Background: Faced with this critical situation and directly involved in the treatment and care of COVID-19 patients, front-line healthcare workers are at high risk in terms of mental health symptoms. Aims and Objectives:To determine the stress, anxiety, depression, and insomnia levels of intensive care nurses during the pandemic with a structural equation model. Design:A multi-site survey study. Methods:The study was performed with 194 nurses working in the intensive care units of five hospitals in Istanbul in July 2020. Data were collected using the Depression Anxiety Stress-21 Scale and Insomnia Severity Index electronically. The data were evaluated with descriptive statistics in SPSS package program. In order to test the structural model and hypotheses of the research, path analysis was performed with LISREL statistical software program. A validation study for the suitability of these scales to the study sample was done by the researchers using the confirmatory factor analysis method. The study conforms to the TREND checklist.Results: In this study, the majority of the intensive care nurses had moderate to extremely severe depression (65.5%), anxiety (58.3%) and stress (72.3%) scores; in addition, 39.7% of the nurses experienced moderate or severe insomnia. Within the framework of a structural model; the effects of stress, anxiety and insomnia on depression, which is the dependent variable, were found to be statistically significant (p < .001). Conclusions:It was found that the majority of the intensive care nurses fighting COVID-19 on the front-line experienced stress, anxiety, depression and insomnia at levels ranging from moderate to extremely severe; in addition, it was determined that there is a positive relationship between stress, anxiety, insomnia and depression. Relevance to clinical practice:This study, in which we have determined the mental health symptoms and insomnia levels of intensive care nurses, who are in the frontline during the COVID-19 pandemic, constitutes the scientific basis for the effective coping strategies that the authorities will take in this subject.

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Aim:The aim of this study is to determine the prevalence of medical device-related pressure injuries in COVID-19 patients. Material and Method:This study was conducted with a cross-sectional and retrospective design. The data of 436 patients who were followed up and treated in the Anesthesia and Reanimation Intensive Care Unit with the diagnosis of COVID-19 disease between 11.03.2020-31.02.2021 in a Training and Research Hospital in İstanbul were included in the study. The sample of the study consisted of 32 patients out of 436 patients who met the sampling criteria. The data obtained by retrospective reviewing of the patient records were analyzed through the "Patient Information Form" and "Pressure Injury Stage" forms.Results: Medical device-related pressure injury developed in 32 (7.3%) of 436 patients examined in the study on the specified dates. 90.6% of these patients were male, and the average age was 67.5. 43.7% had comorbid diseases. According to the Braden Risk Assessment Scale, 25% of these patients had medium and 71.8% high risk. Medical devices that cause pressure injury were continuous positive airway pressure mask (n=13), intubation tube (n=7), nasogastric tube (n=5), nasal cannula (n=3), gel pads (n=3), and oxygen mask (n=1). Conclusion:In this study, the potential factors in the study that may have led to the incidence of medical device-related pressure injury specific to COVID-19 disease include the rapid increase in the need for respiratory support, ischemia caused by this infection, and the use of prone position.

The aim of the European Journal of Rheumatology is to cover various aspects of rheumatology for its readers, encompassing the spectrum of diseases with arthritis, musculoskeletal conditions, autoinflammatory diseases, connective tissue disorders, osteoporosis, translational research, the latest therapies and treatment programs. European Journal of Rheumatology publishes original articles, invited reviews, case based reviews, letters to the editor and images in rheumatology. The publication language of the journal is English. Accepted manuscripts are copy-edited for grammar, punctuation, and format. Once the publication process of a manuscript is completed, it is published online on the journal's webpage as an aheadof-print publication before it is included in its scheduled issue. A PDF proof of the accepted manuscript is sent to the corresponding author and their publication approval is requested within 2 days of their receipt of the proof.

This study has been presented as a poster presentation in ECCMID 2017 in Vienna-Austria.