Objectives The hyperinflammatory state and the viral invasion may result in endothelial dysfunction in SARS-CoV-2 infection. Although a method foreseeing microvascular dysfunction has not been defined yet, studies conducted in patients diagnosed with COVID-19 have demonstrated the presence of endotheliitis. With this study, we aimed to investigate the microvascular circulation in patients diagnosed with COVID-19 and multisystem inflammatory syndrome in children (MIS-C) by nailfold videocapillaroscopy (NVC). Methods Thirty-one patients with SARS-CoV-2 infection, 25 of whom were diagnosed with COVID-19 and 6 with MIS-C and 58 healthy peers were included in the study. NVC was performed in eight fingers with 2 images per finger and 16 images were examined for the morphology of capillaries, presence of pericapillary edema, microhemorrhage, avascular area, and neoangiogenesis. Capillary length, capillary width, apical loop, arterial and venous width, and intercapillary distance were measured from three consecutive capillaries from the ring finger of the non-dominant hand. Results COVID-19 patients showed significantly more capillary ramification ( p < 0.001), capillary meandering ( p = 0.04), microhemorrhage (p < 0.001), neoangiogenesis (p < 0.001), capillary tortuosity ( p = 0.003). Capillary density ( p = 0.002) and capillary length (p = 0.002) were significantly lower in the patient group while intercapillary distance ( p = 0.01) was significantly longer compared with healthy volunteers. Morphologically, patients with MIS-C had a higher frequency of capillary ramification and neoangiogenesis compared with COVID-19 patients (p = 0.04). Conclusion Abnormal capillary alterations seen in COVID-19 and MIS-C patients indicate both similar and different aspects of these two spectra of SARS-CoV-2 infection and NVC appears to be a simple and non-invasive method for evaluation of microvascular involvement.

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Anaphylaxis is defined as a severe hypersensitivity reaction that can cause sudden onset and death. Therefore, it is vital that the diagnosis is made and the timely administration of epinephrine. In this study, it was aimed to determine the knowledge and attitudes of the physicians in Edirne city center regarding the diagnosis and treatment of anaphylaxis. The study was designed as cross sectional survey. Physicians were visited in their institutions. A written questionnaire was applied face-to-face and it included questions about diagnosis and management of anaphylaxis. A total of 347 physician agreed to participate in the study. 43.5% of the physicians did not read any literature, book chapters or guidelines about the diagnosis criteria. Only 16.7% of responders knew all sign and symptoms of anaphylaxis. Twenty eight percent of physicians knew that correct route and dose of epinephrine administration. Associated factors with the knowledge about correct dose and route of epinephrine administration were the number of encounters with anaphylaxis cases and presence of treatment scheme in the instutition; OR (95% CI) were 3.520 (1.879-6.593) and 1.961 (1.168-3.290) respectively. 45.5% of the responders knew that there are no absolute contraindications to administer epinephrine in the case of anaphylactic shock. The study revealed that, knowledge of physicians relating diagnosis, treatment and management of anaphylaxis is unsatisfactory in our city. We think that it would be beneficial to provide physicians with in-service training regarding the diagnosis and management of anaphylaxis.

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Objective The suppressor of cytokine signaling-1 (SOCS-1) gene is an essential physiological regulator of cytokine signaling. Tumor necrosis factor-α (TNF-α) is an important component of the immunological response. Herein, we aimed to investigate the effects of SOCS-1 (-1478 CA > Del) and TNF-α (-308) polymorphisms on disease susceptibility and prognosis in pediatric patients with coronavirus disease 2019 (COVID-19). Methods One-hundred fifty COVID-19 patients in the COVID-19 emergency department between September 2020 and April 2021 and 80 healthy volunteers (control group) without any additional disease were included. Baseline gene polymorphisms were compared between the patient and healthy control groups. Afterward, the gene polymorphism distribution was examined by forming two separate clinical patients' subgroups. Results While CA/CA and CA/Del gene variants of SOCS-1 were higher in the patient group, Del/Del genotype was more common in the control group (p < 0.05). The GG genotype of the TNF-α was significantly more common in the severe subgroup (p = 0.044). The GA genotype of TNF-α was associated with the risk of hospitalization (2.83-fold), while the GG genotype was found to be protective in terms of hospitalization (2.95-fold). Conclusions This study will be a guide in terms of the presence of high cytokine release genotypes and COVID-19-related cytokine release syndromes.