In the last one-year experience in COVID-19, we have learned that the disease may present itself in different clinical pictures. In rough speaking, acute illness lasts about 3 weeks. Chronic type lasts for up to 12 weeks.

Lately, the National Institute for Health and Care Excellence (NICE) defines long COVID as disease effects lasting for more than 12 weeks. Nearly 10% of patients with positive PCR for COVID do not recover after 3 weeks, and a smaller proportion for months.

Why do some people develop long COVID?

It is not known why some people recover late from COVID.

Scientists believe that;

  • Persistent viremia due to weak or absent antibody response,
  • Relapse or reinfection,
  • Inflammatory and other immune reactions,
  • Diminished physical strength and function,
  • Mental factors such as post-traumatic stress, may all contribute.

Moreover, long term respiratory, musculoskeletal, and neuropsychiatric sequelae may be observed in long COVID.

Are symptoms different in long COVID?

Symptoms of long COVID vary widely. Researchers divide the symptoms into two main groups as ones related to respiratory system (including headache and fatigue), and symptoms related to different parts of the body (i.e. heart, brain).

The most commonly reported symptoms are:

  • Fatigue
  • Shortness of breath (dyspnea),
  • Cough,
  • Joint pains,
  • Chest pain,
  • Depression,
  • Muscle pain,
  • Low-grade fever,
  • Digestive system (gastrointestinal) problems,
  • Headache,
  • Metabolic disruptions (i.e. poor control of diabetes),
  • Thromboembolic conditions,
  • Brain fog (it presents with confusion, difficulty in concentration and inability to express thoughts),
  • Skin rashes in various forms (i.e. vesicular, maculopapular),
  • Loss of smell is a very well-known, and long lasting symptom.

Another feature of long COVID is that some patients report that their symptoms have come back after recovery. When compared with short COVID, the recurrence rate is twice.

Are there any risk factors for long COVID?

Recently, a research group from the United Kingdom, the United States of America, and Sweden have conducted a self-reported study to define risk factors for developing long COVID by using a mobile application. It is shown that there is a clear link between having asthma and long COVID development.

Other predictive characteristics of patients for developing long COVID are:

  • Old age (>70 years),
  • Female gender,
  • Presence of five or more symptoms at the onset of the disease,
  • High body mass index (obesity),
  • Having diabetes or hypertension,
  • Having depression,
  • Severe acute COVID infection,

These characteristics are drawn as predictors from studies with limited sample size, and may be considered as preliminary findings. For more concrete definitions, further clinical studies with larger sample sizes should be performed.

How long does it take to recover from long COVID?

There is no definite time frame for recovery from long COVID; it may vary from person to person. Leicester researchers have reported that seven out of ten hospitalized patients with COVID-19 not fully recovered 5 months after the discharge.

The findings have once again supported that long COVID is a multisystem disease, because some signs related to autoimmunity, systemic inflammation, mental and neurological health problems are determined in post-hospitalization survivors.

Can children develop long COVID?

The Office for National Statistics (ONS) has published data of 9063 respondents of all ages from the UK Coronavirus Infection Survey. The survey is conducted to investigate ratio of COVID patients with elongated symptoms more than five weeks. The “estimates” have suggested that 13% of children between 2 and 11 years, 14.5% of children between 12 and 16 years have complaints including fatigue, cough, headache, muscle pains, loss of taste or smell still after 5 weeks of the diagnosis. Despite the limited data, it is clear that some children may also have long COVID.

Some recommendations for managing your symptoms at home

For fatigue and breathlessness

  • Do not over exert yourself: Carefully plan what you will do during the day
  • Break tasks into small pieces, so that when you sum up, the task will be completed.
  • Do some easy and some harder activities alternatively. Have some rest between them.
  • Plan your day according to your energy level.
  • Frequent resting is better than a few longer ones. Do not let yourself become exhausted.
  • If you feel breathless while doing something, rest for a while. Then go on the activity again. If you stop using your muscles, they will get weaker, and this will cause more problem in breathing. You must use your muscles.
  • Level of daily activity/exercise should be increased slowly and gradually i.e. short walks, simple strength exercises.

For mood and mental health

  • Be aware that some days may be worse during healing. Be prepared mentally and try to be kind to yourself.
  • Even you are isolated you can get in touch with family and close friends by phone. This will boost your mood.
  • Have a daily plan. This will help you develop the sense of stability.
  • Stay active (as far as possible of course) at home. When your body moves, then endorphins will be released more. Endorphines are known as “hormones of happiness).”

