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Öğe Convalescent plasma therapy in patients with COVID-19(Pergamon-Elsevier Science Ltd, 2021) Altuntas, Fevzi; Ata, Naim; Yigenoglu, Tugce Nur; Basci, Semih; Dal, Mehmet Sinan; Korkmaz, Serdal; Namdaroglu, SinemIntroduction: Passive antibody therapy has been used to immunize vulnerable people against infectious agents. In this study, we aim to investigate the efficacy of convalescent plasma (CP) in the treatment of severe and critically ill patients diagnosed with COVID-19. Method: The data of severe or critically ill COVID-19 patients who received anti-SARS-CoV-2 antibody-containing CP along with the antiviral treatment (n = 888) and an age-gender, comorbidity, and other COVID-19 treatments matched severe or critically ill COVID-19 patients at 1:1 ratio (n = 888) were analyzed retrospectively. Results: Duration in the intensive care unit (ICU), the rate of mechanical ventilation (MV) support and vasopressor support were lower in CP group compared with the control group (p = 0.001, p = 0.02, p = 0.001, respectively). The case fatality rate (CFR) was 24.7 % in the CP group, and it was 27.7 % in the control group. Administration of CP 20 days after the COVID-19 diagnosis or COVID-19 related symptoms were associated with a higher rate of MV support compared with the first 3 interval groups (?5 days, 6-10 days, 11-15 days) (p=0.001). Conclusion: CP therapy seems to be effective for a better course of COVID-19 in severe and critically ill patients.Öğe Convalescent plasma therapy in patients with COVID-19(Pergamon-Elsevier Science Ltd, 2021) Altuntas, Fevzi; Yigenoglu, Tugce Nur; Bascl, Semih; Dal, Mehmet Sinan; Korkmaz, Serdal; Turgut, Burhan; Erkurt, Mehmet Ali[Abstract Not Available]Öğe COVID-19 clinical course and blood groups: Turkish population-based study(Tubitak Scientific & Technological Research Council Turkey, 2021) DAL, Mehmet Sinan; Ata, Naim; Altuntas, Fevzi; Basci, Semih; Yigenoglu, Tugce Nur; Korkmaz, Serdal; Namdaroglu, SinemBackground/aim: SARS-CoV-2 enters the cell through the binding of the S glycoprotein on the surface of the virus to the angiotensin-converting enzyme 2 (ACE-2) in the host cells and also SARS-CoV S protein binding to ACE-2 was inhibited by anti-A antibodies. The aim of the study was to investigate the relationship between blood groups and the course of COVID-19 in Turkey. Materials and methods: Laboratory confirmed COVID-19 patients aged 18 and over (n = 39.850) were randomized in age and sex -matched groups according to blood groups Results: Advanced age, male sex and blood group A were found to be related with increased rate of intensive care unit (ICU) admission (OR = 1.089, 95% CI: 1.085-1.093 for age; OR = 1.963, 95% CI: 1.737-2.218 for male sex; OR = 1.216, 95% CI: 1.023-1.446 for blood group A). When blood group O individuals were compared to non-O individuals, no significant difference was observed regarding the rate of hospital and ICU admission, mechanical ventilation (MV) support, length of hospital and ICU stay, and case fatality rate (CFR). The CFR in patients with blood group A, B, O, and AB were 2.6%, 2.2%, 3.1%, and 2.3%, respectively. There were no significant differences between Rh-negative and positive patients regarding the rate of hospital and ICU admission (p = 0.280 and p = 0.741, respectively), also the rate of MV support and CFR was similar (p = 0.933 and p = 0.417). Conclusion: Our study revealed that ABO and Rh blood groups do not have any impact on the rate of hospital admission, hospital and ICU stay, MV support, and CFR.Öğe COVID-19 in hematopoietic cell transplant recipients(Springernature, 2021) Altuntas, Fevzi; Ata, Naim; Yigenoglu, Tugce Nur; Basci, Semih; Dal, Mehmet Sinan; Korkmaz, Serdal; Namdaroglu, SinemIn this study, we aim to report the outcome of COVID-19 in hematopoietic cell transplant (HCT) recipients. HCT recipients (n = 32) with hematological disease and hospitalized for COVID-19 were included in the study. A cohort of age and comorbid disease-matched hospitalized COVID-19 patients with hematological malignancy but not underwent HCT (n = 465), and another cohort of age and comorbid disease-matched hospitalized COVID-19 patients without cancer (n = 497) were also included in the study for comparison. Case fatality rate (CFR) was 5.6% in patients without cancer, 11.8 in patients with hematological malignancy and 15.6% in HCT recipients. The CFR in HCT recipients who were not receiving immunosuppressive agents at the time of COVID-19 diagnosis was 11.5%, whereas it was 33% in HCT recipients who were receiving an immunosuppressive agent at the time of COVID-19 diagnosis. In conclusion, our study reveals that for the current pandemic, HCT recipients, especially those receiving immunosuppressive drugs, constitute a special population of cancer patients.