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Introduction: We aimed to evaluate access to diagnosis, treatment and follow-up in patients with viral hepatitis during the COVID-19 pandemic. Methodology: Patients who started treatment for hepatitis B and hepatitis C were included in the study and analyzed in two periods: before-pandemic and during-pandemic. Indication for treatment and frequency of laboratory follow-up was obtained from hospital records. A telephone survey was administered to evaluate treatment access and compliance. Results: Four centers with 258 patients were included in the study. Of these 161 (62.4%) were male, median age was 50 years. The number of patients, admitted to outpatient clinics was 134647 in the before-pandemic period and 106548 in the during-pandemic period. Number of patients who started treatment for hepatitis B were significantly high during-pandemic period compared with before-pandemic (78 (0.07%); 73 (0.05%) respectively; p = 0.04). The number who received treatment for hepatitis C was similar in both periods: 43 (0.04%); 64 (0.05%), respectively (p = 0.25). Prophylactic treatment for hepatitis B, due to immunosuppressive agents was significantly higher in during-pandemic period (p = 0.001). In the laboratory follow-ups at 4th, 12th and 24th weeks of treatment, worse adherence was detected in during-pandemic (for all p < 0.05). Access to treatment and compliance of all patients was over 90% and did not differ in the two periods. Conclusions: During-pandemic, hepatitis patients' access to diagnosis, treatment initiation and follow-up had worsened in Turkey. The health policy implemented during the pandemic had a positive impact on patients' access to and compliance to treatment.

After the declaration Global Health Sector Strategy on Viral Hepatitis by the World Health Organization in 2016, the Turkish Government defined a national strategy covering 2018-2023 to reach goals by 2030. Following a participatory decision process and a series of workshops, the strategy was built on eight separate subheadings. Apart from the official Prevention and Control Program, two separate road maps for hepatitis B and C were developed to obtain targets accessible with the cooperation of the Viral Hepatitis Society and the Turkish Association for the Study of the Liver in 2018 and 2020, respectively. Up to 2023, achievements and the current situation of the National Viral Hepatitis Prevention and Control Program and the hepatitis B virus and hepatitis C virus road maps were assessed in detail on June 28th, 2022, by the subject matter experts in Turkey. Besides the officially reported achievement rate (42\%) of the Program in 2021, participants mentioned undesirable effects of the coronavirus disease-2019 pandemic, unregulated migration, low levels of professional and public awareness, and barriers to access to anti-viral treatment. Recommendations focused on increasing the efficiency of screening and surveillance by integrating the viral carrier identity of individuals into the national health information system, simplifying the drug supplement and treatment initiation process and insisting on education to raise awareness.

Aim: The aim of the study is to classify patients infected with Covid-19 in our population according to the radiological consensus defined by Radiology Society of North America (RSNA) and American College of Radiology (ACR) and to show the relationship of the patients with clinical-laboratory findings. Material and Methods: 127 cases (74 males, 53 females; age range 19-92 years) who applied to Ankara City Hospital with symptoms such as fever, cough and respiratory distress and whose laboratory findings were compatible with Covid-19 were included in our study. The thorax computed tomography (CT) findings of the cases were classified according to the RSNA criteria and their relationship with clinical-laboratory data was statistically evaluated. Results: 47.2% of them had fever, 62.2% cough, 22 dyspnea, 4.7% diarrhea and 28.3% fatigue-malaise symptoms. When the thorax CT findings were evaluated, 55% of the patients had a typical appearance, 21% intermediate appearance, 11% atypical appearance and 13% negative appearance. Conclusion: It is obvious that thoracic CT examination has many advantages in evaluating Covid-19 pneumonia. However, it was concluded that more observations should be made in order to classify the findings better and to reveal their relationship with clinical-laboratory findings.

