INTRODUCTION:The novel coronavirus disease (COVID-19) pandemic has had a profound global impact economically, socially, and in many other areas. As vaccines are developed and introduced, their effect on the disease on both, the global and individual scale is a subject of intense curiosity. This study aimed to evaluate the relationship between risk factors for hospitalization, disease severity, and vaccination status in COVID-19 inpatients in a pandemic hospital. METHODOLOGY: Patients hospitalized for COVID-19 between June and September 2021 were retrospectively analyzed in three groups: unvaccinated, incompletely vaccinated, and fully vaccinated. Disease severity was classifi ed as moderate, severe, or critical according to World Health Organization criteria, and mortality risk factors and the prognostic effect of vaccination were analyzed. RESULTS: The study included 486 patients, 228 women (46.9 %) and 258 men (53.1 %), with a mean age of 55.4 ± 16.5 years. Of these, 264 patients (54.3 %) were unvaccinated, 147 (30.2 %) were incompletely vaccinated, and 75 (15.4 %) were fully vaccinated. Older age, higher Charlson Comorbidity Index, greater disease severity, and being unvaccinated or incompletely vaccinated were associated with higher mortality. CONCLUSIONS: The results of our study indicate that age, disease severity, comorbidities, and vaccination status were factors affecting COVID-19 mortality. Our fi ndings support that full vaccination reduces COVID-19 -related mortality rates, disease severity, and length of hospital stay. However, large-scale studies with larger patient populations are needed (Tab. 2, Ref. 22).

Background: Postoperative pneumonia increases costs associated with inpatient stay, treatment, laboratory testing, and imaging, thereby increasing total healthcare costs. The aim of this study was to determine risk factors in patients who develop pneumonia after thoracic and cardiovascular surgery, evaluate relationships between these risk factors and cost, and conduct a cost analysis of postoperative pneumonia. Materials and Methods: 111 patients who underwent major thoracic or cardiovascular surgery between June 2009 and March 2014 were evaluated retrospectively. Patients who developed postoperative pneumonia (p = 37) were compared with those who had no postoperative complications (p = 74). Results: 40 men and 71 women were included in the study. Mean length of hospital stay was 21 days for patients with pneumonia versus 10 days for patients without pneumonia (p < 0.001). Significant risk factors for postoperative pneumonia were Charlson Comorbidity Index > 2, steroid use, high ASA score, presence of nasogastric tube, peripheral/central venous catheterization, postoperative heart failure/acute kidney failure, total parenteral nutrition, late postoperative mobilization, and prolonged ventilation and intubation (p < 0.05). Postoperative pneumonia was associated with significantly higher mortality rate and total cost (p < 0.001 for both). The mean cost of treatment for patients with and without postoperative pneumonia was 8211.7 TL and 3917.5 TL, respectively (p < 0.001). There were statistically significant differences between the two groups in the costs of surgery, radiology, antibiotics, and cultures (p < 0.001 for all). Correlation analysis between risk factors and cost revealed that prolonged intubation, late mobilization, and lack of respiratory rehabilitation exercises were associated with higher costs (p < 0.05). Conclusions: Postoperative pneumonia significantly increases costs. Identifying and mitigating these factors will reduce both the incidence of infection and the associated costs. Because infection control measures help avoid infection and thereby infection-related costs, it is critically important to support infection control activities and prevent nosocomial infections.

