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Background: The development of candidemia is a highly fatal condition in severe COVID‐19 infection. Objectives: This study aimed to develop a candidemia prediction score in COVID‐19 patient based on the patient's clinical characteristics, and healthcare‐related factors during intensive care units (ICU) follow‐up. Patients/Methods: Severe COVID‐19 patients hospitalised in ICU in Ankara City Hospital during the one‐year period (August 15, 2020, and August 15, 2021) were included. After univariate analysis, multivariate analysis was applied using variable selection approach to investigate the effects of variables together and to create a score model for candidemia. Statistically significant factors were included in the development process of candida prediction score. Results: Of 1305 COVID‐19 ICU patients, 139 had a candidemia episode. According to the final model, four variables, presence of central venous catheter (CVC) (OR 19.07, CI 8.12–44.8, p <.0001), multifocal colonisation (OR 2.28, CI 1.39–3.72, p 0.001), length of ICU stays ≥14 days (OR 3.62, CI 2.42–5.44, p <.0001) and corticosteroids (OR 0.51, CI 0.34–0.76, p 0.0011) were the only statistically significant independent risk factors for candidemia. Score model was demonstrated by a nomogram, and the risk for candidemia was calculated to be high in patients who scored ≥56 points by using the criteria [CVC = 51, multifocal colonisation = 14, prolonged hospitalisation = 23, no steroid use = 12 points]. The AUC of the score is 0.84 (CI 0.81–0.87). Conclusion: We developed and validated an easy‐to‐use clinical prediction score for candidemia in severe COVID‐19 infection. In COVID‐19 ICU patients, the risk of candidemia is high if one of the other risk factors is present together with CVC. [ABSTRACT FROM AUTHOR]

Background: Critically ill COVID‐19 patients have a high risk for the development of candidemia due to being exposed to both well‐defined classical risk factors and COVID‐19‐specific risk factors in ICU. Objectives: In this study, we investigated the incidence of candidemia in critically COVID‐19 patients, and the independent risk factors for candidemia. Patients/methods: COVID‐19 patients hospitalised in ICU during 1‐year period (August 2020 to August 2021) were included. Clinical and laboratory characteristics of all COVID‐19 patients, applied treatments, and invasive procedures that may predispose to candidemia were recorded. Results: Of 1229 COVID‐19 patients, 63 developed candidemia. Candidemia incidence rate was 4.4 episodes per 1000 ICU days. The most common species was Candida albicans (52.3%). Only 37 patients (58.7%) received antifungal therapy. The presence of central venous catheter (OR 4.7, 95% CI 1.8–12.2, p <.005), multifocal candida colonisation (OR 2.7, 95% CI 1.4–5.2, p <.005), a prolonged ICU stay (≥14 days) (OR 1.9, 95% CI 1.08–3–37, p <.05), the absence of chronic lung disease (OR 0.4, 95% CI 0.1–0.9, p <.05) and the absence of corticosteroid use (OR 0.3, 95% CI 0.14–0.52, p <.0001) were significantly associated with candidemia. Conclusions: Our study filled the knowledge gap in the literature about the impact of COVID‐19‐associated risk factors for the development of candidemia. The classical risk factors for candidemia had a significant effect on candidemia, and contrary to expectations, corticosteroids had a protective effect against the development of candidemia. The results of these studies showing interesting effects of corticosteroids in critically ill COVID‐19 patients should be confirmed by further studies. [ABSTRACT FROM AUTHOR]

Post recovery manifestations have become another concern in patients who have recovered from coronavirus disease 2019 (COVID‐19). Numerous reports have shown that COVID‐19 has a variety of long‐term effects on almost all systems including respiratory, cardiovascular, gastrointestinal, neurological, psychiatric, and dermatological systems. We aimed to investigate the prevalence and characteristics of the post‐COVID syndrome among COVID‐19 survivors and to determine the factors associated with persistent symptoms. This prospective study enrolled in patients with COVID‐19 followed in hospital or outpatient clinics in Ankara City Hospital. We performed a special questionnaire to inquire about the presence of persistent symptoms beyond 12 weeks from the first diagnosis. Demographic data, comorbid diseases, characteristics of acute COVID‐19, presence of persistent symptoms by systems, and knowledge about outpatient clinic visits after recovery were assessed. Of a total of 1007 participants, 39.0% had at least one comorbidity, and 47.5% had persistent symptoms. Fatigue/easy fatigability, myalgia, and loss of weight were the most frequent persistent symptoms (overall 29.3%) followed by respiratory symptoms (25.4%). A total of 235 participants had visited outpatient clinics due to several reasons during the post‐COVID‐19 period, and 17 of them were hospitalized. Severe acute COVID‐19, hospitalization, and presence of comorbidity were independent factors for the development of persistent symptoms. Fully understanding the spectrum of the post‐COVID syndrome is essential for appropriate management of all its long‐term effects. Our study once again underlined the fact that the prevalence of post‐COVID syndrome is higher than expected and concerns many systems, and a multidisciplinary follow‐up should be provided to COVID‐19 survivors in the post recovery period. Highlights: COVID‐19 has a variety of long‐term effects on almost all systems.Respiratory, cardiovascular, gastrointestinal, neurological, psychiatric, and dermatological systems are affected in different degree.We detected the prevalence of the post?COVID syndrome among COVID‐19 survivors as 47.5% on 1007 participant.Fatigue/easy fatigability, myalgia, and loss of weight were the most frequent persistent symptoms (overall 29.3%), and followed by respiratory symptoms (25.4%).Severe acute COVID‐19, hospitalization, and presence of comorbidity were independent factors for the development of persistent symptoms. [ABSTRACT FROM AUTHOR]

