Aim: Practices such as the use of masks, cleaning measures, and social distancing have come to the fore to prevent the COVID-19 pandemic. In addition to this, the most important way to fight the epidemic seems to be vaccination. However, “vaccine hesitancy” is seen as an important obstacle to attempts to control the pandemic. With this study, we have aimed to evaluate the effects of having inadequate or incorrect information, one of the possible determinants of attitudes towards the COVID-19 vaccine. Study Design: A cross-sectional design was used. Methods: The data were collected via an online questionnaire from patients who agreed to participate in the study. Sociodemographic Data Form, Turkey Health Literacy Scale-32 (THLS-32) and Anti-Vaccine Scale are filled by 496 participants in total. Results: According to the results of our study, 7.5% of the participants stated that they would not be vaccinated and 14.3% are indecisive. We have found a negative correlation between vaccine refusal and health literacy, thus confirming the main hypothesis of our study. Also, education year was a negative predictor of vaccine hesitation. Conclusions: Currently, the most important approach in fighting the pandemic is the vaccination of society. Having the right information is extremely important to fight vaccine refusal attitudes. The fight against vaccination requires joint efforts from governments and media resources, including social media.

COVID-19 pandemic has caused a necessary reorganization of the elective outpatient device clinic. Remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) has been validated as a safe and effective tool to follow patients, limiting the need for in-person visits. We provided a snapshot of the current clinical practice in a tertiary electrophysiology center in Italy, suggesting a potential model of care for patients with CIEDs. Before the COVID-19 pandemic, patients with implantable cardioverter defibrillators/cardiac resynchronization therapy (ICD/CRTs) were evaluated in the device clinic twice a year and patients with pacemakers (PMs) once a year; loop recorder (ILR) patients were followed remotely only. In the COVID-19 period RM was implemented for all compatible CIEDs. Patients with RM were not seen in clinic anymore and were followed with RM. In the COVID-19 period, 100% of newly implanted devices received RM (82 ILR, 194 PMs, 80 ICDs/CRTs), compared to 68% in the same months of 2019 (106/106 ILR, 83/203 PMs, 78/82 ICD/CRTs), p<0.01. Moreover, 502 previously implanted patients with RM compatible devices were contacted and received RM. By the end of February 2021, 1676 patients were remotely monitored at our Institution, with a potential saving of outpatient visits of 1683 visits/year, against an average of 8514 RM transmissions/year needing evaluation. RM of CIEDs is essential to reduce in-person visits during the COVID-19 pandemic. The potential for elective outpatient appointments reduction has to be counterbalanced by the sustainability of a large number of transmissions and data to analyze.

Background: Following the rapid global spread of the novel coronavirus SARS-CoV-2, the World Health Organization declared COVID-19 a pandemic on March 11, 2020. Over the intervening year, there has been interest in the impact of both SARS-CoV-2 infection and pandemic-induced social restrictions on male reproductive health. This study aimed to evaluate the spermiogram values of men who presented to a urology clinic due to infertility during the pandemic and compare the results with those in the previous two years. Materials and Methods: Patients who presented to the urology outpatient clinic of Medical Park Antalya Hospital Complex for the first time due to infertility were included. The patients’ age, semen volume, and spermiogram results were recorded. The patients were divided by presentation date into pre-pandemic group 1 (March 2018 - February 2019), pre-pandemic group 2 (March 2019 - February 2020), and the pandemic group (March 2020 - February 2021) for comparison. Results: A total of 594 patients were included in the study. There was no significant difference between the three groups in terms of the number of patients who presented (207, 190, and 197 patients, respectively; p=0.691). The mean age was 36.6±7.2 in pre-pandemic group 1, 35.5±7.1 in pre-pandemic group 2, and 33.1±6.3 in the pandemic group. Patients who presented during the pandemic were significantly younger (p<0.001). There was no difference in semen volume among the groups (p=0.910). Analysis of spermiogram results revealed no significant differences in normospermia and pathological spermiogram rates by year (p=0.222). Conclusion : In the first year of the COVID-19 pandemic, there was no significant difference in the number of men who presented for infertility or in their spermiogram results compared to 2018 and 2019. However, it is noteworthy that the patients were significantly younger during the pandemic than in the previous two years.

