Objectives During the pandemic, anxiety, stress, and depression may occur increasingly in the whole society. To evaluate the possible cause, incidence and levels of anxiety and depression in the relatives of the patients in the ICU in accordance with the patients’ SARS‐CoV‐2 PCR result. Materials and Method The study was prospectively conducted on relatives of patients admitted to tertiary intensive care units during COVID‐19 pandemic. Sociodemographic characteristics of the patients and their relatives were recorded. “The Turkish version of the Hospital Anxiety and Depression Scale” survey was applied twice to the relatives of 120 patients to determine the symptoms of anxiety and depression in accordance with the PCR results of the patients (PCR positive n=60, PCR negative n=60). Results The ratios above cut‐off values for anxiety and depression among relatives of the patients were 45.8% and 67.5% for the first test and 46.7% and 62.5% for the second test respectively. The anxiety and depression in the relatives of PCR positive patients was more frequent than the PCR negative (p< 0.001 for HADS‐A and p=0.034 for HADS‐D). The prevalence of anxiety and depression was significantly higher in female participants (p=0.046 for HADS‐A and p=0.009 for HADS‐A). There was no significant correlation between HADS and age of the patient or education of the participants. The fact that the patients were hospitalized in the ICU during the pandemic was an independent risk factor for anxiety (AUC = 0.746) while restriction of patient visiting in the ICU was found to be an independent risk factor for depression (AUC= 0.703). Conclusion While patient with positive PCR and participant with female gender is responsible for both anxiety and depression, hospitalization in the ICU due to COVID‐19 is an independent risk factor for anxiety and restriction of patient visiting in the ICU is an independent risk factor for depression.

Objectives PNI is a calculated parameter using the albumin and the lymphocyte count from the CBC, which demonstrates the immunological and nutritional status of the patient. The aim of this study is to show the relationship between PNI and mortality in COVID-19 patients and to reveal a PNI cut-off value for mortality. Materials and Methods Data of 690 PCR positive COVID-19 ICU patients were recorded. COVID-19 ICU patients were divided into two groups; the first group consisted of survivors, while the second group consisted of patients who died in the ICU. Patients were also evaluated in two groups according to the PNI cut-off value that predicted mortality (PNI≤42.00, PNI≥43) and were compared in terms of demographics, laboratory parameters, clinical findings and mortality rates. Results When 690 COVID-19 patients were divided into two groups as survivors (50.6%) and deceased (49.4%) in intensive care, PNI value was significantly lower in the deceased group compared to the surviving group (p<0.001). The PNI cut-off value predicting mortality was determined as ≤42. Patients were classified into two groups according to the PNI cut-off value. PNI ≤42 was determined as an independent risk factor for mortality (OR:2.9 p<0.001). AUC values for PNI, albumin, and lymphocyte were 0.628, 0.612, and 0.590, respectively; p<0.001 for all. Conclusion PNI is an inexpensive method that can be easily calculated on the basis of routine laboratory parameters. We believe that the PNI value of COVID-19 patients on admission to the ICU may be an independent factor to predict mortality.

Amaç: Pandeminin ilk dört aylık döneminde koronavirüs hastalığı-2019 (COVİD-19) şüphesiyle, COVİD-19 YBÜ’lerine kabul edilen hastalar tanılarına ve dönemlere göre karşılaştırıldı. Gereç ve Yöntem: Tek merkezde aynı algoritma ile COVİD-19 YBÜ’ye kabul edilen 1,430 hasta verisi retrospektif olarak kaydedildi. Hastalar polimeraz zincirleme reaksiyonu sonucu ile radyolojik ve klinik bulgulara göre COVİD-19 ve non-COVİD-19 hastalar olarak sınıflandırıldılar. Ayrıca COVİD-19 hastaları mortalite ve sağkalım açısından da karşılaştırıldı. Bunun yanında, pandeminin başlangıcı ve normalleşme döneminde COVİD-19 YBÜ’lerine kabul edilen hastaların verileri değerlendirildi. Bulgular: Çalışmaya alınan 1,430 hastanın 630’u COVİD-19, 800’ü non-COVİD-19 gruptaydı. Yaş ortalamalarında anlamlı bir farklılık bulunurken, cinsiyetler arasında bir farklılık yoktu (p=0,001, p=0,262). COVİD-19 ölen grubun yaş ortalaması yaşayan gruptan daha yüksekti (p

