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    Characteristics of hospitalised COVID-19 patients and parameters associated with severe pneumonia
    (John Wiley & Sons Ltd, 2021) Turan, Onur; Mirici, Arzu; Duru Akçalı, Serap; Turan, Pakize Ayşe; Batum, Özgür; Şengül, Aysun
    Background: After the first case of coronavirus disease 2019 (COVID-19) was reported in China in December 2019, it caused a global pandemic, including Turkey. Objectives: The aim of this study was to analyse the characteristics of hospitalised COVID-19 patients and assess the parameters related to severe pneumonia. Methods: Included in the study were hospitalised COVID-19 patients with positive naso-oropharyngeal swabs. Patients’ demographics, admission symptoms, laboratory and radiological findings were recorded retrospectively. Results: Of 1013 patients, 583 were males (57.6%) and 430 were females (42.4%), with a mean age of 53.7 ± 17.9. More than half of the patients had at least one comorbidities, the most common of which were hypertension and diabetes mellitus. Cough (59.8%), fatigue (49.5%) and fever (41.2%) were the most common presenting symptoms. Of the hospitalised COVID-19 patients, 84.9% had pneumonia and 83.5% had typical radiological COVID-19 appearances (94.5%: ground-glass areas). The most common laboratory findings were high C-reactive protein (CRP) (73.6%) and lactate dehydrogenase (LDH) (46.2%) levels, as well as lymphopenia (30.1%). Severe pneumonia was present in 28.1% of COVID-19 patients. Multivariate logistic regression analysis indicated that advanced age, hypotension, anaemia and elevated CRP and LDH serum levels were independent risk factors for the severity of COVID-19 pneumonia (P =.011,.006,.017,.003 and.001, respectively). Conclusion: This study, as one of the first multicentre studies about characteristics of COVID-19 in Turkey, may guide about disease-related parameters and severity of pneumonia. Age, blood pressure, complete blood count and routine biochemical tests (including CRP and LDH) would appear to be important parameters for the evaluation of the severity of COVID-19 pneumonia.
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    Characteristics of hospitalized COVID-19 patients and parameters associated with severe pneumonia
    (The European Respiratory Society, 2021) Turan, Muzaffer Onur; Mirici, Arzu; Akçalı, Serap Duru; Turan, Pakize Ayşe; Batum, Özgür; Şengül, Aysun; Ünsal, Zuhal Ekici
    Objectives: The aim of this study is to analyse characteristics of hospitalized COVID-19 patients in Turkey. Methods: Hospitalized COVID-19 patients with positive naso-oropharyngeal swab examples from 10 different centers were included. Demographics, admission symptoms, laboratory and radiological findings were recorded retrospectively. Results: Of 1013 patients included in the study, there were 583 male (57.6%) and 430 female (42.4%), with the mean age of 53.7±17.9. More than half (%51.7) of the patients had at least one comorbid disease; the most common ones were hypertension and diabetes mellitus. Cough (59.8%), fatigue (49.5%) and fever (41.2%) were the most common presenting symptoms. There was pneumonia in 84.9% of hospitalized COVID-19 patients; 83.5% had typical radiological COVID-19 appearance (94.5%: ground glass areas). The most common laboratory findings were high CRP (73.6%) and lactat dehydrogenase (LDH) (46.2%) levels and lymphopenia (30.1%). Severe pneumonia was present in 28.1% of COVID-19 patients. Multivariate logistic regression analysis indicated that high age, hypotension, anemia, elevated serum levels of CRP and LDH were independent risk factors for severity of COVID-19 pneumonia (p=0.011, 0.006, 0.017, 0.003 and 0.001, respectively). Conclusion: Our study, which is one of the first multicenter studies about COVID-19 characteristics in Turkey, is thought to be a guide for COVID-19 patients in terms of clinical features . Age, blood pressure measurement, complete blood count and routine biochemical tests (including CRP and LDH) seem to be important parameters for evaluating the severity of pneumonia in COVID-19 patients.
