ABSTRACT BACKGROUND: Favipiravir is generally used in treating coronavirus disease 2019 (COVID-19) pneumonia in Turkey. OBJECTIVE: To determine the side effects of favipiravir and whether it is a good treatment option. DESIGN AND SETTING: Retrospective study conducted in Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey. METHODS: 357 patients who completed favipiravir treatment at the recommended dose were included. 37 patients with drug side effects and 320 patients without drug side effects were examined in two groups. RESULTS: Side effects were observed in 37 (10.36%) out of 357 patients using favipiravir. The most common side effect was liver dysfunction, in 26 (7.28%) of the patients. The following other side effects were also observed: diarrhea (1.4%), nausea (0.84%), abdominal pain (0.28%) and thrombocytopenia (0.28%). One patient (0.28%) presented both increased transaminases and nausea. CONCLUSION: In this study, it was determined that favipiravir may constitute an alternative for treating COVID-19 pneumonia given that its side effects are generally well tolerated and not serious.

RESUMEN Introducción: El enfoque de tratamiento en la infección por COVID-19 consiste en tratamientos antivirales, inmunomoduladores y de apoyo. El plasma de convalecencia, el plasma inmune o el plasma hiperinmune se refieren al plasma que consiste en anticuerpos policlonales de alto título contra el virus y se encuentra en medio de los tratamientos inmunomoduladores. Aunque se ha informado que el tratamiento con plasma inmune de COVID-19 reduce la estancia hospitalaria y la mortalidad, la eficacia del plasma inmune con la infección por COVID-19 aún no está clara. El presente estudio tiene como objetivo investigar la eficacia del plasma inmune en pacientes que son seguidos en la unidad de cuidados intensivos con el diagnóstico de COVID-19. Materiales y métodos: En este estudio retrospectivo, los pacientes que fueron hospitalizados en la unidad de cuidados intensivos con el diagnóstico de infección por COVID-19 se dividieron en dos grupos: los que recibieron tratamiento IP (Grupo 1; n = 28) y los que lo hicieron. no (Grupo 2; n = 25). La proteína C reactiva bioquímica, lactato-deshidrogenasa, ferritina, dímero D, bilirrubina total, niveles de creatina, parámetros hematológicos (recuentos de leucocitos, neutrófilos, linfocitos, plaquetas), puntuaciones de sepsis clínica (puntuaciones SOFA, APACHE) y tasas de mortalidad de los pacientes fueron evaluados según grupos. Resultados: No hubo diferencia estadísticamente significativa entre el Grupo 1 y el Grupo 2 en cuanto a la presencia de soporte ventilatorio mecánico y traqueotomía, comorbilidades, valores de laboratorio, proteína C reactiva, SOFA, puntajes APACHE. La tasa de mortalidad fue del 61% en el grupo 1 y del 52% en el grupo 2. Conclusiones: Nuestros hallazgos revelaron que el tratamiento con plasma inmune no fue efectivo en la recuperación y la disminución de las tasas de mortalidad en los pacientes de la unidad de cuidados intensivos infectados por COVID-19. Se necesitan más estudios para investigar la eficacia de la administración de terapias inmunomoduladoras sobre el resultado antes de que comience el proceso hiperinflamatorio.

