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    A forgotten oat head aspiration in an adult patient
    (Termedia Publishing House Ltd, 2014) Gonlugur, Ugur; Karabacak, Ersin; Muratli, Asli; Mirici, Arzu
    [Anstract Not Available]
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    A RESTRICTIVE PATHOLOGY IN A PAIIENT WITH HYPERCAPNIC RESPIRATORY FAILURE
    (Carbone Editore, 2012) Gonlugur, Ugur; Mirici, Arzu
    Carbon dioxide narcosis is an important finding in the emergency department. The differential diagnosis of hypercapnia allows to appropriate treatment. Some comorbid conditions can be confusing for the clinicians. In this paper, we present such an interesting case. Extrapleural abundant fat may mimic malignant mesothelioma, fibrothorax or encysted empyema.
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    A restrictive pathology in a patient with hypercapnic respiratory failure
    (Acta Medica Mediterranea, 2012) Gonlugur, Ugur; Mirici, Arzu
    Carbon dioxide narcosis is an important finding in the emergency department. The differential diagnosis of hypercapnia allows to appropriate treatment. Some comorbid conditions can be confusing for the clinicians. In this paper, we present such an interesting case. Extrapleural abundant fat may mimic malignant mesothelioma, fibrothorax or encysted empyema.
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    Adherence to Current COPD Guidelines in Turkey
    (Taylor & Francis Ltd, 2016) Turan, Onur; Emre, Julide Celdir; Deniz, Sami; Baysak, Aysegul; Turan, Pakize Ayse; Mirici, Arzu
    Introduction-objective: Despite the availability of national and international guidelines, chronic obstructive pulmonary diseases (COPD) treatment is not always prescribed according to these recommendations. We aimed to see if COPD patients in Turkey have been treated appropriately according to COPD guidelines. Methods: This is a cross-sectional study carried out in six different chest diseases clinics. The COPD outpatients were categorized by spirometry classification (SC) and the combined classification (CC) of COPD. The treatment protocols were evaluated to check whether they were suitable for both classifications. Results: Overall, 307 patients were included in the study. Of the treatment protocols, 40.4% were suitable for both classifications: 30.9% for CC and 20.8% for SC. A total of 51.8% of the patients were reported to be using an unsuitable therapy for SC and 38.4% for CC. Ninety-eight per cent of the unsuitable treatment was overtreatment. Fifty-eight per cent of the patients were using LABA+LAMA+ICS. Improper ICS usage was identified in 97.1% in CC, 93.1% in SC. The cost savings of all patients in one year would be 17,099$ with an appropriate treatment protocol following COPD guidelines. Conclusion: The most common type of inappropriate COPD treatments is overtreatment, generally with ICS. As treatment protocols following COPD guidelines change over time, there is still a low rate of adherence by clinicians in their clinical practice to guideline recommendations. Awareness of these guidelines by pulmonary specialists should be improved.
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    Akciğer hastalıklarında pnömokok hastalıkları riski ve erişkin aşılamasının önemi
    (2014) Sayıner, Abdullah; Mirici, Arzu; Çilli, Aykut; Uzaslan, Esra; Akova, Murat; Özhan, Mustafa Hikmet; Kılınç, Oğuz
    [Abstract Not Available]
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    Akciğer kanseri tanısında konvansiyonel bronkoskopik yöntemlerin rolü
    (2012) Muratlı, Aslı; Kırılmaz, Sevgül; Gönlügür, Uğur; Mirici, Arzu
    Amaç: Akciğer karsinomu tanısında bronkoskopik işlemlerin tanı değerini araştırmak. Gereç ve Yöntem: Kliniğimizde primer akciğer kanseri tanısı alan ve aynı zamanda bronkoskopi yapılan olguların verileri geriye dönük olarak incelendi. Hastaların demografik özellikleri, bronkoskopik bulguları, patoloji sonuçları kaydedilerek konvansiyonel bronkoskopik yöntemlerin akciğer kanseri tanısındaki sensitiviteleri hesaplandı. İstatistiksel analizde Pearson korelasyonu kullanıldı. Bulgular: Ekim 2009-Ekim 2011 arasındaki dönemde kliniğimizde tanı konulan 121 bronş karsinomu olgusunun %93ü erkekti. Hastaların ortalama yaşı 65 ± 9 idi. Bronkoskopinin akciğer kanserinde tanısal başarısı %91 idi. Bronş biyopsisi ve bronş lavajı kombine edildiğinde tanı oranı %86, bronş biyopsisi ve bronş fırçalama kombine edildiğinde ise tanı oranı %90 idi. Bronş forseps biyopsisi negatif çıkan 18 olgunun sadece birinde bronş lavajı pozitifti. Bu 18 olgunun altısına bronş fırçalama yapılmış ve beşinde (%83) pozitif sonuç çıkmıştı. Direkt tümör bulgusu olanlarda tanı başarısı bronş forseps biyopsisi için %87, bronş fırçalama için %73, bronş lavajı için %28 idi. Bu oranlar indirekt tümör bulgusu olanlarda bronş fırçalama için %63, bronş forseps biyopsisi için %50, bronş lavajı için %16 idi. Sonuç: Fiberoptik bronkoskopi, akciğer kanseri tanısında en yüksek duyarlılığa sahip araçlardan biridir. Bu çalışmada bronş forseps biyopsisi en yüksek tanı başarısına sahipti. Bronş forseps biyopsisi ve bronş fırçalamanın kombine edilmesi en iyi sonuçları vermektedir.
