Passive antibody therapy has been used to immunize vulnerable people against infectious agents. In this study, we aim to investigate the efficacy of convalescent plasma (CP) in the treatment of severe and critically ill patients diagnosed with COVID-19. Method: The data of severe or critically ill COVID-19 patients who received anti-SARS-CoV-2 antibody-containing CP along with the antiviral treatment (n = 888) and an age-gender, comorbidity, and other COVID-19 treatments matched severe or critically ill COVID-19 patients at 1:1 ratio (n = 888) were analyzed retrospectively. Results: Duration in the intensive care unit (ICU), the rate of mechanical ventilation (MV) support and vasopressor support were lower in CP group compared with the control group (p = 0.001, p = 0.02, p = 0.001, respectively). The case fatality rate (CFR) was 24.7 % in the CP group, and it was 27.7 % in the control group. Administration of CP 20 days after the COVID-19 diagnosis or COVID-19 related symptoms were associated with a higher rate of MV support compared with the first 3 interval groups (≤5 days, 6− 10 days, 11− 15 days) (p=0.001). Conclusion: CP therapy seems to be effective for a better course of COVID-19 in severe and critically ill patients.
Objective: The purpose of this study was to evaluate an innovative, protocol-based, group cognitive behavioral therapy (CBT) program delivered by trained teachers to reduce emotional distress and improve psychological functioning among the war-traumatized Syrian refugee students living in Istanbul. Methods: A total of 32 participants, aged between 10 and 15 years (mean = 12.41, SD = 1.68) and mostly females (m/f = 12/20) were randomly selected from a sample of 113 refugee students based on their trauma-related psychopathology as reflected in the Child Post-Traumatic Stress-Reaction Index (CPTS-RI) total score. The treatment program was implemented by the teachers trained by the study team to deliver a weekly, eight-session, protocol-based intervention in school setting. The degree of the fidelity to the original program was tested via video-recordings and subsequent analyses of the sessions. Effectiveness of the intervention was evaluated by a pre-test/post-test comparison using the CPTS-RI, Spence Children's Anxiety Scale (SCAS), and Strengths and Difficulties Questionnaire (SDQ). Results: All participants were accompanied minors. A significant proportion of them had either witnessed or been personally exposed to traumatic events. Statistically significant reduction in post-intervention evaluation was observed in the SCAS total score (t = 3.73, p = 0.001); CPTS-RI total score (t = 2.72, p = 0.011) and in the intrusive (t = 3.88, p = 0.001) and arousal (t = 2.60, p = 0.015) symptoms of the post-traumatic stress disorder (PTSD). In line with improvement in emotional problems as revealed in the anxiety and PTSD scales, the SDQ subcategory of the emotional problems was the only symptom area that showed a significant improvement (t = 2.85, p = 0.008). No significant change was seen in the SDQ subcategories of conduct (t = 1.01, p = 0.32), hyperactivity (t = 1.30, p = 0.20), peer problems (t = .66, p = 0.51), or in prosocial behavior (t = 2.15, p = 0.039). A significant proportion of the participants did no longer meet the diagnostic threshold for anxiety (p = 0.001) and PTSD (p = 0.021) after completion of the intervention. However, the post-intervention SDQ subcategories and the total SDQ score showed no significant difference as compared with the pre-intervention group. Conclusions: To the best of our knowledge, this is the first interventional study reporting promising results from a school-based, teacher-led and culturally sensitive psychological intervention program for refugee children in Turkey. Such protocol-based interventions need to be examined in controlled designs and larger samples so that a well-established intervention can be created and disseminated to provide the psychosocial support for this vulnerable and traumatized population.
More than half of the 2.7 million registered Syrian refugees in Turkey are under 18 years of age. This study investigates prevalence of psychopathology and associated risk factors in refugee children in Turkey. Of a total of 218 children aged 9-15 years, 56.2% lost someone important to them, 55.1% saw dead or wounded people, 70.4% witnessed explosions or gun battles, 42.5% witnessed people being tortured and 25.6% personally experienced cruelty/torture during war. Prevalence of PTSD was 18.3% and that of anxiety-related disorders were as high as 69.0%. Death of an important person (p = .032) and male gender (p = .040) were associated with PTSD; whilst exposure to cruelty or torture (p = .014) and increasing duration of refuge (p = .042) were significantly associated with development of anxiety disorders. Findings of the present study reveals existence of the expected but unspoken mental health needs among the Syrian children in Turkey.