Aim. To compare the cases reported to the Spanish Pharmacovigilance System (SEFV-H) with HCQ used in COVID-19 vs. HCQ used in other indications. Methods. All cases of adverse drug reactions (ADR) submitted to the Spanish Pharmacovigilance database (FEDRA) from 1 January 1982 to 19 February 2021 suspected to be induced by HCQ were identified. Cases were classified into two groups: no-Covid patients and Covid patients. Frequencies of ADR were compared. Reporting Odds Ratios (ROR) with its lower limit of the 95% confidence interval (-ROR) and Omega (Ω) and its lower limit of the 95% credibility interval (Ω -025) were obtained to estimate disproportionalities. Results. More severe cases were reported with the use of HCQ in Covid. Main differences in frequency were observed in hepatobiliary, skin, gastrointestinal, eye, nervous system and heart ADRs. During the Covid-19 pandemic, disproportionality was found for Torsade de Pointes/QT prolongation with a ROR (-ROR) of 132.8 (76.7); severe hepatotoxicity, 18.7 (14.7); dyslipidaemias, 12.1 (6.1); shock, 9.5 (6.9) and ischaemic colitis, 8.9 (2.6). Myopathies, haemolytic disorders and suicidal behaviour increased their disproportionality during the pandemic. Disproportionality was observed for neoplasms, haematopoietic cytopaenias and interstitial lung disease in the pre-Covid period. Ω showed potential interactions between HCQ and azithromycin, ceftriaxone, lopinavir and tocilizumab . Conclusions. The use of HCQ in Covid-19 changed its safety profile. Of particular concern during the pandemic were arrhythmias, hepatotoxicity, severe skin reactions and suicide risk, but not ocular disorders. Some ADRs identified as signals would require more detailed analyses.

Background: Long COVID are the uninterpretable symptoms of COVID-19. However, quality of life and other factors among COVID-19 survivors remain less clear. Objectives: The aim of the study was to evaluate impact of COVID-19 pandemic on quality of life and effecting factors among adults with long COVID. Design and Setting: This cross-sectional study included 440 individuals applying at family health centers for any reason. Methods: The survey consisted of two parts: the first related to socio-demographic information; the second including “COVID-19 Quality of Life Scale”and the “Perception Health Scale”. Results: Of the participants, 40.9% were male, 59.1% were female as well as 33.2% had at least one long COVID symptoms. The median COV19-QoLand Perception of Health Scale scores were 3.0 and 40.0 respectively. Among the prolonged COVID symptoms, fatigue/tiredness was shown with 53.2%. Other common symptoms were muscle pain (27.1%), headache/dizziness (24.1%), difficulty thinking or concentrating (20.9%), difficulty in breathing and heart palpitation (20.0%). The COV19-QoL median score significantly differed by education level, existing chronic conditions, COVID-19 treatment type, number of experienced long COVID symptoms and continuation of the symptoms p<0.05. There was significant correlation between COV19-QoL and age, time since first infected and perceived health score (p<0.05). Conclusion: Aging, low education, existing chronic conditions, hospitalization, number of long symptoms, continuation of symptoms, and perception of health were risky factors for impact of the pandemic on quality of life. Specific rehabilitation services and programmes seems to be urgent need in overcoming this issue and to improve health. Key Words (MeSH Terms): Long COVID; COVID-19; quality of life; adults; family health

The second wave of COVID 19, far outnumbered the first, in cases and deaths. We report outcome of pediatric cancer patients with COVID-19 during the second wave, from a tertiary center in India. Out of 41 patients who tested positive; 51% were asymptomatic, 36% had mild symptoms, 12 required admissions in ward and 4 in intensive care. Mechanical ventilation, systemic steroids, Remdesivir and IVIG were required in those admitted to intensive care unit. Out of 4 deaths (9.7%), 3 occurred in adolescent age and 2 had superimposed bacterial/viral infections. Other contributors to mortality were: cachexia, airway obstruction, disease relapse.

