Effector memory T cell subset CD45RA-CCR7-CD27-CD28- EM3 increases in direct proportion to the disease severity of COVID-19

COVID-19, which emerged in December 2019 and continues to wreak havoc, has led to the death of many people around the world. In this study, we aimed to uncover the variables underlying the exacerbation of the disease by considering the changes in T cell subsets in adults and juveniles with different disease severity of COVID-19. Peripheral blood samples of 193 patients (128 adults and 65 juveniles) diagnosed with COVID-19 were evaluated in a flow cytometer, and a broad T cell profile was revealed by examining T cell subsets in terms of exhaustion and senescence. We found remarkable differences in the effector memory (EM;CD45RA-CCR7-) cell subsets of severe pneumonia cases. The frequencies of EM2 CD4+ T, EM3 CD4+ T, EM3 CD8+ T, EM2 DN T and EM3 DN T cells were found to increase in severe pneumonia cases. Consistently, these cells were found in juveniles and uncomplicated adults in similar or lower proportions to healthy controls. The findings of our study provide a view of the T cell profile that may underlie differences in the course of COVID-19 cases in juveniles and adults and may provide new insights into the development of effective treatment strategies.

Effector memory T cell subset CD45RA−CCR7−CD27−CD28− EM3 increases in direct proportion to the disease severity of COVID-19

COVID-19, which emerged in December 2019 and continues to wreak havoc, has led to the death of many people around the world. In this study, we aimed to uncover the variables underlying the exacerbation of the disease by considering the changes in T cell subsets in adults and juveniles with different disease severity of COVID-19. Peripheral blood samples of 193 patients (128 adults and 65 juveniles) diagnosed with COVID-19 were evaluated in a flow cytometer, and a broad T cell profile was revealed by examining T cell subsets in terms of exhaustion and senescence. We found remarkable differences in the effector memory (EM;CD45RA−CCR7−) cell subsets of severe pneumonia cases. The frequencies of EM2 CD4+ T, EM3 CD4+ T, EM3 CD8+ T, EM2 DN T and EM3 DN T cells were found to increase in severe pneumonia cases. Consistently, these cells were found in juveniles and uncomplicated adults in similar or lower proportions to healthy controls. The findings of our study provide a view of the T cell profile that may underlie differences in the course of COVID-19 cases in juveniles and adults and may provide new insights into the development of effective treatment strategies. © 2022 The Scandinavian Foundation for Immunology.

Multivariate Analysis of the Factors Affecting Tinnitus Severity in Old Age: A Multi-Center Cross- Sectional Study

Aim: The purpose of this study was to analyze the factors affecting tinnitus severity in the population aged 60 and over with a multi-central data and with multivariate analysis. Materials: This prospective study was composed of 130 subjects aged 60 years or older with clinical complaint of tinnitus and administered to five different otorhinolaryngology clinics in four different cities in our country. All participants have been tested with pure tone audiometry. Tinnitus loudness and pitch mapping were determined for all participants. All participants also interviewed individually to complete Tinnitus Handicap Inventory (THI) and asked to characterize their tinnitus symptoms using a visual analog scale (VAS) measuring severity, annoyance of tinnitus. Results: Tinnitus loudness increases significantly in the group over the age of 79, but there is no significant difference between the groups formed according to age in terms of VAS or THI values. Systemic disease does not make a significant difference that increases the severity of tinnitus. risk factors that increase tinnitus severity are included in the logistic regression analysis;High level of education and advanced age over 79 years were determined as independent risk factors. Increasing education level is an independent risk factor for increasing tinnitus severity with an odds ratio of 2.46 (95% CI, 1.080-5.624). At the same time, advanced age over 79 years is an independent risk factor with an odds ratio of 5.4 (95% CI, 1,385-21.197), which causes tinnitus severity to be felt more. Conclusion: In old age population, the incidence of tinnitus does not increase with increasing age, but tinnitus severity increases. As hearing loss increases, tinnitus severity and VAS score increase. According to the results of this study, the most important risk factors that increase the perception of tinnitus in the elderly population were determined as very advanced age and high education level. It is reasonable to think that one of the reasons for this is that the elderly in the vulnerable group for the Covid 19 pandemic should stay away from hospitals unless their tinnitus complaints are very serious. Re-performing our study in elderly individuals after the pandemic is important to see the effect of the pandemic period more clearly in these individuals.

