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.

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Listeria monocytogenes is a common cause of central nervous system infections, especially in immunosuppressed patients, infants and elderly people. Listerial rhombencephalitis is a rare and severe infection of the brainstem that is reported to have high mortality and frequent serious sequelae for survivors. We report the case of a 19-year-old healthy male who presented with listerial brainstem infection due to Listeria monocytogenes.

the causative agent was identified as a new Coronavirus (2019-nCoV), which had not previously been detected in humans [1]. Later, the name of 2019-nCoV disease was accepted as COVID-19, and the virus was named SARS-CoV-2 because of its close resemblance to SARS CoV. After this date, the number of patients increased rapidly, and the WHO declared an "International Public Health Emergency" regarding the coronavirus outbreak at its meeting on January 30, 2020.Although the world was caught unprepared to the sudden emergence and rapid spread of the COVID-19 outbreak, Turkey managed to postpone the emergence of the disease within its borders through the implementation of effective preventive measures until March 11, 2020, when the first case was detected. After cases seen in China, Italy, and Spain starting from January, Turkey executed a meticulous monitoring and evaluation process to decide, implement, and follow up with comprehensive and timely measures. These measures have given time to be prepared for both the community and the healthcare system in this pandemic. Furthermore, since the beginning of the pandemic, Turkish citizens infected with COVID-19 have Background/aim: The aim of this study is to evaluate the epidemiological and clinical characteristics and parameters that determined the clinical course and prognosis of the COVID-19 patients admitted to Ankara City Hospital during the first month of the pandemic in Turkey.Materials and methods: SARS-CoV-2 PCR positive patients who were hospitalized between March 10 and April 10, 2020 were included.Results: Among 222 patients, mean age was higher in severe acute respiratory illness (SARI)/critical disease group (P < 0.001). Median time from illness onset to admission and presence of comorbidity, especially coronary artery disease and chronic obstructive pulmonary disease, were significantly higher in the SARI/critical disease group (P < 0.05). Cough and fever were the most common symptoms, while anosmia and loss of taste were observed in 8.6% and 7.7% patients, respectively. The mortality rate was 5.4%. A high neutrophil/lymphocyte ratio; low lymphocyte, monocyte, and platelet count; elevated liver enzymes; low GFR; and high levels of muscle enzymes, ferritin, and IL-6 on admission were found to be associated with SARI/critical disease (P < 0.05). Bilateral ground-glass opacity and patchy infiltration were more frequently seen in the SARI/critical disease group (P < 0.001). Patients older than 65 years had an 8-fold increased risk for development of SARI/critical disease. Conclusion:This cohort study regarding COVID-19 cases in Turkey reveals that older age, presence of comorbidity, bilateral infiltration on CT, high neutrophil/lymphocyte ratio, low monocyte and platelet count, elevated liver enzymes, low GFR, high levels of muscle enzymes, and high levels of ferritin and IL-6 on admission are predictors of SARI and severe disease.

Objectives During the pandemic, anxiety, stress, and depression may occur increasingly in the whole society. To evaluate the possible cause, incidence and levels of anxiety and depression in the relatives of the patients in the ICU in accordance with the patients’ SARS‐CoV‐2 PCR result. Materials and Method The study was prospectively conducted on relatives of patients admitted to tertiary intensive care units during COVID‐19 pandemic. Sociodemographic characteristics of the patients and their relatives were recorded. “The Turkish version of the Hospital Anxiety and Depression Scale” survey was applied twice to the relatives of 120 patients to determine the symptoms of anxiety and depression in accordance with the PCR results of the patients (PCR positive n=60, PCR negative n=60). Results The ratios above cut‐off values for anxiety and depression among relatives of the patients were 45.8% and 67.5% for the first test and 46.7% and 62.5% for the second test respectively. The anxiety and depression in the relatives of PCR positive patients was more frequent than the PCR negative (p< 0.001 for HADS‐A and p=0.034 for HADS‐D). The prevalence of anxiety and depression was significantly higher in female participants (p=0.046 for HADS‐A and p=0.009 for HADS‐A). There was no significant correlation between HADS and age of the patient or education of the participants. The fact that the patients were hospitalized in the ICU during the pandemic was an independent risk factor for anxiety (AUC = 0.746) while restriction of patient visiting in the ICU was found to be an independent risk factor for depression (AUC= 0.703). Conclusion While patient with positive PCR and participant with female gender is responsible for both anxiety and depression, hospitalization in the ICU due to COVID‐19 is an independent risk factor for anxiety and restriction of patient visiting in the ICU is an independent risk factor for depression.