COVID-19: vaccination vs. hospitalization.

OBJECTIVE: Vaccination is the most efficient way to control the coronavirus disease 2019 (COVID-19) pandemic, but vaccination rates remain below the target level in most countries. This multicenter study aimed to evaluate the vaccination status of hospitalized patients and compare two different booster vaccine protocols. SETTING: Inoculation in Turkey began in mid-January 2021. Sinovac was the only available vaccine until April 2021, when BioNTech was added. At the beginning of July 2021, the government offered a third booster dose to healthcare workers and people aged > 50 years who had received the two doses of Sinovac. Of the participants who received a booster, most chose BioNTech as the third dose. METHODS: We collected data from 25 hospitals in 16 cities. Patients hospitalized between August 1 and 10, 2021, were included and categorized into eight groups according to their vaccination status. RESULTS: We identified 1401 patients, of which 529 (37.7%) were admitted to intensive care units. Nearly half (47.8%) of the patients were not vaccinated, and those with two doses of Sinovac formed the second largest group (32.9%). Hospitalizations were lower in the group which received 2 doses of Sinovac and a booster dose of BioNTech than in the group which received 3 doses of Sinovac. CONCLUSION: Effective vaccinations decreased COVID-19-related hospitalizations. The efficacy after two doses of Sinovac may decrease over time; however, it may be enhanced by adding a booster dose. Moreover, unvaccinated patients may be persuaded to undergo vaccination.

Assessment of inflammatory biomarkers and oxidative stress in pulmonary thromboembolism: follow-up results.

Instability in circulation, hypoperfusion, hypoxia, and ischemia in pulmonary thromboembolism (PTE) may occur as a result of failure in pulmonary circulation. All these conditions cause inflammation and oxidative stress. We aimed to investigate inflammatory markers, asymmetric dimethylarginine (ADMA) levels, and the oxidant-antioxidant balance in patients with PTE. This study was conducted as a prospective case-control study. Thirty-eight patients with PTE enrolled to the study. Age- and gender-matched 38 healthy subjects without risk factors for pulmonary embolism were selected as control group. Venous blood samples were obtained from the PTE patients during the initial diagnosis and at the first month of treatment and from the control subjects. Interleukine-6 (IL-6), tumor necrosis factor alpha (TNF-α), total antioxidant status (TAS), total oxidant status (TOS), and ADMA levels were measured for all the samples. The results of patients and healthy subjects were compared. The mean age of the control group was 51.81 ± 15.18 years, and the mean age of the patients was 52.90 ± 18.22 years (p = 0.770). Deep venous thrombosis was present in 68 % of the patients. While we found significant differences between the patient and control groups in terms of IL-6, TAS, TNF-α, ADMA and oxidative stress index (OSI) values (p = 0.001, p = 0.011, p = 0.038, p = 0.028, and p = 0.024, respectively), the TOS value was not different between the groups (p = 0.080). The ADMA, TNF-α, TAS, TOS, and OSI values of the patients during the initial diagnosis and at the first month of treatment were not different (p > 0.05). The results of this study indicate an increased inflammation, endothelial damage, and oxidative stress in PTE. No difference at the first month of therapy suggests ongoing processes. We consider that these markers may be useful in the diagnosis and follow up of PTE.

Might psoriasis be a risk factor for obstructive sleep apnea syndrome?

BACKGROUND: It is believed that psoriasis is a chronic systemic inflammatory disease. Obstructive sleep apnea syndrome (OSAS) is a disease influencing all systems and characterized by intermittent partial or complete obstruction of the upper respiratory tract during sleep. In our study, we aimed to investigate the frequency of OSAS in patients previously diagnosed with psoriasis in order to investigate a potential association between chronic inflammation psoriasis and OSAS. METHODS: Thirty-three patients diagnosed with psoriasis by biopsy were enrolled into the study. Demographics of patients, Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index (DLQI), and Epworth Sleepiness Scale were examined. All patients underwent polysomnography. RESULTS: OSAS was determined in 18 of 33 patients with psoriasis (54.5 %). Eleven of the 18 patients had mild, 2 had moderate, and 5 had severe OSAS. Mean age was significantly higher in the OSAS group in comparison with non-OSAS group (54.4 ± 15.5 vs 39.4 ± 11.8, respectively, p < 0.05). Mean PASI was higher in the OSAS group in comparison with that of non-OSAS group, and the difference was not significant, although mean DLQI was lower (p > 0.05). It is believed that this was caused by the small patient population. CONCLUSION: We detected that the frequency of OSAS in patients with psoriasis was much higher than that in the normal population. Though OSAS is not easy to diagnose without detailed testing, it should be investigated in psoriatic patients with long disease duration and high PASI score, and patients refractory to conventional systemic treatment. Physicians treating patients with psoriatic disease should incorporate this life-altering comorbidity into their assessment of disease and selection of treatment.

Inflammatory processes and effects of continuous positive airway pressure (CPAP) in overlap syndrome.

We aimed to compare serum levels of the inflammatory mediators including C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and asymmetric dimethylarginine (ADMA) in chronic obstructive pulmonary disease (COPD), obstructive sleep apnea syndrome (OSAS), and their coexistence called overlap syndrome (OVS). In addition, we planned to investigate changes of these mediators with the treatment of continuous positive airway pressure (CPAP) in OSAS and OVS. CRP, TNF-α, and ADMA levels were analyzed by ELISA method from blood samples withdrawn from patients with COPD (N = 25), OVS (N = 25), and moderate- to severe-stage OSAS (N = 25). First blood samples were taken in the morning after polysomnography application, and second blood samples were taken from OSAS and OVS patients who underwent regular CPAP treatment. In comparison of three groups prior to CPAP treatment, ADMA level in OSAS were significantly lower than in COPD (p = 0.009), but CRP and TNF-α were similar among groups. When we compared the parameters before and after CPAP treatment, the level of CRP in both OSAS and OVS decreased significantly (p = 0.02, p = 0.04), whereas TNF-α and ADMA levels did not display any significant differences. A decrease of serum CRP level in OVS and OSAS groups following effective CPAP treatment shows that CPAP is an effective treatment method for systemic inflammation.