Epicardial adipose tissue serves as a source of inflammatory cytokines and mediators. Cytokine storm is an important cause of morbidity and mortality in coronavirus disease 2019 (COVID-19).To investigate the association between epicardial fat volume (EFV), inflammatory biomarkers and clinical severity of COVID-19.This retrospective study included 101 patients who were infected with COVID-19. Serum inflammatory biomarkers including C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT) and ferritin levels were measured. Computed tomography images were analyzed and semi-automated measurements for EFV were obtained. The primary composite endpoint was admission to the intensive care unit (ICU) or death.The primary composite endpoint occurred in 25.1% (n=26) of patients (mean age 64.8±14.8 years, 14 male). A total of 10 patients died. EFV, CRP, PCT, ferritin and IL-6 levels were significantly higher in ICU patients. Moreover, a positive correlation was determined between EFV and CRP (r: 0.494, p0.001), PCT (r: 0.287, p=0.005), ferritin (r: 0.265, p=0.01) and IL-6 (r: 0.311, p=0.005). On receiver operating characteristic analysis, patients with EFV102 cmEFV and serum CRP, IL-6, PCT and ferritin levels can effectively assess disease severity and predict the outcome in patients with COVID-19. EFV is an independent predictor of admission to the ICU in hospitalized COVID-19 patients.O tecido adiposo epicárdico é fonte de citocinas inflamatórias e mediadores. A tempestade de citocinas é uma importante causa de morbilidade e mortalidade na doença coronavírus 2019 (COVID-19).Investigar a associação entre volume adiposo epicárdico (VAE), biomarcadores inflamatórios e gravidade clínica da COVID-19.Este estudo retrospetivo incluiu 101 doentes infetados com COVID-19. Foram avaliados biomarcadores inflamatórios séricos, incluindo os níveis de proteína C-reativa (PCR), de interleucina-6 (IL-6), de procalcitonina (PCT) e de ferritina. Foram analisadas imagens de tomografia computorizada (TC) e foram obtidas medições semi-automáticas do VAE. OOO VAE e os níveis séricos de PCR, IL-6, PCT e ferritina podem avaliar a gravidade da doença e prever o resultado em doentes com COVID-19. O VAE constitui um fator preditivo na admissão dos doentes hospitalizados com COVID-19 numa UCI.

Purpose: This study aims to evaluate the correlations between the severity of the disease and serum steroid levels by analyzing the serum steroid levels in COVID-19 patients with different levels of disease progression and the control group.Methods: Morning plasma Aldosterone, 11-deoxycortisol, Androstenedione, 17- hydroxyprogesterone, Dihydrotestosterone (DHT), Dihydroepiandrostenedion (DHEA), Corticosterone, Dihydroepiandrostenedion sulfate (DHEAS), Estrone, 11- deoxycorticosterone, Cortisol, Corticosterone, Androsterone, Pregnenolone, 17- hydroxypregnenolone levels were measured in 153 consecutive patients were grouped as mild, moderate, and severe based on the WHO COVID-19 disease severity classification and the control group. Steroid hormone levels were analyzed at once with a liquid chromatography-tandem mass spectrometric method (LC-MS/MS). Results: In our study, all of the steroids except DHT and DHEAS were statistically significantly higher in the patients’ group than in the control group (p>0.001). Also, DHEA was an independent predictor of the disease severity with COVID-19Conclusions: Our study reveals that altered steroid hormone levels have a negative impact on COVID-19 prognosis by simultaneous measurement of steroid hormones levels with LC-MS/MS. Also, adrenal insufficiency due to COVID-19 is an endocrinological pathology that should be followed up.