The outbreak of the new coronavirus (COVID-19) has been transferred exponentially. There are many articles that have found the inhibitory effect of plant extracts or plant compounds on the coronavirus family. In this study, we want to use systematic review and meta-analysis to answer the question of which herbal compound can be more effective against the coronavirus. The present study is based on the guidelines for conducting meta-analyzes. An extensive search was conducted in the electronic database, and based on the inclusion and exclusion criteria, articles were selected and data screening was performed. Quality control of articles was performed. Data analysis was carried out in STATA software. The results showed that alkaloid compounds had a good effect in controlling the coronavirus and reducing viral titer. Trypthantrin, Sambucus extract, S. cusia extract, Boceprevir and Indigole B, dioica agglutinin urtica had a good effect on reducing the virus titer but their selectivity index has not been reported and it is recommended to determine for these compounds. Also among the compounds that had the greatest effect on virus inhibition, including Saikosaponins B2, SaikosaponinsD, SaikosaponinsA and Phillyrin, had an acceptable selectivity index greater than 10. Andrographolide showed the highest selectivity index on SARS-COV2, while virus titration and virus inhibition were not reported. The small number of studies that used alkaloid compounds was one of the limitations and it is suggested to investigate the effect of more alkaloid compounds against the coronavirus for verifying its effect.

Aims: During the COVID-19 outbreak, international students in the U.S. were informed that they would be deported to their home countries if enrolled in fully online programs. Although this proclamation was soon altered to permit students to continue learning online without fear of being deported, it spread a wave of stress and anxiety among international students all over the U.S. We aim to capture the emotional challenges and hardships faced by international students due to the changes in U.S. visa regulations during the COVID-19 outbreak. Methods: We conducted a cross-sectional online survey using previously validated questionnaire tools (PHQ-9 and GAD-7), and we received 165 complete responses from international students at University of Florida (UF). The collected data was quantitatively analyzed through ANOVA, Independent Sample t-Test, and Binary Logistic Regression. Results: Our findings provided insights into one main research question: “How did the changes in student visa regulations during the COVID-19 outbreak affect the anxiety and depression levels among international students at UF?” A total of 18.8% (n= 31) of our study sample had a depression score of (15 and above) on the PHQ-9 scale, which is interpreted as moderately severe to severe depressive status. A similar proportion (20.6%; n= 34) scored (15 and above) on the GAD-7 scale, and was symptomatically diagnosed as having severe anxiety. There was also a statistically significant difference in the means depression and anxiety scores based on gender, where males showed lower scores compared to any other demographic group. Conclusion: Our findings show that international students were affected psychologically due to changes in U.S. visa regulations during the COVID-19 outbreak. The findings of this study addressed the importance of taking serious measures when emotionally impactful political issues arise in order to prevent the development of mental illnesses among international students at institutions of higher education.

In the monthly reported by the European Centre for Disease Prevention and Control virus variants, the increasing tendency in the number of positively loaded residues was observed. The formal charge of 34 SARS-CoV-2 lineages since September 2020 to June 2021 was analyzed. The point mutations or small insertions were considered in the crucial for viral infection regions of the spike glycoprotein (S). The most frequently observed were positive mutations, especially D614G and E484K, located in the region of S1/S2 junction, and in the receptor binding domain (RBD), respectively.

