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Item Hepatitis A susceptibility parallels high COVID-19 mortality(2021) Sarialioglu, Faik; Belen, Fatma Burcu; Hayran, Kadir Mutlu; 0000-0002-8257-810X; 0000-0002-9278-6703; 32718125; AAL-7766-2021Background/aim: COVID-19 has become the biggest health problem of this century. It has been hypothesized that immunity against hepatitis A virus (HAV) may provide protection from COVID19. Materials and methods: As of 10 June 2020, the infection had spread to 213 countries, with 7.3 million people infected and 413,733 dead. This data was combined with the World Health Organization susceptibility classification on the worldwide prevalence of HAV, and the relationship between HAV susceptibility and COVID-19 mortality were analyzed. Results: When the data from 213 countries were analyzed, it was found that there was a significant increasing trend in COVID-19 mortality rates by HAV susceptibility (P <0.001). Using a cut-off of 200/million population, the mortality risk associated with living in a more susceptible country (medium/high) was 27.8 times higher (95% CI for OR: 3.6-213.2) Conclusion: The results of this study showed that, despite confounding factors in different countries, hepatitis A susceptibility of the population may have been correlated with COVID-19 mortality. This observation needs to be confirmed by further studies.Item The Relationship Between COVID-19 Severity and Bacillus Calmette-Guerin (BCG)/ Mycobacterium Tuberculosis Exposure History in Healthcare Workers: A Multi-Center Study(2021) Torun, Serife; Ozkaya, Sevket; Sen, Nazan; Kanat, Fikret; Karaman, Irem; Yosunkaya, Sebnem; Sengoren Dikis, Ozlem; Asan, Ali; Aydogan Eroglu, Selma; Semih Atal, Sefa; Ayten, Omer; Aksel, Nimet; Ermis, Hilal; Ozcelik, Neslihan; Demirelli, Meryem; Kara, Iskender; Sumer, Sua; Marakoglu, Kamile; Uzer, Fatih; Uyar, Yasin; Cicek, Tuba; Unsal, Zuhal E.; Vatansev, Husamettin; Botan Yildirim, Berna; Kuruoglu, Tuba; Atilla, Aynur; Ersoy, Yasemin; Kandemir, Bahar; Durduran, Yasemin; Goksin Cihan, Fatma; Demirbas, Nur; Yildirim, Fatma; Tatar, Dursun; Akcay, M. Sule; 0000-0002-6530-6153; 0000-0002-8697-4919; 34014806; ABF-1652-2021The COVID-19 pandemic has brought countries' health services into sharp focus. It was drawn to our group's attention that healthcare workers (HCWs) had a lower mortality rate against higher COVID-19 incidence compared to the general population in Turkey. Since risk of exposure to tuberculosis bacillus among healthcare workers are higher than the population, we aimed to investigate if there is a relationship between BCG and Mycobacterium tuberculosis exposure history with COVID-19 severity in infected HCWs. This study was conducted with 465 infected HCWs from thirty-three hospitals to assess the relationship between COVID-19 severity (according to their hospitalization status and the presence of radiological pneumonia) and BCG and Mycobacterium tuberculosis exposure history. HCWs who required hospital admission had significantly higher rates of chronic diseases, radiological pneumonia, and longer working hours in the clinics. Higher rates of history of contact and care to tuberculosis patients, history of tuberculosis, and BCG vaccine were observed in hospitalized HCWs. HCWs who had radiological pneumonia had a significantly increased ratio of history of care to tuberculosis patients and a higher family history of tuberculosis. The findings from our study suggest that the lower mortality rate despite the more severe disease course seen in infected HCWs might be due to frequent exposure to tuberculosis bacillus and the mortality-reducing effects of the BCG vaccine.Item Evaluation of Clinical Symptoms, Laboratory Findings, Radiological Characteristics, and Treatments of Adult Patients with Severe COVID-19 Pneumonia(2021) Kurekci, Yesim; Gumus, Hatice Hale; Ezirmik, Elif; 0000-0001-9071-9606; AAJ-2108-2021Introduction: In this study, it was aimed to retrospectively evaluate the clinical course, laboratory findings and radiological features of patients with severe Coronavirus disease-2019 (COVID-19) pneumonia in a 200-bed secondary state hospital. Materials and Methods: Male and non-pregnant female patients older than 18 years who were hospitalized with the diagnosis of COVID-19 pneumonia between 01.04.2020-01.07.2020 were included in our study. Severe pneumonia was defined as the presence of tachypnea (>30 breaths/ min) and/or hypoxia (SpO2 <90% room air) and/or bilateral diffuse ground-glass infiltrations. Conformity of continuous data to normal distribution was evaluated with Kolmogorov-Smirnov and Shapiro-Wilk tests. In the analysis of the relationship between laboratory parameters and mortality, independent groups t-test was used for parametric data and Mann-Whitney U test was used for non-parametric data. Results: Sixty two (60.8%) of the patients were male, with a mean age of 60.2 +/- 16.1 years (n=102). Of the study group 76.5% had at least one or more comorbid diseases. The most common comorbidities were hypertension (60.3%), diabetes mellitus (42.3%) and coronary artery disease (26.9%). The most common symptoms observed in patients at the time of admission were cough (n=63, 61.8%), dyspnea (n=57, 55.9%), fever (n=33, 32.4%) and malaise (n=22, 21.6%). Severe acute respiratory syndrome-Coronavirus-2 polymerase chain reaction test was positive in 68% (n=70) of the patients. Blood culture was taken from 42.3% of the patients who were admitted with the complaint of fever and there was no detected culture growth. During the hospitalization period, the rate of patients who received any of the antibiotic treatments including azithromycin, clarithromycin, moxifloxacin was 90.2% and 66.7% (n=68) of them were treated with azithromycin. Of the patients 42.2% (n=43) required treatment in the intensive care unit. A favorable clinical response was observed in 74.5% (n=77) of the patients and nine of these patients were discharged with partial recovery and recommendation for home oxygen support therapy. The mortality rate was 24.5% (n=25). The mean of lactate dehydrogenase level and the mean urea level were higher in the group with mortality (p <= 0.001). Conclusion: Despite the low rates of bacterial coinfection and/or secondary bacterial infection in COVID-19, frequently given antibiotic treatments contribute to the problem of antimicrobial resistance, creating a serious public health problem and causing an economic burden. Large-scale randomized controlled trials are required for treatment protocols of which potential benefits have not yet been proven.