9 hours and 5-9 hours (p= 0.024 and p=0.049, respectively). In terms of the vital parameters of the subjects working with and without breaks, only PETCO2 levels of those working uninterruptedly increased significantly at the 4th hour in comparison to the beginning-of-shift baseline levels (p=0.003). Conclusion Although the decrease in SBP and MAP values is assumed to be caused by increased fatigue due to workload and work pace as well as increase in muscle activity, the increase in PETCO2 levels in the ED healthcare staff working with no breaks between 0-4 hours should be noted in terms of PPE-induced hypoventilation.

Extensive immune response associated inflammation is the major reason for the pathological outcome of COVID-19 infection. Infliximab is an anti tumor necrosis factor (anti-TNF) drug that is used to reduce inflammation through TNF-α inhibition. Inhibition of main inflammatory cytokine such as TNF-α may has a potential effect in COVID-19 treatment. Here, we report the clinical outcome associated with Infliximab treatment in a 65-year-old woman with confirmed COVID-19 infection. Infliximab therapy was started on day 9th, patient demonstrated clinical improvement and recovery from COVID-19. Our findings suggest that the association of TNF-α inhibition and clinical management together contributes to COVID-19 patient survival.

Purpose To investigate the relationship between laboratory blood parameters and ocular findings in hospitalized moderate or severe COVID-19 patients. Methods Ophthalmologic examination of 215 patients who were hospitalized with the diagnosis of COVID-19 was performed in their beds and their ocular findings were noted. Blood parameters were compared in patients with and without conjunctivitis like symptoms. Results Conjunctivitis like inflammatory findings were detected in 15 (7.44%) of 215 moderate or severe COVID-19 patients. There was no difference between the patients with and without ocular findings in terms of laboratory findings such as WBCs, neutrophil counts, lymphocyte counts, NLR, LDH, procalcitonin, D-dimer, CRP, and ferritin. Conclusion There was a significant relationship between COVID-19 and an acute conjunctival inflammatory response. Blood parameters that determined progression in patients with COVID-19 were not significant in terms of ocular findings.

Aim and objectives: Coronavirus disease (COVID-19) can affect the menstrual cycle and menstrual volume. We aimed to examine the changes in menstrual symptoms of women who had recovered from COVID-19 and determine the factors affecting these changes. Methods: A questionnaire, prepared using Google Forms, was completed online in May 18-31, 2021 by 180 women (26.08±6.62 years) who had recovered from COVID-19. Menstrual symptoms, menstrual pain severity, fatigue severity and anxiety levels of the participants were assessed with Menstrual Symptom Questionnaire (MSQ), Visual Analogue Scale (VAS) and Fatigue Severity Scale (FSS), Coronavirus Anxiety Scale (CAS), respectively. Results: Post-COVID-19 individuals’ MSQ total scores and subgroup scores, FSS scores and menstrual pain showed a statistically significant increase compared to pre-COVID-19 (p < 0.001 for all). Multiple linear regression analysis identified age at menarche and change in FSS and VAS scores as significant contributors to 38.4% of the variance explained in the significant regression for change in MSQ score (F (3.176) = 38.23, p < 0.001). Individuals with prolonged fatigue, muscle–joint pain and dyspnea symptoms showed increased MSQ total scores (p = 0.006, p = 0.009, p = 0.046 respectively) and negative effects/somatic complaints subgroup scores (p = 0.004, p = 0.002, p = 0.017 respectively). Also, individuals with prolonged gastrointestinal symptoms showed increased pain symptoms (p = 0.029) and coping methods subgroup scores (p = 0.002), while those with prolonged muscle and joint pain showed increased coping methods (p = 0.022) subgroup scores. Conclusion: In this study, we observed worsened menstrual symptoms, fatigue, and menstrual pain severity in women recovered from COVID-19. In addition, age at menarche and fatigue and menstrual pain scores differences after COVID-19 were determiners of the changes in menstrual symptoms. Menstrual symptoms were more severe in women who have prolonged fatigue, dyspnea, muscle–joint pain, and gastrointestinal symptoms.