Objective: In this study, it was aimed to evaluate the healthy and infected area volumes and elementary lesion characteristics in thorax computed tomography examinations of mild-moderate and severe patient groups according to the clinical severity scoring determined by the World Health Organization, and to compare the obtained findings with laboratory and clinical data.Material and Methods: A total of 100 cases (59 males, 41 females; age range 18-95 years) were retrospectively and randomly selected from the patients who had non-contrast thoracic computed tomography scan and were diagnosed with Covid-19 pneumonia by reverse transcription polymerase chain reaction test. According to clinical severity scoring, patients were classified as mild-moderate and severe groups. Volumetric measurements were made in the lungs using quantitative analyses. In addition, lesion characteristics (ground glass opacity, consolidation, air bronchogram) in the infiltration areas were recorded. The relationship between radiological findings and clinical-laboratory data was statistically evaluated.Results: The age of the patients ranged between 58.80±14.74 years; 52% of the cases were in the severe category, 48% of them were in the mild-moderate category. Lung volumes did not differ significantly between disease groups. According to computed tomography findings, there was a statistically significant correlation between subpleural reticulations and air bronchogram and disease groups. IL-6, D-dimer, ferritin, neutrophil lymphocyte ratio and C-Reactive Protein values were higher in the severe disease group than in the mild-moderate group.Conclusion: Volumetric values associated with laboratory parameters are thought to be an important indicator of the immune response that determines the course of the disease.

Aim: COVID-19 is an epidemic communicable disease that has been declared as a pandemic caused by severe acute respiratory syndrome coronavirus 2. Clinical studies have demonstrated that advanced age and comorbid conditions enhance the severity of the infection. The objective of this study was to examine the of effects of blood group types on risk of infection, disease severity, and mortality in COVID-19 patients. Material and Method: Included in this study were 1618 patients who had been diagnosed with PCR confirmed COVID-19 infection. The age, gender, blood type, disease severity, need for intensive care, and deaths of the patients were analyzed retrospectively. For the distribution of the blood types in a healthy population, statistics for the blood types of individuals in Ankara for 2020 were obtained from the Republic of Turkey Red Crescent Blood Services and used as a healthy control group for comparison with the data of the patients included in the study. Results: Among the COVID-19 patients, blood type A was the most common type at a rate of 46.2%. This was followed by blood type O at a rate of 28.4%. The least common blood type was found to be type AB at a rate of 9%. When compared to the healthy population, blood type A was determined to be statistically significantly more common in COVID-19 infection (p=0.07,). In contrast, blood type O was determined to be less common when compared to the healthy population (p

Objectives: The aim of this study was to share the results, follow-up, and treatment characteristics of our pregnant women who were followed-up with anti-Toxoplasma gondii Immunoglobulin (Ig) M positivity during pregnancy. Methods: Anti-T. gondii IgM- and IgG-positive pregnant women were evaluated between 2014-2018. Demographic characteristics, treatment, and information about pregnancy were obtained from the electronic database. Pregnant women were divided into three groups; primary infection, no infection, and suspected infection in pregnancy. Primary and suspected infection in pregnancy were followed up congenital toxoplasmosis risky pregnancy. Fetal ultrasonography (USG), T. gondii DNA polymerase chain reaction (PCR) result in amniotic fluid were recorded. Results: Twenty-four pregnant women with a mean age of 27.9 years were followed up. IgG avidity results were low in 37.5% (n = 9), intermediate avidity in 8.3% (n = 2), and high avidity in 54.2% (n = 13) of pregnant women. Eleven (45.9%) pregnant women had congenital toxoplasmosis risky pregnancy. Fetal USG was performed on ten pregnant women, and no signs of congenital toxoplasmosis were found. Amniocentesis was performed in 72.7% (n = 8) of the participants, and the amniotic fluid T. gondii DNA-PCR result was negative in all of them. Ten (90.9%) pregnancies resulted in mature birth and one (9.1%) resulted in miscarriage. Conclusions: Anti-T. gondii IgM positivity is an indication of acute infection. But IgM can persist for years, and be false-positive in pregnancy. Therefore, additional tests are required, and leading to emotional distress and unnecessary interventions in pregnacy women. These results can aid in developing an approach to screening and diagnosis of T. gondii infection in pregnancy.