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    Anxiety and Depression Levels of Healthcare Workers During COVID-19 Pandemic
    (The European Respiratory Society, 2021) Turan, Muzaffer Onur; Demirci, Nilgün Yılmaz; Ak, Güntülü; Akçay, Şule; Aktürk, Ülkü Aka; Bilaceroğlu, Semra; Mirici, Arzu
    Background: Coronavirus disease 2019 (COVID-19), which causes a pandemic in the world, has started to appear in Turkey since March 2020. Healthcare workers are at the top of the groups most at risk for COVID-19 infection, which can have a negative impact on psychological state. Objectives: It was aimed to evaluate anxiety and depression levels among healthcare workers. Methods: This cross-sectional study performed via an online survey in April 2020. Participants answered questions about sociodemographic features, personal views and experiences about COVID-19 and the Hospital Anxiety and Depression Scale (HADS). Results: A total of 300 healthcare workers, 193 men and 107 women, participated in the survey. According to HADS, 44.6% of participants scored above anxiety and 68.2% scored above depression cut-off points. Being younger than 50 and taking care of COVID-19 patients in hospitals were independently associated with anxiety risk. Female gender, young age (less than 50) and having a comorbidity were independent risk factors for depression. Conclusion: Healthcare workers were at high risk of anxiety and depression during COVID-19 outbreak. For this reason, psychological support should be given, especially to the group with high risk.
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    Cervical necrotizing fasciitis associated with descending necrotizing mediastinitis
    (Biomed Central Ltd, 2011) Gonlugur, Ugur; Guclu, Oguz; Karatag, Ozan; Mirici, Arzu; Derekoy, Sefa
    We report a case of potentially fatal cervical necrotizing fasciitis and descending necrotizing mediastinitis due to deep neck infection in a 66-year-old male patient with no history or evidence of immunocompromising disorders. On admission, he had painful neck movements and the skin over his neck was red, hot and tender. A computerized tomography (CT) scan of his neck and chest showed evidence of air collection in soft tissues. He was treated with broad-spectrum intravenous antibiotics and early massive cervical drainage. Prompt diagnosis by CT of the neck and chest enabled an early surgical treatment of cervical necrotizing fasciitis. Although acute mediastinitis is a fatal infection involving the connective tissues that fill the interpleural spaces and surround the median thoracic organs, an extensive cervicotomy combined with appropriate antibiotics can prevent the need for mediastinal drainage.
