Due to current advances and growing experience in the management of coronavirus Disease 2019 (COVID‐19), the outcome of COVID‐19 patients with severe/critical illness would be expected to be better in the second wave compared with the first wave. As our hospitalization criteria changed in the second wave, we aimed to investigate whether a favorable outcome occurred in hospitalized COVID‐19 patients with only severe/critical illness. Among 642 laboratory‐confirmed hospitalized COVID‐19 patients in the first wave and 1121 in the second wave, those who met World Health Organization (WHO) definitions for severe or critical illness on admission or during follow‐up were surveyed. Data on demographics, comorbidities, C‐reactive protein (CRP) levels on admission, and outcomes were obtained from an electronic hospital database. Univariate analysis was performed to compare the characteristics of patients in the first and second waves. There were 228 (35.5%) patients with severe/critical illness in the first wave and 681 (60.7%) in the second wave. Both groups were similar in terms of age, gender, and comorbidities, other than chronic kidney disease. Median serum CRP levels were significantly higher in patients in the second wave compared with those in the first wave [109 mg/L (interquartile range [IQR]: 65–157) vs. 87 mg/L (IQR: 39–140); p < 0.001]. However, intensive care unit admission and mortality rates were similar among the waves. Even though a lower mortality rate in the second wave has been reported in previous studies, including all hospitalized COVID‐19 patients, we found similar demographics and outcomes among hospitalized COVID‐19 patients with severe/critical illness in the first and second wave.

Aim: The coronavirus disease 2019 (COVID-19) pandemic has presented significant challenges to healthcare systems worldwide, impacting the mental health of healthcare workers. This study aimed to assess and compare anxiety levels among different categories of healthcare workers during the pandemic. Methods: A cross-sectional survey study was conducted with 180 healthcare workers categorized into four groups: COVID-19 negative healthcare workers (n=45), COVID-19 positive hospitalized and treated healthcare workers (n=45), COVID-19 positive healthcare workers treated at home (n=45), and COVID-19 negative healthcare workers who were off duty due to chronic illnesses (n=45). The Coronavirus Anxiety Scale (CAS) was used to measure anxiety levels. Results: COVID-19 negative healthcare workers reported relatively lower anxiety levels (mean CAS score = 1.29, SD = 1.829), with the majority experiencing minimal anxiety. COVID-19 positive hospitalized and treated healthcare workers had expressively higher anxiety levels (mean CAS score = 4.09, SD = 5.049), indicating substantial distress. COVID-19 positive healthcare workers treated at home demonstrated intermediate anxiety levels (mean CAS score = 3.09, SD = 3.014). COVID-19 negative healthcare workers with chronic illnesses showed higher anxiety levels compared to their non-chronically ill counterparts (mean CAS score = 2.02, SD = 2.19). Conclusion: This study highlights the diverse psychological impact of the COVID-19 pandemic on healthcare workers. COVID-19 positive hospitalized and treated healthcare workers experienced the highest levels of anxiety, followed by those treated at home. Even COVID-19 negative healthcare workers and those with chronic illnesses experienced notable anxiety. These findings emphasize the need for targeted interventions and support systems to address the mental health needs of healthcare workers effectively during and beyond the pandemic. Understanding and mitigating anxiety among healthcare workers are crucial for their well-being and the quality of patient care. Further research is warranted to explore additional factors influencing anxiety levels in this population.

Background and Objectives: Postspinal hypotension (PSH) remains a common complication of cesarean delivery under spinal anesthesia. Simple prespinal predictors may assist in identifying patients at increased risk. This study evaluated the associations of shock index (SI), modified shock index (MSI), diastolic shock index (DSI), and right internal jugular vein collapsibility index (RJV-CI) with postspinal hypotension (PSH). Materials and Methods: This prospective observational study included term parturients undergoing elective cesarean delivery under spinal anesthesia. Prespinal SI, MSI, DSI, and RJV-CI were measured before intrathecal injection. PSH was defined as systolic arterial pressure <90 mmHg or a reduction of ≥30% from baseline within 15 min after intrathecal injection. Receiver operating characteristic (ROC) analyses were performed for individual predictors. Three logistic regression models combining RJV-CI with SI, MSI, or DSI were evaluated using bootstrap internal validation. Results: Of 80 enrolled patients, 76 were included in the final analysis; 36 (47.4%) developed PSH. SI, MSI, DSI, and RJV-CI were significantly higher in the PSH group than in the non-PSH group. The areas under the ROC curve (AUCs) were 0.757 for SI, 0.747 for MSI, 0.693 for DSI, and 0.709 for RJV-CI. In multivariable models, RJV-CI remained significantly associated with PSH after adjustment for the respective shock index. The model combining RJV-CI and SI showed the highest apparent AUC (0.790; 95% confidence interval, 0.688–0.886) and an optimism-corrected AUC of 0.775. The RJV-CI plus MSI model showed an optimism-corrected AUC of 0.774. Conclusions: Prespinal SI, MSI, DSI, and RJV-CI were associated with PSH in this cohort. Models combining RJV-CI with SI or MSI showed numerically higher discrimination than the individual predictors. The derived cutoff values should be considered exploratory and require external validation before routine clinical use.

