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Öğe Applicability of the ROX index in decision-making for hospitalization in COVID-19 patients(Bayrakol Medical Publisher, 2022) Kasapoglu, Umut Sabri; Selcuk, Engin Burak; Yalcinsoy, Murat; Uckac, Kadir; Sahin, Abdullah Fahri; Bentli, RecepAim: Data on the outpatient follow-up of COVID-19 cases is still scarce. Also, the significance of the ROX index in decision-making for hospitalization in the ambulatory COVID-19 cases remains unknown. The aim of this study is to determine the general characteristics of COVID-19 patients treated as outpatients and to investigate whether the ROX index is applicable in hospitalization decisions.Material and Methods: This retrospective cohort study was conducted in confirmed adult COVID-19 cases between 15 October 2020 and 01 March 2021. A total of 5240 confirmed COVID-19 patients were included in the present study. Factors affecting hospitalization were investigated.Results: The study population was divided into two groups as those who require hospitalization (n=672) and those who did not (n=4568). The number of male patients and the mean age of the patients were significantly higher in hospitalized patients group (p=0.046, p<0.001). ROX index that was calculated at the home visit on the third day of disease was found significantly lower in the group of hospitalized patients (p<0.001). There was a significant correlation between ROX index and inflammatory biomarkers in the present study (p<0.001). The ROX index was found the most accurate parameter for decision-making for hospitalization in ambulatory COVID-19 patients (AUC=0.794 CI=0.773-0.814, p<0.001).Discussion: The ROX index can be a useful and objective clinical tool for decision making for hospitalization in the ambulatory COVID-19 cases.Öğe Comparison of nutritional risk status assessment tools in predicting 30-day survival in critically ill COVID-19 pneumonia patients(K Faisal Spec Hosp Res Centre, 2022) Kasapoglu, Umut Sabri; Gok, Abdullah; Delen, Leman Acun; Ozer, Ayse BelinBACKGROUND: Few clinical studies have addressed nutritional risk assessment in patients with COVID-19 pneumonia admitted to the intensive care unit (ICU). OBJECTIVES: Assess the nutritional risk status of the critically ill COVID-19 pneumonia patients admitted to the ICU, and compare the nutritional risk screening tools. DESIGN: Medical record review SETTINGS: Tertiary critical care unit PATIENTS AND METHODS: We included adult (age >18 years) PCR-confirmed critically ill COVID-19 pneumonia cases admitted to the ICU between August 2020 and September 2021. Scoring systems were used to assess COVID-19 severity and nutritional status (mNUTRIC: modified Nutrition Risk in Critically Ill, NRS2002: Nutritional Risk Screening 2002). The 30-day mortality prediction performance of nutritional scores and survival comparisons between clinical and demographic factors were assessed. MAIN OUTCOME MEASURES: Compare the nutrition risk tools SAMPLE SIZE: 281 patients with a mean (SD) age of 64.3 (13.3) years; 143 (50.8%) were 65 years and older. RESULTS: The mean mNUTRIC score of the cases was 3.81 (1.66) and the mean NRS-2002 score was 3.21 (0.84.), and 101 (35.9%) were at high risk of malnutrition according to the mNUTRIC score and 229 (81.4%) according to the NRS 2002 score. In cases at high risk of malnutrition by the mNUTRIC score there was a greater need for invasive mechanical ventilation, vasopressors, and renal replacement therapy (P<.001 for all comparisons). The mNUTRIC score was superior to the NRS-2002 score in estimating 30-day mortality. In patients who died within 30 days, the mNUTRIC score and NRS-2002 score on the day of hospitalization were significantly higher (P<.001), and the proportion of patients with NRS2002 score >= 3 and mNUTRIC score >= 5 was significantly higher in the non-surviving group (P<.001). In addition, patients with a high risk of malnutrition had a shorter survival time. The mNUTRIC score was an independent and important prognostic factor for 30-day mortality, and patients with an mNUTRIC score >= 5 had a 6.26-fold risk for 30-day mortality in the multivariate Cox regression. CONCLUSION: One third of critical COVID-19 pneumonia cases hospitalized in the ICU due to acute respiratory failure have a high risk of malnutrition, and a high mNUTRIC score is associated with increased mortality. LIMITATIONS: Single center retrospective study.