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    Changes in inhalation therapy after combined assessment of COPD
    (European Respiratory Soc Journals Ltd, 2015) Turan, Muzaffer Onur; Emre, Julide Celdir; Deniz, Sami; Baysak, Aysegul; Turan, Pakize Ayse; Mirici, Arzu
    [Anstract Not Available]
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    Changes in quality of life and physiological status in newly diagnosed COPD patients
    (European Respiratory Soc Journals Ltd, 2015) Turan, Muzaffer Onur; Kasan, Turgay; Mirici, Arzu
    [Anstract Not Available]
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    Characteristics of hospitalised COVID-19 patients and parameters associated with severe pneumonia
    (John Wiley & Sons Ltd, 2021) Turan, Onur; Mirici, Arzu; Duru Akçalı, Serap; Turan, Pakize Ayşe; Batum, Özgür; Şengül, Aysun
    Background: After the first case of coronavirus disease 2019 (COVID-19) was reported in China in December 2019, it caused a global pandemic, including Turkey. Objectives: The aim of this study was to analyse the characteristics of hospitalised COVID-19 patients and assess the parameters related to severe pneumonia. Methods: Included in the study were hospitalised COVID-19 patients with positive naso-oropharyngeal swabs. Patients’ demographics, admission symptoms, laboratory and radiological findings were recorded retrospectively. Results: Of 1013 patients, 583 were males (57.6%) and 430 were females (42.4%), with a mean age of 53.7 ± 17.9. More than half of the patients had at least one comorbidities, the most common of which were hypertension and diabetes mellitus. Cough (59.8%), fatigue (49.5%) and fever (41.2%) were the most common presenting symptoms. Of the hospitalised COVID-19 patients, 84.9% had pneumonia and 83.5% had typical radiological COVID-19 appearances (94.5%: ground-glass areas). The most common laboratory findings were high C-reactive protein (CRP) (73.6%) and lactate dehydrogenase (LDH) (46.2%) levels, as well as lymphopenia (30.1%). Severe pneumonia was present in 28.1% of COVID-19 patients. Multivariate logistic regression analysis indicated that advanced age, hypotension, anaemia and elevated CRP and LDH serum levels were independent risk factors for the severity of COVID-19 pneumonia (P =.011,.006,.017,.003 and.001, respectively). Conclusion: This study, as one of the first multicentre studies about characteristics of COVID-19 in Turkey, may guide about disease-related parameters and severity of pneumonia. Age, blood pressure, complete blood count and routine biochemical tests (including CRP and LDH) would appear to be important parameters for the evaluation of the severity of COVID-19 pneumonia.
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    Characteristics of hospitalized COVID-19 patients and parameters associated with severe pneumonia
    (The European Respiratory Society, 2021) Turan, Muzaffer Onur; Mirici, Arzu; Akçalı, Serap Duru; Turan, Pakize Ayşe; Batum, Özgür; Şengül, Aysun; Ünsal, Zuhal Ekici
    Objectives: The aim of this study is to analyse characteristics of hospitalized COVID-19 patients in Turkey. Methods: Hospitalized COVID-19 patients with positive naso-oropharyngeal swab examples from 10 different centers were included. Demographics, admission symptoms, laboratory and radiological findings were recorded retrospectively. Results: Of 1013 patients included in the study, there were 583 male (57.6%) and 430 female (42.4%), with the mean age of 53.7±17.9. More than half (%51.7) of the patients had at least one comorbid disease; the most common ones were hypertension and diabetes mellitus. Cough (59.8%), fatigue (49.5%) and fever (41.2%) were the most common presenting symptoms. There was pneumonia in 84.9% of hospitalized COVID-19 patients; 83.5% had typical radiological COVID-19 appearance (94.5%: ground glass areas). The most common laboratory findings were high CRP (73.6%) and lactat dehydrogenase (LDH) (46.2%) levels and lymphopenia (30.1%). Severe pneumonia was present in 28.1% of COVID-19 patients. Multivariate logistic regression analysis indicated that high age, hypotension, anemia, elevated serum levels of CRP and LDH were independent risk factors for severity of COVID-19 pneumonia (p=0.011, 0.006, 0.017, 0.003 and 0.001, respectively). Conclusion: Our study, which is one of the first multicenter studies about COVID-19 characteristics in Turkey, is thought to be a guide for COVID-19 patients in terms of clinical features . Age, blood pressure measurement, complete blood count and routine biochemical tests (including CRP and LDH) seem to be important parameters for evaluating the severity of pneumonia in COVID-19 patients.
