Objective The aim of the study was to detect the frequency and course of coronavirus disease 2019 (Covid‐19) infection among our rheumatology outpatients and to investigate how patient follow‐up differed during Covid‐19 pandemic in a tertiary University Hospital in the capital of Turkey. Patients and method Patients with inflammatory rheumatic diseases (IRDs) registered in our rheumatology clinic were assessed during their routine outpatient follow‐up control or contacted via phone between July and December 2020. Patients' demographics, diagnosis, medication, comorbidities, frequency of going outside during the pandemic, work status, whether patients could attend their routine follow‐up, treatment changes, access to drugs during the pandemic, and the incidence of Covid‐19 infection were collected. Results A total of 320 patients with IRD were analysed; 114 (35.6%) patients were treated with conventional synthetic disease‐modifying antirheumatic drugs (csDMARDs) (methotrexate/leflunomide/sulfasalazine), 93 (29.1%) patients with biologic DMARDs (bDMARDs), 113 (35.3%) patients with glucocorticoids, and 103 (32.2%) patients with hydroxychloroquine (HCQ). A total of 15.9% of patients on HCQ experienced problems in medication supply. Only 87 (27.2%) patients presented for their routine follow‐up appointment, and 38 (11.9%) of the patients changed their treatment without professional health advice. While 53 (57%) patients on biological agents continued their treatment, 31 patients (33.3%) interrupted the treatment with doctor's recommendation and 9 patients (9.6%) on their initiative, and 23 of these 31 patients had to restart treatment because of disease activation. The nasopharyngeal swab collected from 30 patients with a suspected Covid‐19 contact but without any symptoms was negative. In total, there were 33 patients diagnosed with Covid‐19; none of whom had severe respiratory complications or death. Conclusions Many patients with rheumatic diseases are left without disease monitoring during the pandemic. There was no increased risk of severe Covid‐19 infection among patients with IRD.

Objectives This study aims to evaluate the efficacy of extracorporeal shock wave therapy (ESWT) in carpal tunnel syndrome (CTS) compared to the wrist splint treatment. Patients and methods Between April 2016 and March 2017, a total of 189 patients (22 males, 167 females, mean age 48.8±9.5 years, range, 24 to 70 years) with mild-to-moderate CTS were included in this double-blind, prospective, randomized, placebo-controlled study. The patients were divided into four treatment groups using stratified randomization: splint group (Group 1, n=47), splint+ESWT (Group 2, n=47), ESWT (Group 3, n=45), and splint+placebo ESWT (Group 4, n=50). All patients were evaluated at baseline, and one and three months. Pain using the Visual Analog Scale (VAS), finger pinch strength, Boston Carpal Tunnel Questionnaire (BCTQ), Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), and electrophysiological examination were assessed. Results A total of 168 patients completed the study. There was no significant difference among the four groups in terms of age, sex, comorbid diseases, symptom duration, VAS-pain, BCTQ, and LANSS scores (p>0.05). Pain and functionality significantly improved in all groups (p<0.05). In the group with ESWT and using wrist splint combined, a greater improvement of the hand function and electrophysiological measures was observed. Conclusion Our study results show that ESWT is a valuable and reliable treatment modality for mild-to-moderate CTS.

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Objectives To determine the seroconversion (SC) rate after CoronaVac and BNT162b2 vaccines in adults with inflammatory rheumatic disease (IRD). Methods Patients who were followed up with IRD and who received two doses of either CoronaVac or BNT162b2 vaccines were included in this prospective observational single-center study. Subjects with two doses of CoronaVac or BNT162b2 without known IRD were included in the healthy controls. The blood samples were taken at a minimum of two and a maximum of 12 weeks after the second dose of vaccine. Results A total of 81 patients with IRD (61 CoronaVac, 20 BNT162b2) and 100 healthy controls (70 CoronaVac, 30 BNT162b2) were included. The SC rate was slightly lower among patients with IRD versus controls (84 vs 97%, p = 0.002). The SC rate was 100% in all participants who received BNT162b2 both in the patient and control group. The IgG antibody level after CoronaVac in the patient group was significantly lower than both the BNT162b2 ( p = 0.031) and the healthy group ( p < 0.001). Among patients with IRD, those on rituximab (RTX) (12/81,14.8%) had significantly less SC rate (5/12, 41.7%). The median neutralizing antibody titers were significantly higher in patients with BNT162b2 compared with CoronaVac (1.97 vs. 16.34, p < 0.001). Conclusions This study showed that all patients with BNT162b2 vaccine developed immunogenicity in patients with IRD, while there was a decreased antibody response with CoronaVac vaccine compared to that of BNT162b2. In particular, RTX significantly reduces the SC rate.

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