Taş, Hakan Gökalp; Kuyrukluyildiz, Nursel; Akkus, Mustafa; Kuyrukluyildiz, Ufuk

Introduction: on January 7th 2020, SARS-CoV-2 was identified in Wuhan, China, and on March 11th, 2020, the World Health Organization declared it a "Pandemic". The aim of this research is to assess depression, anxiety, work, and social status in healthcare workers during the COVID-19 pandemic. Methods: the research was designed to be a cross-sectional face-to-face survey. The study included 111 healthcare employees and 222 non-healthcare workers between the ages of 18 and 65 who applied to the hospital. For some reason, no one was excluded from the research. Socio-demographic and lifestyle-related questions, depression, anxiety, work-social adjustment scores, and pandemic-social status-operation connections were all assessed using a self-report questionnaire containing psychometric measures. Results: the mean age of the participants in the study was 33.67±10.01 and 59% of the participants were female. PHQ9: 11.67±6.41, GAD7: 9.06±5.81, and W&SAS: 17.55±10.98 were the scores of the healthcare professional groups. PHQ9: 10.25±6.21, GAD7: 7.59±5.65, and W&SAS: 14.75±10.27 were the non-healthcare professional groups' results. When the PHQ9, GAD7, and W&SAS scores of both groups were compared, there was no statistically significant difference in the PHQ9 depression score between the two groups (p=0.107), the GAD7 (p<0.05) and W&SAS (p<0.05) scores of the healthcare professionals were statistically significantly higher. Conclusion: in comparison to the non-healthcare worker group, healthcare professionals had the same level of depression, greater levels of moderate and high anxiety, and higher levels of work-social adjustment disorder. Unlike the literature, we found that the degree of depression fell to the same level as the non-health professional group in our study, but it was still disadvantaged in terms of anxiety and work-social adjustment.

Onk, Didem; Işık, Onur; Subaşı, Faruk; Karaali, Soner; Kuyrukluyıldız, Ufuk

Negative-pressure pulmonary edema (NPPE) is a rare but life-threatening postoperative complication that occurs due to the acute obstruction of the upper airway. In our case report, we present a 25-year-old female patient who underwent elective mammoplasty under general anesthesia and developed NPPE 4 hours after extubation. The patient had a preoperative mallampati score of 3. After routine anesthesia induction, the patient was intubated with an endotracheal tube with a guide wire. Aspiration wasn't observed during extubation. The patient was followed in the post-anesthesia care unit (PACU) for 30 minutes with a saturation of 95% and was subsequently transferred to the service. Four hours after the operation, the patient was re-examined due to dyspnea and shortness of breath. Due to oxygen saturation of 88% and pO2 of 56mmHg despite mask ventilation, the patient was admitted to the intensive care unit (ICU). A computed tomography (CT) scan revealed extensive diffuse ground-glass opacities and consolidations in both lungs. She did not respond to mask ventilation and was given non-invasive ventilation with continuous positive airway pressure (CPAP). Forced diuresis was induced with furosemide. Tachypnea resolved within 2 hours after CPAP was initiated, the patient did not require oxygen support and COVID-19 polymerase chain reaction (PCR) testing was negative. Subsequently, the patient was discharged to the clinical ward on postoperative day 1. When considering NPPE, early diagnosis and respiratory support are associated with reduced mortality and rapid recovery. Patients who develop laryngospasm during extubation must be closely monitored, and in the case of pulmonary edema, NPPE should be considered in the differential diagnosis.

Unver, Edhem; Kuyrukluyildiz, Ufuk; Karavas, Erdal; Tas, Hakan Gokalp

Although the severity of coronavirus disease 2019 (COVID-19) being more frequently related to acute respiratory distress syndrome and acute cardiac and renal injuries, thromboembolic events have been increasingly reported. Acute respiratory distress syndrome due to SARS-CoV-2 (Severe Acute Respiratory Syndrome-Corona Virus 2) often requires intensive care follow-up. As well as respiratory failure, the SARS-CoV-2 may cause central nervous system (CNS) involvement. The pandemic has raised many challenges in managing critically ill older adults, a population preferentially killed by COVID-19. The mortality and morbidity rates are extremely high in critically ill patients with COVID-19. Recent studies have reported the potential development of a hypercoagulable state in COVID-19. Viral infections and hypoxia may cause these state. It is increasingly reported that thromboembolic events are associated with a poor prognosis. Due to these thromboembolic complications, COVID-19 patients often have neurological symptoms. These symptoms may not be observed in intensive care patients who are sedated. We report one case who was sedated COVID-19 pneumonia and who was later diagnosed with cerebral venous thrombosis with cranial imaging when he could not awaken even though sedation was discontinued. Since COVID-19 causes intense thrombotic susceptibility due to cytokine storm, cerebrovascular thromboembolic complications associated with COVID-19 infection should be considered first and foremost for unconsciousness ventilated patients. Severe and potentially cerebral thrombosis may prolong the patient´s stay in intensive care.