Background: Health professionals who have direct contact with patients, provide primary care, and have the longest contact time are nurses. The pandemic caused by Covid-19, a virus with high mortality, high spreading rate, and no precise treatment, causes anxiety and fear in nurses. This study aimed to evaluate the anxiety and experience of the nurses who care for patients diagnosed with Covid-19. Material and Methods: This study was carried out based on cross-sectional research principles. The study was conducted between April 1 and May 30, 2020, with 327 nurses providing care to the hospitalized patients diagnosed with Covid-19. Results: The nurses stated that 70.6% of them had increased anxiety, and 51.1% of the nurses indicated that they were concerned about transmitting this disease to themselves while giving care to the patient diagnosed with Covid-19. Approximately half of the nurses (49.5%) stated that they needed psychological support. Conclusion: Nursing is a profession with long working hours, very stressful working environment, work in high-risk environments due to potential risk factors (bacteria, virus and radiation) and the shift system in hospitals. Having long working hours is a risky situation for mental health. Mental health problems are more common in nurse and thus, they need psychological support. Similarly, our study revealed that the nurses who work long hours, have night shift and experience changes in sleep patterns need psychological support. Nurses experience problems such as impaired sleep patterns, increased anxiety levels, and increased fear and anxiety about transmitting the virus to themselves, their families, loved ones, friends, and colleagues. To ensure that nurses cope with these problems and work efficiently during the Covid-19 pandemic process.

Introduction: The effect of lockdown measures due to COVID-19 pandemic in children with respiratory underlying conditions are still unclear. We analyzed the impact of lockdown measures in the management and evolution of children with asthma and preschool wheeze during the first wave of COVID-19. Matherial and Methods: observational study carried out in children with recurrent wheezing or asthma before and after the implementation of the lockdown by using: a questionnaire aimed to examine pre-existing respiratory disorders, step treatment (according to Spanish Guide for Asthma Management) and level of asthma control before/after lockdown (CAN questionnaire), COVID history and laboratory testing including IgG SARS-CoV-2. Results: we enrolled 475 asthmatic and preschool wheezers (60.6% males), mean age 5.6 years. There were not differences in asthma treatment comparing both periods, since 81.7% maintained the same treatment (p=0.103). According to CAN questionnaire 87.7% remained well controlled during confinement. Nearly a third of children (34.9%) needed reliever treatment, mainly in older children. Determination of IgG SARS-CoV-2 was performed in 233 children (49.1%) of whom 17 (7.3%) tested positive. Seven patients positive to IgG SARS-CoV-2 were assisted in the emergency department and two required hospital admission. Conclusions: During the COVID-19 lockdown most of the children with asthma and recurrent wheezing maintained their preventive treatments unchanged and remained well controlled from their underlying disease. Our results suggest that children that tested positive to IgG SARS-CoV-2 showed significant increase in paediatric hospital admissions and attendances to urgent care settings.

Understanding the composition of human immune responses to SARS-CoV-2 and vaccines is essential for predicting protection from infection and determining vaccine efficacy. Here, we explored T-cell immune responses to SARS-CoV-2 and the UK (B.1.1.7) variant of concern (VOC) in infected and vaccinated individuals. In infected patients, CD4+ T-cells demonstrated consistent, robust responses against Spike peptides, while CD8+ T-cells had heterogeneous responses to 5 SARS-CoV-2 proteins. We found 80% of infected and vaccinated individuals showed positive CD4+ T-cell immunity against SARS-CoV-2. Moreover, CD4+/CD8+ T-cell responses to SARS-CoV-2 and the United Kingdom (B.1.1.7) variant are robust and nearly identical in infected and vaccinated individuals. Thus, the UK variant did not interfere with T-cell recognition and elicited responses. These observations will be of critical importance in assessing human immune responses to emerging VOCs.

