SARS-CoV-2 virus was initially identified in Wuhan, China, in December 2019 and a global pandemic was declared in March 2020 by World Health Organization. COVID-19 disease is characterized with severe pneumonia and hypoxemia, especially in the elderly population. The elderly population was primarily vaccinated with CoronaVac, which is a whole virion inactivated vaccine (Sinovac Biotech, China) in Turkey. This study aimed to investigate the association of viral load and laboratory parameters with the severity of the disease and vaccination status in elderly (older than 60 years old) COVID-19 patients. The age range of the patients was 61–97 years old with a mean of 71.80. Vaccinated patients had a lower viral load (P = 0.253) in nasopharyngeal swabs during breakthrough COVID-19 infection compared to unvaccinated ones and were hospitalized for a shorter period of time in hospital wards (P = 0.035). A lower number of patients were vaccinated in both moderate (n = 33, 29.20%) and severe/critical group (n = 46, 34.07%) (P = 0.412). Only 17 (32.08%) vaccinated patients were hospitalized in an intensive care unit (ICU), whereas 36 (67.92%) of the ICU patients were unvaccinated (P = 0.931). Severe/critical patients had higher c-reactive protein (CRP), platelet-to-lymphocyte ratio (PLR), fibrinogen, ferritin, and lactate dehydrogenase (LDH) levels compared to the moderate group on the admission day (P < 0.05). Our study suggested that elderly patients vaccinated with CoronaVac had a shorter stay in hospitals and according to our results CRP, PLR, fibrinogen, ferritin, and LDH levels could be used to determine the severity of the infections.
Background
Venous thromboembolism (VTE), is a prevalent complication of inpatient care, causing high burden of morbidity and mortality. Prophylaxis reduces the events thus; these practices are promoted. We aimed to assess the VTE prophylaxis practices in the general internal medicine wards of a tertiary-care university hospital and utilize this data to propose quality improvement projects.
Methods
Electronic medical records were used to collect data cross-sectionally from January 1st, 2019 to June 30th, 2019. Padua Prediction Score was used to assess the appropriateness of VTE prophylaxis. Underlying health conditions, hospitalization causes, anti-platelets, and use of glucocorticoids were also assessed as confounding factors.
Results
A total of 295 patients were included. Higher proportion of patients who received VTE prophylaxis were obese and had higher rates of diabetes and coronary artery disease. Prophylaxis was more commonly utilized among patients who were elderly, obese, having an acute infection and/or rheumatologic disorder, and prolonged bed rest (p= <0.001, p= 0.01, p= 0.22 and p= <0.001, respectively). Thirty-five patients (11.8%) received VTE prophylaxis, despite 89 patients (30.2%) were high-risk patients. In the high-risk group (n=89), 27 patients (30.3%) received appropriate pharmacological prophylaxis, while 8 patients (3.9%) received VTE prophylaxis in the low-risk group (total n=206). A considerable percentage of the high-risk population (69.6%) did not receive VTE prophylaxis.
Discussion
Underuse constitutes a major challenge in our hospital but differing from other institutions, overuse is not a significant issue. Further studies are needed whether VTE prophylaxis improvement implementations uniformly increase appropriate VTE use.
e13583 Background: Previous studies demonstrated increased risk of cancer in systemic autoimmune diseases like rheumatoid arthritis, systemic lupus erythematosus (SLE) and sjögren syndrome due to uncontrolled inflammation. Behçet’s disease (BD) was also reported to be associated with an increased risk of cancer, although data is limited and differences in study designs was an important issue. In this study, we aimed to assess cancer incidence in a large cohort of BD patients and to compare with the data of the Turkish National Cancer Registry (TNCR) in the same age and gender groups. Methods: The study cohort consisted of BD patients of > 18 years old age and without a prior cancer diagnosis who were prospectively recorded in Hacettepe University Vasculitis Center. Data on any cancer was collected from the patient files. Cancer incidence was compared with age- and gender-specific cancer incidence rates of the normal population retrieved from the 2014 Turkish National Cancer Registry (TNCR) data using standardized incidence rates (SIR). Results: Totally 451 adult cases with BD were included in the study. The median age of the cohort was 43 (20-75) and 52.5% of the patients were males. Eleven cancer cases were observed during a median 124 months follow up. Behçet’s Disease was associated with an increase in cancer risk compared to expected counts in the corresponding age and sex group (SIR 2.84, 95% CI 1.50-4.94, p < 0.001). Cancer risk was particularly increased in men (SIR: 5.63, 95% CI: 2.62–10.70, p < 0.001) compared to TNCR data. Patients with papulopustular lesions had a trend towards a decreased risk of cancer (p = 0.060) and patients using azathioprine had a significantly decreased cancer risk (p = 0.031). Conclusions: This study revealed the cancer risk of patients BD was increased approximately three times compared to corresponding age and sex group. Besides the routine care, increased attention for cancer surveillance is required in the follow-up of BD patients.
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