© 2022 The Author(s)High resistance rates to antimicrobials continue to be a global health threat. The incidence of multidrug-resistant (MDR) microorganisms in intensive care units (ICUs) is quite high compared to in the community and other units in the hospital because ICU patients are generally older, have higher numbers of co-morbidities and immune-suppressed; moreover, the typically high rates of invasive procedures performed in the ICU increase the risk of infection by MDR microorganisms. Antimicrobial stewardship (AMS) refers to the implementation of coordinated interventions to improve and track the appropriate use of antibiotics while offering the best possible antibiotic prescription (according to dose, duration, and route of administration). Broad-spectrum antibiotics are frequently preferred in ICUs because of greater infection severity and colonization and infection by MDR microorganisms. For this reason, a number of studies on AMS in ICUs have increased in recent years. Reducing the use of broad-spectrum antibiotics forms the basis of AMS. For this purpose, parameters such as establishing an AMS team, limiting the use of broad-spectrum antimicrobials, terminating treatments early, using early warning systems, pursuing infection control, and providing education and feedback are used. In this review, current AMS practices in ICUs are discussed.

SARS-CoV-2 might present with multisystem involvement due to its entry into many cells with ACE2 receptors on their surfaces, such as heart, endothelial, and lung alveoli cells. Studies have indicated that COVID-19 infection causes a severe clinical presentation in diabetic patients due to dysregulation of the metabolic and immune systems. The hematological effects of COVID-19 and the relationship of lymphopenia with the severity of the disease have been reported previously. The parameter of percentage of large unstained cells (LUCs) reflects active lymphocytes and peroxidase-negative cells. The neutrophil-to-lymphocyte ratio (NLR) is another reliable marker of inflammation in cases of cardiac diseases, solid tumors, and sepsis. The present study aimed to evaluate whether the parameters of LUCs and NLR differed between diabetic and nondiabetic individuals with COVID-19. Associations with disease severity were also sought.In our retrospective study, the data of 1,053 patients [230 diabetic patients (21.83%) and 823 nondiabetic patients (78.15%)] were reviewed. The white blood cell (WBC) count, neutrophil count, neutrophil%, lymphocyte count, lymphocyte%, LUC count, %LUCs, NLR, platelet count, hemoglobin level, HbA1c, history of diabetes, surveillance during hospitalization, and pulmonary infiltration status within the first 24 hours after admission to the hospital were analyzed from the records.When diabetic patients were compared with nondiabetics, the age [65 (20-90) vs. 42 (18-94) years], WBC count [6.72 (2.6-24.04) vs. 5.91 (1.35-52.68)], neutrophil count [4.29 (1.28-65) vs. 3.68 (0.02-50.47)], neutrophil% [67.53±12.3 vs. 64.08±13.28], NLR [3.35 (0.83-38.11) vs. 2.48 (0.01-68.58)], and LUC count [0.11 (0.03-0.98) vs. 0.1 (0.02-3.06)] of the diabetic group were found to be higher and these differences were statistically significant (p0.001, p0.001, p0.001, p0.001, p0.001, and p=0.015, respectively).We determined that LUC counts and NLR values in COVID-19-positive patients with diabetes were statistically significantly higher compared to nondiabetic patients.