Aim: The aim of this study is to investigate the anxiety levels of healthcare workers (HCWs) in hospitals in Istanbul, which is one of the cities most affected by the COVID-19 pandemic. Methods: The study was conducted online with 177 HCWs (127 doctors, 31 nurses, 15 paramedics, 4 health technicians) due to the pandemic. Beck Anxiety Invantory (BAI) was used for anxiety levels. Results: The anxiety levels of HCWs were found as 48% “minimal”, 23.7% “mild”, 17.5% “moderate”, 10.7% “severe”. The mean BAI score of other HCWs is from doctors (15.94 ± 12.776 vs 9.53 ± 8.868), the mean BAI score of women is from men (14.07 ± 10.899 vs 7.61 ± 8.681), for those who have no children, the mean BAI score is from those with a child (13.77 ± 11.713 vs 9.66 ± 9.260), and the mean BAI score of those who were over 65 years old or had a relative with chronic disease at home was higher than the others (14.11 ± 9.752 vs 10.44 ± 9.752) (p <0.05). The mean BAI score of those who did not examine COVID-19 patients were higher than the examiners (11.47 ± 10.693 vs 1.23 ± 10.394), and the mean BAI score of night shift workers (12.42 ± 11.063 vs 9.515 ± 9.255) than the others (p> 0.05). Conclusion: Healthcare workers actively working during the COVID-19 pandemic have high levels of anxiety. Working conditions of health workers should be improved and psychosocial support activities for them should be implemented continuously.

The aim of this study is to evaluate the sleep behaviors of healthcare professionals working in secondary and tertiary hospitals in a large population in Turkey and to show how sleep quality is affected during the pandemic process by using the easily applicable Jenkins sleep scale (JSS). Methods The population of this cross-sectional descriptive study consists of two pandemic hospitals (2nd level state hospital and 3rd level university hospital) determined in Kahramanmaraş province. Data were collected between 03.08.2020 and 30.09.2020 with responses to online survey questions. The security of the data was assigned to SurveyMonkey enterprise. In our questionnaire, we asked subjective sleep quality (poor, moderate, high), sleep time (<24:00 and ≥24:00), time to fall asleep (minutes), total sleep time (hours), and medication use (sleeping pills). We also used Jenkins Sleep Scale Turkish version (JSS-TR) to assess sleep quality and the Epworth sleepiness scale (ESS) for increased daytime sleepiness. Results Healthcare workers who participated in our survey reported that they started to go to bed later, fell asleep later (mean: 41.75±35.35 minutes), their total sleep time (mean: 6.67±1.88 hours) was shortened, and they needed medication to sleep more (%5.7) after the COVID-19 pandemic. During the COVID-19 pandemic, bedtime behavior after 24:00 decreased from 80.1% to 43.9% of those who previously went to bed before 24:00. For those who went to bed after 24:00 before, it increased from 19.9% to 56.1%.In addition, sleep quality as assessed by subjective and JSS significantly deteriorated after the COVID-19 pandemic. Excessive daytime sleepiness increased. Those with ESS>10 before COVID-19 were 3.9%, post- COVID-19 ESS>10 14.1% (p<0.001). Conclusion The COVID-19 pandemic has significantly adversely affected the sleep behavior and sleep quality of healthcare professionals. The JSS is an easily applicable scale for assessing sleep quality in large population studies.

The first case of sever pneumonia caused by coronavirus (COVID-19) was detected in Wuhan, China in December 2019 and spread rapidly around the world. Pneumothorax has been reported as an uncommon complication following COVID-19 infection which caused by alveolar rupture, air leakage and interstitial emphysema after alveolar damages. Bilateral pneumothorax is also an uncommon life threatening complication induced by COVID-19 which has to be considered in patients present with late sudden dyspnea after Coronavirus infection. In this case report, we are presenting a patient with mild COVID-19 pneumonia with a left massive pneumothorax following a late sudden dyspnea in third week of the disease, during the hospitalization, in addition to aggravating the respiratory condition, right pneumothorax was also added.