Öğe EFFECTS OF HYDROXYCHLOROQUINE PLUS FAVIPIRAVIR TREATMENT ON THE CLINICAL COURSE AND BIOMARKERS IN HOSPITALIZED COVID-19 PATIENTS WITH PNEUMONIA(Sestre Milosrdnice Univ Hospital, 2022) Delen, Leman Acun; Gok, Abdullah; Kasapoglu, Umut Sabri; Cagasar, Ozlem; Gok, Zarife; Berber, Nurcan; Derya, SerdarBackground: The novel coronavirus disease 2019 (COVID-19) has a broad spectrum of clin-ical manifestations, the most common serious clinical manifestation of the coronavirus infection being pneumo-nia. Unfortunately, the optimal treatment approach is still uncertain. However, many studies have been conducted on the effectiveness of several medications in the treatment of COVID-19 infection. The aim of this study was to evaluate the effectiveness of the hydroxychloroquine (HCQ) + favipiravir (FAV) treatment regimen and HCQ alone by comparing the patient's clinical response and laboratory results on the fifth day of treatment in patients hospitalized due to COVID-19 infection.Patients and methods: This retrospective cohort study was conducted in Malatya Training and Research Hospital between March 2020 and July 2020. The study included 69 patients with confirmed COVID-19 with pneumonia. The patients were divided into 2 groups, those receiving HCQ alone and those receiving the HCQ + FAV combination.Results: A total of 69 patients were included in the study, and the mean age was 60.09 +/- 15.56 years. A statisti-cally significant decrease was observed in C-reactive protein (CRP) levels, at the end of the fifth day, in patients who received HCQ + FAV treatment (p=0.002), whereas there was no decrease in CRP levels in patients who received HCQ treatment alone. In addition, an increase in lymphocyte count and a better fever response was observed at the end of the fifth day in patients who received HCQ + FAV (p=0.008). However, there was no statistical difference between both treatment regimens in terms of hospital stay and treatment results (p=0.008, p=0.744, p=0.517).Conclusion: Although the combination of HCQ + FAV treatment was observed to be effective on CRP levels and fever response in patients with COVID-19 pneumonia, there was no difference in terms of hospital stay and discharge.Öğe Efficacy of tocilizumab therapy in severe COVID-19 pneumonia patients and determination of the prognostic factors affecting 30 days mortality(Marmara Univ, Fac Medicine, 2022) Delen, Leman; Kasapoglu, Umut Sabri; Gok, Abdullah; Cagasar, Ozlem; Tetik, Bora; Oksuz, ErsoyObjective: In coronavirus disease - 19 (COVID-19) patients, cytokine storm develops due to the increase of pro-inflammatory cytokines. Tocilizumab (TU.), has been used in the treatment of COVID-19 patients and successful results have been obtained. The aim of this study was to determine the efficacy of TCZ and also investigate the prognostic factors affecting the success of treatment and mortality in COVID-19 patients treated with TCZ. Patients and Methods: Between March 2020 and August 2021, a total of 326 confirmed severe COVID-19 pneumonia patients, treated in the intensive care unit, were included in the study. Results: The mean age of the patients was 63.02 +/- 11.58 years, and 203 (62.3%) of the patients were male. Patients treated with TCZ had a longer survival time compared with the standard therapy (p=0.012). It was found that type of respiratory support (HR:2.19, CI:1.10-4.36, p=0.025) and hyperlactatemia on the day of TCZ therapy admission (HR:2.93 CI:1.53-5.64, p=0.001) were the significant and independent prognostic factors of survival in severe COVID-19 pneumonia patients treated with TCZ. Conclusion: Tocilizumab therapy improved 30-days survival in critically ill COVID-19 pneumonia patients. Also, among the patients with TCZ, types of respiratory support and hyperlactatemia on the day of TCZ admission were the independent prognostic factors.