Clinical outcomes of COVID-19 in patients with chronic diseases.

OBJECTIVE: This study was carried out to evaluate the clinical outcomes of patients having chronic diseases (CD) and COVID-19 infection. METHODS: The study was carried out retrospectively by including 1.516 patients with CDs who applied to two education and research hospitals between June 01, 2021, and August 01, 2021, and were diagnosed with COVID-19. As CDs; cardiovascular diseases, diabetes mellitus (DM), hyperlipidemia, asthma, chronic obstructive pulmonary diseases, rheumatological diseases, malignancy, cerebrovascular disease, and chronic kidney diseases (CKD) were screened and evaluated statistically. RESULTS: A total of 1.516 patients with a mean age of 58.05±18.51 years were included in the study. It has been observed that 68.9% of COVID-19 patients have at least one CD. Women were more tend to have CDs than men (73.8% vs. 64.8%). Patients with a history of CD were significantly older and had a longer hospital stay than those without. Patients with CDs were 5.49 times more likely to be hospitalized in the intensive care unit (ICU) and their death rate was 2.52 times higher than the other patients. After the regression analysis, while hypertension (HT) (Odds Ratio [OR]: 2.39), DM (OR: 3.64), and any type of cancer (OR: 2.75) were seen as independent risk factors in hospitalizations in the ICU, cardiovascular diseases (OR: 2.27), CKD (OR: 3.69) and psychiatric disorders (OR: 2.18) were seen as independent risk factors associated with mortality. CONCLUSION: The follow-up of COVID-19 patients with CDs should be done more cautiously than others. It should be kept in mind that patients with HT, DM, and cancer may need intensive care at any time of hospitalization, while those with cerebrovascular disease, CKD, and psychiatric problems may have a higher mortality rate than other patients.

Development of a gestational diabetes risk assessment scale: a validity and reliability study.

Background/aim: The aim of this study was to develop a gestational diabetes risk assessment scale (GEDRISK). Materials and methods: This methodological study included 652 pregnant women who presented to six public health institutions in Istanbul between September 2021 and February 2022. Content validity was evaluated using the content validity index, while construct validity was assessed through exploratory and confirmatory factor analyses. Item discrimination was examined using Cronbach's alpha coefficients, Spearman-Brown and Guttman coefficients, item-total correlation tests, and 27% lower and upper quartile t tests. Reliability was determined through test-retest analysis methods. Results: The scale-level content validity index demonstrated strong coherence at 0.83, confirming its robustness. In the EFA, the scale, comprising 18 items and 5 subdimensions, accounted for 57.48% of the variance (n = 652). The results of the confirmatory factor analysis were as follows: χ2/df = 2.28; RMR = 0.01; CFI, GFI, and IFI = 0.95; AGFI = 0.93; NFI = 0.92; RFI = 0.90; and RMSEA = 0.04. The Spearman-Brown and Guttman split-half coefficient equal length analysis produced a result of 0.826, Cronbach's alpha value was 0.756, and the temporal consistency of the scale was evaluated with the test-retest method (p = 0.184). The structure of the scale was evaluated with a validity and reliability analysis and was found to have acceptable, valid, and reliable properties. The mean total GEDRISK score of the pregnant women participating in the study was 33.57 ± 4.71. It was observed that the GEDRISK scale identified 51% of the respondents diagnosed with diabetes through an oral glucose tolerance test. Conclusion: The GEDRISK scale was found to be a valid and reliable tool for the measurement of gestational diabetes risk in a sample of the Turkish population.

The association between QT interval changes and the treatment protocols of COVID-19 patients.

OBJECTIVE: This study aimed to investigate the QT, QTc, and QTc dispersion changes that may occur with the use of hydroxychloroquine (HCQ), favipiravir, and moxifloxacin in combination or alone in COVID 19 patients. METHODS: This study was retrospectively conducted on 193 inpatients diagnosed with COVID-19. We divided the patients into four separate groups due to their medications as, group-1: favipiravir, group-2: favipiravir + HCQ, group-3: favipiravir + moxifloxacin, and group-4: favipiravir + moxifloxacin + HCQ. We recorded their pre and post-treatment QT parameters of each group and evaluated the changes of these parameters with the SPSS statistical program. RESULTS: The mean age of the patients was 63.1±17.7. In group 1 and 2, although there were slight changes in QT parameters, these results were not statistically significant. In group 3, significant increases in QT and QTc dispersion occurred (p=0.005 and p=0.018). In the 4th group where the triple therapy was applied, there was a significant increase only in the QTc values (p=0.027). When we compared the changes of QT parameters for each group, a significant difference was found in ΔQTc dispersion, and post hoc analysis showed that it was due to changes in the third group (p=0.047). CONCLUSION: We thought that, if there is a COVID-19 infection with an additional bacterial infection, and if there is a need of using moxifloxacin alone or together with HCQ, additional risk factors that may cause QT interval prolongation should be reviewed and ECG monitoring of the patients should be performed during the treatment period.