Introduction/Background: The nationwide lockdown enforced due to the devastating effect of the coronavirus disease -2019 had a definite impact on sleep health. Objective: To look out for any change in the duration, pattern and quality of sleep among pharmacy students that can be attributed to the lockdown. Methods: A google form-based cross-sectional and descriptive study was carried out after approval was obtained from the institutional ethics committee in the month of July 2021 among 310 pharmacy students. The validated form was electronically administered after obtaining the volunteer informed consent. All the data pertaining to duration, pattern and quality of sleep before and during the lockdown was collected and analysed using STATA version 16.0. Results and Discussion: Out of the total 310 participants, majority of the respondents were females 242 (78.06%). The study revealed an increase in the time needed to fall asleep (p-value<0.001) and in the total duration of sleep (p-value<0.001). A delay in the time of sleep in the morning (p-value<0.001) and at night (p-value<0.001) was also one among the many significant results. Well known reasons or consequences of disturbed sleep such as jerky leg movements (p-value<0.001), snoring (p-value<0.001), frequent nightmares (p-value<0.001) and anxiety (p-value<0.001) were also increased as a direct effect of the lockdown. Conclusion: The study has been able to establish the incidence of significant disturbances in the sleep architecture of pharmacy students due to the lockdown.

Background: Neutralizing antibody (NAb) is an important immunological marker in Coronavirus disease 2019 (COVID-19). This study aims to explore the different changes of NAbs level in COVID-19 patients and screen specific laboratory findings to predict disease severity. Methods: Eighty-eight COVID-19 patients, forty-eight healthy controls and sixty-two healthy vaccinated people were included. Epidemiological, clinical and laboratory data were obtained from the electronic medical record information system. The NAbs levels were determined by the double antibody sandwich method. The first set of laboratory results of the COVID-19 patients was selected after onset to construct the receiver operating characteristic curve (ROC). Correlation curves were also constructed to explore the relationship between laboratory findings and NAbs. Results: In mild cases of COVID-19, NAbs levels reached the peak at 25-30 days after onset. NAbs levels during convalescence were lower than those after onset and were found to gradually decrease during 0-15 days. In severe cases, NAbs levels peaked at 20-25 days after onset. The ROC analysis demonstrated that the area under the curve of C-reactive protein (CRP) was 0.94 at 20.42 mg/L cut-off with sensitivity and specificity of 100% and 82% respectively. The levels of NAbs, CRP, glucose (Glu), neutrophils (NE) and urea nitrogen (Urea) in mild cases were lower than those in severe cases (p<0.05). Correlation analysis showed that CRP was positively associated with NAbs. Conclusion: The levels of NAbs dynamically changes at different stages in COVID-19 patients with various severities. CRP and other laboratory findings provide the basis for clinical differential diagnosis.

Brugada syndrome is an inherited arrythmia syndrome characterized by a right bundle branch block and dynamic ST-segment changes in precordial leads V1-V3. In patients with Brugada syndrome, fever is a known trigger that may induce arrythmia. For patients with Brugada syndrome who contract COVID-19, the inflammatory response poses risk of causing ventricular arrythmias. The following case discusses management of a patient with Brugada syndrome presenting with electrical storm after contracting COVID-19. Treatment should be focused on aggressive antipyretic management along with concomitant pharmacological therapy.

Background: Healthcare workers (HCWs) are the occupational group with the highest potential to be affected by infectious diseases and epidemics. Objectives: In this study, it was aimed to reveal the fatigue and sleep quality levels of HCWs who survived COVID-19 and influencing factors. Methods: This cross-sectional study was conducted with 133 post-COVID-19 HCWs who applied to internal medicine outpatient clinic between March 1, 2021 and April 15, 2021 in Turkey. Sociodemographic Data Form, Fatigue Assessment Scale (FAS) and Pittsburgh Sleep Quality Index (PSQI) were used to obtain research data. Results: More than half of the post-COVID-19 HCWs had fatigued (55.6%) and had poor sleep quality (59.4%). The mean fatigue and sleep quality score was higher under the age of 40. Increasing PSQI score (the worse sleep quality), increased the fatigue 1.54 times. Being female worsened sleep quality 6.61 times, being overweight worsened sleep quality 4.81 times, and increasing FAS score worsened sleep quality 1.39 times. Discussion: In this study, it was determined that post-COVID-19 HCWs had high levels of fatigue and sleep quality. order for the health service to continue without interruption during the prolonged pandemic process, it is thought that post-COVID-19 HCWs should be followed up regularly in terms of possible health problems.