Objective: To assess and compare the Maternal and fetal outcomes of critically ill pregnant women infected with COVID – 19 cases of pneumonia who required admission to the intensive care unit. Design: A retrospective observational study Settings: Tertiary care hospital settings affiliated with an academic center in UAE. Patients and Methods: A total of 123 patients in their third trimester were included from 1 December 2020 to 31 March 2021 in the study with 30 cases of severe or critical COVID and 93 mild to moderate pregnant COVID patients. The maternal demographic, radiological, and biochemical profile of mothers was noted. Maternal and fetal outcomes were compared. Main outcomes Measured: Maternal and fetal outcomes were compared in severe and mild COVID cases. Result: A total of 30 (24.3%) patients were admitted in ICU and eight required invasive ventilation meaning, Severe COVID was significantly associated with higher mortality (20% vs 0% p-value <0.001), postpartum complications (50% vs 9.67% p-value<0.001) and increased overall hospital stay (p-value<0.001). Neonates born to severe COVID patients had significant higher chances of being born preterm (76.6% vs 35.7% p-value<0.001) and have low birth weight (46.6% vs 13.9% p-value=0.002). There were four cases of stillbirth, two cases of vertical transmission, and no neonatal deaths. Conclusion: Pregnant females with severe COVID have high mortality, peripartum complications; and increased hospital stay. The newborns born to such mothers may be premature, have low birth weights but have comparable mortality

Abstract Objectives: The COVID-19 pandemic continues to claim victims around the world, and Iran is no exception from this ravage. Vaccine development led to growing optimism regarding control of COVID-19. Vaccine acceptance by the majority of the population is important for the success in controlling COVID-19. This study assessed the attitude of Iranian population toward COVID-19 vaccination. Also, the adverse effects of the COVID-19 vaccines on vaccinated individuals were reported. Method: This cross-sectional study was conducted from May to July 2021 among Iranian population. The data was collected using the online researcher-made questionnaire. The questionnaire contained 16 questions in 3 sections. Results: The questionnaire was filled out by 916 people in total. The majority of participants had 40-65 years old (N:480, 52.4%). More than half of participants were from health care team (N:543, 59.3%). The majority of participants trusted the vaccine and said they would inject it (N:582, 63.5%). However more than 80% of participants preferred non-domestic vaccines over Iranian ones. Potential adverse effect following vaccination was the main concern of responders (N:576, 62.9%). The most common adverse effects reported by vaccine recipients were temporary fatigue and muscle pain (N:313, 71.95%). The level of education, academic area and area of practice in the health system were significantly associated with the positive response to COVID-19 vaccination (P-value 0.0001, 0.0001 and 0.004 respectively). Conclusion: According to the results of this study, Iranian health authorities should provide clear information about the safety and efficacy of COVID-19 vaccines, especially domestic types, to increase public confidence and awareness regarding vaccines.

Introduction Syria has been suffering war for 10 years and COVID-19 added particular stress to people. Medical students are more prone than general population to anxiety and obsessive-compulsive disorder (OCD) which we are going to assess in this study. Methods This is a cross-section study that used online questionnaires were distributed in Social Media groups that included medical students. They included demographics, Zung self-Rating Anxiety Scale (SAS) and Yale-Brown OCD Scale (YBCOS). Results Overall, 180 participants were included, of which, 67 (37.2%) were males. Females and interns had higher OCD scores compared with males and more junior students p<0.05. OCD scores were not associated with social status, work, smoking, residency status, or having chronic diseases. Factors that were associated with higher anxiety scores were female gender and smoking p<0.05. In contrast, anxiety had no significant association with social status, residence status, academic year, work, and chronic diseases. Anxiety scores were not correlated with the consumption of tea, coffee, mate, or alcohol. OCD scores were also not correlated with coffee, mate, or alcohol consumption, but they were significantly correlated with tea consumption. When using regression, OCD and anxiety were associated with only sex, smoking and with each other. Conclusion These numbers were not higher than most of other studies. Further studies are needed for further evaluation to determine the cause whether it was from war having equal effect on mental health or COVID did not affect people as much in Syria.

