Clinical characteristics of patients hospitalized for COVID-19 vaccinated with at least two doses in a tertiary care hospital in Turkey

Background. We aimed to examine the characteristics of Turkish patients hospitalized with COVID-19 despite being fully vaccinated. Method. A retrospective, single-center study was conducted in fully vaccinated patients with inactivated whole virion (CoronaVac) and/or BNT162b2 mRNA (Pfizer-BioNTech) vaccines and admitted to the hospital. We evaluated the hospitalized patients regarding the intensive care unit admission and death. A multivariate binary logistic regression analysis was used to determine the factors for mortality. Results. We conducted the study with 541 patients. The mean age was 70.2, and 52.1% of the patients were women. 73.6% of the patients were 65 years or older. The most common comorbidities were hypertension, diabetes mellitus, and COPD. The rate of the alpha variant was 54.3%, and the delta variant was 29.4%. The mortality rate was 45.8%, and the ICU admission rate was 55.3%. The delta (B.1.617.2) variant had higher ICU admission and mortality rate. Patients vaccinated with two-dose Sinovac-CoronaVac had a higher mortality rate. There was no difference between the time between the last vaccination dose to hospitalization, ICU admission, and mortality. LOS in the hospital was longer in ICU and mortality patients. In multivariate binary logistic analysis; age (odds ratio (OR), 1.06; 95% confidence intervals (95% CI) 1.04-1.08- year increase), male gender (OR, 1.57; 95% CI, 1.04-2.38), presence of comorbid diseases (OR, 4; 95% CI, 2-8) and delta variant (OR, 7.3; 95% CI, 4.4- 12.2) and vaccination with CoronaVac plus BioNTech (OR, 0.21; 95% CI, 0.07-0.62) were associated with death. Conclusion. Our results suggest administering a third and fourth dose of mRNA vaccine to subjects vaccinated primarily with two doses of CoronaVac

Seroprevalence of SARS COV-2 anti-nucleocapsid antibodies in Turkish healthcare workers before vaccination schedule: January 2021

Objective: We aimed to assess the seroprevalence of SARS-CoV-2 infection and associated factors among Turkish HCWs, before the Covid-19 vaccination program in January 2021. Material and methods: We performed antibody assessment against SARS-CoV-2 in blood samples from participants using the Elecsys® Anti-SARS-CoV-2 electrochemiluminescence immunoassay. Samples with a cut-off index (COI; signal sample/cut-off) <1.0 were considered negative, samples with ≥1.0 were deemed positive. Results: 714 HCWs, 487 women (68.2%), were included in our study. The mean age of the participants was 35.9 ± 8.4 (min:18, max: 62). 370 (51.8%) HCWs's the antibody level was negative, and 344 (48.2%) was positive. While 47.1% (n=122) of the HCWs with positive RT-PCR were antibody positive, 48.8% (n=222) were negative. There was no statistically significant difference in mean age and age groups (p values ​​0.338 and 0.414, respectively). Also, there was no statistically significant difference in antibody levels by gender (p=0.236). There was no significant difference between antibody positivity according to the presence of comorbidity, and the risk area studied (p=0.556, p=0.335, respectively). There was a statistically significant difference between lung involvement and antibody positivity during Covid-19 infection (p= <0.001). Conclusion: In our study, the seroprevalence of SARS-CoV-2 antibodies in HCWs was higher than the average population and approximately fifty percent. Multicenter studies with more HCWs would be helpful to determine overall seroprevalence rates

CAN HOMEOPATHY BE A "REMEDY" FOR LOSS OF SMELL AND TASTE IN PATIENTS WITH COVID-19?

Background: Homeopathy is applied as a supportive in the treatment of viral infections and in relieving their symptoms. Objective: To create an awareness that effective remedial results can be obtained by homeopathy in patients with loss of smell and taste in Coronavirus Disease 2019. Methods: A prospective, cohort and randomized study was conducted. The main inclusion criterion was the loss of smell and taste for at least one week. Homeopathic remedies were also applied as supportive therapy. Visual Analog Scale (VAS) was used to evaluate the loss of smell and taste perception before and after treatment. Results: A total of 30 patients, 32.17±10.25 years, were included in the study. The mean pre-treatment VAS-smell perception of the patients was 0.67±1.24, while the mean VAS-taste perception was 2.57±3.01. After the treatment, the mean of VAS-smell perception was 8.67±1.92, while the mean of VAS-taste increased to 9.43±1.22. There was a strong positive correlation between ΔVAS-smell perception and ΔVAS-taste perception (r: 0.563, p: 0.001). There was also a strong negative correlation between ΔVAS-taste perception and the level of ferritin (r: -0.552, p: 0.002). Conclusion: The present study on the effective improvement via homeopathy treatment in patients with loss of smell and taste in COVID-19 that “has spoiled the taste of life and living” should be supported by further studies

The course of COVID-19 in patients with hematological malignancies and risk factors affecting mortality: A cross-sectional study

Objective: This study aimed to determine the clinical outcomes and risk factors affecting mortality in patients with COVID-19 following hematological malignancy (HM). Methods: Patients diagnosed with HM and hospitalized for COVID-19 were included in this retrospective study. The age, demographic and clinical characteristics, prognosis and treatment of surviving and non-surviving patients were compared. Results: A total of 49 patients were included in this study, 17 (34.6%) of whom died within 28 days of being diagnosed with COVID-19. Older age (p = 0.001), diabetes (p = 0.001), chronic obstructive pulmonary disease (p = 0.002), secondary infection (p < 0.001) and secondary bacterial infection (p = 0.005) were statistically significantly higher in non-survivors. The remission status of HM was higher in surviving patients (p < 0.001). In multivariate regression analysis, age (OR: 1.102, p = 0.035) and secondary infection (OR: 16.677, p = 0.024) were risk factors increasing mortality, the remission status of HM (OR: 0.093, p = 0.047) was a protective factor from mortality. Conclusion: The older age, the remission status of HM and secondary infection due to COVID-19 were determined as prognostic factors predicting mortality in HM patients with following COVID-19

