Comparative validation and clinical performance data are essential for the reliable interpretation of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibody test results. This study ...aimed to assess the performance of six SARS-CoV-2 IgG immunoassays in the context of different disease severities. Four automated chemiluminescence immunoassays (Access Beckman Coulter, Architect Abbott, Atellica-IM Siemens, and Elecsys Roche) as well as two ELISA assays (SARS-CoV-2 IgG-S1-based and NCP IgG Euroimmun) were evaluated using samples from 143 patients as well as 50 pre-pandemic control serum samples. Accuracy and precision tests were performed for validation purposes. Overall sensitivity ranged between 73.38–88.65% and was higher in spike protein-based assays, while the specificity was ≥98% in all immunoassays. The clinical performance of the immunoassays differed depending on disease severity and target antigen. For instance, the IgG response was lower for samples taken <20 days post-symptom onset (87.30%) compared with those taken ≥20 days post-symptom onset (94.80%). Moreover, moderate disease levels led to the highest levels of IgG. Higher levels of antibodies were detected in the clinically moderate disease group. In asymptomatic and mild groups, more antibody positivity was detected with spike protein-based assays. All the assays tested could be used to detect SARS-CoV-2 IgG. However, spike-based assays revealed relatively higher sensitivity rates than nucleoprotein-based assays, particularly in cases of asymptomatic and mild disease.
Introduction
Guidelines recommend using a pulse oximeter rather than arterial blood gas (ABG) for COVID‐19 patients. However, significant differences can be observed between oxygen saturation ...measured by pulse oximetry (SpO2) and arterial oxygen saturation (SaO2) in some clinical conditions. We aimed to assess the reliability of the pulse oximeter in patients with COVID‐19.
Methods
We retrospectively reviewed ABG analyses and SpO2 levels measured simultaneously with ABG in patients hospitalised in COVID‐19 wards.
Results
We categorised total 117 patients into two groups, in whom the difference between SpO2 and SaO2 was ≤4% (acceptable difference) and >4% (large difference). A large difference group exhibited higher neutrophil count, C‐reactive protein, ferritin, fibrinogen, D‐dimer and lower lymphocyte count. Multivariate analyses revealed that increased fibrinogen, increased ferritin and decreased lymphocyte count were independent risk factors for a large difference between SpO2 and SaO2. The total study group demonstrated the negative bias of 4.02% with the limits of agreement of −9.22% to 1.17%. The bias became significantly higher in patients with higher ferritin, fibrinogen levels and lower lymphocyte count.
Conclusion
Pulse oximeters may not be sufficient to assess actual oxygen saturation, especially in COVID‐19 patients with high ferritin and fibrinogen levels and low lymphocyte count with low SpO2 measurements.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Objectives: Brucellosis is a zoonotic infectious disease. C-reactive protein (CRP) is widely used in the diagnosis, treatment and follow-up of brucellosis. However, CRP is not a specific test. In ...this study, it is aimed to investigate the role of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio and red cell distribution width (RDW) as inflammatory markers in brucellosis. Materials and Methods: In our study, ≥18 year old brucellosis patients followed between January 1st, 2017 and January 1st, 2019 were included. Patients’ data were obtained through hospital information systems. Initial and monthly consecutive values of neutrophil counts, lymphocyte counts, platelet counts, RDW and CRP levels were recorded. Results: One hundredand thirty-six patients were included in the study. 63.2% (n=86) of the cases were male. It was determined that Brucella spp. was cultured in 7.4% of the patients’ samples. The patients were given antibacterial treatment during the median period of 7 (6-40) weeks. Under treatment, CRP and NLR declined significantly (p<0.05). At the end of the first and second months, RDW declined significantly but the same association could not be detected at the end of the third month (p=0.059). It was found that only NLR was correlated with CRP levels and its declining trend (p<0.05). Conclusion: It is concluded that the values of NLR and RDW are useful to monitor treatment response in brucellosis patients. These values provide advantage since they can speedily be measured via automated complete blood count analyzer with no necessity for additional cost and human capital.
It is known that there is an increase in the frequency of psychiatric disturbances in the acute and post‐illness phase of coronavirus disease (COVID‐19). Comorbid psychiatric symptoms complicate the ...management of patients and negatively affect the prognosis, but there is no clear evidence of their progress. We aimed to determine psychiatric comorbidity in inpatients and outpatients with COVID‐19 and recognize the factors that predict psychiatric comorbidity. For this purpose, we evaluated patients on the first admission and after 4 weeks. We investigated psychiatric symptoms in outpatients (n = 106) and inpatients (n = 128) diagnosed with COVID‐19. In the first 7 days after diagnosis (first phase), sociodemographic and clinic data were collected, a symptom checklist was constructed, and the Hospital Anxiety and Depression Scale (HADS) and the Severity of Acute Stress Symptoms Scale (SASSS) were applied. After 30–35 days following the diagnosis, the SASSS and the HADS were repeated. In the first phase, the frequency of depression and anxiety were 55% and 20% in inpatients, and 39% and 18% in outpatients, respectively. In the second phase, depression scores are significantly decreased in both groups whereas anxiety scores were decreased only in inpatients. The frequencies of patients reporting sleep and attention problems, irritability, and suicide ideas decreased after 1 month. Patients with loss of smell and taste exhibit higher anxiety and depression scores in both stages. Our results revealed that the rate of psychiatric symptoms in COVID‐19 patients improves within 1 month. Inpatients have a more significant decrease in both depression and anxiety frequency than do outpatients. The main factor affecting anxiety and depression was the treatment modality. Considering that all patients who were hospitalized were discharged at the end of the first month, this difference may be due to the elimination of the stress caused by hospitalization.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Objective : Non-compliance with antibiotic use is a major cause of treatment failure, increased adverse effects, higher healthcare costs and antibiotic resistance. In this study, our objective was to ...investigate the factors affecting non-compliance with antibiotic use in Dursunbey, to define preventive measures, and to design content of educational activities. Methods : 129 volunteers who have used antibiotics in the last 3 months were involved in the study. A brief questionnaire with 14 questions was applied through face to face interview. A cross-sectional study was performed on the basis of volunteers' replies. The data were evaluated by bivariate analysis and a logistic regression model. Results : Non-compliance in antibiotic use was detected to be 35%. Bivariate analysis revealed that female sex, age, antibiotic prescription in family medicine centers, antibiotic consumption for upper respiratory tract complaints, feeling better on the first days of antibiotic course, low education level were significantly related to non-compliance in antibiotic use. Multivariate analysis showed that "feeling better on the first days of antibiotic course" (Odds ratio: 5.05) and "female sex" (Odds ratio: 14.38) were significantly related to noncompliance in antibiotic use. Conclusions : Compliance with antibiotic use can be increased by physicians and pharmacists giving satisfactory and appropriate information, performing rapid diagnostic tests, thorough evaluation of antibiotic necessity in each patient with upper respiratory tract complaints by physicians and designing educational activities about antibiotics in schools and maternal healthcare centers.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Appendicitis is a common surgical emergency among children. The coronavirus pandemic affected the system of hospitals more than any other field, and great amount of people were concerned about ...visiting the hospitals for any reason. In this study, it was aimed to evaluate the profile of appendicitis by emphasizing perforated and acute appendicitis in the pandemic period and to compare the rates with previous three years.
