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    Evaluation of COVID-19 patients receiving long-term oxygen support in the post-COVID period
    (Kare Publ, 2024) Turan, Muzaffer Onur; Bozkus, Fulsen; Batum, Ozguer; Alkan, Aycan; Kabalak, Pinar Akin; Alkilinc, Ersin; Soyler, Yasemin
    BACKGROUND AND AIM: Persistent physical and medical sequelae, including chronic hypoxemia, may be observed in patients with long-lasting post-COVID syndrome. Long-term oxygen therapy (LTOT) is commonly employed for managing chronic hypoxemia in chronic airway diseases. This study aims to assess the ongoing requirement for LTOT in Coronavirus Disease 2019 (COVID-19) patients during the post-COVID period and to ascertain the persistence of their oxygen therapy needs. METHODS: This cross-sectional, multicentered study included 320 COVID-19 patients who were evaluated for LTOT two months post-discharge. Patient demographics, symptoms at admission, and laboratory and radiological data were retrospectively collected from hospital databases. RESULTS: Continuous oxygen support was necessary for 22.9% of the patients, while 15% of the participants passed away during the post-COVID period. Factors significantly associated with the prolonged need for LTOT included admission to the intensive care unit (ICU), presence of anemia, high serum D-dimer levels (>1000 mu g/L), and low oxygen saturation levels at hospital admission (p=0.026, p=0.011, p=0.010, and p<0.001, respectively). Multivariable regression analysis identified high D-dimer levels (p=0.012) and low oxygen saturation at admission (p<0.001) as the most significant predictors of a continued need for oxygen therapy. Furthermore, advanced age, non-use of steroids in treatment, and mechanical ventilation during hospitalization were significantly linked to mortality during the post-COVID period (p=0.003, p=0.048, and p=0.009, respectively). CONCLUSIONS: ICU admission and certain laboratory parameters can predict the need for LTOT during the post-COVID process. The observation that most COVID-19 patients do not require LTOT after a two-month period suggests that clinicians should adopt a more selective approach in planning LTOT.
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    Evaluation of Exudative Pleural Effusions: A Multicenter, Prospective, Observational Study
    (Springer, 2022) Ak, Guntulu; Metintas, Selma; Taşkın, Ayşe Naz; Sener, Melahat Uzel; Soyler, Yasemin; Yilmaz, Meltem; Turna, Akif
    Purpose The aim of this study is to determine the diagnostic performances of pleural procedures in undiagnosed exudative pleural effusions and to evaluate factors suggestive of benign or malignant pleural effusions in tertiary care centers. Methods This was a multicenter prospective observational study conducted between January 1 and December 31, 2018. A total of 777 patients with undiagnosed exudative pleural effusion after the initial work-up were evaluated. The results of diagnostic procedures and the patients' diagnoses were prospectively recorded. Sensitivity, specificity, and accuracy estimates with 95% confidence intervals were used to examine the performance of pleural procedures to detect malignancy. Results The mean age +/- SD of the 777 patients was 62.0 +/- 16.0 years, and 68.3% of them were male. The most common cause was malignancy (38.3%). Lung cancer was the leading cause of malignant pleural effusions (20.2%). The diagnostic sensitivity and accuracy of cytology were 59.5% and 84.3%, respectively. The diagnostic sensitivity of image-guided pleural biopsy was 86.4%. The addition of image-guided pleural biopsy to cytology increased diagnostic sensitivity to more than 90%. Thoracoscopic biopsy provided the highest diagnostic sensitivity (94.3%). The highest diagnostic sensitivity of cytology was determined in metastatic pleural effusion from breast cancer (86.7%). Conclusion The diagnostic performance increases considerably when cytology is combined with image-guided pleural biopsy in malignant pleural effusions. However, to avoid unnecessary interventions and complications, the development of criteria to distinguish patients with benign pleural effusions is as important as the identification of patients with malignant pleural effusions.