Background: Liver transplant (LT) recipients with COVID-19 have been reported as a high-risk population for severe disease through the COVID-19 pandemic. Studies have shown that liver transplantation did not significantly increase the risk of death and severe disease in patients with SARS-CoV-2 infection. Methods: From September 2020- March 2021, we collected data and serum anti-SARS-CoV-2 IgM +IgG results for 91 liver transplant recipients. Study enrolment was performed when patients presented for scheduled routine follow-up. All participants with serum anti-SARS-CoV-2 IgM+IgG completed a questionnaire querying information including clinical symptoms in the last six months. We further collected 91 patients with anti-SARS-CoV-2 IgM + IgG results. Seven patients had a known history of symptomatic COVID-19 during the previous six months. Of the 84 participants included in the study, 21 (25 %) had positive anti-SARS-Cov-2 IgM + IgG results. In addition, we applied the COVID-19 PCR test to all 21 patients, and all of them were negative. Overall, only seven patients declared flu-like upper respiratory tract infection symptoms or diarrhea in detailed inquiry. Conclusion: We documented past SARS-CoV-2 infection in 25 % of our outpatient LT recipients, and the majority were asymptomatic. There was no significant relationship between symptoms and seropositivity for SARS-COV-2.

The world is under the threat of COVID-19 pandemic caused by SARS-COV2 since January 2020. And this pandemic has caused millions of deaths still it is affecting the lives of many people affected by this viral disease. The unavailability of definite treatment is a main focus to ponder because symptomatic treatment like use of antibiotics, steroids and oxygen therapy is also a cause of many opportunistic infections like oral candidiasis caused by Candida Albicans and the main reasons of this infection are the excessive use of medications which may cause drug reaction, the continuous use of oxygen therapy and co-morbidities and poor oral hygeine etc. which increase the length of hospital stay of patient and also affect the quality of life of patient as patients become dysphagic as unable to take orally due to the severity of this opportunistic infection. This case study was done to check the prevalence of oral candidiasis in inpatients of COVID-19 and their possible management was done with the use of both topical as well as systemic antifungals and this condition resolved in 5 to 7 days with the proper management and proper maintenance of oral hygiene. Keywords: Pandemic, opportunistic, infection, topical, systemic, hygiene

Developing a good therapeutic drug for SARS-CoV-2 infection responsible for the ongoing coronavirus disease 2019 (COVID-19) pandemic is highly essential. Thus, identifying the key host molecular pathway targeted by SARS-CoV-2 during infection is of topmost importance. Subsequent screening of old or new drugs as well as medicinal plants targeting the identified pathways will prove useful and hasten the discovery of a potent COVID-19 drug. The information and data on COVID-19 were collated from various resources and literature databases such as PubMed, Science Direct, Wiley, Springer, Taylor and Francis, Scopus, Inflibnet, Google, and Google Scholar. The keywords and corresponding Relevant Medical Subject Headings (MeSH) terms used for searching databases include COVID-19; Herbal Medicine; Molecular Pathways; Pathophysiology, Phytotherapy, SARS-CoV-2. The study reviewed the existing literature on molecular action pathways of SARS-CoV-2 infection. We also discussed the ongoing SARS-CoV-2 drugs. The review also critically analyzes the molecular signaling and prospective therapeutic targets, cellular infection, incubation and proliferation strategy, clinical signs, symptoms of COVID-19 infection, the current global infection, mortality statistics, current medical management, and the prospect of therapeutic development. Plant-derived natural compounds could be evaluated and developed into antiviral drugs for the inhibition of coronavirus enzymes. Some herbal medicines have also been used and found to be therapeutically effective as secondary interventions for the prevention and treatment of COVID-19.