Charts of the children who underwent laparoscopic appendectomy due to appendicitis between March 11-September 30 between 2017-2020 were retrospectively analyzed in terms of demographic data, duration of symptoms, duration between hospital admission and surgery, radiologic imaging and perioperative outcomes.
This study includes 467 children who underwent laparoscopic appendectomy. There were 97 procedures in 2020, 111 in 2019, 146 in 2018 and 113 in 2017. Multiple comparison tests revealed that age did not show difference; but onset of symptoms in admission (p= 0.004), hospitalization time before surgery (p <0.001), total hospitalization time (p <0.001) showed statistically significant difference between years. Pairwise comparisons showed that these parameters were increased in 2020 compared to other years. Perforated appendicitis rate was significantly increased in 2020 when compared to previous years.
Although there is no direct relation between appendicitis and COVID-19 infection in the current knowledge, perforated appendicitis was found to be increased in children during the COVID pandemic. Reason of the higher rate of perforated appendicitis may be multifactorial; however, the pandemic appears to have a role in increased morbidity in children with appendicitis indirectly due to delay of hospital admissions.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Coronavirus Disease-19 (COVID-19) is a highly contagious infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The development of rapid antigen tests has ...contributed to easing the burden on healthcare and lifting restrictions by detecting infected individuals to help prevent further transmission of the virus. We developed a state-of-art rapid antigen testing system, named DIAGNOVIR, based on immune-fluorescence analysis, which can process and give the results in a minute. In our study, we assessed the performance of the DIAGNOVIR and compared the results with those of the qRT-PCR test. Our results demonstrated that the sensitivity and specificity of the DIAGNOVIR were 94% and 99.2%, respectively, with a 100% sensitivity and 96.97% specificity, among asymptomatic patients. In addition, DIAGNOVIR can detect SARS‑CoV‑2 with 100% sensitivity up to 5 days after symptom onset. We observed that the DIAGNOVIR Rapid Antigen Test's limit of detection (LoD) was not significantly affected by the SARS‑CoV‑2 variants including Wuhan, alpha (B1.1.7), beta (B.1.351), delta (B.1.617.2) and omicron (B.1.1.529) variants, and LoD was calculated as 8 × 10
, 6.81 × 10
, 3.2 × 10
, 1 × 10
, and 1 × 10
TCID50/mL, respectively. Our results indicated that DIAGNOVIR can detect all SARS-CoV-2 variants in just seconds with higher sensitivity and specificity lower testing costs and decreased turnover time.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Associations between inherited Killer Immunoglobulin-like Receptor (KIR) genotypes and the severity of multiple RNA virus infections have been reported. This prospective study was initiated to ...investigate if such an association exists for COVID-19. In this cohort study performed at Ankara University, 132 COVID-19 patients (56 asymptomatic, 51 mild-intermediate, and 25 patients with severe disease) were genotyped for KIR and ligands. Ankara University Donor Registry (n:449) KIR data was used for comparison. Clinical parameters (age, gender, comorbidities, blood group antigens, inflammation biomarkers) and KIR genotypes across cohorts of asymptomatic, mild-intermediate, or severe disease were compared to construct a risk prediction model based on multivariate binary logistic regression analysis with backward elimination method. Age, blood group, number of comorbidities, CRP, D-dimer, and telomeric and centromeric KIR genotypes (tAA, tAB1, and cAB1) along with their cognate ligands were found to differ between cohorts. Two prediction models were constructed; both included age, number of comorbidities, and blood group. Inclusion of the KIR genotypes in the second prediction model exp (-3.52 + 1.56 age group - 2.74 blood group (type A vs others) + 1.26 number of comorbidities - 2.46 tAB1 with ligand + 3.17 tAA with ligand) increased the predictive performance with a 92.9% correct classification for asymptomatic and 76% for severe cases (AUC: 0.93;
P
< 0.0001, 95% CI 0.88, 0.99). This novel risk model, consisting of KIR genotypes with their cognate ligands, and clinical parameters but excluding earlier published inflammation-related biomarkers allow for the prediction of the severity of COVID-19 infection prior to the onset of infection. This study is listed in the National COVID-19 clinical research studies database.
Graphical abstract
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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