Background: The aim of our analysis was to evaluate the impact of the COVID-19 pandemic on the procurement program and kidney transplantation in Slovakia and to identify the risk factors for a severe course of COVID-19 disease, as well as the risk factors for COVID-19 fatalities, with focus on the parameters preceding the infection. Methods: 305 KTRs (68.8% males) with confirmed SARS-CoV-2 positivity were included in the multicentric retrospective analysis. Results: The procurement program and kidney transplants in Slovakia dropped in the observed period by 28.6% (P<0.0001) and by 33.5% (P<0.0001) respectively. Age over 59 years (OR=1.03, P=0.0088) and diabetes mellitus (OR=2.04, P=0.0106) were identified as independent risk factors for severe course of the disease. Risk factors for death were age over 59 years (OR=1.05, P=0.0003) and graft dysfunction with CKD-EPI<0.5 mL/s (OR=4.87, P=0.0029). The prevalence of the alpha variant in Slovakia was associated with a severe course in KTRs treated with corticoids (OR=5.72, P=0.0273) and in graft dysfunction with CKD-EPI<0.5 mL/s (OR=2.94, P=0.0076); the risk of death was higher in KTRs over 59 years (OR=1.07, P=0.0173) and again with CKD-EPI<0.5 mL/s (OR=4.42, P=0.0393). KTRs had a 3.7 times lower risk of infection compared to hemodialysis patients (14% vs 52%, P<0.0001), with mortality of 9.8% vs 30% (P<0.0001). Conclusion: The procurement and transplant program is sustainable even during a pandemic, provided that measures are set up quickly. Morbidity and mortality from COVID-19 in KTRs was comparable to the situation in EU countries.

The understanding of Coronavirus disease 2019 (COVID-19) immune dysregulation is evolving. Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease with alternations in both innate and adaptive immunity, probably caused by a complex interplay of genetics and environmental exposure with various triggers. A rare hematological complication of SLE as well as recently reported in adult with COVID-19 is thrombotic thrombocytopenic purpura (TTP). We report a pediatric case with features suggestive of multisystem inflammatory syndrome in children (MIS-C) with coronary artery ectasia, TTP, autoimmune hemolytic anemia (AIHA) and thrombocytopenia with new onset SLE as well.

Background: Coronavirus disease 2019 (COVID-19) has become pandemic in 2020 and recently mutated coronavirus has emerged in many countries. This study firstly identified the clinical characteristics and risk factors for COVID-19 patients in Zhengzhou for clinical prevention and management. Methods: A total of 70 patients hospitalized with COVID-19 were enrolled between 21th January and 29th February 2020, in Zhengzhou, China. Clinical characteristics, hematological findings, neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and inflammatory index on admission were selected from medical records and the comparison between COVID-19 patients with different outcomes were evaluated. Results : The median age was 55 years. Forty-three (43%) patients were classified as severe or critical cases. Eighteen (12.8%) patients died in hospital and the remaining fifty-two were discharged. Patients who died tend to old aged, expectoration, with chronic obstructive pulmonary disease. Compared to survivor, non-survivor has significantly higher leucocytes, neutrophils, NLR, AST, GGT, TBIL, DBIL, LDH, PT, D-dimer, CRP, and decreased platelet, lymphocyte, UA, ALB, CHE, PTA. Multiple logistic regression analysis identified leucocytes, platelet, PLR, NLR, AST, and ALB as independent factors for poor outcomes. The AUC of combination of leucocyte, PLR, NLR, and AST have the largest area under curve at 0.87, with the sensitivity of 0.83 and specificity of 0.81. Conclusion : Our results identified the risk factors among COVID-19 patients in-hospital fatality. Leucocyte, PLR, NLR, and AST could have important reference value for prognostic prediction and early intervention.

