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    CMV reactivation in immunocompetent critically ill intensive care unit patients: a retrospective study
    (Journal of Infection in Developing Countries, 2024) Onder, Taylan; Alkan, Sevil; Dogan, Ebru; Sener, Alper
    Introduction: Cytomegalovirus (CMV) reactivation is observed in immunosuppressive patients and causes adverse clinical outcomes. CMV reactivation in immunocompetent patients is less known. We aimed to retrospectively investigate CMV reactivation in immunocompetent critically ill patients with bacterial growth in lower respiratory tract; and investigate the relationship between reactivation and outcomes such as length of stay (LOS), mechanical ventilation duration, and mortality. Methodology: Intensive care unit (ICU) patients that were CMV IgG-positive, CMV IgM-negative immunocompetent, mechanically ventilated for over 48 hours, and were diagnosed with respiratory tract colonization with Acinetobacter baumannii or ventilator-associated pneumonia (VAP) were included. Reverse transcriptase polymerase chain reaction (RT-PCR) was performed on serum and endotracheal aspirate samples. The patients were divided into groups of those with and without VAP and sepsis. Reactivation rates and CMV DNA levels were compared between the groups. Results: CMV reactivation was seen in 27 of 34 patients (79.4%). CMV DNA level was 5.8 times higher in patients with VAP and sepsis than patients without, but the difference was not statistically significant (p = 0.717). LOS and mechanical ventilation duration were higher in patients with reactivation (p = 0.047 and 0.036). No relationship was found between reactivation and mortality (p = 0.774). Conclusions: The rate of CMV reactivation was 79.4%. This was the second-highest reactivation rate reported in the literature. The reactivation was associated with prolonged hospitalization and mechanical ventilation. Copyright © 2024 Onder et al.
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    Evaluation of the Hospitalized Coronavirus Disease 2019 Patients in First 3 Months of the Pandemic
    (Aves, 2022) Alkan, Sevil; Akca, Anil; Sener, Alper; Dogan, Ebru; Gonlugur, Ugur; Simsek, Tuncer; Ozer, Sule
    OBJECTIVE: Data about Turkish coronavirus disease 2019 patients are limited. We evaluated hospitalized coronavirus disease 2019 patients who were followed up in the first 3 months of the pandemic. MATERIAL AND METHODS: This retrospective, single-center, observational study included 415 confirmed hospitalized coronavirus disease 2019 patients. The patients were divided into groups, namely, mild, moderate, and critically ill patients. Symptoms at the time of admission, clinical, laboratory, and imaging findings were examined. RESULTS: In our study, 6.74% of coronavirus disease 2019 patients had severe disease, 59.5% were male, and the mortality rate was 11.3%. Diabetes mellitus and chronic obstructive pulmonary disease were more frequently seen in critically ill patient groups and hyper- tension in moderate patient groups. Anemia and aspartate aminotransferase levels were higher in non-survivors among mild coronavirus disease 2019 patients. In the moderate patients' group, aspartate aminotransferase, lactate dehydrogenase, international normalized ratio, ferritin, and D-dimer levels were higher and lymphocyte, hemoglobin levels were lower; in the critically ill patients' group, platelets were lower and uric acid levels were higher in non-survivor patients. CONCLUSION: In mild patients, anemia, lymphopenia, and increased aspartate aminotransferase levels; in moderate patients, leukopenia, anemia, and increased aspartate aminotransferase, lactate dehydrogenase, international normalized ratio, ferritin, and D-dimer levels; in the critically ill patient group, lower platelet and increased uric acid levels should he followed closely as they are mortality predictors.