During our routine work at the Turkish Red Crescent (TRC) laboratories, human immunodeficiency virus (HIV) 1/2 antibody false-positive results were observed among Coronavirus disease-2019 convalescent plasma (CP) donors more frequently than healthy donors. We aimed to determine anti-HIV 1/2 antibody false-positivity rates among the CP donors and healthy blood donors. Methods:The present study was designed as a cross-sectional study which was a type of observational study. Total 3689 donations from 2593 donors donated CP to the TRC between 11 April-06 July 2020, were screened by electrochemiluminescence immunoassay for the presence of antibody against HIV ½. The confirmation tests were performed with line immunoassay. All of the donors were non-remunerated CP donors between the ages of 18-60. For the control group, 411078 donations from 407363 healthy blood donors were received on the same days.Results: Repeated reactivity rates (1.87%) were significantly higher than the control group (0.13%, p<0.05). However, there was not a statistically significant difference between the confirmed reactivity rates of the study group (0.03%) and the control group (0.01%, p=0.217). Conclusion:In our study, it was determined that the false-positive results obtained from serologic HIV screening tests of CP donors were significantly higher when compared to the healthy blood donors.
Öz Amaç: COVID-19 pandemisi gibi afetlerin yönetiminde hastaları ilk karşılayan acil servislerin hastanedeki diğer kliniklerle olan iş birliği ve koordinasyonu acil servislerin işleyişini kolaylaştırmaktadır. Çalışmamızda COVID-19 salgınındaki acil servis yönetimimizi ve bunun sonuçlarını araştırdık. Gereç ve Yöntemler: Bu çalışmada 1 Mart 2020 ile 30 Nisan 2020 tarihleri arasındaki 3.basamak bir acil servise başvuran hastaların süreci ve bu süreçteki Covid-19 tanılı ve şüpheli vakaların yönetimi ile acil servisteki Covid-19 pandemisine cevap için yapılan hazırlıklar ve Covid-19 ön triyaj sistemi ve sonuçları değerlendirildi. İstatistik anlamlılık düzeyi olarak p<0,05 alındı. Bulgular: 2019 göre 2020 Mart ayı toplam başvuru oranında artış olduğu (p<0.01; %50,1'den %66,8'e), Nisan ayı toplam başvuru oranında ise düşüş olduğu (p <0.01; %49,9'dan %33,2'ye), saptandı. 2020 Nisan ayında Mart ayına göre tüm kliniklere hasta yatışı 1,35 kat azaldığı, enfeksiyon hastalıkları konsültasyon sayısının 3,81 kat arttığı saptandı. 21 Mart ile 30 Nisan 2020 tarihleri arasında acil servisten istenen toraks bilgisayarlı tomografilerinin %89,2'sinin nedeni COVID-19 şüphesi ile olmuştu. Acil servisin dışında COVID-19 şüpheli hastalar ayrımı için ön triyaj kuruldu. 2020 Mart ayında COVID-19 şüpheli hastaların %66,6'sı, Nisan ayında ise %91'i evde izolasyona gönderilerek takip edildi. Nisan ayında sokağa çıkma yasağı uygulanan günlerde acil servis başvuruları %66,7 azalırken (p<0,01) sokağa çıkma yasağının bittiği günlerdeki acil servis başvuruları %142,9 artmıştı (p<0,01). Sonuç: Pandemiler önceden öngörülemeyen durumlardır ve tüm hastane ile beraber acil servis işleyişini derinden etkilemektedir. COVID-19 pandemisi gibi afetlerin yönetiminde acil servislerin hastanedeki diğer kliniklerle olan iş birliği ve koordinasyonu ile hızlı kararlar alıp uygulayabilen multidisipliner yönetim sistemine ihtiyaçları vardır.
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