Aim: Our aim was to investigate the relationship between prothrombintime(PT), activated partial thromboplastin time (aPTT), INR (International Normalized Ratio) and D-dimer levels, platelet (PLT)levels at admission to hospital and positivity or negativity of Polymerase Chain Reaction (PCR) result in patients with suspected COVID-19 followed at COVID-19 services. Material and Method: 238 people who applied with suspicion of COVID-19 in March-April-May of 2020 were included in the study. According to COVID-19 results, PCR negative 119 participants and PCR positive 119 patients were included in the study. PT, aPTT, Ddimer, INR and PLT levels were examined. Results: While PCR negative participants had a mean PT value of 11.46±0.86 sec, PCR positive patients had a mean PT value of 12.97±3.65 sec (p<0.001). There was no significant difference in mean aPTT values of PCR positive and negative patients. Whereas INR, D-dimer increased significantly in PCR positive patients. PLT value decreased from mean value of 266.75±71.36*109/L in PCR negative participants to 241.18±96.64*109/L in PCR positive patients (p=0.002). Conclusion: In our study, it was found that in patients who were admitted to Samsun Training and Research Hospital with COVID-19 suspicion and followed up in COVID-19 services, PT, D-dimer, INR, PLT values were important in detecting Coagulopathy and Thrombocytopenia in the group who were PCR positive according to COVID-19 results. Keywords: COVID-19, PT, aPTT, D-dimer, INR, PLT

Hydatid cyst of pulmonary artery is extremely rare. There were few reports of intramural involvement of pulmonary artery secondary to cardiac or lung hydatic cyst in literature. To the best of our knowledge there was no report of primary isolated extraluminal hydatid cyst of left pulmonary artery. A twenty-eight–year-old female presented to the hospital with complaint of progressive dyspnea. The patients had no common COVID-19 infection symptoms. The RT-PCR for COVID-19 RNA was negative. Spiral chest CT-scan demonstrated a cystic mass sized 83×34 in middle mediastinum. Intraoperatively, the intrapericardial mass arising from left pulmonary artery and extended to the hilum of left atrium. The mass was resected and pathology report noted a hydatid cyst. The postoperative course was uneventful and the patient was discharged with administration of albendazol for 3 months. However hydatid cyst primary isolated extraluminal hydatid cyst of pulmonary artery are extremely rare, in cases with pulmonary artery stenos or hypertension manifestation should be considered as a probable differential diagnoses. Regarding to ongoing COVID-19 pandemic the present case misdiagnosed with coronavirus infection.

The prevalence of asthma in children in Europe is an average of 10.3%. The role of asthma as a risk factor for COVID-19 in children is unknown. Our aim was to study the prevalence of asthma in children with SARS-CoV-2 infection and to compare them in hospitalized children and those with mild ambulatory symptoms. We conducted an observational retrospective study in 99 children (between 3- 17 years of age) with a confirmed SARS-CoV-2 infection between March and December 2020. The existence of a history of asthma was investigated using the validated ISAAC questionnaire and clinical data on COVID-19 were compiled. The median age was 10 years (IQR=13-5), and 60/99 (60.6%) patients had mild infections controlled as outpatient, while 39/99 (39.4%) required admission. The prevalence of asthma ─affirmative response to question 6 of the ISAAC questionnaire─ was 11.1% (11/99). The prevalence of asthma in children who required admission increased to 17.9% and to 21.4% in patients requiring PICU, while in outpatients children was 6.7% (p=0.079). We found a significant association between the use of salbutamol during the last year and the need for admission (23.1% in hospitalized patients vs 3.3% in outpatients; OR= 8.7, 95%CI 1.7-42.8). Likewise, budesonide treatment in the last year (17.9% vs 1.7%, OR= 12.9, 95%CI 1.5-109.5) was also a risk factor for admission. Therefore, a history of asthma was not a risk factor for SARS-CoV-2 infection in our series, but active asthma could be a risk factor for severity and need for hospitalization for COVID-19 in children

COVID-19 has caused global pandemics since the emergent outbreak and resulted in a large number of deaths. IL-6, as an important autoimmune cytokine, had been suggested for the treatment of acute respiratory distress syndrome (ARDS) patients in COVID-19. A review of the relevant literature revealed more than one role for IL-6 in the lung infection because of its diverse biological effects. It may have a variety of different physiological functions in the development of lung infection. We have summarized its role in different progress of COVID-19, including lung infection, pneumonia, ALI, pulmonary fibrosis, and lung translation and even lung cancer. This will facilitate a deeper understanding of the role of IL-6 in the treatment of COVID-19.