For memory and effective thinking

  • Make notes to remember i.e. your daily plan, medical appointments
  • Try to reduce distractions. A quiet environment may help you to be more concentrated.
  • A clear plan divided into steps will always be easier for you to apply and follow.

For joint or muscle pains

  • Flexibility exercises i.e. stretches, yoga, tai chi,
  • Strength exercises i.e. climbing stairs, lifting weights, working with resistance bands, may help for joint and muscle pains.
  • If you plan to have an exercise program, you should consult it with your doctor in the first place.



  1. BMJ 2020;370:m3026 | doi: 10.1136/bmj.m3026. Last access 8.4.
  2. Last access 8.4.2021.
  3. Last access 8.4.2021.
  4. Last access date4.2021.
  5. Last access date 12.4.2021.


Prof. İlknur Erenler Bayraktar, M.D. is recently certified with the Diploma of EBSQ (Coloproctology) of the European Union of Medical Specialists. This is the only form of certification in the speciality of coloproctology within Europe and candidates who successfully pass the examination are awarded this title.

The European Society of Coloproctology recognizes the surgeons who have received the title as true Colorectal Surgeons, ready to be an opinion leaders in their countries as well as in Europe.

We wish better achievements to Prof. İlknur Erenler Bayraktar in her future career life…

Prof. İlknur Bayraktar, MD





2011 – 2018

2010 – 2011

2009 – 2009

2007 – 2009

2001 – 2007


On December 9, 2020; the third virtual meeting of “Webinar Series by Experts” has been performed about “Allogeneic Stem Cell Transplantation in Covid-19 Era”. Founding Director of Hematopoietic Stem Cell Transplant (HSCT) Center at the Group Florence Nightingale Hospitals, Prof. Mutlu Arat, M.D. has mentioned about pitfalls in pre-transplant procedures, and GVHD management bone marrow transplantation in Covid-19 era. During panel section, he has explained principles about how to overcome challenging conditions.

We are delighted to have a total of 48 attendees from Azerbaijan, Russia, Georgia, Kazakhstan, Ukraine, Mongolia, and Uzbekistan. We look forward to sharing experiences with our colleagues in new topics again!

You can direct further questions at

On November 18, 2020; the second virtual meeting of “Webinar Series by Experts” has been performed about “Autologous Stem Cell Transplantation in Covid-19 Era”. Founding Director of Hematopoietic Stem Cell Transplant (HSCT) Center at the Group Florence Nightingale Hospitals, Prof. Mutlu Arat, M.D. has mentioned about pitfalls in pre-transplant procedures, and GVHD management bone marrow transplantation in Covid-19 era. During panel section, he has explained principles how to overcome challenging conditions.

We are delighted to have a total of 61 attendees from Azerbaijan, Russia, Georgia, Kazakhstan, Ukraine, Algeria, and Mongolia. We look forward to sharing experiences with our colleagues in new topics again!

You can reach webinar recording at

and direct further questions at


EXCLUSIVE: The family were forced to fly their dad 1,700 miles to Turkey for a liver transplant after UK doctors said he was too unwell to have the surgery here

Zahid Anwar, 61, had begun suffering problems last year and was diagnosed in February with the hepatitis B virus.

By April he was so ill that doctors began to consider a transplant. But his condition worsened in June.

Son Hamza said: “We were told he was not fit for transplant. By July they said he had little time left. Then he went into a coma and they were talking just a week.”

Hamza, 32, and wife Zubera, 30, had already begun a search to get his dad a transplant with him as his donor. He said: “We looked at places like India and China. Then we contacted the hospital in Istanbul.

“They wanted to see his records and treatments. They came back and told us Dad didn’t have much time. It was a small window of opportunity, we very nearly didn’t get him out in time.”

Clothes shop owner Zahid, of Lytham St Annes, Lancs, was in the coma for six days. When he came out of it, Hamza says doctors at Blackpool Victoria Hospital said he was too ill to leave.

So on August 11 Zahid discharged himself and was taken by private ambulance to Manchester Airport, where a private jet with a doctor and nurse on board was waiting to fly him to Turkey.

Three days later father and son were going under the knife at Florence Nightingale Hospital in Istanbul. Hamza said: “In the UK they try to find a deceased donor first but in Turkey nearly every transplant is from a living donor.

“Families are larger and more close-knit. I’d do anything for Dad – I was his only lifeline. We rushed through the tests and hardly had time to pause before we were in surgery.”

In parallel 12-hour ops on August 14, Hamza gave his father 70 per cent of his liver, which will grow back to normal size. He said: “Dad’s liver had been almost destroyed so they took a bit more than normal.”

