ABSTRACT
Aim: Coronavirus disease 2019 (COVID-19) is complex multisystem disease. After 4 weeks of persistent symptoms, it is termed as Long COVID-19. Long COVID-19 causes a decrease in health-related quality of life (HRQoL). In this study, it was aimed to determine which symptoms were associated with lower HRQoL in Long COVID-19 in this study. Material(s) and Method(s): This cross-sectional study was conducted in a tertiary research hospital. Patients who have positive RT-PCR results at least 28 days and at most 180 days ago were selected for the study. Online survey was applied to 266 patients who had positive PCR test results for COVID-19. The EuroQoL 5D-3L scale was used to measure the HRQoL as a dependent variable. Socio-demographic features and symptoms were assessed by the survey as independent variables. Due to heteroscedasticity, a robust standard error regression analysis was conducted to make inferences on the effects of persistent symptoms on HRQoL. Result(s): Of the total 266 participants, 163 were females (63.3%). The mean age was 41.2 +/- 11.8 years. One hundred forty-two patients (53.3%) did not report any ongoing symptom. Female gender and lower education level as socio-demographic variables, visual problems and myalgia as persistent symptoms were identified as risk factors for reduced HRQoL in Long COVID-19 patients. Discussion(s): Long COVID-19 patients experience lower levels of HRQoL, especially those with visual problems and/or myalgia. Interventions to raise the HRQoL of Long COVID-19 patients should first target visual problems and myalgia.Copyright © 2023, Derman Medical Publishing. All rights reserved.
ABSTRACT
The infection, reported by the WHO as COVID-19, may occur with asymptomatic or mild symptoms, resulting in shock and even death. Stroke occupies an important place among the neurological complications of this disease. In the acute period, intravenous (IV) alteplase therapy is useful in patients suitable for the treatment. This case report includes a 70-year-old patient with mild COVID findings, who had an early complication of stroke and who received a nearly complete benefit from thrombolytic therapy. Stroke can occur in COVID patients at an early stage of the disease. IV thrombolytic therapy should be administered in appropriate patients during the period of acute stroke. As far as we know, the earliest application in our country was carried out in our hospital and was quite successful. After the treatment, the symptoms of COVID-19 also regressed and he was discharged on the 5th day of his hospitalization.Copyright © 2021, Derman Medical Publishing. All rights reserved.
ABSTRACT
Objective: Many neurological symptoms due to central nervous system, peripheral nervous system and musculoskeletal system damage have been reported in more than a third of patients with coronavirus disease-2019 (COVID-19). Although optic neuritis has been reported in patients with COVID-19, they are extremely rare. The aim of this study was screening optic nerve involvement in COVID-19 with visual evoked potential (VEP) in asymptomatic patients without a history of visual impairment. Materials and Methods: Pattern reversal VEP measurements were made in 101 adult patients with COVID-19 without a history of visual impairment after they completed COVID-19 treatments and the quarantine period. VEPs were recorded with the 4-channel electromyography-evoked device in a dark room. P100 latencies and amplitudes were analyzed by the same neurologist. Results: A total of 34 (33.7%) patients had P100 latency prolongation. There was no significant difference in terms of gender, age or outpatient/inpatient treatment status. There was no significant correlation between the time of polymerase chain reaction diagnosis and VEP values. Conclusion: Contrary to previous studies, asymptomatic optic nerve involvement after COVID-19 was detected by VEP measurements. Prolongation of P100 latency shows the probable linkage between COVID-19 virus and angiotensin converting enzyme 2 receptors in human eyes.
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Objective: To investigate the clinical symptoms of coronavirus disease 2019 (COVID-19) patients with and without B.1.1.7 mutation. Method(s): This retrospective observational study included COVID-19 patients who were divided into two groups, the mutation and the non-mutation group. Demographics characteristics, clinical characteristics, laboratory parameters, and mortality rates were recorded and compared between the two groups. Result(s): A total of 196 patients were included in the study. The relationship between the mutant virus status and sex, age, comorbidity, survival status, and disease severity was not significant (P>0.05). No significant differences were found in duration of hospitalization between the mutation and the non-mutation group (P>0.05). However, there was a statistically significant difference between patients with and without mutant viruses in hemoglobin, mean platelet volume, procalcitonin, low density lipoprotein, ironbinding capacity, potassium, calcium, C-reactive protein, folate, creatine kinase myocardial band, D-dimer, and international normalized ratio (P<0.05). Conclusion(s): No significant difference is found in mortality rate, disease severity or duration of hospitalization between the patients with and without variant B.1.1.7. Careful monitoring of COVID-19 patients is required for all variants. Copyright ©2022 Journal of Acute Disease Produced by Wolters Kluwer-Medknow.
ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) first appeared in China in December 2019, and has become a global pandemic. Because the clinical progression of the disease is highly variable, better prediction of prognosis and mortality is important. In the present study, we investigated the role of procalcitonin/albumin ratio (PAR) as a new biomarker in predicting mortality in patients with COVID-19 infection. Methods: In this study, patients with COVID-19 diagnosis were enrolled from Sakarya Yenikent State Hospital and Ayancık State Hospital between 09.11.2020 and 04.05.2021. The demographic characteristics, biochemical and hematological parameters such as age, gender, length of hospital stay, and comorbidities of the patients were collected retrospectively from medical records. Results: Of the 105 patients, 51 were mild and 54 were critically ill. Between mild and critical cases, age, lymphocyte count, red cell distribution width, neutrophile count, mean corpuscular volume (MCV), monocyte count, albumin, C-reactive protein, ferritin, procalcitonin, D-dimer, and PAR were statistically different (p<0.001 for all). All patients in the critical group and only 2% of the mild group died. PAR showed the largest area under the curve (0.949) for the prediction of mortality (p<0.001). Conclusion: We report that PAR, a simple, cheap, and easily accessible biomarker, can be used to predict the prognosis in patients with COVID-19 infection.
ABSTRACT
Isolated bilateral peripheral facial paralysis in Guillain-Barré syndrome (GBS) is also quite rare. This case meets the diagnostic criteria of GBS with isolated bilateral peripheral facial paralysis following the coronavirus disease-2019 (COVID-19) infection. A 48-year-old male patient with bilateral peripheral facial nerve paralysis on neurological examination and without other abnormalities was admitted to the emergency department, 18 days after a COVID-19 infection. An increase in cell-free protein (albuminocytological dissociation) in the patient’s cerebrospinal fluid and demyelinating polyneuropathy in electrophysiological examinations suggested GBS in the patient. Facial paralysis findings were completely resolved after 5 days of intravenous immune globulin therapy. Physicians must closely monitor patients’ neurological signs because of the possible association between GBS and COVID-19. © 2021 by Turkish Neurological Society Turkish Journal of Neurology published by Galenos Publishing House.
ABSTRACT
The infection, reported by the WHO as COVID-19, may occur with asymptomatic or mild symptoms, resulting in shock and even death. Stroke occupies an important place among the neurological complications of this disease. In the acute period, intravenous (IV) alteplase therapy is useful in patients suitable for the treatment. This case report includes a 70-year-old patient with mild COVID findings, who had an early complication of stroke and who received a nearly complete benefit from thrombolytic therapy. Stroke can occur in COVID patients at an early stage of the disease. IV thrombolytic therapy should be administered in appropriate patients during the period of acute stroke. As far as we know, the earliest application in our country was carried out in our hospital and was quite successful. After the treatment, the symptoms of COVID-19 also regressed and he was discharged on the 5th day of his hospitalization.
ABSTRACT
Objective: The aim of this study was to compare distance and face-to-face learning models applied in neurology clinic education during the coronavirus disease-2019 (COVID-19) pandemic. Materials and Methods: Medical faculty students who received clinical neurology education in the 2019-2020 academic years were included in the study. The online questionnaire used in the study consisted of three parts. The first part contained questions on students’ sociodemographic data and education;in the second part, questions were asked on the students’ competence level in meeting the cognitive and practical learning objectives of clinical neurology education;and in the third part, the medical school students’ attitudes toward online learning scale was included. Results: The average passing grades of the 45 students (84.3) who took the clinical neurology education face to face were lower than those of the 40 participants (91.1) who received distance education. In 30 of the 40 cognitive goals and 39 of the 40 practical goals, the group averages of the students who received face-to-face training were higher than those of the distance education group. There was no correlation between passing grades and total scores on cognitive and practical goals. There was a significant correlation between the cognitive and practical total scores of the students and attitude scale toward distance/online learning scale score in the distance education group. Conclusion: Distance education was started for clinical neurology education in the COVID-19 pandemic. The proficiency levels declared by students regarding their learning goals after distance education were lower. The results achieved with distance education, especially in practical goals, were worse. Conversely, student grades were higher in the distance education group. These results show that there are serious difficulties in measurement and evaluation methods in distance education. It is necessary to review the experiences gained from the pandemic to eliminate deficiencies and improve clinical neurology education.
ABSTRACT
Objective: The aim of this study is to profile the complaints in the disease application using a symptom survey in patients presenting with the suspicion of COVID-19 disease and to determine the disease-specific and descriptive characteristics of the initial symptoms in those who were diagnosed with the disease. Methods: In this cross-sectional study, symptoms at first admission were questioned in adult patients who applied to the Covid Outpatient Clinic between 21 December 2020 - 22 January 2021. A total of 43 complaints were analyzed in PCR test positive and negative patients. Results: 273 (62.0%) first application and 167 (38.0%) control applications were included in the study. The PCR test was positive in 16.5% of the first admissions. The most common complaints in the first admissions with positive PCR test were fatigue (73.0%), headache (64.9%), pain (32.2%), cough (56.8%), sore throat (51.4%), loss of appetite (45.9%) while 15.9% of them were asymptomatic. Odd's rates of significant complaints for PCR positivity were calculated as 2.607 for fever, 2.724 for anorexia, 2.051 for cough, 2.594 for loss of smell, and 2.243 for loss of strength. Conclusions: COVID-19 is a disease that affects many organs and systems. Comparing the admission symptoms with the PCR test results will contribute to the recognition of the disease at the initial stage. Fever, anorexia, cough, loss of smell and loss of strength were found to be the distinguishing complaints of PCR positivity in our study.