Background CoronaVac, an inactivated whole-virion SARS-CoV-2 vaccine, has been shown to be well tolerated with a good safety profile in individuals aged 18 years and older in phase 1/2 trials, and provided a good humoral response against SARS-CoV-2. We present the interim efficacy and safety results of a phase 3 clinical trial of CoronaVac in Turkey. Methods This was a double-blind, randomised, placebo-controlled phase 3 trial. Volunteers aged 18-59 years with no history of COVID-19 and with negative PCR and antibody test results for SARS-CoV-2 were enrolled at 24 centres in Turkey. Exclusion criteria included (but were not limited to) immunosuppressive therapy (including steroids) within the past 6 months, bleeding disorders, asplenia, and receipt of any blood products or immunoglobulins within the past 3 months. The K1 cohort consisted of health-care workers (randomised in a 1:1 ratio), and individuals other than health-care workers were also recruited into the K2 cohort (randomised in a 2:1 ratio) using an interactive web response system. The study vaccine was 3 mu g inactivated SARS-CoV-2 virion adsorbed to aluminium hydroxide in a 0.5 mL aqueous suspension. Participants received either vaccine or placebo (consisting of all vaccine components except inactivated virus) intramuscularly on days 0 and 14. The primary efficacy outcome was the prevention of PCR-confirmed symptomatic COVID-19 at least 14 days after the second dose in the per protocol population. Safety analyses were done in the intention-to-treat population. This study is registered with ClinicalTrials.gov (NCT04582344) and is active but no longer recruiting. Findings Among 11 303 volunteers screened between Sept 14, 2020, and Jan 5, 2021, 10 218 were randomly allocated. After exclusion of four participants from the vaccine group because of protocol deviations, the intention-to-treat group consisted of 10 214 participants (6646 [65.1%] in the vaccine group and 3568 [34.9%] in the placebo group) and the per protocol group consisted of 10 029 participants (6559 [65.4%] and 3470 [34.6%]) who received two doses of vaccine or placebo. During a median follow-up period of 43 days (IQR 36-48), nine cases of PCR-confirmed symptomatic COVID-19 were reported in the vaccine group (31.7 cases [14.6-59.3] per 1000 person-years) and 32 cases were reported in the placebo group (192.3 cases [135.7-261.1] per 1000 person-years) 14 days or more after the second dose, yielding a vaccine efficacy of 83.5% (95% CI 65.4-92.1; p, TUSEB, We are grateful to all participants who volunteered to be part of this study and to all members of the clinical research teams of the participating sites. We thank TUSEB for funding the study and Omega-CRO for the statistical analyses and production of figures, and providing the study protocol. We also thank the members of the data and safety monitoring board for their contributions in the safe execution of this study.

A SENSITIVE INDICATOR FOR THE SEVERITY OF COVID-19: THIOL Abstract Background/aim: Thiol status is a good reflector of the cellular redox and have vital roles in various cellular signaling pathways.The purpose of the study was to investigate thiol status in patients with SARS-CoV-2 infection. METHODS: A total of 587 subjects (517 patients/70 healthy controls) were enrolled in the study.The patients were categorized into the groups regarding to the severity of disease (mild, moderate, severe, and critical).Thiol status of all groups were compared. RESULTS: The patients had significantly diminished thiol levels compared to controls.Thiol levels were gradually decreased as the severity of the disease increased.Logistic regression analyses identified that thiol concentrations were an independent risk factor for the disease severity in each phase (mild group OR 0.975, 95%CI 0.965-0.986; moderate group, OR 0.964, 95%CI 0.953-0.976; severe group OR 0.953, 95%CI 0.941-0.965; critical group OR 0.947, 95%CI 0.935-0.960).Thiol test exhibited the largest area under the curve at 0.949, with the highest sensitivity (98.6%) and specificity (80.4%). CONCLUSIONS: Depleted thiol status was observed in SARS-CoV-2 infection.Decline of the thiol levels by degrees while the severity of infection increased was closely related to the progression of the disease.This outcome highlights that thiols could be an impressible biomarker for predicting of the severity of COVID-19. Key words: COVID-19, inflammation, immune response, severity, thiol.