Association of blood groups on the risk of COVID-19 infection, morbidity, and mortality.

OBJECTIVE: We aimed to compare the effects of blood groups and Rh factor on the development of coronavirus-19 disease (COVID-19) with all aspects such as clinical course, inflammatory parameters, and organ-specific biochemical parameters with a significant number of patients. METHODS: This multicenter study was carried out retrospectively on 3551 patients hospitalized with the diagnosis of COVID-19 and whose blood groups were recorded during the time of hospitalization. As control groups, 22133 individuals' medical data who were admitted to the blood bank affiliated with our hospitals during the last year was used. The differences between the blood groups and clinical characteristics were analyzed. RESULTS: Of the 3551 patients, A Rh (+) blood group was found to be in a higher ratio in the case group than controls, with increased risk to be infected (case: 41.3% vs. control: 38.8%), (OR 1.113; 95% CI: 1.036-1.197; p=0.003). Meanwhile O Rh (+) blood group ratios were significantly lower in the case group than in the control group (case: 26% vs. control: 28.3%) (OR 0.862; 95% CI: 0.823-0.966; p=0.005). There was no significant difference between blood groups in terms of admission to the intensive care units and mortality, it was observed that patients with AB Rh (+) blood group have a greater risk for intubation than others (OR: 1.467; 95% CI: 1.040-2.071; p=0.028). CONCLUSION: We demonstrated that people with blood group A Rh (+) more susceptible to COVID-19, whereas blood group 0 Rh (+) have a protective effect against the infection. Once a person has been infected with severe acute respiratory syndrome coronavirus 2, we should be mindful that patients with blood group AB Rh (+) would be prone to intubation more than other blood groups.

Current situation analysis of diabetic home care patients.

OBJECTIVE: Diabetes is one of the primary diagnoses for admission to home health care units. Although there are many studies about elderly diabetic patients, there are not many studies on home care patients with diabetes. The present study aims to analyze the current status of diabetic home care patients with their biochemical data and medications. METHODS: This was a retrospective study, including 256 diabetic patients who were following up by the Home Health Unit of Istanbul Provincial Health Directorate Public Hospitals Services-2. In this study, we analyzed the current biochemical data of the patients with their medications. RESULTS: In this study, 185 female (72.3%) and 71 male (27.7%) patients were recruited with the mean HbA1c of 8.25±1.77. Among these patients, 65% of them were using oral antidiabetic (OAD), and 58% were using insulin. There were 21 (8.2%) patients who were not receiving any treatment. While patients who were using only oral antidiabetic have better A1c levels (A1c: 7.73±1.45), patients who were insülin using had HbA1c levels as high as the patients who were not using any medication. This may be due to the progression of diabetes, fear of hypoglycemia or insufficient insülin use. While metformin was the most commonly used OAD, with a 38% usage rate. When compared to HbA1c levels, there was no difference between the types of insulin used (p=0.167). CONCLUSION: As a result, it is important to plan regular visits and personalized treatment by keeping in mind the benefits to risk ratios in home-care diabetic patients.

Determination of health workers' level of knowledge about blood transfusion.

OBJECTIVE: This study was conducted to determine the knowledge level of healthcare workers about blood transfusion. METHODS: The study was conducted between October 1, 2015 and November 2, 2015 with 100 healthcare personnel working in a training and research hospital. A survey consisting of 19 questions based on the literature was prepared and administered. In addition to descriptive statistical methods (frequency), Fisher's exact chi-square test and Yates' correction for continuity were used to compare qualitative data. Significance was assessed at p<0.05. RESULTS: Of the total, 52% of the participants were ≤29 years of age and 94% were women. In all, 71% were nurses and 42% had been working at the hospital for 2 to 5 years. Seventy-nine percent indicated that they had been trained in blood and blood product transfusion, 86% stated that transfusions were performed to replace deficient blood volume, and 95% responded that blood was to be requested by a physician, and 97% indicated that informed consent of the patient should be obtained for a blood transfusion. In all, 78% of respondents identified crossmatching as the final check for ABO compatibility. With respect to blood unit quality, 90% of the respondents stated that they would return blood if the label could not be read and 98% would reject the product if the integrity of the blood bag was compromised or of the blood had a cloudy or foamy appearance. In the event of a patient experiencing fever and shock, 96% of the survey participants indicated that they would consider that it could be a reaction to a blood transfusion. The need to confirm the patient's identity and the type of blood products was corroborated by 91%, and 85% agreed that no other medication should be added to the blood to be transfused. Furthermore, 88% of the study participants approved of continuous training regarding the transfusion of blood and blood products. CONCLUSION: According to the results of this research, while the knowledge of the healthcare professionals surveyed was adequate, standardization was lacking. In this respect, it may be advisable to conduct further studies on blood transfusion practices, and to provide additional in-service training to ensure patient safety and avoid medical errors.