In the literature, there is no study on the anxiety and depression status of the relatives of intensive care COVID-19 and non-COVID-19 patients during the pandemic period. In this study, we aimed to compare the risk of developing anxiety and depression in the relatives of COVID-19 and non-COVID-19 intensive care patients during the pandemic, and also to determine the factors that may cause anxiety and depression. Relatives of patients admitted to Ankara City Hospital COVID-19 (n=45) and non-COVID-19 (n=45) intensive care units between 15 May and 31 July 2021 were included in this prospective study. The Hospital Anxiety and Depression Scale (HADS) questionnaire was administered to the relatives of the patients within the first 48 hours of their admission to the intensive care unit. The answers were recorded and HADS, HADS-A (anxiety) and HADS-D (depression) scores were calculated accordingly. Demographics, education and marital statuses of both the patients and their relatives were recorded. Logistic regression analysis was performed to determine the factors associated with depression and anxiety. Receiver operator characteristics (ROC) curves were drawn for the factors affecting depression and anxiety, and the area under the curve values were calculated. Demographics, APACHE II score, and patient affiliation were similar in both groups. The mean HADS scores of the relatives of COVID-19 and non-COVID-19 patients were 24.76 and 16.04 (p<0.001). The mean HADS-A scores were 12.89 and 7.78 (p<0.001), and the mean of HADS-D scores were 11.87 and 8.27 (p=0.001). Moderate and high-risk anxiety and depression were significantly higher in relatives of COVID-19 patients (p=0.018, p=0.001, respectively). The area under curve (AUC) values were 0.727 in the ROC curve plotted for the independent risk factor Q3 responses that reduced anxiety, and 0.791 and 0.785 in the ROC curve drawn for the independent risk factor Q1 and Q3 responses that reduced the development of depression. We found that the anxiety and depression risk of the relatives of COVID-19 patients in the intensive care unit during the pandemic period is significantly higher than the relatives of non-COVID-19 patients in the intensive care unit. In addition, regardless of the diagnosis, younger intensive care patients may increase the anxiety and depression of the relatives of the patients during the pandemic. The higher-education level of the relatives of patients was determined as a factor reducing anxiety and depression.

Pregnant women are one of the vulnerable groups affected by COVID-19. With the mutation of the virus, the severity of the disease in this vulnerable group may vary in different waves of COVID-19 subtypes. The aim of this study is to define the demographic, clinical, laboratory, and mortality results of pregnant COVID-19 patients according to three time frames (March to December 2020, January to June 2021, and July to November 2021). The data of patients admitted to the ICU between March 23, 2020, and November 30, 2021, were retrospectively scanned. Pregnant patients with SARS-CoV-2 PCR test positivity or pregnant patients with COVID-19 who have a negative PCR test but symptoms of COVID-19 and radiological findings consistent with COVID-19 on thorax CT who need intensive care were included in the study. The patients were divided into three groups according to the dates when the Ministry of Health of the Republic of Turkey reported the variants of COVID-19 in Turkey. The nonvariant type was dominant in the first period (March to December 2020), alpha and beta variants were dominant in the second period (January to June 2021), and the delta variant appeared in the last period (July to November 2021). Demographic, clinical, and laboratory findings at the first admission to the ICU and mortality rates of the patients were recorded. PCR test was performed in all 109 patients, of whom 101 were PCR test positive. In other eight patients, despite the negative PCR test, thorax CT findings were typical of COVID-19 pneumonia, and other bacterial and viral agents were also excluded. The mean age of the patients was 30.53 years, the mean APACHE II score was 9.68, and the mean gestational age was 28.55 weeks. Around 72.5% of the patients were in the third trimester. Of the 101 PCR-positive patients, 20.2% were delta variants, 16.5% alpha or beta variants, and 63.3% were of unknown variants. Five of the patients were vaccinated. The most common symptom was dyspnea (94.5%), and the most common comorbidity was hypothyroidism (9.17%). Invasive mechanical ventilation (IMV) was needed in 44.95% of pregnant patients. The distribution of pregnant patients admitted to the ICU according to the periods March to December 2020, January to June 2021, and July to November 2021 was 16.5%, 21.1%, and 62.4%, respectively (p<0.001). Two groups of patients were compared: those that survived versus those that deceased. Variables predicting mortality were APACHE score, IMV requirement, length of stay in the ICU, prone positioning, Anakinra treatment, and ECMO (extracorporeal membrane oxygenator) requirement, which were significantly higher in the deceased group than in the living group (p<0.001, p<0.001, p=0.001, p<0.001, p<0.001, and p=0.001, respectively). There was no significant difference between the patients' age, gestational age, variants, treatments other than Anakinra, and the number of patients admitted to the ICU in the three periods (p=0.667, p=0.174, p=0.904, and p=0.605, respectively).In the multiple logistic regression analysis for mortality, high APACHE II score and IMV requirement were found as risk factors for mortality. In the last period of delta variant predominance, pregnant COVID-19 patients were admitted to the ICU significantly more frequently than in the first two periods. Mechanical ventilation requirement and high APACHE II score were determined as risk factors for mortality.

COVID-19,intensive care,intensive care unit,pandemic,follow-up