Background A pneumothorax is common in patients admitted to the intensive care unit (ICU) with coronavirus disease (COVID-19) when non-invasive or invasive mechanical ventilation is performed to maintain adequate oxygenation. The aim of the present study was to investigate the effects of elevated inflammatory markers and an elevated systemic immune inflammatory index (SII) on mortality in this patient population. Materials and methods Between March 2020 and May 2021, 124 patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reacion positviity who were admitted to the ICU in our hospital and diagnosed with and treated for a pneumothorax were evaluated retrospectively. Interleukin-6 (IL-6), C-reactive protein, neutrophil, lymphocyte, platelet and white blood cell levels were measured. These parameters were used to calculate the neutrophil–lymphocyte ratio (NLR) and SII, and the association of these parameters with pneumothorax-related mortality was examined. Results This study included 39 female (31.5%) and 85 male (68.5%) patients. The mean age was 65.3 ± 12.6 years. Non-invasive mechanical ventilation was performed in 13 (10.5%) patients, and 111 (89.5%) patients received invasive mechanical ventilation. Tube thoracostomy was performed in 113 patients (91.1%), and 11 patients (8.9%) were treated with oxygen therapy. The factors affecting mortality in the pneumothorax patients were the Charlson Comorbidity Index (four or higher), IL-6 level and NLR. The IL-6 level was 53.4 in those who died versus 24.6 in those who survived ( p = 0.017). The NLR in the patients who died was 16.9 as compared to 12.5 in those who survived ( p = 0.011). Conclusion Elevated markers of infection were associated with an increased risk of mortality in pneumothorax patients with COVID-19 who received invasive or non-invasive mechanical ventilation in the ICU. In this patient population, high levels of positive end-expiratory pressure should be avoided, and inflammatory marker levels and the SII should be closely monitored.

Zika virus is a Flavivirus in the family Flaviviridae, and transmitted to humans by Aedes species mosquitoes. Zika virus infection is asymptomatic in 80% of cases and has a mild course when symptoms occur. These symptoms include headache, myalgia, mild fever, maculopapular rash and conjunctivitis. Zika virus has been associated with serious neurological complications such as Guillain-Barre syndrome in adults and microcephaly development in neonates. It has recently become a global public health problem as a result of increasing cases. As it is known that the vector of this disease is present in our country; entry of Zika virus infection in our country has a great importance. In this report the clinical and laboratory findings of two cases of Zika virus infection imported to Turkey by a couple returning from Cuba in October 2017 were presented. Newly married couple, both 29 years old, without a known chronic disease history, went on honeymoon to Cuba between 17-29 September and they visited Havana and Varadero. They reported that they were bitten repeatedly by the mosquitoes and did not use insect repellents during this time. Four days after returning to Turkey, they had headaches, back pain and myalgia followed by rash and joint pain. They reported having their symptoms started in the same day in a few hours difference. The symptoms for both patients disappeared in 10 days. Serum samples from the patients were sent to the Public Health General Directorate National Arboviruses and Viral Zoonoses Laboratory to be tested for Dengue, Chikungunya and Zika viruses. Nucleic acid testing yielded negative results. The Arbovirus Indirect Immunofluorescence test were positive both for IgM and IgG for Zika virus. No cross reactivity with Dengue virus was detected. Chikungunya antibodies were found as negative. At two months of the diagnosis, urine and semen samples of the male patient were tested by real-time reverse transcriptase polymerase chain reaction (rRT-PCR). The result was negative for urine but positive for semen sample. This report is important to present the first cases of Zika virus infection published in Turkey. Zika virus infection should be suspected in patients with fever, headache, rash, myalgia and joint pain returning from an endemic areas. All travelers, especially pregnant women, have to take precautions for mosquitos during the trip.

Background: In this study, it was aimed to evaluate the factors affecting the prognosis and mortality of patients hospitalized for coronavirus disease 2019 .Methods: Patients hospitalized with COVID-19 infection between March and November 2020 were examined retrospectively. The Systemic Immune-Inflammation Index (SII), platelet lymphocyte ratio (PLR), and neutrophil-lymphocyte ratio (NLR) values were evaluated for their effect on prognosis.Results: Of the 1013 patients included in the study, 204 (20.1%) had a severe infection. In the multivariate analysis, it was determined that the prognosis was significantly worse in patients who were >65 years of age, had a Charlson Comorbidity Index (CCI) score of >2, and had a high NLR rate. The C-reactive protein (CRP), PLR, SII values were detected as insignificant variables. Mortality was found to be statistically significant in patients with a CCI score of 2 or more and in patients with high CRP, NLR, PLR, and SII values at the time of admission (p<0.05) in the multivariate analysis.Conclusions: It was found that the most important factor affecting the severity of the disease was advanced age and high comorbidities, and a high NLR value. The most important prognostic factors affecting mortality were high levels of comorbidities, and high NLR, PLR, SII, and CRP values.