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    Chronic obstructive pulmonary disease and COVID-19
    (Kare Publ, 2020) Turan, Onur; Mirici, Arzu
    The coronavirus disease 2019 (COVID-19) pandemic tends to have a more severe clinical picture in the elderly and in patients with chronic diseases, one of which is chronic obstructive pulmonary disease (COPD). Around 2%-3% of patients infected with coronavirus have had the diagnosis of COPD; the critical care, intubation requirement, and mortality rate have been higher among this group of patients with the development of hypoxemia. Exacerbation and COVID-19 pneumonia are two differential diagnoses in patients with COPD; the fever among the symptoms, lymphopenia among the laboratory findings, and typical radiological findings in thoracic tomography of patients may be helpful in the diagnosis of COVID-19. The stabilization of the disease is important in the follow-up of patients with COPD during this pandemic; the continuation of maintenance treatment of patients has been accepted as the main strategy. Droplet and contact transmissions should be decreased, and basic hygiene and nutritional rules should be followed in the COPD patient group in which the risk of infection development is high. There are various opinions on the administration of treatment through nebulizers during the pandemic; the use of inhaler devices is the safer and recommended method. Since noninvasive mechanical ventilators may increase the risk of contamination, they are not included among the routine treatment recommendations for patients with COPD.
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    Clinical characteristics and outcomes in hospitalized COVID-19 patients with COPD
    (The European Respiratory Society, 2021) Turan, Muzaffer Onur; Yigitbaş, Burcu Arpınar; Turan, Pakize Ayşe; Mirici, Arzu
    Introduction: COPD can be more fatal in this in COVID-19 patients. The aim of this study was to determine the prevalence of COPD and to investigate the characteristics and prognosis of COPD patients in population infected with SARS-CoV2. Material-Method: Patients who had the diagnosis of COVID-19 by positive Polymerase Chain Reaction test in oro-nasopharyngeal swab samples were included. Patients with the airway obstruction (FEV1/FVC <70%) in the spirometrics were included in “COPD group”. The symptoms, laboratory and radiological findings, outcomes for patients with and without COPD were compared. Results: The prevalence of COPD in COVID-19 patients was 4.96% (53/1069). The mortality rate was 13.2% in COPD and 7% in non-COPD patients (p=0.092). The significant predictors of mortality were higher age, hypoxemia (p <0.001) and presence of pneumonia (p=0.043) in COVID-19 patients. Conclusion: Our research is a multicentered, retrospective cohort study, which is one of the first studies investigating the prevalence and characteristics of COVID-19 patients with COPD in Turkey. There were some demographic, symptomatic, laboratory and radiological differences between COPD and non-COPD COVID-19 patients. Although COPD patients had some poor prognostic features, there was no statistically difference between overall survival rates of COVID-19 patients with or without COPD. Significant predictors of mortality were high age, hypoxemia and presence of pneumonia in hospitalized COVID-19 patients.
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    Clinical characteristics and outcomes of hospitalized COVID-19 patients with COPD
    (Taylor and Francis Ltd., 2021) Turan, Onur; Arpınar Yigitbaş, Burcu; Turan, Pakize Ayşe; Mirici, Arzu
    Background: Although COPD is not one of the most common comorbidities in COVID-19 patients, it can be more fatal in this group. This study aimed to investigate the characteristics and prognosis of COPD patients among the population with COVID-19. Research design and methods: Patients diagnosed with positive PCR test were included in our multicentered, retrospective study. Patients with airway obstruction (previous spirometry) were included in ‘COPD group’. Results: The prevalence of COPD in COVID-19 patients was 4.96%(53/1069). There was a significant difference between COPD and non-COPD COVID-19 patients in terms of gender, mean age, presence of dyspnea, tachypnea, tachycardia, hypoxemia and presence of pneumonia. The mortality rate was 13.2% in COPD, 7% in non-COPD patients(p = 0.092). The significant predictors of mortality were higher age, lymphopenia (p < 0.001), hypoxemia (p = 0.028), high D-dimer level (p = 0.011), and presence of pneumonia (p = 0.043) in COVID-19 patients. Conclusions: Our research is one of the first studies investigating characteristics of COPD patients with COVID-19 in Turkey. Although COPD patients had some poor prognostic features, there was no statistical difference between overall survival rates of two groups. Age, status of oxygenization, serum D-dimer level, lymphocyte count and pneumonia were significantly associated parameters with mortality in COVID-19.