Öğe Dysentery caused by Balantidium coli in a patient with non-Hodgkin's lymphoma from Turkey(Baishideng Publ Grp Co Ltd, 2004) Yazar, Suleyman; Altuntas, Fevzi; Sahin, Izzet; Atambay, MetinBalantidium coli is the only parasitic ciliate of man. It is a flattened oval organism covered with cilia, and a gullet at the anterior end. It is infrequently pathogenic for man, although epidemic buds in tropical zones have been described. The infection fundamentally affects the colon and causes variable clinic pictures, from asymptomatic to serious dysenteric forms. We present a case of parasitologically diagnosed as causes of diarrhea in a patient with non-Hodgkin's lymphoma from Turkey. In order to find out the causative etiologic agent of diarrhea, stool samples were examined by native, lugol and flotation methods and we detected moving trophozoites, which were approximately 60 m m long and 35 m m wide. These bodies were diagnosed as Balantidium coli. This case underlines that Balantidium coli should also be considered as a possible pathogen in immunocompromised patients with diarrhea.Öğe Extracorporeal blood purification treatment options for COVID-19: The role of immunoadsorption(Pergamon-Elsevier Science Ltd, 2020) Yigenoglu, Tugce Nur; Ulas, Turgay; Dal, Mehmet Sinan; Korkmaz, Serdal; Erkurt, Mehmet Ali; Altuntas, FevziThe activation of the innate and adaptive immune systems by SARS-CoV-2 causes the release of several inflammatory cytokines, including IL-6. The inflammatory hypercytokinemia causes immunopathological changes in the lungs including vascular leakage, and alveolar edema. As a result of these changes in the lungs, hypoxia and acute respiratory distress syndrome occur in patients with COVID-19. Even though there are clinical trials on the development of therapeutics and vaccines, there are currently no licensed vaccines or therapeutics for COVID-19. Pharmacological approaches have shown poor results in sepsis-like syndromes caused by the hypercytokinemia. Suppressing the cytokine storm is an important way to prevent the organ damage in patients with COVID-19. Extracorporeal blood purification could be proposed as an adjunctive therapy for sepsis, aiming to control the associated dysregulation of the immune system, which is known to protect organ functions. Several extracorporeal blood purification therapies are now available, and most of them target endotoxins and/or the cytokines and aim improving the immune response. For this purpose, plasmapheresis and immunoadsorption may be an important adjunctive treatment option to manage the complications caused by cytokine storm in critically ill patients with COVID-19.Öğe Outcome of COVID-19 in patients with chronic myeloid leukemia receiving tyrosine kinase inhibitors(Sage Publications Ltd, 2020) Basci, Semih; Ata, Naim; Altuntas, Fevzi; Yigenoglu, Tugce Nur; Dal, Mehmet Sinan; Korkmaz, Serdal; Namdaroglu, SinemIntroduction In this study, we aim to report the outcome of COVID-19 in chronic myeloid leukemia (CML) patients receiving tyrosine kinase inhibitor (TKI). Method The data of 16 laboratory-confirmed COVID-19 patients with CML receiving TKI and age, gender, and comorbid disease matched COVID-19 patients without cancer at a 3/1 ratio (n = 48), diagnosed between March 11, 2020 and May 22, 2020 and included in the Republic of Turkey, Ministry of Health database, were analyzed retrospectively. Results The rates of intensive care unit (ICU) admission, and mechanical ventilation (MV) support were lower in CML patients compared to the control group, however, these differences did not achieve statistical significance (p = 0.1, and p = 0.2, respectively). The length of hospital stay was shorter in CML patients compared with the control group; however, it was not statistically significant (p = 0.8). The case fatality rate (CFR) in COVID-19 patients with CML was 6.3%, and it was 12.8% in the control group. Although the CFR in CML patients with COVID-19 was lower compared to the control group, this difference did not achieve statistical significance (p = 0.5). When CML patients were divided into 3 groups according to the TKI, no significant difference was observed regarding the rate of ICU admission, MV support, CFR, the length of stay in both hospital and ICU (all p > 0.05). Conclusion This study highlights that large scale prospective and randomized studies should be conducted in order to investigate the role of TKIs in the treatment of COVID-19.Öğe The outcome of COVID-19 in patients with hematological malignancy(Wiley, 2021) Yigenoglu, Tugce N.; Ata, Naim; Altuntas, Fevzi; Basci, Semih; Dal, Mehmet Sinan; Korkmaz, Serdal; Namdaroglu, SinemIn this study, we aim to report the outcomes for COVID-19 in patients with hematological malignancy in Turkey. Data from laboratory-confirmed 188 897 COVID-19 patients diagnosed between 11 March 2020 and 22 June 2020 included in the Republic of Turkey, Ministry of Health database were analyzed retrospectively. All COVID-19 patients with hematological malignancy (n = 740) were included in the study and an age, sex, and comorbidity-matched cohort of COVID-19 patients without cancer (n = 740) at a 1:1 ratio was used for comparison. Non-Hodgkin lymphoma (30.1%), myelodysplastic syndrome (19.7%), myeloproliferative neoplasm (15.7%) were the most common hematological malignancies. The rates of severe and critical disease were significantly higher in patients with hematological malignancy compared with patients without cancer (P = .001). The rates of hospital and intensive care unit (ICU) admission were higher in patients with hematological malignancy compared with the patients without cancer (P = .023,P = .001, respectively). The length of hospital stay and ICU stay was similar between groups (P = .7,P = .3, retrospectively). The rate of mechanical ventilation (MV) support was higher in patients with hematological malignancy compared with the control group (P = .001). The case fatality rate was 13.8% in patients with hematological malignancy, and it was 6.8% in the control group (P = .001). This study reveals that there is an increased risk of COVID-19-related serious events (ICU admission, MV support, or death) in patients with hematological malignancy compared with COVID-19 patients without cancer and confirms the high vulnerability of patients with hematological malignancy in the current pandemic.Öğe Patients with hematologic cancers are more vulnerable to COVID-19 compared to patients with solid cancers(Springer-Verlag Italia Srl, 2022) Basci, Semih; Ata, Naim; Altuntas, Fevzi; Yigenoglu, Tugce Nur; Dal, Mehmet Sinan; Korkmaz, Serdal; Namdaroglu, SinemPrevious studies reported that COVID-19 patients with cancer had higher rates of severe events such as intensive care unit (ICU) admission, mechanical ventilation (MV) assistance, and death during the COVID-19 course compared to the general population. However, no randomized study compared the clinical course of COVID-19 in patients with hematologic cancers to patients with solid cancers. Thus, in this study, we intend to reveal the outcome of COVID-19 in hematologic cancer patients and compare their outcomes with COVID-19 patients with solid cancers. The data of 926 laboratory-confirmed COVID-19 patients, including 463 hematologic cancer patients and an age-gender paired cohort of 463 solid cancer patients, were investigated retrospectively. The frequencies of severe and critical disease, hospital and ICU admission, MV assistance were significantly higher in hematologic cancer patients compared with the solid cancer patients (p = 0.001, p = 0.045, p = 0.001, and p = 0.001, respectively). The hospital stay was longer in patients with hematologic cancers (p = 0.001); however, the median ICU stay was 6 days in both groups. The case fatality rate (CFR) was 14.9% in patients with hematologic cancers, and it was 4.8% in patients with solid cancers, and there was a statistically significant difference regarding CFR between groups (p = 0.001). Our study revealed that COVID-19 patients with hematologic cancers have a more aggressive course of COVID-19 and have higher CFR compared to COVID-19 patients with solid cancers and support the increased susceptibility of patients with hematologic cancers during the outbreak.Öğe Therapeutic plasma exchange in patients with neurologic diseases: Retrospective multicenter study(Pergamon-Elsevier Science Ltd, 2008) Kaynar, Leylagul; Altuntas, Fevzi; Aydogdu, Ismet; Turgut, Burhan; Kocyigit, Ismail; Hacioglu, Sibel Kabukcu; Ismailogullari, SevdaTherapeutic plasma exchange (TPE) is commonly used in many neurological disorders where an immune etiology was known or suspected. We report our experience with TPE performed for neuroimmunologic disorders at four university hospitals. The study was a retrospective review of the medical records of neurological patients (n = 57) consecutively treated with TPE between April 2006 and May 2007. TPE indications in neurological diseases included Guillain-Barre Syndrome (GBS) (n = 41), myasthenia gravis (MG) (n = 11), acute disseminated encephalomyelitis (ADEM) (n = 3), chronic inflammatory demyelinating polyneuropathy (CIDP) (n = 1) and multiple sclerosis (MS) (n 1). Patient median age was 49; there was a predominance of males. Twenty-two patients had a history of other therapy including intravenous immunoglobulin (IVIG), steroid, azothioprin, and pridostigmine prior to TPE. Another 35 patients had not received any treatment prior to TPE. All patients were classified according to the Hughes functional grading scores pre- and first day post-TPE for early clinical evaluation of patients. The TPE was carried out 1-1.5 times at the predicted plasma volume every other day. Two hundred and ninety-four procedures were performed on 57 patients. The median number of TPE sessions per patient was five, and the median processed plasma volume was 3075 mL for each cycle. Although the pre-TPE median Hughes score of all patients was 4, it had decreased to grade I after TPE. While the pre-TPE median Hughes score for GBS and MG patients was 4, post-TPE scores were decreased to grade 1. Additionally, there was a statistically significant difference between post-TPE Hughes score for GBS patients with TPE as front line therapy and patients receiving IVIG as front line therapy (1 vs. 3.5; p = 0.034). Although there was no post-TPE improvement in Hughes scores in patients with ADEM and CIDP, patients with MS had an improved Hughes score from 4 to 1. Mild and manageable complications such as hypotension and hypocalcemia were also observed. TPE may be preferable for controlling symptoms of neuroimmunological disorders in early stage of the disease, especially with GBS. (C) 2008 Elsevier Ltd. All rights reserved.
