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AIM: To demonstrate the importance of an integrated viral surveillance to tackle the changing epidemiology and the continuing disease burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). BACKGROUND: International institutions such as European Centre for Disease Prevention and Control provide guidance for integrated surveillance of respiratory viruses. However, SARS-CoV-2 is not an integral part of sentinel influenza like illness and severe acute respiratory infections surveillance in Türkiye. METHODS: We utilized the database from the Global Influenza Hospital Surveillance Network project in Türkiye between November 1st, 2022 and May 31st, 2024 over two seasons. Patients admitted to five hospitals with influenza like illness symptoms in the last 7 days and stayed overnight in the hospital were screened three days a week and swabbed within 72 hours of admission in a standardized year around surveillance methodology. An oligonucleotide panel analysis was utilized during November 1st 2022 to October 31st 2023 and multiplex PCR was utilized thereafter to test for influenza A and B, SARS-CoV-2 and respiratory syncytial virus (RSV). RESULTS: A total of 984 inpatients were enrolled and 969 of them, 724 (75%) of whom were adults, had valid laboratory results. RSV was the most prevalent pathogen detected in 4.9% of the samples, followed by SARS-CoV-2 (4.8%) and influenza A and B (3%). CONCLUSIONS: SARS-CoV-2 is circulating and resulting in hospital admissions among all age groups adding onto the influenza and RSV peaks. Integrated respiratory virus surveillance is crucial to guide informed public health policies and effective vaccination programs.

Objective: It is important to determine the presence of SARS-CoV-2 in the vaginal fluid samples of reproductive-aged women with severe disease during the acute stage of the disease and to determine the risks of transmission by sexual or vertical transmission. Material and methods: Adult women with confirmed severe COVID-19 who were admitted to Ankara City Hospital intensive care unit (ICU) between December 1st, 2020, and January 1st, 2021, were enrolled in the study. Vaginal swab samples were collected within 48 h in the ICU using Dacron or rayon swabs and tested for SARS-CoV-2 using reverse transcription real-time polymerase chain reaction (RT PCR). Results: Thirty women of reproductive age were included in the study, five (16.7%) of whom were pregnant. The mean age was 44.9 (±10.5) years. The most common symptoms were headache (100%), muscle soreness (86.7%), cough (76.7%), fever (60%), and nausea and vomiting (20%). Nineteen (63.3%) patients had underlying medical conditions. The time interval from obtaining vaginal swab samples to admission to the ICU was 48 h. The time between vaginal sampling and PCR positivity ranged from 2 to 18 days. SARS-CoV-2 was not detected in any vaginal samples. Conclusion: Our study showed that women with severe COVID-19 did not have SARS-CoV-2 in their vaginal fluids. Investigation of the presence of SARS-CoV-2 in vaginal secretions may help in determining the risks of sexual transmission and vertical transmission from mother to baby. Information on this subject is still limited. Larger studies on comprehensive biological samples are needed.

Background: In this study, we aimed to compare the intensive care unit (ICU) admission rate of hospitalized mild/moderate COVID-19 patients treated with hydroxychloroquine (HCQ), favipiravir, and HCQ plus favipiravir. Methods: Single center retrospective designed observational study conducted in Ankara City Hospital. Patients who were hospitalized between March 15, 2020 and June 1, 2020 in COVID-19 inpatient clinics with laboratory confirmed diagnosis of COVID-19 were included in the study. An inverse probability of treatment weighting (IPTW) for multiple treatment groups approach was used to balance the differences in several variables on admission. Results: Among 2441 patients hospitalized with diagnosis of COVID-19 during the study period, 824 were eligible for the analysis. Median age of patients was 42 (18−93 years). Among all, 347 (43.2%) of the patients had mild disease, 470 (56.8%) had pneumonia. Propensity scores ranged from 0.1841 to 0.9381 in the HCQ group, from 0.03643 to 0.29885 in the favipiravir group, and from 0.03542 to 0.56184 in the HCQ plus favipiravir group. After IPTW for multiple treatment groups was applied, all the covariates in the planned propensity score had weighted standardized effect sizes below 10% which were ranged from 0.005 to 0.092. Multivariate analysis of treatment effect (adjusted effect of treatment) was indicated that there is no statistically significant difference between HCQ, favipiravir, and HCQ plus favipiravir treatment. After using combination of SMOTE and Bootstrap resampling approach, we found no statistically significant difference between HCQ and HCQ plus favipiravir groups in terms of ICU admission. However, compared with the HCQ group, ICU admission rate was statistically significantly higher in the favipiravir group. We obtained the similar results after the sensitivity analysis. Conclusions: HCQ with or without favipiravir treatment is associated with reduced risk of ICU admission compared to favipiravir alone in mild to moderate COVID-19 adult patients.