ABSTRACT Introduction: Treatment approach in COVID-19 infection consists of antiviral, immunomodulatory, and supportive treatments. Convalescent plasma, immune plasma or hyperimmune plasma refers to the plasma that consisting of high titer polyclonal antibodies against the virus and are amidst the immunomodulatory treatments. Although it has been reported that immune plasma treatment of COVID-19 reduces hospital stay and mortality, the efficacy of immune plasma with COVID-19 infection is not clear yet. The present study aims to investigate the efficacy of immune plasma in patients who are followed up in the intensive care unit with the diagnosis of COVID-19. Materials and methods: In this retrospective study, the patients who were hospitalized in the intensive care unit with the diagnosis of COVID-19 infection were divided into two groups: those who received IP treatment (Group 1; n=28) and those who did not (Group 2; n=25). The biochemical C -reactive protein, lactate-dehydrogenase, ferritin, D-dimer, total bilirubin, creatine levels, hematological parameters (Leukocyte, neutrophil, lymphocyte, platelet counts), clinical sepsis scores (SOFA, APACHE scores) and mortality rates of the patients were evaluated according to groups. Results: There was no statistically significant difference between Group 1 and Group 2 in terms of the presence of mechanical ventilation support and tracheostomy, comorbidities, laboratory values, C -reactive protein, SOFA, APACHE scores. The mortality rate was 61% in Group 1 and 52% in Group 2. Conclusions: Our findings revealed that immune plasma treatment was not effective in recovery and decreasing the mortality rates in the COVID-19 infected intensive care unit patients. Further studies are needed to investigate the efficacy of administering immunomodulatory therapies on the outcome before the hyper inflammatory process starts.

SUMMARY OBJECTIVE: Failure to achieve high levels of medication adherence in obstructive lung diseases is a major cause of uncontrolled disease. The purpose of this study is to reveal clinicians’ opinions on the level of patient adherence and the change in adherence during the COVID-19 pandemic. METHODS: A questionnaire containing multiple-choice questions about treatment adherence in patients with obstructive lung diseases was voluntarily applied to doctors working in a tertiary hospital for chest diseases. RESULTS: Eighty-one doctors (mean age, 37.2 years [standard deviation, 9.7 years]; 57 (70.4%) women) answered the questionnaires. Almost all clinicians participating in the study reported that they always or frequently asked patients if they adhered to treatment. Most clinicians think that in 20–50% of patients with asthma and less than 20% of patients with chronic obstructive pulmonary disease, a decrease in medication adherence appears in the first year of treatment. Most clinicians think the main reason for patients with obstructive lung diseases not adhering is patients’ reluctance to be treated regularly. Regarding the impact of the COVID-19 pandemic on patients’ drug adherence, 43.2% of clinicians observed that adherence increased after the start of the pandemic. CONCLUSIONS: Adherence to medication is not at the desired levels in patients with obstructive lung diseases. However, when faced with a serious health threat, such as the COVID-19 pandemic, patients realize the severity of their illness and begin using their treatments more regularly.

Abstract Introduction Despite much advancement in medicine, endocrine and metabolic diseases remain an important cause of morbidity and even mortality in children. Objective The present study was planned to investigate the evaluation of hearing that also includes high frequencies, and the presence and degree of vertigo and tinnitus symptoms in pediatric patients diagnosed with endocrine diseases such as type 1 diabetes mellitus (DM), growth hormone deficiency (GHD), obesity, idiopathic short stature, and precocious puberty Methods The present study included a patient group of 207 children patients diagnosed with endocrine disease (95 males, 112 females; mean age 9.71 years old [range 6-16 years old]) and a control group including 55 healthy children who do not have any kind of chronic disease (26males, 29 females;mean age 9.33 years old [range 6-16 years old]). The subjects underwent a hearing test with frequencies between 250 and 20,000 Hz. The vestibular and tinnitus symptoms were evaluated with the Pediatric Vestibular Symptom Questionnaire. Results Out of 207 patients in the patient group, 5 (2.4%) had hearing loss in pure tones, 10 (4.8%) had it in high frequencies, 40 (19.3%) had tinnitus symptoms, and 18 (8.7%) had vertigo symptoms. A total of 4 out of 207 patients in the study group (1.9%), 2 out of 59 with type 1 DMpatients (3.4%), 1 out of 46 with GHD (2.2%), and 1 out of 43 obesity patients (2.3%) had hearing loss, vertigo, and tinnitus symptoms. Conclusions Our results suggest that some childhood endocrine diseases can cause some changes in the inner ear, although the exact cause is unknown. Perhaps, a detailed hearing and balance examination should be a routine in a child diagnosed with an endocrine disease.We think it is necessary to work on more comprehensive patient groups and tests in the future.