Background: Coronavirus disease-2019 (COVID-19) can cause asymptomatic, mild upper respiratory tract symptoms, pneumonia in young persons. How the disease will progress in each patient is still unknown. Therefore, we aimed to investigate the prognostic markers of the development of pneumonia and the clinical characteristics of patients under 65 years with COVID-19 confirmed by a positive reverse transcriptase polymerase chain reaction (RT-PCR) test. Method: In this retrospective study, a total of 271 patients admitted in our unit were included. The patients were divided into two groups, those who did or did not develop pneumonia. Their clinical features, treatment protocols and laboratory parameters were recorded retrospectively. Results: Pneumonia developed in 67.9% (n = 184) of the cases. Age in the pneumonia group was higher than in the non-pneumonia group (p < 0.001). In the logistic regression analysis, when symptom and comorbidity status were examined according to the presence of pneumonia; HT (OR: 4,525 95% CL: 1,494–13,708) were the most important risk factor for pneumonia. When age and laboratory values were examined according to the presence of pneumonia, advanced age (OR: 1.042 95% CL: 1.01–1.073), low albumin (OR: 0.917 95% CL: 0.854–0.986) and high troponin (OR: 1.291 95% CL: 1.044–1.596) were identified as risk factors for pneumonia. Conclusion: HT, older age, low albumin, high troponin were important factors for predicting COVID-19 pneumonia in patients under 65 years of age. Young patients with these predictive factors should be more carefully evaluated by further diagnostic procedures, such as thoracic CT. Key Words: COVID-19, pneumonia, young adults

Introduction: This study is planned to determine the knowledge of personal protective equipment use of senior paramedic students before graduation during COVID-19 pandemic. Methods: The research is a descriptive study. The universe of the study consisted of 180 senior paramedic students studying at three universities in İzmir. When evaluating the study data, descriptive findings were expressed as percentage, mean, standard deviation and median. Results: 38.1% of the students are between 18-20 years old, 50.0% are between 21-23 years old and 11.9% are 23 years old and above. 58.3% of the students participating in the study are females and 41.7% are males. In the study, 74.4% of paramedic students stated that healthcare personnel working in ambulance or patient transport vehicles should use medical masks, gowns, gloves and eye protection while transporting suspected COVID-19- (SARS-CoV-2) patients to the health institution. 78.5% of the students answered that an N95/FFP2 mask should be used while intervening and taking samples in a patient suspected of having COVID-19. Discussion: As a result, it was found that during the COVID-19 pandemic period, the knowledge of personal protective equipment use of senior paramedic students before graduation is sufficient in some cases and not clear and sufficient in some cases. It is recommended that students should be given effective training on the use of PPE during the intervention of the patient with COVID-19 before graduation.

Background: The social stigma associated with a disease represents an important issue for health policymakers at the local, national, and international levels. This study aimed to survay and analyze the experience of stigma among patients with coronavirus disease 2019 (COVID-19) in Iran. Methods and Materials: This qualitative study was conducted from September to December 2020 in the Fars, Khorasan, and Yazd provinces of Iran. Sampling was done via the snowball method; based on data saturation criteria, 24 adults over 18 years of age who had experienced affliction with COVID-19 were recruited. Semi-structured telephone interviews were conducted with each patient. Data were analyzed following the conventional content analysis method described by Erlingsson and Brysiewicz. Results: The results showed that during their affliction with COVID-19, the participants experienced difficult, anxious times, with rejection and alienation from their first-degree relatives taking them by surprise. The three main themes extracted from this study were (i) fear and rejection, (ii) discrimination, and (iii) loneliness. These experiences have changed the attitudes of the participants toward life and themselves. Conclusion: Based on our results, it can be said that paying attention to social stigma among patients during pandemics is an important social necessity and health policy. It is recommended to have psychological counseling sessions for those afflicted and to provide education and training to the public regarding the proper treatment of patients with COVID-19. Quantitative studies in this field are highly recommended.