Öğe Idiopathic Chronic Eosinophilic Pneumonia: Retrospective Analysis of 17 Cases from a Single Center in Turkey(Aves, 2016) Arinc, Sibel; Kasapoglu, Umut Sabri; Gungor, Sinem; Agca, Meltem; Yalcinsoy, Murat; Irmak, Ilim; Guney, PinarObjective: Idiopathic chronic eosinophilic pneumonia (ICEP) is a rare eosinophilic lung disorder with an unknown etiology and is characterized by subacute or chronic respiratory and general symptoms, alveolar and/or peripheral eosinophilia, and the accumulation of eosinophils in the lungs. We aimed to present diagnostic test results and follow-up outcomes of 17 patients who were diagnosed with ICEP in our hospital in light of literature. Methods: Between 2008 and 2013, we examined 17 cases of ICEP. We evaluated clinical and laboratory findings together with the long-term follow-up data. Results: The patients had a mean age of 40.8 years at presentation, and the female/male ratio was 0.8. The most common symptoms were cough (94%), shortness of breath (76%), and high fever (35%). Bronchoalveolar lavage eosinophil percentages of the patients ranged from 3% to 80%. Nine (53%) patients experienced recurrence. Six patients were maintained on low dose steroid due to repeating relapses. Among these patients, 7 (77.7%) had a total IgE level of above 500/IU/mL. Conclusion: Relapses are common in ICEP after the withdrawal of corticosteroid treatment or during dose reduction. We point out the importance of the close monitoring of patients for identifying relapse. A higher total IgE level during diagnosis may serve as a predictor of recurrence.Öğe Leukocyte albumin ratio as an early predictor of mortality in critical COVID-19 patients(Bayrakol Medical Publisher, 2022) Geckil, Aysegul Altintop; In, Erdal; Berber, Nurcan Kirici; Kasapoglu, Umut Sabri; Karabulut, Ercan; Ozdemir, CengizAim: The aim of this study is to analyze the effectiveness of the leukocyte albumin ratio (LAR) in predicting mortality in critical COVID-19 patients. Material and Methods: In this retrospectively-designed study, we evaluated a total of 98 critical patients who were hospitalized in the intensive care unit. Patients were divided into two groups according to hospital mortality as survivors (n=43) and non-survivors (n=55). Results: The non-survivors group was statistically significantly older (67.3 +/- 9.7 versus 62.5 +/- 10.9; p=0.023). HT and DM were detected more in the non-survivors group than in the survivors group (p=0.031, p=0.018, respectively). Mean LAR values were significantly higher in non-survivors than in survivors (5.9 +/- 3.5 versus 3.3 +/- 1.4; p<0.001). LAR values was positively correlated with urea (r=0.43, p<0.001), LDH (r=0.35, p<0.001), ferritin (r=0.25, p=0.015), procalcitonin (r=0.34, p<0.001), and pro-BNP (r=0.24, p=0.015) levels. A cut-off value of 3.71 ng/mL for LAR predicted mortality with a sensitivity of 76% and a specificity of 70% (AUC:0.779 95% Cl:0.689-0.870; p<0.001). Multivariable logistic regression analysis revealed that older age (OR:1.114, 95% CI:1.020-1.218; p=0.017) and increased ferritin (OR:1.003, 95% CI:1.001-1.004; p=0.002) and LAR (OR:1.583, 95% CI:1.073-2.337; p=0.021) values were independent predictors of mortality in patients with critical COVID-19. Discussion: LAR can be a useful and prognostic marker that can be used to predict mortality in COVID-19 patients admitted to the intensive care unit.Öğe Lung carcinoma patients aged eighty years over and prognostic factors affecting survival(Turkish Assoc Tuberculosis & Thorax, 2017) Kasapoglu, Umut Sabri; Gungor, Sinem; Arinc, Sibel; Yalcinsoy, Murat; Misirlioglu, Aysun; Akbay, Ozlem MakbuleIntroduction: Almost 50% of all cancers and 70% of cancer deaths occur in cases aged 65 years and more. Thus diagnosis, treatment and follow up in old cases gain importance. Since there a limited number of study that show age-mortality relation in lung cancer cases aged 80 years and over, issues may arise in diagnosis and treatment process of these cases. In this study, we aimed to evaluate general characteristics of lung cancer cases aged 80 years or over and factors that affect survey. Materials and Methods: Between 2010 and 2013, the retrospective cohort study was done in Sureyyapasa Chest Diseases and Chest Surgery Training and Research Hospital and 100 cases of lung carcinoma were examined. Results: In the study, 70% of the cases were male and 30% were female. Median age was 83 +/- 2.91 (80-92) years. 