COVID-19 Disease in Kidney Transplant Recipients

Aim: Coronavirus infection can lead to severe acute respiratory distress syndrome. Information on COVÍD-19 infection in patients with kidney transplants (KT) is lacking yet. In our study, clinical, radiological, laboratory features and clinical course of COVÍD-19 infection in these patients were investigated. Methods: We retrospectively investigated KT recipient patients with COVID-19 diagnosed between March 15, 2020, and December 15, 2020. Clinical, radiological, laboratory features and clinical course of COVID-19 infection in these patients were recorded. Results: We identified 23 KT recipient patients with COVID-19 infection. Eighteen KT patients (78.3%) had positive reverse transcription polymerase chain reaction (RT-PCR) results for COVID-19, 5 patients (21.7%) were negative. Twelve KT patients (52.2%) were male and 11 (47.8%) were female. Fifteen of the KT patients (65.2%) had comorbidity. Thorax computed tomography showed infiltrations in 21 KT patients (91.3%). There were 14 patients (60.8%) with glomerular filtration rate (GFR) below 60 ml/ min, who were considered acute renal failure. One patient needed plasma treatment, 2 needed hemodialysis. Mortality rate was 26%. Conclusion: COVÍD-19 infection causes kidney failure in patients with kidney transplant. Mortality is high in kidney transplant patients with COVÍD-19 infection. Suggested poor prognostic factors increasing death risk are being 60 years or older, recent transplantation, low oxygen saturation level, high WBC count, high CRP level, high troponin level, high D-dimer level, high creatinine level, low GFR value, low sodium level.

Compliance with Public Health Measures and Psychological Effects of COVID-19: Two-Group Cross-Sectional Research

Objective: COVID-19 has spread since the day it emerged and was declared as a global pandemic. Determining the psychological effects of this situation and the compliance with public health measures will be a guide both in the fight against the COVID-19 pandemic and possible epidemics in the future. This two-group, cross-sectional descriptive study aimed to determine compliance with public health measures against COVID-19 and to evaluate the levels of fear, depression, anxiety, and stress by analysing individuals who experienced and did not experience COVID-19. Method: The study sample consisted of a total of 636 participants. Of these participants, 328 had a positive Polymerase Chain Reaction test and 308 had a negative test. Data was collected using the Diagnostic Form, Questionnaire for the Compliance with Public Health Measures Against the COVID-19, Fear of COVID-19 Scale, and the Short Form Depression Anxiety Stress Scale in our online database. Results: Although the participants' compliance with public health measures regarding the use of masks is high, their compliance with the measures related to physical distance is low. Moreover, fear of COVID-19, anxiety, stress, and depression levels are higher in individuals who experienced COVID-19 than those who did not experience COVID-19. Also, both groups have high levels of fear, anxiety, stress, and depression. Conclusion: In conclusion, priority should be given to strategies aimed to increase compliance with physical distance and to detect and control the psychological effects of COVID-19 in the whole society, especially in individuals experiencing COVID-19.

Serum Calprotectin Levels in Dogs with Diarrhea

Background: Diarrhea induced by infectious factors may lead to significant health problems in dogs. Canine parvovirus (CPV), canine coronavirus (CCV), canine distemper virus (CDV), Giardia spp., Escherichia coli (E. coli), and Salmonella spp. are the important infectious agents that may induce diarrhea in dogs. The present study aimed to investigate the effect of CPV, CCV, CDV, Giardia spp., E. coli, and Salmonella spp. infections on the change in serum calprotectin (Calp) concentration. Materials, Methods & Results: A total of 30 dogs were enrolled in the study. The study dogs were divided into 3 groups. Healthy animals as confirmed by clinical examination and animals negative for the specified pathogens were placed in Group 1. Animals infected by one or more agents, including CPV, CCV, CDV, and Giardia spp., but negative for E. coli or Salmonella spp. were placed in Group 2. Finally, animals positive for E. coli or Salmonella spp. and infected or not infected by one or more agents, including CPV, CCV, CDV, and Giardia spp., were placed in Group 3. Stool samples and rectal and conjunctival swab samples were collected to investigate the etiologic agents that induced diarrhea. Blood samples were collected through vena cephalica antebrachii for hematological and biochemical examinations. The samples were obtained via routine clinical examinations at the Prof. Dr. Servet Sekin outpatient clinic at Dicle University Veterinary Faculty. CPV, CCV, CDV, and Giardia spp. diagnoses were made based on immunochromatographic test kits. The bacteriological analysis of stool samples was used to diagnose E. coli and Salmonella spp. infection. Serum Calp concentrations were measured by Enzyme-Linked Immunosorbent Assay (ELISA). The analysis of swab and stool samples by immunochromatographic rapid diagnosis kits and microbiological methods showed that 5 animals were infected with CPV, 10 with CCV, 6 with CDV, 3 with Giardia spp., 12 with E. coli, and 2 with none of the specified agents. Total leukocyte count (WBC), lymphocyte (Lym - %), and granulocyte (Gra - %) values were higher in the diarrheal dogs when compared with the control group. In the biochemical examination of serum samples, total bilirubin (TBIL) and phosphorus (P) levels were higher and sodium (Na) levels were lower in Group 3 when compared to the control group (P = 0.025, 0.024, and 0.018, respectively). Total protein (TP) and albumin (Alb) values were lower in Group 2 compared to Groups 1 and 3 [P = 0.001 and 0.019 for TP, P = 0.000 and 0.01 for Alb, respectively]. There was a statistically significant difference in creatine kinase (CK) levels between Group 1 and Group 2 (P = 0.013). Serum Calp level was higher in the E. coli infected group (Group 3) compared to the other groups, no significant differences were noted between the groups (P > 0.05). Discussion: In conclusion, to the best of authors knowledge, this study is the first to evaluate serum Calp levels in dogs with diarrhea induced by viral, bacterial, and protozoan infections. The Calp level was higher in the sick dogs that were infected by at least one agent, including CPV, CCV, CDV, and Giardia spp., and were at the same time E. coli positive when compared with the control group and the group without E. coli infections. It was concluded that new studies could be useful to reveal the diagnostic importance of serum Calp concentration in dogs with diarrhea and that these results may contribute to future studies in this area.

