Elevated red blood cell distribution width (RDW) has been associated with adverse outcomes of heart failure and pulmonary hypertension. A total of 702 consecutive patients with acute pulmonary embolism (PE) were evaluated. There was a graded increase in mortality rate with RDW quartiles of 5.8% in quartile I (≤13.6), 9.7% in quartile II (13.7%-14.5%), 13.1% in quartile III (14.6%-16.3%), and 20% in quartile IV (>16.3%; P < .001). Patients who died had higher baseline RDW values (16.1% [11.7-28.3] vs 14.5% [10.7-32.5]; P < .001). The optimal cutoff value of RDW for predicting in-hospital mortality was ≥15%. The area under the curve of mortality for RDW was 0.649 (confidence interval [CI]: 0.584-0.715); the negative predictive value was 93%. In multivariable regression analysis, RDW remained associated with an increased odds of death (odds ratio: 1.2, 95% CI: 1.1-1.4). High RDW level was an independent predictor of short-term mortality in PE. The RDW levels may provide a potential marker to predict outcome in patients with PE.

The goal of this study was to investigate whether blood group type caused susceptibility to COVID-19 infection. Two hundred and eleven consecutive patients admitted with various symptoms associated with COVID-19 were included. We compared the AB0 and Rh subgroup distributions between patients with a positive polymerase chain reaction (PCR) test result and the patients without. We compared the AB0 and Rh subgroup distributions between patients with lung involvement and patients without. Additionally, comparisons were performed between the patients both with positive PCR result and lung involvement, and the patients with a negative PCR result. No significant difference of ABO and Rh subgroup distributions was evident between patients with and without a positive PCR test result (p=0.632 and p=0.962). No significant difference of ABO and Rh subgroup distributions was evident between the patients with and without lung involvement (p=0.097 and p=0.797). No significant difference of ABO and Rh subgroup distributions was evident among patients both with PCR positivity and lung involvement, patients with only PCR positivity, and the patients with negative PCR test results (p=0.3 and p=0.993). All blood group types seem to have an equal risk of COVID-19 infection. Everyone should follow the precautions to avoid the COVID-19 infection.

Objective: This study aimed to examine the relative contributions of clinical severity indicators and psychosocial factors—including depression, anxiety, stress, emotion regulation difficulties, and perceived social support—on quality of life in patients with Chronic Obstructive Pulmonary Disease (COPD), and to test their mediating mechanisms within an integrated model. Methods: A total of 120 patients with COPD were assessed using spirometry, dyspnea, and symptom severity measures (mMRC, CAT), psychological assessments (DASS-21, DERS-16, MSPSS), and the WHOQOL-BREF. Mediation models using the PROCESS macro (Model 4) for SPSS were applied to evaluate the pathways linking clinical severity and psychosocial factors to quality-of-life domains. Results: Among 120 participants diagnosed with COPD, disease stages were found to be GOLD A: 25.8%, GOLD B: 35.8%, and GOLD E: 38.3%. Clinical severity measures (CAT, mMRC) were moderately correlated with both psychological symptoms and emotion-regulation difficulties (p < 0.05). CAT had a significant indirect adverse effect on physical quality of life via emotion regulation difficulties [b = –0.174, 95% CI (–0.303, –0.069)]. Perceived social support positively predicted physical quality of life via lower depressive symptoms (b = 0.52, 95% CI (0.06, 1.10)). Stress was indirectly associated with poorer psychological quality of life through reduced social support [b = –0.191, 95% CI (–0.363, –0.042)]. Conclusion: Psychosocial mechanisms substantially contribute to quality-of-life impairment in COPD and operate alongside traditional clinical indicators. Emotion-regulation difficulties and social support emerge as key psychological pathways linking symptom severity and quality-of-life outcomes, suggesting that comprehensive COPD management should integrate psychosocial intervention strategies.