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    Covid-19 Diagnosis: Comparative Approach Between Chest X-Ray and Blood Test Data
    (Institute of Electrical and Electronics Engineers Inc., 2021) Öztaş, Ali Emre; Boncukçu, Dorukhan; Özteke, Ege; Demir, Mahir; Mirici, Arzu; Mutlu, Pınar
    The Covid-19 virus has made a major impact on the world and is still spreading rapidly. A reliable solution to prevent further damage, early diagnosis of coronavirus patients are incredibly important. While chest X-Ray diagnosis is the easiest and fastest solution for this, an average radiologist has only a 75% to 85% accuracy when evaluating X-Ray data, thus it is desirable to achieve an accurate artificial network for this. Throughout this study, chest X-Ray data and blood routine test data are utilised and compared. X-Ray data consists of 5000 chest X-Ray images which are gathered from an open-source research and from a local hospital in which both have anonymous data. The blood test results were also taken from the same hospital. For the chest X-Ray diagnosis we utilised two of the popular convolutional neural networks, which are Resnet18 and Squeezenet and concluded that Resnet18 provided slightly more accurate results, while both having almost 98% accuracy. For blood test diagnosis, a feed-forward multi layer neural network was used. Even though it was worked on an insufficient dataset, 72% accuracy was obtained, thus making it a feasible option for further research. Hence, we concluded that in general chest X-Ray diagnosis is preferable over routine blood test diagnosis and the usage of AI yields better approximate results than humans.
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    DUMANLI KÖYÜ ’NDE (ÇANAKKALE - TÜRKİYE) ASBEST MARUZİYETİNİN TIBBİ JEOLOJİ AÇISINDAN DEĞERLENDİRİLMESİ; DİSİPLİNLER ARASI BİR ÇALIŞMA
    (2015) Yiğitbaş, Erdinç; Mirici, Arzu; Gönlügür, Uğur; Bakar, Coşkun; Tunç, İsmail Onur; Şengün, Fırat; Işıkoğlu, Özgür
    Biga Yarımadası genel jeolojik nitelikleri ve doğal kaynak çeşitliliği yanı sıra önemli tıbbi jeoloji sorunları bakımından da oldukça ilginç bir bölgedir. Bölgenin muhtemel tıbbi jeolojik sorunlarının başlıcaları; doğal radyoaktivite, içme sularında metal/mineral kirliliği,asit kaya/maden drenajı, jeotermal ve diğer su kaynaklarında kalite sorunu, vb olarak sayılabilir. Bu kadar geniş tıbbi jeolojik sorunlara sahip olan Biga Yarımadası'ndaki kritik birbölgede asbest maruziyeti tıp ve yerbilimcilerden oluşan bir grup tarafından incelenmiştir.Araştırma Kuzeybatı Anadolu'da Biga Yarımadasının kuzeybatısında, Çanakkale ilininLapseki ilçesine bağlı Dumanlı köyü ve çevresinde sürdürülmüştür. Çanakkale İl SağlıkMüdürlüğü tarafından 2011 yılında Dumanlı köyünde 3 ve yakınındaki Çamyurt köyünde1 adet mezotelyoma vakası tespit edilmiştir. Bunun üzerine yer bilimciler ile Göğüs Hastalıkları ve Halk Sağlığı uzmanlarından oluşan bir çalışma grubu tarafından bölgede araştırmalar yapılmıştır. Çalışmalar yer bilimlerinde ve sağlık bilimlerinde eş zamanlı ve paralel olarak sürdürülmüştür. Dumanlı köyü çevresinde asbestiform mineraller ileri derecedemakaslamaya uğramış (sheared) serpantinitler içerisinde yer almaktadır. Serpantinitler bölgede yaygın mostra veren ve mikaşist, gnays, mermer litolojilerinden oluşan Çamlıca metamorfikleri içinde tektonik dilim ve mercekler halinde bulunmaktadır. Bu doğrultu atımlısistem içerisindeki gerilme-makaslama alanlarında asbestiform mineral damarları gelişmiştir. Petrografik ve mineralojik tayinler bu minerallerin başlıca klinokrizotil, lizardit veantigorit ile aktinolit olduğunu göstermiştir. Yerbilimleri çalışmalarına paralel olarak, köyde son beş yılda gerçekleşen ölüm nedenlerinin saptanması amacıyla sözel otopsi çalışmaları ile solunum fonksiyon testleri ve radyografik tetkikler yapılmıştır. Radyolojik patolojiile asbest maruziyeti arasında anlamlı korelasyon saptanmış, bu olgularda maruziyet süresinin 23-80 yıl arasında değiştiği anlaşılmıştır
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    ENCOUNTERED OCCUPATIONAL RESPIRATORY TRACT DISEASES IN THE PRODUCTION OF CERAMIC
    (Rating Academy, 2018) Okumus, Halide; Arcasoy, Ateş; Mirici, Arzu
    It is a serious problem that the ceramists are exposed to substances detrimental to the health in the production of ceramic. In recent years, the developing technology as well as the increase in the number and the diversity of the chemicals and the raw materials used has increased the severity of the detriment. The product of ceramic, contributing greatly to the needs of the humans, requires the ceramicist to deliberately use the facilities of the ceramic design and its technology in order to protect the health of theirs and the people using such products. The measures to be taken are very easy to apply. However, irreversible risks may occur in terms of health when the necessary attention is ignored. In this study, it is aimed to raise awareness about the causes and consequences of occupational respiratory tract diseases that ceramicists may encounter.
