Although the epidemiological and clinical characteristics of COVID-19 patients have been described; the pathogenesis of the disease and its long-term consequences are still unclear. Pulmonary fibrosis is one of these late outcomes. In this study we evaluated Interleukin-17 (IL-17), vascular endothelial growth factor (VEGF), and immunoglobulin G4 (IgG4) levels of COVID-19 infected patients with different clinical course and their effect on pulmonary fibrosis in post-COVID period. In total, 90 patients were evaluated. Among the patients who presented for a control visit between 3-12 weeks after acute infection; patients with signs of pulmonary sequelae radiologically (traction bronchiectasis, interseptal thickening, disorders in parenchyma architecture) were classified as Group I (n= 32), patients who recovered without sequelae radiologically as Group II (n= 32). The Control group included healthy individuals who did not have COVID-19, and was classified as Group III (n= 26). The mean age in Group I was significantly higher than Group II and III (p<0.001). There was a statistically significant difference between the VEGF and IL-17 values based on the patient group they are in (p<0.05). Vascular endothelial growth factor values of Group I and III were significantly lower than the patients in Group II (p<0.001). IL-17 values of Group I and II were found to be significantly lower than Group III (p= 0.005). There was no statistically significant relationship between groups in terms of IgG4 values. In our study, it was observed that the profibrotic effects of VEGF, IL-17, and IgG4 were not dominant in patients who recovered with pulmonary sequelae after COVID; therefore, it is thought that different mechanisms mentioned or not yet revealed may cause this outcome.

Aim: To evaluate the hospitalization process of suspect COVID-19 patients in Samsun Training and Research Hospital, to evaluate the clinical characteristics of the patients, the treatment process, and the success of the treatment. Material and Methods: The data from 284 suspected COVID-19 patients who were admitted to COVID-19 clinic at Samsun Training and Research Hospital between 18 March 2020 and 29 May 2020 were analyzed. Results: 284 suspect COVID-19 patients were evaluated. The age range of the patients was 18-95 and the mean age was 53. Average hospitalization days were 7.14. A definite diagnosis of COVID-19 was made in 33 patients (11.6%) due to reverse transcription polymerase chain reaction (RT-PCR) positivity. Although the RT-PCR test of 35 patients was negative, these patients were evaluated as COVID-19 with high clinical probability because of the ground glass opacities in harmony with COVID-19 in CT (Computed Tomography). There were no radiological findings in 10 of our RT-PCR positive patients. The patients mostly presented with complaints of cough and fever. 68 (23.9%) of 284 patients we followed were evaluated as COVID-19. Conclusion: The number of unnecessary hospitalizations was high due to the fact that clinical complaints were the main criteria for admission to the hospital. Yet, no CT finding was observed in about 1/3 of the RT-PCR positive patients. Clinical and radiological improvement was achieved in most of the patients using the treatments in hand.

Purpose: To investigate the effect of nocturnal chronic hypoxia on the thickness changes of the corneal limbal epithelial area that provides regeneration of the corneal epithelium and ocular surface evaluation parameters in patients with obstructive sleep apnea (OSA). Methods: All patients diagnosed with OSA and the control group underwent a complete ophthalmological examination, including slit-lamp examination and funduscopy. Tear break-up time, Schirmer test-I, Ocular Surface Disease Index Questionnaire, and anterior segment optical coherence tomography were performed with fluorescein sterile strip for ocular surface evaluation. Results: Oxygenation levels of patients during night sleep were different between mild-severe and moderate-severe groups. The Ocular Surface Disease Index results were statistically significantly different between the severe OSA group and the mild OSA group, and between the control group and all other OSA groups ( P < 0.05). The limbal epithelial thickness (LET) value was found to be lower in the moderate OSA group than in the mild OSA group and the control group and was statistically significantly higher than in the severe OSA group. In the severe OSA group, the LET value was found to be statistically significantly lower than all other groups ( P < 0.05). Conclusions: In the literature, there is no study evaluating the effect of prolonged hypoxia on limbus epithelium as in patients with OSA. In this study, LET was measured to be statistically significantly thinner as the severity of OSA increased. Considering these results, it can be concluded that the proliferation of limbal stem cells is reduced in prolonged hypoxia.

