Evaluation of steroid therapy in COVID-19 patients; in the right dose at the right time to the right patients.

Background: Although there is still no universally accepted treatment agent, steroids have been administered chronologically at every dose and at every stage of the COVID-19 pandemic. Aim: We aimed to evaluate the clinical efficacy of high-dose steroid therapy and its effect on mortality in COVID-19 patients with severe pneumonia, severe Acute Respiratory Distress Syndrome (ARDS), and septic shock. Patients and Methods: : Patients with severe pneumonia, septic shock, and ARDS due to COVID-19 who were followed up in the intensive care unit were retrospectively reviewed. Results: The study population was divided into two groups; the methylprednisolone pulse group (MP) (n = 55) and the dexamethasone group (Dex) (n = 39). When the values before and after treatment were compared; there was a statistically significant increase in the neutrophil/lymphocyte ratio after treatment in the MP group (p = 0.006). Although it was not statistically significant in the MP group, There was a numerical increase in D-dimer levels (p = 0.28). Thromboembolic complications developed in 2 patients in the MP group. The mortality outcomes of the groups were statistically similar (p = 0.943). Conclusion: We recommend steroids use in the condition that it is indicated in the critically ill group with the poor general condition. Since there is no significant difference between high-dose pulse steroid treatment and standard treatment doses, we think that the risk of complications should not be taken into account and high doses should not be used.

Investigation of long-term COVID-19 patients' quality of life and affecting factors: Data from single COVID-19 follow-up center.

Background: Patients with COVID-19 experienced changes in their quality of life. However, far less is known about how quality of life changes in long-term COVID-19 follow-ups. Aim: This article aims to explore the relationship between quality of life change and long-term COVID-19 patient status in the COVID-19 follow-up center. Patients and Methods: This study was designed retrospectively with patients admitted to the COVID-19 follow-up center between January and May 2021. The single group consisted of 125 patients. Their status and 36-Item Short-Form Health Survey (SF-36) variables were compared at two different time intervals. The first admission indicates the first 3 months, and the second admission covers 3-6 months after being diagnosed with COVID-19. Results: Cough and chest pain increased in the second admission (P < 0.001). No significant differences were found in SF-36 change according to age. The general health subgroup scores were lower in females than males (P = 0.004). The SF-36 Form's subgroups for physical function, physical role, emotional role, bodily pain, energy, mental health, general health, and social function showed improvement (P = 0.001, P = 0.001, P = 0.026 P < 0.001, P = 0.007, P = 0.031, P <0.001, P <0.001, respectively). In addition, comparing with the SF-36 subgroups in terms of treatment places, a significant result was found between the inpatient and intensive care unit (ICU) in the general health subgroup (P = 0.044). Conclusions: The results show that quality of life may worsen during follow-up for COVID-19. In summary, these findings have significant implications for understanding long-term COVID-19 patients with a multidisciplinary approach and the necessity of follow-up centers to detect the unpredictable results of long-term COVID-19.

Post-COVID-19 syndrome in a cohort of hospitalized COVID-19 patients.

OBJECTIVE: The study aimed to investigate the frequency of post-COVID-19 syndrome and associated factors in patients who visited the post-COVID-19 outpatient clinic after hospital discharge in the first, third, and sixth months of the first year of the pandemic. PATIENTS AND METHODS: The study was a clinical cohort study of patients hospitalized due to COVID-19. The modified British Medical Research Council (mMRC) Dyspnea Scale, the Clinical Frailty Scale (CFS), the Mini Nutritional Assessment short-form (MNA-SF), and the Malnutrition Universal Screening Tool (MUST) were evaluated using a standard form and symptom interview by a specialist physician. RESULTS: Of the 254 patients in the study group, 50.4% were women, and their ages ranged from 18 to 85 years, with a mean (SD) of 55.3±11.5. Post-COVID-19 syndrome was diagnosed in 57.5% of the patients. It was found that the frequency of some of the symptoms persisted and increased in the first month, decreased significantly in the third month, and did not differ between the third and sixth months. Body mass index (BMI), MNA-SF, MUST, and CFS improved over time. Multiple logistic regression analysis showed that the risk of the post-COVID-19 syndrome was 1.91- and 1.40-fold higher in patients with severe COVID-19 and patients with more symptoms in the first month, respectively. CONCLUSIONS: COVID-19 is not a short-term infectious disease but an infectious disease with long-term effects. Cohorts of patients who are still symptomatic at the end of the first month after severe COVID-19 should be followed up for a longer period and their clinical outcomes monitored.

Surgical management of complete penile duplication accompanied by multiple anomalies.

Diphallus (penile duplication) is very rare and seen once every 5.5 million births. It can be isolated, but is usually accompanied by other congenital anomalies. Previous studies have reported many concurrent anomalies, such as bladder extrophy, cloacal extrophy, duplicated bladder, scrotal abnormalities, hypospadias, separated symphysis pubis, intestinal anomalies and imperforate anus; no penile duplication case accompanied by omphalocele has been reported. We present the surgical management of a patient with multiple anomalies, including complete penile duplication, hypo-gastric omphalocele and extrophic rectal duplication.