Background COVID-19 pandemic, limiting the availability of anesthesiologists, has impacted heavily on the organization of invasive cardiac procedures such as transcatheter atrial fibrillation (AF) ablation. Objective We compared the safety and efficacy of deep sedation with dexmedetomidine administered by electrophysiologists without anesthesiologist supervision, against the standard protocol performed with propofol. Methods We retrospectively included all AF ablation procedures performed in 2020: 23 patients sedated with 1% propofol (2 ml bolus followed by infusion starting at 1 mg/Kg/h), 26 patients with dexmedetomidine (infusion starting at 0.7 mcg/Kg/h). Both groups additionally received 1 mcg/Kg of midazolam as a single bolus and 0.05 mg single boluses of fentanyl prior to ablation on each pair of pulmonary veins (PV). Primary outcomes were oxygen desaturation (<90%) or need for assisted ventilation/intubation, bradycardia (heart rate <45 bpm) and persistent hypotension (systolic blood pressure <90 mmHg). Results Baseline characteristics and hemodynamic variables did not differ between the two groups (all p>0.05). In 8/23 (35%) patients propofol infusion velocity reduction was necessary to maintain the hemodynamic values, compared to 7/26 (27%) with dexmedetomidine. Inter-group comparison of hemodynamic variables during the procedure showed no statistically significant difference, despite a trend in favor of dexmedetomidine (3 respiratory depressions and 3 persistent hypotension episodes with propofol vs. 0 with dexmedetomidine; p = 0.057). Conclusion Deep sedation with dexmedetomidine administered by electrophysiologists without anesthesiologist supervision is safe and effective for AF transcatheter ablation. A trend towards a lower incidence of hypotension and respiratory depression was noted when compared to propofol.

Background: The empirical basis for a quantitative assessment of the disease burden imposed by long-COVID is currently scant. We aimed to assess the disease burden caused by long-COVID in Japan. Methods: We conducted a cross sectional self-report questionnaire survey. The questionnaire was mailed to 530 eligible patients, who were recovered from acute COVID-19 in April 2021. Answers were classified into two groups; participants who have no symptom and those who have any ongoing symptoms that lasted longer than four weeks at the time of the survey. We compared health-related quality of life scores estimated by the EQ-5D-3L questionnaire between these two groups after adjusting basic characteristics of the participants by propensity score matching. Results: 349 participants reported no symptoms and 108 reported any symptoms at the time of the survey. The participants who reported any symptoms showed a lower value on a Visual Analogue Scale (median 70 [IQR 60-80]) and on the EQ-5D-3L (median 0.81 [IQR 0.77-1.0]) than those reporting no symptoms (median 85 [IQR 75-90] and 1.0 [IQR 1.0-1.0], respectively). After adjusting for background characteristics, these trends did not change substantially (Visual Analog Scale: median 70 [IQR 60-80] vs 80 [IQR 77-90], EQ-5D-3L: median 0.81 [IQR 0.76-1.0] vs 1.0 [IQR 1.0-1.0]). Conclusions: Due to their long duration, long-COVID symptoms represent a substantial disease burden expressed in impact on health-related quality of life.

Objective: Since the emergence of coronavirus disease, health care professionals in high-risk environments are mandated to wear N95 respirators for prolonged periods. The effect of this prolonged use on cardio-respiratory variables and gas-exchange is poorly defined. The objective of the current study was to determine gas exchange abnormalities and physiological changes among healthcare workers during a 4-hour emergency department (ED) shift while wearing the N95 respirator. Methods: This was a single-center prospective observational study that consisted of medical staff working at the Sheba Medical Center ED. Physiological effects and gas exchange variables were obtained under normal breathing conditions and after 4-hour shifts while continuously wearing an N95 respirator. Comparisons of paired measurements were performed using a non-parametric Wilcoxon matched-pairs signed-rank test. Results: Forty-one subjects were included in the study. Prolonged N95 respirator use was associated with a significant decline in plasma pH [7.35mmHg vs. 7.34mmHg, P=0.02], PvO2 [23.2 mmHg vs. 18.6 mmHg, P<0.001] and a concurrent increase in EtCO2 [32.5mmHg vs. 38.5mmHg, p<0.0001]. PvCO2 and bicarbonate levels did not differ. No significant change was observed for heart rate or oxygen saturation. Conclusion: Using an N95 respirator for prolonged periods by healthcare professionals may provoke changes in gas exchange. The clinical significance of these changes in terms of symptoms or longer-term health status is unknown and remains to be determined. Key Words: N95 Respirator, Physiological effects, SARS CoV 2.