In this retrospective research, it was aimed to evaluate predictive values of lactate-related ratios on mortality in intensive care units (ICUs) at multivariable level. A total of 4985 patients who were hospitalized in the Anesthesia Intensive Care Unit of Istanbul Gaziosmanpaşa SUAM between January 2015 and January 2025 were included in the study. Patients’ age, gender, body mass index, hospitalization diagnoses and chronic diseases, lactate, albumin, hemoglobin, potential of hydrogen (pH), HCO₃⁻, base excess, platelets, APACHE II score, and 28-day mortality values were obtained. Lactate albumin ratio (LAR), lactate hemoglobin ratio, lactate pH ratio, and lactate bicarbonate ratio of the patients were analyzed. Age, pH, and LAR parameter means were significantly higher in the non-survival group, whereas blood extracellular fluid mean was significantly higher in the survival group ( P < .05). Acute renal failure and ketoacidosis were more common in the non-survival group ( P < .05). Twenty-eight-day mortality was significantly correlated with age ( R = 0.077; P < .01), acute renal failure ( R = 0.030; P < .05), ketoacidosis ( R = 0.028; P < .05), albumin ( r = −0.117; P < .01), base excess in the extracellular fluid ( R = 0.032; P < .05), pH ( R = 0.036; P < .05), LAR (0.057; P < .01), and hospitalization duration ( R = 0.044; P < .01). Effects of age ( B = 0.020; P < .01), acute renal failure ( B = −0.648; P < .05), base excess in the extracellular fluid ( B = 0.024; P < .05), pH ( B = 1.753; P < .05), and LAR ( B = 4.893; P < .01) were statistically significant. Although the LAR parameter has a predictive value on 28-day mortality in ICU patients, this is not the case in acute renal failure patients. The LAR variable in acute renal failure patients may have different mechanism than in other ICU patients, and this mechanism may be misleading for LAR. Therefore, further predictive parameters are needed for ICU 28-day mortality in acute renal failure patients.

Aims: Chronic postsurgical pain (CPSP) is an well-recognised complication following caesarean delivery and may adversely affect maternal quality of life. Effective postoperative analgesia has been suggested to reduce the risk of CPSP. This study aimed to evaluate the effect of ultrasound-guided regional blocks, applied as part of multimodal analgesia, on the incidence and characteristics of CPSP after caesarean section under spinal anaesthesia. Methods: This retrospective, single-center cohort study included women aged 18–40 years with singleton pregnancies who underwent elective caesarean section under spinal anaesthesia between January 2024 and March 2025. Patients were divided into two groups: Group RA (regional anesthesia), who received multimodal analgesia with either anterior quadratus lumborum block or ilioinguinal–iliohypogastric nerve block, and group non-RA, who received standard systemic analgesia alone. Data were obtained from anaesthesia and postoperative analgesia records. Patients were contacted by telephone after completing ≥90 postoperative days to assess their pain status. Neuropathic features such as burning, tingling, itching, and numbness were also evaluated. Results: A total of 191 patients were included: 90 in group RA and 101 in group non-RA. The demographic characteristics of the two groups were comparable. The incidence of CPSP at three months was 27.8% in group RA and 28.7% in group non-RA (p=0.886). All pain was localised to the incision site and was mostly mild and intermittent. No significant differences were found between the groups for burning (8.9% in group non-RA vs. 8.9% in group RA), tingling (10.9% in group non-RA vs. 7.8% in group RA), and itching (25.7% in group non-RA vs. 16.7% in group RA). However, the rate of numbness was significantly higher in the non-RA group compared to the RA group (20.8% vs. 10.0%, p=0.041). Conclusion: The incidence of CPSP at ≥3 months after caesarean delivery was similar between patients receiving regional blocks and those treated with standard analgesia. However, regional blocks were associated with a lower frequency of certain neuropathic symptoms, suggesting a potential qualitative benefit in postoperative pain management.