The flight to Istanbul cost £22,000, and surgery £60,000. It is feared the total will top £100,000. From hospital in Turkey, Zahid, who also has a daughter, Annum, 28, said: “I’m grateful for my family refusing to give up on me. I’d have been a dead man if I stayed any longer. They were brave to resist.”

Estate agent Hamza added: “We think the NHS is great, and the nurses and a lot of the doctors who cared for dad were wonderful. But we feel something went wrong with the management of his care.”

A spokesman for Blackpool Teaching Hospitals NHS trust said individual cases could not be discussed.

Dr Phil Wood, chief medical officer for Leeds Teaching Hospitals, said: “Our specialist team follows nationally-set criteria to determine which patients may be eligible.”


By clicking the Contact Us button, you can easily get medical second opinion and ask your questions (medical procedures, quotation, assistance services etc.). Your queries will be responded within 48 hours at most.

To the management of Group Florence Nightingale,

We, the Bahraini liver transplant patients, express our sincerest thanks and appreciation to the management of GROUP FLORENCE NIGHTINGALE and its medical staff, headed by the team leader PROF.N.YILDIRAY YÜZER, for all the care, attention and high level of care and successful treatment they provided to Bahraini patients, which demonstrates the hospital management’s interest in the improvement of the medical services for the good of all people.

On behalf of liver patients in Bahrain,

M. A. Nabi AlSaikh
Friends of Liver Patients Society Bahrain

By clicking the Contact Us button, you can easily get medical second opinion and ask your questions (medical procedures, quotation, assistance services etc.). Your queries will be responded within 48 hours at most.


Did you know that urinary tract stones are one of the most common diseases in the whole Middle East region and in our country?

It usually manifests itself with severe pain. Kidney stones are formed approximately in 10% of males and 3% of females in a period of their lives.

How do the urinary tract stones form?

Kidney stones are usually formed due to precipitation of the minerals that we take into the body with food and beverages as small particles in the kidney. Normally, the formation of those stones are prevented through the protective substances of the body in the urine. However, in some cases this protective mechanism loses its effect. If the resulting particles are small, they are excreted from the urine without causing any symptoms. Larger stones may be trapped somewhere and cause obstruction in the kidney or urinary tract.

Who are at risk for kidney stone formation?

Kidney stone may be observed in kidney stone family history, with the use of high dose calcium and vitamin D, overweight, in patients with urinary tract infection, high blood pressure, metabolic diseases such as gout disease, inflammatory bowel diseases, thyroid and parathyroid diseases and some types of cancer, as well as with some foods and beverages consumed.

What is renal calculi?

Burning sensation may be felt during voiding in patients who pass a high volume of renal calculi. No association between passing kidney stone and sexual life was found.

Is passing renal calculi and stone formation seasonal?

It is known that passing renal calculi increases in the summer month. Increased fluid loss due to sweating in the summer month causes insufficient fluid intake leading to increased mineral density in urine. Therefore, the risk of stone formation is higher. When a comparison is made between day and night, the effect of sweating during the night when there is no fluid intake, stone formation is more likely to occur at night than in the daytime.

For which stone size is surgery required?

It is known that the stones 5 mm or less in size do not require any process since they pass spontaneously. However, based on the extensive studies and disease management guidelines, it is suggested that recently detected stones below 10 mm in size will also pass spontaneously. Stones over 10 mm in size should be treated with surgery or non-surgical treatment (lithotripsy). More important than stone size in stone disease is the severity of the complaints that the patient has experienced and the degree of damage to the kidney and urinary tract.

What comes to mind when it is said surgery?

When the surgery is said, open surgery occurs to people’s mind immediately. However, most of the kindey stone operations in today’s technology are performed endoscopically without an incision is made on the body which is called “minimally invasive”. In this way, patients may rapidly recover and return to daily life.


In our Breast Health Center, breast cancer, breast disease treatment and breast conserving surgery have been applied with a multidisciplinary approach since 1992, sentinel lymph node biopsy after 1996 and oncoplastic breast surgery method for the last 10 years

Our specialist physicians have been working in scientific cooperation with; AAMC Breast Center Breast Center, the Breast Health Global Initiative, the Senologic International Society, World Society of Breast Health, Turkey Breast Diseases Association Federation and Turkey’s first fixed Breast Health established the Screening Center for Breast Health Association (memeder)
Early diagnosis and effective treatment can be provided with advanced devices in our breast health center.

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Contact us now if you have a medical need, we will reply swiftly and provide you with a reliable medical opinion.

Group Florence Nightingale Hospitals Ltd UK 2020, all rights reserved.

Group Florence Nightingale Hospitals Ltd UK 2020, all rights reserved.