HSV and SARS-CoV-2 Encephalitis “Or to Take Arms Against a Sea of Troubles (W. Shakespeare)”

Published data suggest that encephalitis is one of the most fatal neurologic manifestations of coronavirus disease-2019 (COVID-19) involving both adult and pediatric patients. Herpes simplex virus (HSV) encephalitis is one of the most common causes of sporadic encephalitis. There have been cases of systemic and pulmonary reactivation of HSV due to immune dysregulation following COVID-19 infection. An 88-year-old woman diagnosed with Alzheimers disease was admitted to the intensive care unit (ICU) with fever and general condition disorder. On admission, the patient with fever and neck stiffness was found to be positive for HSV DNA in the cerebrospinal fluid (CSF) sample studied with lumbar puncture (LP) and positive for COVID polymerase chain reaction (PCR) in the nasopharyngeal swab sample taken together. While the COVID PCR test was positive in the CSF sample studied with LP performed on the 9th day of intensive care hospitalization, HSV DNA was found to be negative in the patient whose acyclovir treatment was continued. The COVID PCR test was also positive in the nasopharyngeal swab sample taken at the same time. Cardiac arrest occurred after sudden desaturation, and the patient was resuscitated for 6 min on the 11th day of ICU admission. Left frontotemporal epileptic activity in bedside electroencephalography was evaluated in favor of focal disorganization. In addition to frontotemporal lobe involvement, which is common in HSV and COVID-19 encephalitis, we want to report the coexistence of these two viruses. We believe that this case report should help professionals remind co-infections of HSV and severe acute respiratory syndrome coronavirus-2 to cure the morbidity appropriately

Picturing asthma in Turkey: results from the Turkish adult asthma registry

Introduction: National data on asthma characteristics and the factors associated with uncontrolled asthma seem to be necessary for every country. For this purpose, we developed the Turkish Adult Asthma Registry for patients with asthma aiming to take a snapshot of our patients, thereby assigning the unmet needs and niche areas of intervention. Methods: Case entries were performed between March 2018 and March 2022. A web-based application was used to record data. Study outcomes were demographic features, disease characteristics, asthma control levels, and phenotypes. Results: The registry included 2053 patients from 36 study centers in Turkey. Female subjects dominated the group (n = 1535, 74.8%). The majority of the patients had allergic (n = 1158, 65.3%) and eosinophilic (n = 1174, 57.2%) asthma. Six hundred nineteen (32.2%) of the patients had obese asthma. Severe asthma existed in 670 (32.6%) patients. Majority of cases were on step 3–5 treatment (n: 1525; 88.1%). Uncontrolled asthma was associated with low educational level, severe asthma attacks in the last year, low FEV1, existence of chronic rhinosinusitis and living in particular regions. Conclusion: The picture of this registry showed a dominancy of middle-aged obese women with moderate-to-severe asthma. We also determined particular strategic targets such as low educational level, severe asthma attacks, low FEV1, and chronic rhinosinusitis to decrease uncontrolled asthma in our country. Moreover, some regional strategies may also be needed as uncontrolled asthma is higher in certain regions. We believe that these data will guide authorities to reestablish national asthma programs to improve asthma service delivery