Background: In December 2019, pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. Its effects on the national and global economies have been tremendous. There is limited evidence on treatment costs and effects of comorbidities on treatment costs, which are crucial inputs for policymakers. Objective: The main objective of this study is to retrospectively determine the direct costs of hospitalization due to COVID-19 treatment and their association with comorbidities. Methods: This is a retrospective study conducted at two prominent research and training hospitals in İzmir, Turkey during the first year of the COVID-19 pandemic. First hospitalization costs of 2,067 patients with COVID-19 were analyzed. Second association of comorbidities with hospitalization costs of 532 patients with COVID-19 was estimated. Results: Analyses based on the whole sample of 2,067 patients showed that the average hospitalization cost was $1,432.3 (PPP $4,994.7). Treatment cost is higher for male patients and increases with age and intensive care unit admissions. The average length of hospitalization was 10.6 days (SD=8.5) and the average length of ICU hospitalization was 9.9 (SD=9.6). The average daily hospitalization cost was $135.25 (PPP $471.63). Analyses showed that sex, age, intensive care unit hospitalization, myocardial infarction, cerebrovascular and transient ischemic attacks, chronic obstructive pulmonary disease and chronic kidney disease were found significantly associated with hospitalization costs. Conclusion: COVID-19 is a novel pandemic that causes morbidity and mortality at considerable levels. A holistic approach to fight the pandemic requires unraveling not only medical but also financial aspects.

Introduction: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus (HCV) in the world. Aims: The aim of this study was to compare direct acting antivirals (DAAs) treatment of HCV for PWID and non-PWID in real life setting. Materials and methods: We performed a prospective, non-randomized, observational multi-center cohort study in 37 centers. All patients treated with DAAs therapy between April 1, 2017 to February 28, 2019 were included. In total, 2,713 patients were included in the study among which 250 were PWID and 2,463 were non-PWID. Besides patient characteristics, treatment response, follow-up and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: DAAs were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization’s objective of eliminating viral hepatitis.

Aims: The differential diagnosis of Fever of Unknown Origin (FUO) is still a major clinical challenge despite the advances in diagnostic procedures. In this multicenter study, we aimed to reveal FUO etiology and factors influencing the final diagnosis of FUO in Turkey. Methods: A total of 214 patients with FUO between the years 2015-2019 from 13 tertiary training and research hospitals were retrospectively evaluated. Results: The etiologic distribution of FUO was infections (44.9%), malignancies (15.42%), autoimmune/inflammatory (11.68%) diseases, miscellaneous diseases (8.41%) and undiagnosed cases (19.62%). Brucellosis (10.25%), extrapulmonary tuberculosis (6.54%) and infective endocarditis (6.54%) were the most frequent three infective causes. Solid malignancies (7.1%) and lymphoma (5.6%), adult-onset still’s disease (6.07%) and thyroiditis (5.14%) were other frequent diseases. The etiologic spectrum did not differ in elderly (p<0.05). Infections were less frequent in Western (34.62%) compared to Eastern regions of Turkey (60.71%) (p< 0.001, OR: 0.31, 95% Cl: 0.19 to 0.60). The ratio of undiagnosed etiology was significantly higher in elderly (p: 0.046, OR: 2.34, 95% Cl: 1.00 to 5.48) and significantly lower in Western Turkey (p: 0.004, OR: 3.07, 95% Cl: 1.39 to 6.71). Conclusion: Brucellosis, extrapulmonary tuberculosis and infective endocarditis remain to be the most frequent infective causes of FUO in Turkey. Solid tumors and lymphomas, AOSD and thyroiditis are the other common diseases. The etiologic spectrum did not differ in elderly, on the other hand, infections were more common in Eastern Turkey. A considerable amount of etiology remained undiagnosed despite the state-of-the-art technology in healthcare services.