Introduction: Worldwide influenza vaccination rates remain low despite guideline recommendations to support vaccinations. It is important to identify attitudes, barriers and motivating factors influencing patients’ vaccination behaviours. We aimed to evaluate the knowledge, attitudes and factors influencing the vaccination behaviours against influenza and sources of information used by patients about influenza vaccine. Materials and Methods: This was a cross-sectional, self administered questionnaire-based study of 229 patients who visited infectious diseases and clinical microbiology outpatient clinic between December 2018 and February 2019. The questionnaire consisted of 39 items in 5 sections: Demographic data (8), questions about influenza vaccine (9), vaccination history (2), factors influencing vaccination behaviours (18) and sources of information used by patients about influenza vaccination (2). Results: Vaccinated group had a higher education level compared to the unvaccinated group, and the difference was statistically significant (p= 0.007). Vaccination against any diseases in adulthood was also statistically higher in the influenza-vaccinated group (p= 0.000). Other features were similar in both groups. The percentage of correct answers to proposals were similar and high between the two groups. Correct answers given to “People with chronic illness should have a flu vaccine” was statistically higher in the vaccinated group (80.5% vs. 61.8%, p= 0.004). Regular annual vaccination rate was only 10.3% in the vaccinated group. The most common motivating factor in vaccination was doctor’s advice (54.5%). The most common barrier against influenza vaccination was the idea that they did not need vaccination (51.3%). The information source affecting the patients mostly was the doctors in both vaccinated and unvaccinated groups. Conclusion: In order to increase the knowledge level and vaccination rates, doctors should be informed rigorously about advising influenza vaccine to patients, especially high risk groups. Education and advice from healthcare professionals about vaccine is crucial for increasing vaccination rate.

Introduction: The aim of this study was to compare hospital-acquired infections in the elderly and adult patients hospitalized in an intensive care unit in terms of incidence, risk factors, and factors affecting mortality. Materials and Methods: The study included 462 patients who were hospitalized for more than 48 hours in intensive care units, including elderly patients (aged ≥ 65 years) and adult patients (aged 18-64 years). Patients were evaluated for hospital-acquired infections and the groups were compared. Results: In total, 462 patients were diagnosed with hospital-acquired infections comprising 28.5% and 25.1% elderly and adult patients, respectively, with no significant difference between the two groups in terms of total incidence of hospital-acquired infections (p= 0.48). A history of hospitalization and aspiration, diabetes mellitus, chronic obstructive pulmonary disease, chronic renal failure, and presence of chronic diseases were identified to be risk factors for elderly patients while a history of blood transfusion was determined a risk factor for adult patients. In the multivariate analysis, LOS and diabetes mellitus were determined to be risk factors for hospital-acquired infection in the elderly group. Logistic regression analysis identified advanced age, LOS, and the use of a mechanical ventilator as independent risk factors for mortality. Conclusion: In our study, age was not identified as a risk factor for hospital-acquired infections in a world with ageing population. However, it is evident that increased LOS, resistance pattern, and mortality are associated with increasing age. Therefore, it would be appropriate to perform different evaluation procedures for the elderly patients in intensive care units in terms of hospital-acquired infections.

Introduction: The Standardized Infection Ratio (SIR) is a statistic used to track healthcare associated infections over time, at a national or facility level. SIR gives clearer data due to patient and institutional characteristics. It makes it possible to fairly compare hospital performance because the data are risk-adjusted. The aim of our study is to evaluate SIR and cumulative attributable difference (CAD) and to compare for national data. Materials and Methods: The study was conducted in Atatürk Training and Research Hospital reanimation 1 and 2, coronary, cardiovascular surgery, internal medicine-neurology and general surgery intensive care units (ICU). Based on total data reported at national level, stratified calculations based on type of institution and intensive care unit (ICU) type ventilator-associated pneumonia, central line-associated bloodstream infection and catheter-associated urinary tract infection rates calculated, and SIR and CAD were calculated by SIR-matic, which was organized by the Department of Infectious Diseases, General Directorate of Public Health of the Turkish Ministry of Health. Results: According to the infection rate and SIR value for ventilator-associated pneumonia, our ventilator-associated pneumonia rate in all ICUs, the ventilator utilization rate of coronary, internal medicine-neurology and general surgery ICUs is above the Turkey’ average, and in all ICUs except coronary and general surgery ICU, SIR values for ventilator-associated pneumonia were found to be statistically significant > 1.00. According to the infection rate and SIR values for catheter-associated urinary tract infection, our rates were high in ICUs, while SIR value was calculated equal to 1.00. There was no more infection than predicted on an institution basis. When the CAD values were examined, it was found that the unit-based cardiovascular surgery and general surgery ICUs had less infection than expected within one year. According to the infection rate and SIR values for central line-associated bloodstream infection, the rates in our ICUs are higher than the national average. Conclusion: As a result of the study, infection rates and SIR values were higher in most intensive care units than national values. SIR values were found to be more reliable in infection monitoring.

