Comorbidity,COVID-19,elderly patient,mortality

Introduction: the aim of this study is to investigate and report on the data regarding the clinical characteristics and outcomes of healthcare workers with COVID-19 at tertiary education hospitals from Turkey. Materials and Methods: This was a single center, retrospective, descriptive and observational study using cross-sectional data, which were collected from confirmed COVID-19 patients at a tertiary education hospital. Patients' demographic and clinical characteristics, mortality rates, and the factors associated with hospitalization were analyzed. Results: By May 15, 2020, 480 patients were diagnosed with COVID-19 in our hospital where 49 (10.2%) of whom were HCWs. The mean age was 40.0 +/- 8.45 (75.5% female). The most common symptoms were cough (32.7%), fever (30.6%), and myalgia (14.3%). Comorbidities were present in 32.7% of the patients. Most of the HCWs were nurses (53.1%) and physicians (18.4%), and the remaining 14 (28.6%) were cleaning and administrative staff. The severity of the disease was mild in 65.3% and severe in 34.7% HCWs. Leukocyte, neutrophil, lymphocyte and platelet values were statistically lower in hospitalized patients. There was a statistically significant relationship between the presence of infiltration on the chest X-ray, and the patient's symptoms with the severity of the disease (respectively p= 0.002 and 0.009). Conclusion: In conclusion, the frequency of COVID-19 in healthcare workers is high. The study presents the characteristics of HCWs infected with coronavirus from a single center in Turkey.

In this study conducted in a single center in Türkiye, we aimed to investigate the effect of sex differences on survival and treatment adverse effects in 100 patients with advanced non-small cell lung carcinoma (NSCLC) treated with immune checkpoint inhibitors. This was a single-center, retrospective, observational study. All 100 patients with non-small cell lung carcinoma admitted to the Pulmonary and Medical Oncology Department of a Training and Research Hospital between January 2018 and March 2024 were evaluated. Demographic data, cancer characteristics, overall survival, and adverse effects of immune checkpoint inhibitors were investigated in the male and female patient groups. Patients were treated with nivolumab and atezolizumab as immune checkpoint inhibitors (ICI). This study included 100 patients, with 88 (88%) men and 12 (12%) women. The average age of the patients was 64.3±8.5 years, 63% had adenocarcinoma, and 80.6% of all patients were stage 4. Although overall survival was significantly lower in women compared to men in univariate analysis (P=0.047), this difference disappeared in multivariate analysis (P=0.168). Adverse effects were observed in 91% of the patients. Pleural effusion (P=0.040), hypothyroidism (P=0.003), and rash (P<0.001) were more common in women, whereas tiredness (P=0.804), pneumonitis (P=0.097), and hyperthyroidism (P=0.507) were not significantly different according to sex. The average follow-up period was 33.8±22.6 months, and 25% of patients died. The association of sex differences with adverse effects and survival in patients with NSCLC receiving ICI treatment is not fully understood. Further studies are needed to support this area of interest.

Giriş: Alt solunum yolu enfeksiyonları (ASYE) hastaneye ayaktan başvurularda ve yatan hastalarda önemli mortalite ve morbidite nedenidir. Hastane yatışı gerektiren ASYE vakalarında antibiyoterapinin zamanında başlanması önemlidir. Enfeksiyon tablosuna yol açan etkeni belirlemek için solunum yolu kültürleri alınmadan başlanan ampirik antibiyoterapi ve “en geniş” spekturumlu antibiyotikleri kullanma eğilimi enfeksiyon hastalıklarının yönetimini zorlaştırmakta, antibiyotik direnci gibi ciddi bir sorunu karşımıza çıkarmaktadır. Bu çalışmada hastaneye yatırılan ASYE olgularında izole edilen etkenler, antibiyotik direnç oranları, hastaların önceden hastaneye yatış ve antibiyotik kullanım durumları araştırılmıştır. Yöntem: Bu çalışmada 2013-2018 yılları arasında hastanemize ASYE tanısı ile yatırılan ve solunum yolu örneği kültürlerinde üreme saptanan olguların demografik özellikleri, hastane yatış sayıları, antibiyotik kullanım öyküleri ile kültürle elde edilmiş etkenleri ve antibiyotik dirençleri kesitsel tanımlayıcı metotla araştırılmıştır. Bulgular: 469 hastadan izole edilen 484 etkeni ve bu etkenlerin antibiyotik direnç profillerini inceledik. Hastaların etkenleri balgam ya da bronkoskobik aspirasyon örneklerinden elde edildi. Olguların çoğu erkek cinsiyette ve 63 yaşın üzerinde idi. En fazla izole edilen etken Pseudomonas aeruginosa (n= 220; %44) idi. Hastaların 451 (%96) tanesine yatışta ampirik antibiyotik başlanmış ve 247 tanesine (%65) başlanan antibiyotik ortalama 7,9 gün sonra değiştirilmişti. Hastalarımızın 228’i (%49) son bir yıl içinde en az iki kez hastaneye yatırılmış; 43 (%9.2) hasta son bir ay içinde antibiyotik almıştı. Son hafta içinde antibiyotik kullanmış ve halihazırda kullanmakta olan 19 hastanın 8’inde P. aeruginosa (%42) izole edildi. İzole edilen 17 S. pneumonia kökeninde bir (%6) penisilin, üç (%17) makrolid dirençli izolat saptandı. H. influenza 33 olguda izole edildi. Üç olguda (%8) ampisilin ve dört (%12) kinolon direnci rapor edildi. Tartışma ve Sonuç: Ampirik antibiyotik tedavisi başlanırken, artan kinolon direncinin ve olguların yarısından fazlasında P. aeruginosa etken olduğunun göz önüne alınması, özellikle daha önce hastaneye yatış sıklığı ve antibiyotik kullanma öyküsünün sorgulanması ve lokal antibiyotik direnç paternlerinin göz önüne alınmasının gerekli olduğu sonucuna vardık.

Objective: In our study, we aimed to examine the characteristics of COVID-19 disease, disease severity, comorbidities and mortality rates in elderly patients compared with non-elderly patients. Methods: Patients(n:469) who were followed up in outpatient, inpatient and intensive care units with the diagnosis of COVID-19 between 11 March 2020 - 01 June 2020 were retrospectively included in the study. Two groups of patients were formed, namely the elderly group (≥65 years, n:101) and non-elderly (<65 years, n:368). Results: When compared to the non-elderly group; The incidence of severe pneumonia (31% / 12.6%) and critical illness (16% / 5.8%), comorbidity (85% /% 37.2), hospitalization time (8/5 days) were significantly higher in the elderly group ( p <0.05). 23 (22.8%) of elderly patients and 27 (7.3%) of non-elderly patients died (p = 0.000). It was seen that mortality increased 3.5 times in elderly patients compared to Nonelderly group. Expected survival time; It was 145.85 days (CI 95% = 133-158.66) in the elderly age group and 170.36 days (CI 95% = 166-174.6) in the non-elderly age group (p 56 (AUC = 0.775; p <0.001). Measurements and Main Results: In elderly patients diagnosed with COVID-19, mortality is high, comorbidities are more frequent, and the disease is more severe. Age> 56 can be used to predict cut-off mortality.