71% of the cases were found to be suffering from a comorbid disease; 29% did not have any comorbid disease. Dyspnea (56%), cough (50%) and chest pain (41%) were the most frequent symptoms. Histopathologically, 41% of the patients diagnosed with adenocarcinoma and 40% were diagnosed with squamous cell carcinoma. Median survival time was 2.73 months (% 95 CI 0.96-4.49) and 1-year survival rate was 17%. Length of time of the cases with smoking history was found shorter than of cases without smoking history (p=0.013). Life expectancy of the cases with advanced disease and performance score of 3-4 was detected to be short (p=0.006, p< 0.001). Compared to the cases who operated on and had chemoradiotherapy, length of life who had symptomatic treatment was shorter (p< 0.001). Conclusion: Despite the comorbidity in lung cancer cases aged 80 years and over, life expectancy of the cases who had surgical and/or chemoradiotherapy treatment is longer. While deciding on treatment methods on these cases, patient's performance must be taken into consideration.Öğe Morbidity and mortality results of COVID-19 variant in COVID-19 positive patients treated in the intensive care unit(Bayrakol Medical Publisher, 2023) Aydin, Ahmet; Koca, Erdinc; Kutlusoy, Sevgi; Kasapoglu, Umut SabriAim: COVID-19 has the potential to affect many systems and organs, resulting in serious clinical symptoms that necessitate admission to the intensive care unit. The purpose of this study was to examine the relationship between CAR, other laboratory findings, comorbidities, and mortality in patients infected with the original SARSCoV-2 or other variants.Materials and Methods: The data of 368 patients admitted to the intensive care unit with COVID-19 pneumonia between March 2020 and July 2021 were analyzed. These patients were divided into two groups. The first group included [(OC) Original SARSCoV-2 ] COVID-19 infected patients in the first period of the pandemic. The second group [(OV) Other Variants] included patients with COVID-19 infection due to other variants.Results: The mean age (Mean +/- SD) in the OC group was 69.79 +/- 11.77 years. The mean age of the patients in OC was higher than in the OV group (p=0.001). The most common comorbid disease in both groups was Hypertension (54.1%, 48.8%), followed by diabetes mellitus (DM) (30.2%, 31.6%). The mean age of the survivors in the OC and OV groups was lower (64.53 +/- 13.04, 57.85 +/- 16.78, p=0.001, p=0.001, respectively). It was observed that albumin and lymphocyte counts were lower in the deceased, while LDH, CRP, Neutrophil, procalcitonin, NLR and CAR were higher (p<0.05). Discussion: In critically ill COVID-19 patients, high CAR and NLR are good predictors of mortality. In the period when the variants were dominant, the mean age of the patients and the length of stay in the intensive care unit were lower.Öğe PROGNOSIS OF GERIATRIC COVID-19 PATIENTS ADMITTED TO INTENSIVE CARE UNIT ACCORDING TO VACCINATION STATUS(Gunes Kitabevi Ltd Sti, 2022) Aydin, Ahmet; Kacmaz, Osman; Koca, Erdinc; Kutlusoy, Sevgi; Kasapoglu, Umut Sabri; Oterkus, MesutIntroduction: As of June 27, 2022, the COVID-19 pandemic has caused over 540 million infections and 6.3 million deaths. We aimed to investigate the effect of the vaccine on the clinical course of elderly patients hospitalized in the intensive care unit and to determine the prognosis of the patients according to their vaccination status. Materials and Methods: The study included 157 patients over the age of 65. Patients were divided into two groups. The first group consisted of patients who were vaccinated with two doses of CoronaVac, and the second group consisted of patients who were not vaccinated. Demographic data of the patients, prehospital clinical frailty scales, Charlson Comorbidity Indexes, APACHE II scores, laboratory values, and patient prognoses were recorded. Results: Of the 157 patients, 93 (59.2%) were female, and the median age was 76 years (65-99). 96 (61.1%) patients were vaccinated and 61 (38.9%) patients were unvaccinated. Patients were grouped as survivors (n=26) and deceased. We found that APACHE II, prehospital clinical frailty scales, and Charlson Comorbidity Indexes scores were higher in patients who died. There was a significant difference between blood lymphocyte and ferritin levels and survival. The 28-day survival rate was higher and intensive care unit overall survival time were longer in the vaccinated group. Conclusions: We observed that the vaccinated patients had higher survival times and lower mortality rates than those who were not vaccinated. We think that it is important to vaccinate elderly patients and that additional doses may be needed.