Background and Objectives: Obstructive sleep apnea syndrome (OSAS) and heart failure (HF) frequently coexist, amplifying cardiovascular risk through mechanisms involving chronic inflammation and autonomic dysfunction. This study investigates the impact of systemic inflammation, measured by the systemic immune-inflammation index (SII), and OSAS severity, assessed by the apnea–hypopnea index (AHI), on myocardial repolarization heterogeneity in patients with both conditions. Materials and Methods: In this retrospective study, 160 patients with HF and polysomnography-confirmed OSAS (AHI ≥ 5 events/h) were evaluated between January 2018 and November 2024. Patients were stratified by QT dispersion (QTd < 40 ms vs. ≥40 ms) to assess electrical heterogeneity. SII was calculated from neutrophil, platelet, and lymphocyte counts, and electrocardiographic markers (QTd, frontal QRS-T angle, T wave peak-to-end interval [TPEI]) were measured. Logistic regression and receiver operating characteristic (ROC) analyses were used to identify predictors of repolarization heterogeneity and ventricular arrhythmias. Results: Patients with QTd ≥ 40 ms (n = 78) exhibited higher SII (p < 0.001) and AHI (p < 0.001) compared to those with QTd < 40 ms (n = 82). SII and AHI independently predicted increased QTd in multivariate analysis (p = 0.01 and p < 0.001, respectively). ROC analysis identified SII ≥ 625.4 (sensitivity 73.1%, specificity 72%) and AHI ≥ 22.4 (sensitivity 79.5%, specificity 79.3%) as optimal cut-offs for predicting repolarization heterogeneity. SII, QTd, and TPEI were significantly associated with ventricular arrhythmias (p < 0.05). Patients with moderate-to-severe OSAS (AHI ≥ 15) had higher rates of ventricular tachyarrhythmias (17.8% vs. 5.7%, p = 0.03) and sudden cardiac death (9.3% vs. 1.9%, p = 0.05). Conclusions: Elevated SII and AHI are independent predictors of myocardial repolarization heterogeneity in patients with HF and OSAS, contributing to increased arrhythmic risk. These findings highlight the potential use of SII and AHI as accessible biomarkers for risk stratification, particularly in patients with a preserved ejection fraction, and underscore the need for targeted interventions to mitigate inflammation and OSAS severity.

Objectives: This study aims to evaluate lung findings using lung ultrasonography (USG) in patients with PCR-positive COVID-19 pneumonia treated in the ward or intensive care unit and to explore the relationship with prolonged COVID-19 symptoms. Methods: This prospective cross-sectional study was conducted at the University Medical Faculty Hospital outpatient clinic from December 2022 to April 2023. It involved 54 adult patients with PCR-positive COVID-19 pneumonia, treated and discharged from the ward or intensive care unit (ICU). Clinical and demographic data, lung ultrasonography results, and prolonged COVID-19 symptoms were recorded. Results: Among the 54 patients, the ICU group had a mean age of 52.84 ± 12.30 years, while the ward group had a mean age of 58.80 ± 11.36 years (P=0.085). Shortness of breath was the most common prolonged symptom in both groups. The ICU group had significantly more right lung B lines than the ward group (P=0.002). Myalgia was more frequent in the ward group (P=0.024). No significant differences were observed in other variables (P>0.05). Prolonged COVID-19 symptoms were interrelated (P<0.05), and the total number of B lines was significantly associated with dyspnea (P=0.023). Conclusions: Our study demonstrated that lung USG is a valuable tool in the assessment of lung injury after COVID-19 and in the management of long-term COVID-19 symptoms. B lines detected by lung USG are significantly associated with the long-term COVID symptom of shortness of breath, and the number of B lines may be an important biomarker in the management of shortness of breath.

OBJECTIVE: Obstructive sleep apnea (OSA) is a disorder characterized by obstructive apnea and hypopnea, with most patients complaining of excessive daytime sleepiness. Overweight and obesity are major risk factors for OSA. OSA is known to be associated with type 2 diabetes mellitus (T2DM). The primary aim of this study was to establish the prevalence of T2DM in patients with OSA. MATERIAL AND METHODS: Our study is a retrospective, analytical study conducted at the Trakya University Hospital. Adult patients diagnosed with OSA by polysomnography between October 2019 and March 2023 were included in the study. Demographic data, Type 2 DM diagnoses and risk factors of the patients were screened from hospital data. RESULTS: Of the total 244 patients diagnosed with OSA included in the study, 191 (78.3%) were male and 53 (21.7%) were female. The prevalence of T2DM was 31.6% in the patients. The rate of type 2 DM was 27.2% in male OSA patients and 47.2% in female OSA patients. When OSA cases were analyzed according to disease severity based on AHI value, no significant relationship was found between diabetes and disease severity. We found that the prevalence of T2DM was significantly higher in female OSA patients, which was directly associated with body weight and body mass index (BMI). CONCLUSIONS: The prevalence of T2DM is high in patients with OSA and this prevalence is more pronounced in females. Evaluation of patients with T2DM and OSA in terms of comorbidities may contribute to early diagnosis and treatment of both diseases.