Purpose: Effective management of chronic obstructive pulmonary disease (COPD) depends on sustained adherence to inhaled therapies, yet real-world factors associated with inhaler adherence and disease awareness are not fully characterized. This study aimed to evaluate inhaler medication adherence among patients with COPD and to explore its associations with sociodemographic, clinical, and contextual factors, including self-reported disease awareness. Patients and Methods: This single-center, cross-sectional descriptive study was conducted between July and October 2025 in the Chest Diseases Outpatient Clinic of a tertiary hospital. Patients aged ≥ 18 years with a confirmed diagnosis of COPD based on GOLD 2025 criteria were included. Sociodemographic and clinical data were collected using structured, interviewer-administered questionnaires. Inhaler adherence was assessed using a structured questionnaire adapted from the Test of Adherence to Inhalers (TAI). Symptom burden and dyspnea were evaluated using the COPD Assessment Test (CAT) and the modified Medical Research Council (mMRC) dyspnea scale, respectively. Statistical analyses were performed using IBM SPSS Statistics version 23.0, with a two-sided p value < 0.05 considered statistically significant. Results: A total of 170 patients were included in the analysis (GOLD group A: 31.2%, group B: 44.1%, and group E: 24.7%). Marital status (p = 0.003), family history of COPD (p< 0.001), and home use of nebulizers or oxygen concentrators (p< 0.001) were significantly associated with higher inhaler adherence, whereas age, educational level, income status, and smoking status were not. TAI adherence scores did not differ significantly across GOLD groups (p> 0.05), whereas exacerbation frequency and hospitalization rates increased significantly with disease severity (p< 0.001). Conclusion: In this single-center cross-sectional study, inhaler adherence in patients with COPD was found to be associated with contextual and social factors, such as marital status, family history of COPD, and home use of respiratory support devices, rather than with demographic characteristics or disease severity. These findings highlight the importance of routinely assessing inhaler use and adherence in clinical practice and suggest that contextual factors may play a role in adherence behaviors, in line with current GOLD recommendations.

Objective: Chronic Obstructive Pulmonary Diesase (COPD) is an inflammatory lung disease that progresses with attacks. Pneumonia is an infectious lung disease that progresses with lung infiltrations. Osteopontin (OP) is a cytokine which participates in inflammation. Neutrophil Gelatinase Associated Lipocalin (NGAL) is an antimicrobial peptide with neutrophil activation and antibacterial properties. In this study, serum OP and NGAL levels were assayed in COPD exacerbation, stabile COPD and pneumonia. The aim of our study is to assess the importance of NGAL and OP levels as biomarkers in the differential diagnosis of COPD and pneumonia. Material and Methods: One hundred twenty consecutive patients who were admitted to our department between May 2011 and August 2013 were included in the study. Serum OP and NGAL levels were measured with ELISA method within 24 hours following the determination of diagnosis. COPD acute exacerbation (AE-COPD) group was comprised of 95 patients (87 male and mean age 69.0±10.6), and the pneumonia group was comprised of 25 patients (16 male and mean age 57.5±22.9). Serum OP and NGAL levels of the patients in the AE-COPD group were re-measured within 30-45 days following acute exacerbation in stabile period. Results: Serum OP levels were higher in the pneumonia group compared to the AE-COPD group (93.47 ng/ml vs 53.10 ng/ml; p84 ng/ml is an independent predictor that increases risk for pneumonia more than 8-fold (95% CI, 2.43-26.59). Sensitivity and specificity of OP in the differentiation of pneumonias from AE-COPD were determined to 80% and 92%, respectively. Serum NGAL levels also increased as COPD severity increased and was found to be statistically significant (p: 0.032). Conclusion: It has been indicated that serum osteopontin level can be an independent predictor in differentiating COPD exacerbation from pneumonia. Additionally, as COPD severity (stage) increases, serum NGAL levels also increase, which may be helpful in assessing the severity of COPD.

Background: Bronchiectasis is a heterogeneous chronic inflammatory airway disease characterized by recurrent exacerbations. Data on composite inflammatory biomarkers for assessing disease activity remain limited. Methods: This retrospective study included 97 patients with non-cystic fibrosis bronchiectasis categorized as stable (n = 39) or with exacerbated bronchiectasis (n = 58). Demographic, clinical, and laboratory data were analyzed, and inflammatory indices—NLR (neutrophil–lymphocyte ratio), PLR (platelet–lymphocyte ratio), SII (Systemic Immune-Inflammation Index), PIV (Pan-Immune-Inflammation Value), CAR (C-reactive protein-to-albumin ratio), and HALP score (hemoglobin × albumin × lymphocyte/platelet)—were calculated, followed by multivariate logistic regression and ROC analyses. Results: Patients with bronchiectasis exacerbations had a higher NLR, PLR, PIV, SII, and CAR and lower HALP (all p < 0.001). The C-reactive protein-to-albumin ratio demonstrated the highest discriminative ability (AUC = 0.995), followed by SII and NLR, while lower HALP and SII were independent predictors of exacerbation. The C-reactive protein-to-albumin and sedimentation-to-albumin ratios were strongly correlated with hospitalization duration (both p < 0.001). Conclusions: Composite inflammatory indices are strongly associated with disease activity in bronchiectasis. CAR showed excellent discriminative performance, while HALP and SII independently predicted exacerbation. These simple, cost-effective biomarkers may support risk stratification and clinical monitoring in routine practice.