Background and Objectives: Immune checkpoint inhibitors (ICIs) have emerged as groundbreaking agents in cancer therapy; however, their immune-related adverse effects, especially pulmonary toxicity, significantly limit their use. This study aimed to determine the incidence and risk factors associated with ICI-induced pulmonary toxicity. Materials and Methods: We conducted a prospective observational study involving 126 patients aged ≥18 years with malignancies treated with ICIs between April 2022 and April 2024. Patients were followed every six months over a two-year period. Clinical, laboratory, and radiological data were collected to assess pulmonary toxicity. Results: The mean age of our patients was 62.93 ± 12.94 years, and 81% were male. The ICI-related pulmonary toxicity rate was 16.7%, and the all-cause mortality rate was 68.3%. In the analysis, the conditions associated with pulmonary toxicity were the type of malignancy, the presence of lung cancer, COPD, long-term ICI use, dyspnea, cough and sputum, the pre-ICI lung nodule mass, and high blood monocyte levels. Our regression analysis results for the determination of risk factors showed a 7.70-fold increase in the presence of cough symptoms, a 4.57-fold increase in the presence of COPD, a 0.998-fold increase for every 1 unit decrease in lymphocyte count, and an 11.75-fold increase in risk for a monocyte count of 130 or less. Conclusions: Our study’s findings suggest that patients with identifiable risk factors for pulmonary toxicity should undergo closer monitoring and early diagnostic evaluation during ICI therapy to reduce morbidity and mortality.

This study primarily aimed to examine the significance of the C-reactive protein to lymphocyte ratio (CLR), a key marker of inflammation, in relation to the disease progression and management of COVID-19 patients admitted to the intensive care unit (ICU). A total of 464 patients aged 18 years or older, diagnosed with COVID-19 and admitted to the ICU between April 1, 2021, and February 1, 2022, were included in the study. Sociodemographic, laboratory, radiological, and clinical data were collected for each patient. The cohort was then divided into two groups—those who survived and those who did not—and analyzed accordingly. Among the patients included in the study, 58.2% were male, and the mean age was 62.39 ± 15.65 years. The mortality rate was 42%. The analysis revealed that the need for high-flow oxygen and mechanical ventilation increased the risk of death by 9.64 times. Furthermore, for each 1-point increase in the SOFA Score, Charlson Comorbidity Index, and Nutric Score, the risk of death increased by 1.27, 1.18, and 1.40 times, respectively. Intravenous immunoglobulin, administered to a select group of patients, reduced the risk of death by 23.8 times. The optimal threshold value for CLR was identified as 103.05, with values above this increasing the risk of death by 1.84 times. Critically ill patients with CLR values exceeding the identified threshold should receive more intensive monitoring and timely adjustments in treatment. Given that CLR is a simple, accessible, and cost-effective marker, it holds particular value in managing aggressive diseases like COVID-19.

Objective: "COVID-19-related liver damage" can occur frequently in course of COVID-19 disease and cause significant problems. Our study aimed to investigate prevalence of liver damage due to COVID-19, its risk variables, and the effect of liver damage on course of COVID-19 and mortality. Method: One hundred patients over eighteen years of age who were hospitalized between 01.08.2021-01.03.2022 and had positive RT-PCR tests were included in our study. Impaired liver function tests were identified as having alanine aminotransferase(ALT) and aspartate aminotransferase(AST) levels exceeding upper laboratory limits. Results: The mean age of patients included in study was 57.9 ± 14.9 years, with 49% of them being male. In our study, we had an 8% death rate and 37% of patients had abnormal liver function tests. The presence of severe disease(p<0.001), anorexia symptoms(p=0.027), and abdominal pain(p=0.010) were significant for mortality. A prolonged hospital stay was significantly associated with death(p=0.029), with the mean length of hospital stay being 11.8 ± 4.6 days. Favipiravir use for longer than five days was associated with a substantial risk of liver damage(p=0.044) and mortality(p=0.020), while use of antibiotics in carbapenem group was associated with a significant risk of death(p=0.001). Conclusions: It is noteworthy that a considerable proportion of COVID-19 patients may exhibit increased liver tests, which could serve as a significant predictor and risk factor, particularly with regard to mortality. In order to properly monitor and manage COVID-19 patients, particularly those who are at risk, comprehensive measurements, including liver tests, should be carried out on a regular basis.

Purpose: Blood-derived biomarkers have been extensively considered as possible prognostic indicators in idiopathic pulmonary fibrosis (IPF) recently. In order to assess the value of circulating biomarkers in common IPF clinical practice, the study intends to draw conclusions regarding the link between disease severity, prognostic indicators, and serum matrix metalloproteinase in patients with stable idiopathic pulmonary fibrosis. Materials and Methods: The study comprised 22 people with an IPF diagnosis that had been verified by a multidisciplinary approach. The sociodemographic details, clinical and radiologic symptoms, pulmonary function tests and the Gender-Age-Physiology (GAP) score were noted. ELISA has been used to research serum MMP concentrations. Results: There is no statistically significant correlation between the Matrix Metalloproteinase (MMP) 2, MMP 7, MMP 9, and MMP13 and the GAP index and, pulmonary function tests, or disease severity. GAP score was found to be higher in stage 3 in patients with severe disease, in stage 2 in patients with moderate disease, and in stage 1 in patients with mild disease. Conclusion: There are consistent findings in the literature, despite the fact that the association between MMP and IPF prognostic markers, pulmonary function tests, and disease severity could not be seen in this investigation. However, because they could open the door to a cutting-edge treatment strategy, these indicators should be investigated prospectively in larger series.