Severe COVID‐19 patients in ICU are at high risk for candidemia due to exposure to multiple risk factors for candidemia. We aimed to compare the incidence of candidemia in ICU patients with and without COVID‐19, and to investigate epidemiologic and clinical characteristics of candidemia patients and risk factors for mortality in candidemia patients. This retrospective study was conducted in patients followed in the ICUs of Ankara City Hospital for 2 years, divided into pre‐pandemic and pandemic periods. The incidence (event per 1000 patient‐days) and epidemiology of candidemia, clinical and laboratory characteristics of patients were compared in COVID‐19 and non‐COVID‐19 groups. Candidemia incidence was higher in the COVID‐19 group (2.16, 95% CI 1.77–2.60) than the non‐COVID‐19 group (1.06, 95% CI 0.89–0.125) (p <.001). A total of 236 candidemia episodes (105 in COVID‐19 patients and 131 in non‐COVID‐19 patients) were detected during the study periods. COVID‐19 cases had a higher rate of corticosteroid use (63.8% vs. 9.9%, p <.001). Epidemiology of candidemia and antifungal susceptibility were similar. Candidemia developed 2 weeks earlier in COVID‐19 groups and resulted in higher mortality (92.5% vs. 79.4%, p.005). One‐third of candidemia patients died before receiving any antifungal treatment, and this rate was higher in the COVID‐19 group. In multivariate logistic regression analysis, corticosteroid use, presence of sepsis and age older than 65 years were independent risk factors for mortality in candidemia patients. Candidemia with high mortality is a more serious problem for COVID‐19 patients due to its increased incidence, earlier occurrence and a higher rate of mortality. [ABSTRACT FROM AUTHOR]

COVID‐19 pandemic has been affecting the whole world by increasing morbidity and mortality rates day by day. Treatment algorithms have been attempted as parallel to the increasing experience with COVID‐19. In the pathogenesis of this virus pro‐inflammatory cytokine storm has been called to have the main role. The right timing should be made for treatments. We proposed IL‐ 1 blocking by anakinra in seventeen COVID‐19 patients at high risk of worsening. Patients were assessed according to HScore, SOFA (Sequential Organ Failure Assessment Score = SOFA), MuLBSTA Score (multilobular infiltration, hypo‐lymphocytosis, bacterial coinfection, smoking history, hyper‐tension, and age), Brescia‐COVID respiratory severity scale (BCRSS). In our study, the mortality rate was 17.6%. Consequently, 1 (5.9%) patient was receiving low‐flow oxygen supply, 3 (17.6%) patients needed no longer oxygen supply and 10 (58.8%) patients were discharged from the hospital. According to the results of our study in the manner of general evaluation; we found that SOFA, MuLBSTA, and BCRSS scores were one step ahead according to HScore being insufficient to determine early phases of the disease. In our opinion, the prominent factors that emphasize the use of anakinra could be listed as comorbidity, risk, or presence of secondary infection, ongoing malignant disease. However, the other factors that enhance the use of anakinra in the situation of viremia also could be sorted as no response to full dose antivirals, antiviral side effects, or no success to antiviral treatment. [ABSTRACT FROM AUTHOR]

Crimean Congo hemorrhagic fever (CCHF) is a viral zoonotic disease with high mortality rate. There are only a few studies on viral load in CCHF. In our study, we revealed the dynamics of viral load and its relationship with mortality in early phase of the disease. A total of 138 serum samples were collected from 23 patients. All patients had positive PCR for CCHF on admission. Serum samples were obtained daily from all patients for the first 6 days of hospitalization and stored at −80°C for viral load measurement. We found statistically significant difference between mean number of viremic serum samples of fatal and non‐fatal patients. Furthermore, non‐fatal cases' viral loads demonstrated statistically significant decreases over time; however, we could not observe a similar trend in viral loads of fatal cases. Limited number of studies on CCHF indicate that score of the contest between CCHF virus and immune system determines the survival in CCHF and viral load is found to be the most prognostic factor. In our study, we found that there is a notable decrease trend in viral loads of non‐fatal patients over time and this clearance of CCHF virus is significantly related with survival. [ABSTRACT FROM AUTHOR]

The first reactive arthritis case associated with COVID-19 Abbreviations ACE2 angiotensin-converting enzyme-2 anti-CCP antibodies to cyclic citrullinated peptide COVID-19 novel coronavirus disease 2019 NSAID nonsteroidal anti-inflammatory drug ReA reactive arthritis RF Rheumatoid factor SARS-CoV-2 novel coronavirus INTRODUCTION New type pneumonia, later termed the novel coronavirus disease 2019 (COVID-19) arose from Wuhan Province in China in December 2019, has quickly become a global public health emergency.1 The etiological agent was identified as a new type coronavirus, named as novel coronavirus (SARS-CoV-2).2 Outbreak has rapidly spread all over the world3 and the first confirmed COVID-19 patient in Turkey was reported on 11th March 2020.2 A syndrome of dysregulated and systemic immune overactivation described as a cytokine storm or hyperinflammatory syndrome may develop during of the course COVID-19.4 As a result, coagulation and inflammation can significantly affect disease progression.4,5 In this case, we report the first reactive arthritis associated with COVID-19 infection. Also, gastrointestinal manifestation was reported in approximately 12% of COVID-19 patients.7 Gastrointestinal system may serve as a secondary site for COVID-19 infection in relation to the expression of angiotensin-converting enzyme-2 in the gastrointestinal tract.8 ReA may be related to this involvement. [Extracted from the article]