The CoronaVac vaccine was found to be effective against symptomatic COVID-19 and protective against severe disease in phase 3 studies. However, there are little data about its effectiveness in real-world conditions. The aim of the current study was to investigate the protective effect of the CoronaVac vaccine in health-care workers (HCWs) in Turkey, a country where CoronaVac is widely used. The questionnaire was sent to all employees in the form of a survey link by using a telephone application. In the survey, HCWs were asked about demographic characteristics; CoronaVac vaccination status, history of a COVID-19 infection, whether COVID-19 infection was before or after the CoronaVac vaccination; the time between being vaccinated and the COVID-19 infection; the clinical pictures of COVID-19 infection. Those who experienced COVID-19 before vaccination were compared with the breakthrough cases in terms of demographic and clinical features. A total of 628 HCW agreed to participate in the study. A total of 536 (85.3%) volunteers had been vaccinated and 92 (14.6%) had not been vaccinated against COVID-19 with CoronaVac. There was a history of COVID-19 infection in 234 (37.2%) subjects and 188 (35%) had been vaccinated and 46 (50%) not vaccinated. The rate experiencing COVID-19 disease was significantly lower in the vaccinated than the unvaccinated volunteers. The rate of breakthrough cases after CoronaVac was found to be 7%. The hospitalization rate was similar in the breakthrough cases and those who had COVID-19 before CoronaVac vaccination. The results of our study indicate that CoronaVac provides protection against COVID-19.

Purpose The purpose of the present study was to investigate the effects of COVID-19 on audiovestibular system with Transiently Evoked Distortion Otoacoustic Emissions (TOAE), Distortion Product Otoacoustic Emissions (DPOAE), video head impulse test (vHIT) and caloric test. Methods Audiovestibular findings of 24 patients with moderate/severe COVID-19 and 24 healthy controls were compared using pure tone audiometry, tympanometry, TOAE, DPOAE, caloric test, and vHIT. Results On audiometry, the pure tone averages of the COVID-19 patients were higher than the controls ( P = .038). The TEOAE amplitudes at 4000 and 5000 Hz ( P = .006 and P < .01), and DPOAE amplitudes at 3000, 6000, and 8000 Hz ( P < .001, P = .003 and P < .001) were significantly lower in COVID-19 patients compared to the controls. On vestibular tests, there was no significant difference between the caloric test results of the patients and the controls ( P > .05). On vHIT testing, amplitudes of right semicircular canal was found to be significantly lower in COVID-19 group compared to the control group ( P = .008). Conclusion COVID-19 may affect inner ear functions causing a subtle damage in the outer hair cells and lateral semicircular canals. It must be kept in mind that COVID-19 may cause cochleovestibular problems.

Introduction: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus (HCV) in the world. Aims: The aim of this study was to compare direct acting antivirals (DAAs) treatment of HCV for PWID and non-PWID in real life setting. Materials and methods: We performed a prospective, non-randomized, observational multi-center cohort study in 37 centers. All patients treated with DAAs therapy between April 1, 2017 to February 28, 2019 were included. In total, 2,713 patients were included in the study among which 250 were PWID and 2,463 were non-PWID. Besides patient characteristics, treatment response, follow-up and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: DAAs were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization’s objective of eliminating viral hepatitis.