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    Evaluation of asbestos exposure in dumanli village (çanakkale-Turkey) from a medical geology viewpoint: An inter-disciplinary study
    (General Directorate of Mineral Research and Exploration (MTA), 2015) Yi?itbaşi, Erdinç; Mirici, Arzu; Gönlügür, U?ur; Bakar, Coşkun; Tunç, Ismail Onur; Şengün, Firat; Işiko?lu, Özgür
    Biga Peninsula has many varied and interesting medical geologic problems, as well as being rich in natural geological resources. Mainly these problems are natural radioactivity, mineral dust, metal/mineral contamination in drinking water, acid rock/mine drainage, and problems related to geothermal and drinking water. With this view exposure to asbestos was surveyed and the results of this survey were evaluated by earth scientists and medical doctors. This inter-disciplinary study was done in Dumanli village (Çanakkale-Turkey) in the Biga Peninsula, NW Turkey. Studies have been carried out in earth sciences and the health sciences simultaneously. The asbestiform minerals around Dumanli village are contained in sheared serpentinites which occur as tectonic slices and lenses within Çamlica metamorphics. These tectonic slices and lenses are bounded by strike-slip faults and probably obtained their final tectonic positions in a transpressional regime during late Cretaceous-early Eocene time. Asbestiform minerals occur within stretching-shear zones in the strike-slip system. Petrographic and miner alo gic indications show that the asbestiform minerals are clinochrysotile, lizardite, antigorite and actinolite. In parallel with earth science studies; verbal autopsy, pulmonary function tests and radiological examination studies were carried out. A significant correlation between asbestos exposure and radiographic pathology was identified in the region and it was understood that the duration of exposure in these cases varies from 23-80 years.
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    Evaluation of the clinical characteristic of psychiatric patients who are among the risk groups in the COVID-19 pandemic
    (Bayrakol Medical Publisher, 2022) Mutlu, Pinar; Oyekcin, Demet Gulec; Mirici, Arzu; Gonlugur, Ugur
    Aim: The pandemic caused by COVID-19 has been a major concern for public health worldwide. Traditional medical practices need to be adapted quickly to meet the needs of vulnerable patients due to the COVID-19 outbreak. One of these patient groups is the mentally ill. Although COVID-19 itself affects mental health, this study aimed to investigate the clinical characteristics of COVID-19 patients who were previously diagnosed with mental illness. Material and Methods: Patients older than 18 years of age with COVID-19 pneumonia, PCR positive or negative, thoradc CT compatible with COVID-19 pneumonia, and who also had been diagnosed with psychiatric disease between 1 April - 1 October 2020 were included in the study Psychiatric diagnoses of the patients, drugs they used, places they lived, PCR results, CT results, comorbidities, the treatment of COVID-19, and the final status of the patients were evaluated. Results: Between the specified dates, the number of patients with COVID-19 with psychiatric disease was 37 (28.24%) out of 131. The average age of patients with COVID-19 was 56.63 +/- 11.25 years, and the average length of stay in the hospital was 5.57 +/- 1.52 days. There were 35 (94.6%) patients living in a nursing home. There were 26 patients (70.3%) with a previous history of psychiatric illness, and 23 of them (62.2%) had psychotic disorders. During the treatment period, 27 (73.0%) of the patients received multiple pharmacotherapies, and atypical antipsychotic drugs (51.4%) were mostly prescribed. Discussion: As a result, in our study, we determined that living in nursing homes, having a psychiatric disorder, and taking multiple pharmacotherapies due to this psychiatric disorder increase the possibility of getting COVID-19.