The patient presented with a chief complaint of lower extremity pain was found to be positive SARS-CoV-2 test. Contrast-enhanced computed tomography scans showed endocarditis, vasculitis and lower extremity ischemia. Despite we treated the patient with dexamethasone, the patient died.

Introduction: During the COVID-19 pandemic, the risk of transmission of SARS-CoV-2 has not been precisely known in bronchoscopy procedures. We have designed a cabinet device called Ankara University Bronchoscopy Cabinet (Aubrocab®) to protect healthcare. In this study, we aimed to evaluate preventing effect of Aubrocab® on aerosol spreading by measuring the number of particles in the bronchoscopy suite. Methods: The patients were categorized into two groups as those who underwent bronchoscopy with and without Aubrocab®. We measured PM0.5 level just before and after the bronchoscopy procedure in the bronchoscopy suite. Results: A total of 82 patients, 62 of whom underwent bronchoscopy with Aubrocab®, were enrolled the study. The PM 0.5 level measured before bronchoscopy were similar in both groups, whereas the PM0.5 level measured just after bronchoscopy was significantly lower in the Aubrocab® group (42,603±8,632 vs 50,377±10,487, p=0.001). The analyses showed that the percent particle change (50.76 ± 19.91% vs 67.15 ± 24.24%, p=0.003) and the difference of the particle numbers between pre and post-procedure (13,638±4,292 and 19,501±5,891, p<0.001) were significantly lower in the Aubrocab® group. Conclusion: Our institution developed a barrier device named Aubrocab® which was shown to prevent excessive aerosol release in addition to routine precautions during bronchoscopy procedures.

Objective: The severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) and the resulting COVID-19 pandemic pose significant challenges in terms of diagnosis and recurrent infections. Literature data suggest that age, gender and BMI factors are associated with immune response. The first aim of the study was to analyze the change in antibody titer at 15-day intervals until 60 days post symptom onset (PSO) The second aim was to analyze relationship between antibody titer and symptom grade, gender, age, BMI, therapeutic drugs, vitamin supplements, and herbal therapies. Materials and methods: Blood samples were collected from 43 patients (5 mild, 21 moderate, 17 severe diseases), 18 women (41.9 %), and 25 men (58.1 %), on 15, 30, 45, and 60 days PSO after COVID-19 infection. The serum antibody titers were determined by measuring the COVID-19 IgG antibodies by ELISA. Associations between the duration of symptoms, demographic and clinical parameters, medications and vitamins used, and herbal therapies were evaluated by interviewing the participants. Results: Within the first 15 days of illness, 81.4% of the patients were positive. From day 45 PSO, seropositivity was 89.5%. The anti-SARS-CoV-2 antibody titers were statistically higher in men than women at all-time (p<0.01). Antibody titer was higher in older participants compared to younger participants (p<0.02). Plaquenil or Favipiravir use did not effect antibody response (p>0.05). Men had higher fever (p=0.006), shortness of breath (p=0.004), and chest pain (p=0.03) than women. Conclusion: We found powerful antibody response by sixty days PSO, as well as higher antibody response and severity of symptoms in men gender. Data also showed that SARS-CoV-2 antibodies are higher in individuals with older age, whereas BMI, coexisting chronic disease, and drug used had no effect on antibody titers.