A Model of Endogenous Risk Intolerance and LSAPs: Asset Prices and Aggregate Demand in a "COVID-19" Shock

We theoretically investigate the interaction of endogenous risk intolerance and monetary policy following a large recessionary shock. As asset prices dip, risk-tolerant agents' wealth share declines. This decline reduces the market's risk tolerance and triggers a downward loop in asset prices and aggregate demand when the interest rate policy is constrained. In this context, large-scale asset purchases are effective because they transfer unwanted risk to the government's balance sheet. These effects are sizable when the model is calibrated to match the estimates of aggregate asset demand inelasticity. The COVID-19 shock illustrates the environment we seek to capture.

Estimating the effect of governmental preventive actions on control of covid-19 pandemic in six countries

Background: In this study, we aimed to assess effectiveness of the major preventive measures to control of COVID-19 pandemic in six countries Methods: Case numbers and intervention times of countries documented by the World Health Organization were used. A natural estimation plot (M0) was constructed for the initial period with no interventions. Estimation models (M1, 2, 3, etc.) to reach the threshold number of cases (5000 cases/day) were calculated for each intervention. The effectiveness of intervention was measured by the magnitude of displacement of its prediction plot to the right of the M0 plot. Results: In the absence of interventions (M0 model), Turkey had the earliest threshold time (26.81 days), whereas France had the longest (58.72 days). Event-specific effect size was the largest for suspension of formal education in all countries, except for Italy (0.03). The effect size of closing the schools was the largest in Iran (16.52) and France (6.75) and the least in Spain (0.45) and Italy (0.03). Turkey (3.82) and the UK (6.07) had a medium effect size. The closure of workplaces had the largest effect size in the UK (4.27) and Italy (4.20). A recommendation to stay at home policy had the lowest impact in the UK (0.58). A second increase was noted in the case trend in Iran after lifting the containment measures. Conclusions: Major interventions are effective and should be adopted early to achieve a higher health impact;however premature easing of restrictions can lead to a loss in controlling the spread of pandemic. © 2021 A. CARBONE Editore. All rights reserved.

A model of endogenous risk intolerance and LSAPs: asset prices and aggregate demand in a "COVID-19" shock

In this paper we: (i) provide a model of the endogenous risk intolerance and severe asset price and aggregate demand contractions following an adverse real (non-financial) shock;and (ii) demonstrate the effectiveness of Large Scale Asset Purchases (LSAPs) in addressing these contractions. The key mechanism stems from heterogeneous risk tolerance: as a recessionary shock hits the economy and brings down asset prices, risk-tolerant agents' wealth share declines and their leverage rises endogenously. This reduces the market's risk tolerance and generates downward pressure on asset prices and aggregate demand. When monetary policy is unconstrained, it can offset the decline in risk tolerance with an interest rate cut that boosts the market's Sharpe ratio. However, if the interest rate policy is constrained, new contractionary feedbacks arise: recessionary shocks lead to further asset price and output drops, which feed the risk episode and trigger a downward loop. In this context, LSAPs improve asset prices and aggregate demand by transferring risk to the government's balance sheet, which reduces the market's required Sharpe ratio and reverses the contractionary feedbacks. Quantitatively, we show that aggregate shocks and LSAPs have large impacts on asset prices when the model is calibrated to fit the inelastic demand for aggregate assets uncovered in recent literature. We also show that heterogeneity in risk tolerance explains part of the demand inelasticity in normal times, and further reduces the elasticity after a recessionary shock. The Covid-19 shock and the large response by all major central banks provide a vivid illustration of the environment we seek to capture.