The association of De Ritis ratio with the severity of Crimean-Congo hemorrhagic fever

Aim: This study aimed to present the characteristics and poor prognostic factors of Crimean-Congo hemorrhagic fever (CCHF) patients. Materials & methods: Adult patients (>18 years) with CCHF were included in this retrospective study. Demographics, risk scores and laboratory findings of survivors and nonsurvivors were compared. Results: Fifteen (9.2%) of 163 CCHF patients were nonsurvivors and had a higher Severity Score Index (p 3 in 10.1% of survivors and 53.3% of nonsurvivors (p 3 (OR: 5.428, p = 0.045) and SGS (OR: 1.776, p = 0.005) were found as predictive factors. Conclusion: De Ritis ratio may predict prognosis in combination with severity risk scores in CCHF. Plain language summary Crimean-Congo hemorrhagic fever is a disease caused by a virus that causes a high fever and bleeding. Unfortunately, there is no cure for this disease yet. It is important for doctors to be able to predict which patients are more or less likely to get better, so they need inexpensive tests to predict this. One example test checks the liver enzymes in the blood. This study looked at these tests and discovered that when a certain enzyme called aspartate transaminase is high, patients were more likely to be seriously ill and the sickness affected their whole body. Another enzyme called alanine transaminase was also high when sickness was severe. By checking liver enzymes, doctors can predict whether a patient will recover. If the ratio of these two enzymes, called the De Ritis ratio, is more than 3, the patient may not recover easily. Tweetable abstract De Ritis ratio (aspartate transaminase/alanine transaminase) increases in correlation with clinical severity in patients with Crimean-Congo hemorrhagic fever. If the De Ritis ratio is >3, the probability of mortality is found to increase 5.4-times

Low-dose tocilizumab is associated with improved outcome and a low risk of secondary infection in severe COVID-19 pneumonia

Background Respiratory failure and death are the leading causes of severe Coronavirus disease 2019 (COVID-19). Hyper-inflammation and cytokine storm cause lung damage. This study aimed to compare the low-dose and high-dose effects of tocilizumab, an IL-6 receptor antagonist. Method Patients with severe pneumonia and hyper-inflammation signs because of COVID-19 were included in this retrospective study. Patients receiving tocilizumab = 200 mg as the high-dose group, and those not treated with tocilizumab as the control group. Demographic and clinical data of patients who died and survived in both low-high dose and control patients were compared. According to symptom day and radiological infiltration, patients with tocilizumab were also evaluated in two groups as early and late periods at tocilizumab administration time. Results A total of 160 patients were included in the study; 70 were treated with a low dose and 50 with high-dose tocilizumab. Forty patients were in the control group. Age, comorbidity and clinical features were similar in the control, low-dose tocilizumab and high-dose tocilizumab groups. The mortality rate (12.9%, 30.0%, 37.5, P = .008) was less in the low-dose tocilizumab group. The secondary infection rate was higher in the high-dose group than in the low-dose tocilizumab and control groups (44.0%, 10.0%, 10.0%, P < .001). Distinguishing between those patients who died and survived, age (OR: 1.1589, P < .001), higher APACHE II scores (OR: 1.225, P = .001) and needs for non-invasive mechanical ventilation (OR: 14.469, P < .001) were the most critical risk factors. Low-dose tocilizumab was associated with a lower mortality rate (OR: 0.244, P = .012). Conclusion The use of tocilizumab at a low dose is associated with lower secondary infections and mortality

The Outcomes of Direct-acting Antiviral Treatment in 177 Patients with Hepatitis C Virus: A Single-center Experience

Introduction: Hepatitis C virus (HCV) is an essential cause of hepatitis, cirrhosis, and hepatocellular carcinoma. Hepatitis C virus is a global public health problem. “Field practice” in patients with HCV infection is significant for directly observing treatment responses with antiviral agents. Our study aimed to evaluate the effectiveness of direct-acting antivirals (DAAs) in Kayseri City Hospital. Materials and Methods: Our retrospective observational study, conducted at a single center, evaluated HCV-RNA-positive patients who were genotyped between January 2019 and April 2023. Demographic characteristics, laboratory values, treatment agents, and HCV genotypes of the patients were recorded using the hospital information system. The primary endpoint of the study was the sustained virological response 12 weeks after treatment. Results: In our five-year study involving 177 patients, the average age was 60.6, and 55.4% (n=98) of the participants were male. Genotype 1b was the most common at 51.8%, followed by genotype 4 at 19.2%. Additionally, six of 11 Syrian patients were identified as genotype 3. The glecaprevir/pibrentasvir combination was administered to 91.5% of the patients, while the sofosbuvir/velpatasvir/voxilaprevir combination was started in 8.5% (n=15). A total of 6.2% of the patients had prior treatment experience. At week 12, all patients exhibited negative HCV-RNA levels, resulting in a 100% treatment success rate. Conclusion: These two DAAs currently used in HCV infection were highly effective. The prevalence of genotype 4 in our region was higher than the national HCV genotype distribution