Coronavirus disease 2019 (COVID-19) has been demonstrated to be the cause of emerging atypical pneumonia. In patients with tracheostomy, coronavirus hypothetically coexists with well-known bacterial agents. A 61-year-old male patient with tracheostomy was admitted to the hospital with dyspnea, fever and increased tracheal secretions. Laboratory findings revealed lymphopenia and elevated C-reactive protein and procalcitonin levels. Chest computed tomography showed consolidation areas and ground-glass opacities more prominent in subpleural areas. Although; two consecutive RT-PCR analyses of combined nasopharengeal/oropharengeal swabs were found to be negative for SARS-CoV-2 RNA, positivity was reported for endotracheal aspirate (ETA) sample. Significant growth of Pseudomonas aeruginosa and Stenotrophomonas maltophilia was detected in the bacterial culture of ETA sample. In conclusion, clinical samples for SARS-CoV-2 should be obtained through the lower respiratory tract, if possible and if upper airway samples are negative. To the best our knowledge, our paper is the first report of the patient with tracheostomy who was treated successfully for COVID-19.

It is important to make the differential diagnosis of restrictive changes associated with hepatic hydrothorax or hepatopulmonary syndrome seen in the later stages of chronic liver diseases and restrictive changes associated with interstitial lung disease. Lymphocytic interstitial pneumonia (LIP) is in the rare idiopathic interstitial pneumonia subgroup of interstitial lung diseases. LIP is a rare disease, and its incidence is unknown. LIP is characterized by infiltration of the alveolar interstitium with lymphocytes, plasma cells, and histiocytes. The etiology of LIP includes idiopathic causes, rheumatological diseases, immune deficiencies, viral infections, and drug-related causes. Chronic liver diseases are also rarely included in the etiology of LIP. A 75-year-old male patient who was followed up for liver cirrhosis presented with dyspnea. He had hypoxemia in the arterial blood gas. In the thorax and abdominal computed tomography, irregular reticulations in bilateral lungs, ground-glass opacities, and scattered air cysts in both lung parenchyma, chronic liver parenchymal disease, splenomegaly, chronic portal vein thrombosis were determined. Clinical and radiological changes in the patient were evaluated in favor of interstitial lung disease. Although histopathological diagnosis could not be made, the patient whose radiological pattern was compatible with LIP was evaluated together with clinical findings and was accepted as lymphocytic interstitial pneumonia. He was evaluated in terms of diseases that could cause LIP. He was accepted as LIP due to chronic liver disease. Although histopathological examination is the gold standard for the diagnosis, a biopsy could not be performed in our case. Radiological and clinical findings were considered sufficient for the diagnosis of LIP. Chronic viral hepatitis and cirrhosis are also present in the etiology of LIP. Our case is presented as an example in the literature because it is a case of LIP due to chronic liver disease, and it is rare.

Aim: Acute exacerbation of COPD and pulmonary thromboembolism (PTE) are often presents similar clinical presentation. This study investigates the frequency of PTE in patients followed up with the diagnosis of COPD evaluates the factors that may affect the embolism status of these patients. Methods: 458 patients with prediagnosed of COPD and hospitalized with prediagnosis of PTE between 2016-2021 were included and searched retrospectively. After exclusion criteria 178 patients with a diagnosis of COPD and investigated with a prediagnosis of PTE were identified. These patients divided into two groups as those with PTE and without PTE. Results: Atherosclerosis was found to be lower in patients with PTE than the group without PTE. The presence of hemoptysis, immobility and sudden desaturation were significantly higher in the group with PTE than in the group without PTE. COPD years were longer in patients with RV/LV ratio ≥1. Although d-dimer was negative, embolism was detected in 31.5% of the patients with PTE. D-dimer was positive in 53.6% of the patients without embolism. Positive correlation was found between GOLD stages and CRP values (r=0.327, p<0.01). DVT was found in 31 of the patients with embolism and additional risk factors were observed in others. erj;64/suppl_68/PA1236/F1 F1 F1 Conclusion: Evaluation of the predisposing factors and clinical findings of the patients is more important for the preliminary diagnosis and further examination plan.

Health literacy encompasses patients' abilities to access healthcare, comprehend health information, and make decisions based on that knowledge. We aimed to examine the relationship between dyspnea levels, acute exacerbations, hospitalizations, disease severity and comorbidities of chronic obstructive pulmonary disease (COPD) patients according to their health literacy levels. A total of 106 COPD patients were prospectively enrolled in our study. Demographic data, history, pulmonary function tests, COPD severity, comorbidities, health status, quality of life and the factors determining the course of the disease in the last year were collected. We also measured patients' health literacy using the Turkish version of the European Health Literacy scale. Our findings revealed that elderly COPD patients (p= 0.04) with advanced disease stages (p< 0.001), higher Charlson Comorbidity Index and Saint George Hospital Respiratory Questionnaire scores (p< 0.001), and lowincome (p= 0.02) had lower levels of health literacy. Moreover, patients with lower health literacy experienced more frequent exacerbations (p= 0.01), more severe exacerbations (p< 0.001), and higher rates of hospitalization (p< 0.001). Logistic regression analysis unveiled that GOLD stages (OR: 11.62, 95% CI: 3.36-26.25), and recent severe exacerbations within the last year (OR: 14.24, 95% CI: 5.41-38.13) stood out as the most strongly associated risk factors for poor health literacy. COPD patients with low health literacy have a higher risk of severe disease. Recognizing the concept of health literacy and identifying risk factors associated with low health literacy are crucial steps in enhancing education, care, and social support for COPD patients. It emphasizes the need for tailored interventions and support for COPD patients, especially those with lower health literacy.

This study aimed to investigate whether coronavirus disease-2019 (COVID-19) leads to impaired pulmonary function, fibrotic-like abnormalities or psychological symptoms six months after discharge. This study involves 162 laboratory-confirmed patients with COVID-19 who were diagnosed in Ankara University Faculty of Medicine, Department of Chest Diseases from February 1, 2021 to July 1, 2023. All patients were diagnosed with COVID-19 pneumonia by thorax computed tomography (CT). Patients who applied to the outpatient clinic six months after COVID-19 treatment were included in the study. A total of 133 patients underwent thorax CT scan, pulmonary function tests, six minutes walking test simultaneously. Radiographic patterns were categorized into two groups (normal/non-fibrotic and fibrotic-like). Group A had 66 patients who either had no fibrotic or non-fibrotic changes, and 67 patients who had fibrotic-like changes were categorized as group B. Mean age of the study subjects was 55.95 ± 12.42 years, and 75 (56.4%) patients were male. Overall, median diffusing capacity of the lungs for carbon monoxide (DLCO) % predicted measured as 73.5% [IQR 61-88]. DLCO and six-minute walking distance were significantly lower in the fibroticlike pattern group (p< 0.001, p= 0.014, respectively). Reduced DLCO in patients with fibrotic-like pattern after six months was common. Presence of ground-glass opacities, reticulations and traction bronchiectasis correlated strongly with reduced diffusing capacity (r= -0.190 p= 0.043, r -0.305 p= 0.001, r -0.404 p< 0.001, respectively). We demonstrated that smoking history and intensive care unit (ICU) admisson during COVID-19 pneumonia were independent risk factors for fibrotic-like radiographic abnormalities. Residual abnormalities resembling fibrosis were notably prevalent, particularly among severely ill patients, and impaired lung diffusion persisted in some individuals even six months post-discharge. Post-COVID-19 lung sequelae can persist and progress after hospital discharge, suggesting airways involvement and formation of new fibrotic-like lesions, mainly in patients who had been in the ICU and had smoking history.