Knowledge, attitude and practices of personnel working in the department of health services in ankara province regarding covid-19

Objectives: In this study, it was aimed to evaluate the knowledge, attitude, and practices of the personnel providing health services in the Department of Health Services in Ankara Provincial Health Directorate about COVID-19. Materials and Methods: The data of our cross-sectional type of study was collected between the dates of 26 October-November 30, 2020, and 85% percent of the pre-defined population was reached. Statistical evaluation was performed with number and percentage distributions and chi-square test. Results: The average knowledge score of the personnel was found to be 9.35±1.02. Out of 10 knowledge questions, 7 were answered correctly over 91%. 60.6% of respondents answered all knowledge questions correctly. A statistically significant difference was found in the level of knowledge according to profession and level of education (p<0.001). 47.6% of participants exhibited exactly the right practice, and a statistically significant difference was found in the level of practice by profession, gender and education level (p<0.05). Conclusion: Considering the lower level of knowledge and practice of non-health professional groups, comprehensive in-service training for health professionals should further contribute to the fight against the pandemic. © 2021 Ankara Yildirim Beyazit University. All rights reserved.

The mysterious of SARS and mers vaccines, new approaches to a coronavirus vaccine. (Covid-19 özel sayi.) [Turkish]

COVID-19 pandemic caused by SARS-CoV-2, a new type of coronavirus that causes severe acute respiratory syndrome in humans, has caused great concern to humanity and significantly affected life all over the world. SARS-CoV-2 has been transmitted to millions of people due to the lack of established treatments and vaccines. Vaccination applications in the world are regarded as both the most effective and the most economical and promising method in the protection and control of infectious diseases in humans and animals. The determination of the genome and protein structure of SARS-CoV-2 in a record-breaking time allowed the development of prophylactic virus-like particle, subunit, RNA, DNA and vector vaccines as well as inactivated or attenuated viral vaccines. In addition, the experiences obtained from SARSCoV, MERS-CoV which are closely related to this virus, and animal coronavirus infections, have previously caused epidemics in humans, and contributed greatly to this process. The latest coronavirus pandemic has caused universities and research institutes around the world to change their work plans. These institutions have entered into a busy schedule to determine how the disease can be stopped with a specific vaccine. Currently, many companies, universities and institutes around the world and in our country have included an effective vaccine development program against SARS-CoV-2. In this review, previous experiences with coronavirus vaccines and current approaches to SARS-CoV-2 vaccine development, methods and strategies carried out around the world and vaccine candidates are reviewed.

Contact tracing management of the COVID-19 pandemic

Objective: The new type of Corona virus (SARS-CoV-2) is the most important item on the agenda, currently affecting our world. The number of cases has exceeded millions and the number of dead has exceeded hundreds of thousands. The precautions to be taken by societies and individuals, especially states, will undoubtedly be the most important task at the end of this epidemic. In our study, analyzes the data and consequences regarding COVID-19, making use of worldwide experiences and national statistics. In the report writing process, evidence-based and scientific tables and charts were used. In these times when most citizens have just begun to encounter the word pandemic, this report has been prepared using the data and scientific facts of the Ministry of Health of the Republic of Turkey. In this study, it was aimed to evaluate "contact tracing management" (detection, referral and follow-up) studies for positive cases with COVID-19 test results and their contacts in Ankara. Methods: With the Laboratory Information Management System (LBYS), Public Health Management System (HSYS), Contact Tracing and Isolation Tracking System (FITAS) and the Family Medicine Information System (AHBS) prepared by our Ministry, the COVID-19 test results in Ankara were directed towards the "the Our study, which aims to evaluate contact tracing management" (detection, referral and follow-up) studies, is a descriptive study. Within the scope of the research, the studies between March 11, 2020 and May 31, 2020 were examined. In order to use the data in the study, permission was obtained from the General Directorate of Public Health of the Ministry of Health of the Republic of Turkey. dated 06/12/2020 and numbered 119016548. Results: In Ankara, the number of contacts per case is 4.07 and the number of contact tracing per case is 4.05. With a total of 398 "Field Contact Tracing Teams" consisting of 1 doctor and 2 health care personnel throughout the city, the average of 50 ± standard deviations reached 99.4% within hours. Conclusion: The most effective way to prevent the spread of the virus;the epidemic is expected to be brought under control by public health interventions such as mask use, social distance, hand washing, hygiene rules, infection prevention activities such as indoor ventilation and contact management made through Field Contact Tracing Teams" and Family Medicine providing service across the country with GPS-based mobile application FITAS. © 2020 Refik Saydam National Public Health Agency (RSNPHA).