Studies regarding effectiveness of anakinra and tocilizumab treatments in coronavirus disease 2019 (COVID-19) have contradictory results. Furthermore, there is scarce comparative data regarding superiority of any agent. To further elucidate any superiority between these two agents, we retrospectively investigated and compared outcomes in hospitalized COVID-19 patients of our inpatient cohort who received anakinra or tocilizumab.This study was designed as a single-center, retrospective, cross-sectional cohort study. Hospitalized patients with confirmed diagnosis of COVID-19 who had Brescia-COVID respiratory severity scale score ≥3 and hyperinflammation (defined as elevation of C reactive protein ≥50 g/L or ferritin ≥700 ng/mL) and received anakinra or tocilizumab in addition to standard care were enrolled in the study. Length of hospital stay after initiation of antiinflammatory treatment, need for mechanical ventilation, need for intensive care unit admission, mortality were set as primary outcomes and compared between tocilizumab and anakinra recipients after propensity score matching.One hundred and six patients were placed in each group after propensity score matching. In the anakinra group, relative risk reduction for intensive care unit admission was 50% when compared to the tocilizumab group and the number needed to treat to avert an intensive care unit admission was 3 (95% CI, 2-5). In terms of mortality, a 52% relative risk reduction was observed with anakinra treatment and the number needed to treat to avert an intensive care unit admission was 8 (95% CI, 4-50). Significantly more patients were observed to receive glucocorticoids in the anakinra group.Anakinra administration in severe COVID-19 patients was significantly associated with better survival and greater clinical improvement compared to the tocilizumab administration in our study. Increased rate of glucocorticoid use in the anakinra group might have contributed to better outcomes.

Determination of the effect of deep breathing exercise applied with Triflo on dyspnoea, anxiety and quality of life in patients who are hospitalized for COVID-19 and have dyspnoea.COVID-19 is a viral infection that can cause severe pulmonary disease. Deep breathing exercise with Triflo in patients with COVID-19 may contribute to the reduction/elimination of dyspnoea and anxiety, and improvement of respiratory and quality of life.The study was a randomized controlled clinical trial and conducted in accordance with the Consolidated Standards of Reporting Trials (CONSORT) 2010 guidelines.The study was conducted in the clinic of COVID-19 of a tertiary hospital. A total of 44 eligible participants were enrolled from January to April 2021. Primary outcomes included oxygen saturation in the blood, respiratory assessment and dyspnoea level. Secondary outcomes included anxiety and quality of life. In the statistical analysis of the data, the independent sample t-test, Wilcoxon test, Mann-Whitney U test and Spearman correlation were used to examine the intervention effect on primary outcomes and secondary outcomes, according to numbers, percentage, mean, standard deviation and conformity to normal distribution.It was determined that the patients in the deep breathing group had a statistically significant shorter hospitalization time (3.04 ± 0.65), higher SpODeep breathing exercise with Triflo increases the SpOWith deep breathing exercise applied with Triflo, respiratory rate reaches normal limits in a short time, SpOhttps://clinicaltrials.gov; NCT04696562.

The World Health Organization (WHO) declared COVID-19 as a Public Health Emergency of international concern on January 30, 2020, and a pandemic on March 11, 2020. Afterward, it spread rapidly all over the world, causing almost 4 million deaths as of June 2021. It is clear that effective preventive measures are needed in this devastating disease, which still has no cure. In addition to mask using, social distancing, and hygiene practices, which enter our lives as the most basic precautions, communities aim to reduce the effects of the COVID-19 pandemic. All over the world, the measures taken and activities performed in the COVID-19 pandemic are discussed, and information in this regard is shared. Mask usage, social distancing, hygiene, avoiding crowded and closed areas, contact tracing, rapid and accurate testing, increased indoor air quality, vaccination, and lockdown measures constitute the main preventive measures. This review summarizes the efficiency of public policy measures against COVID-19.