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    Clinical characteristics and outcomes in hospitalized COVID-19 patients with COPD
    (The European Respiratory Society, 2021) Turan, Muzaffer Onur; Yigitbaş, Burcu Arpınar; Turan, Pakize Ayşe; Mirici, Arzu
    Introduction: COPD can be more fatal in this in COVID-19 patients. The aim of this study was to determine the prevalence of COPD and to investigate the characteristics and prognosis of COPD patients in population infected with SARS-CoV2. Material-Method: Patients who had the diagnosis of COVID-19 by positive Polymerase Chain Reaction test in oro-nasopharyngeal swab samples were included. Patients with the airway obstruction (FEV1/FVC <70%) in the spirometrics were included in “COPD group”. The symptoms, laboratory and radiological findings, outcomes for patients with and without COPD were compared. Results: The prevalence of COPD in COVID-19 patients was 4.96% (53/1069). The mortality rate was 13.2% in COPD and 7% in non-COPD patients (p=0.092). The significant predictors of mortality were higher age, hypoxemia (p <0.001) and presence of pneumonia (p=0.043) in COVID-19 patients. Conclusion: Our research is a multicentered, retrospective cohort study, which is one of the first studies investigating the prevalence and characteristics of COVID-19 patients with COPD in Turkey. There were some demographic, symptomatic, laboratory and radiological differences between COPD and non-COPD COVID-19 patients. Although COPD patients had some poor prognostic features, there was no statistically difference between overall survival rates of COVID-19 patients with or without COPD. Significant predictors of mortality were high age, hypoxemia and presence of pneumonia in hospitalized COVID-19 patients.
  • Küçük Resim
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    Clinical characteristics and outcomes of hospitalized COVID-19 patients with COPD
    (Taylor and Francis Ltd., 2021) Turan, Onur; Arpınar Yigitbaş, Burcu; Turan, Pakize Ayşe; Mirici, Arzu
    Background: Although COPD is not one of the most common comorbidities in COVID-19 patients, it can be more fatal in this group. This study aimed to investigate the characteristics and prognosis of COPD patients among the population with COVID-19. Research design and methods: Patients diagnosed with positive PCR test were included in our multicentered, retrospective study. Patients with airway obstruction (previous spirometry) were included in ‘COPD group’. Results: The prevalence of COPD in COVID-19 patients was 4.96%(53/1069). There was a significant difference between COPD and non-COPD COVID-19 patients in terms of gender, mean age, presence of dyspnea, tachypnea, tachycardia, hypoxemia and presence of pneumonia. The mortality rate was 13.2% in COPD, 7% in non-COPD patients(p = 0.092). The significant predictors of mortality were higher age, lymphopenia (p < 0.001), hypoxemia (p = 0.028), high D-dimer level (p = 0.011), and presence of pneumonia (p = 0.043) in COVID-19 patients. Conclusions: Our research is one of the first studies investigating characteristics of COPD patients with COVID-19 in Turkey. Although COPD patients had some poor prognostic features, there was no statistical difference between overall survival rates of two groups. Age, status of oxygenization, serum D-dimer level, lymphocyte count and pneumonia were significantly associated parameters with mortality in COVID-19.
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    Factors That May Affect FEV1 Change Of COPD Patients In One-Year Period
    (M. Tayyib KADAK, 2020) Turan, Muzaffer Onur; Turan, Pakize Ayşe; Mirici, Arzu
    INTRODUCTION: One of the hallmarks of COPD is the rate of FEV1 decline. There are many factors that may affect pulmonary parameters in a COPD patient. It was aimed to investigate the factors affecting FEV1 changes.   MATERIAL-METHODS: COPD outpatients who attended our pulmonology clinic were included. Spirometric values and inhaler device usage performance at that time and 12 months ago were compared.   RESULTS: Mean FEV1 values of 204 COPD patients decreased from 1.56±0.51 lt (53.4%) to 1.51±0.50 lt (53.2%). There was a statistically significant relationship between FEV1 change (decline / not) and gender, active smoking, regular inhaler device usage, exacerbation, hospitalization history in last year, presence of comorbidities and inhaler device adherence. FEV1 decline had positive correlation with the number of exacerbations in last year (r=0.432, p<0.001), and negative correlation with inhaler device usage score (r=-0.512, p<0.001). Multivariate regression analysis demonstrated that smoking status, number of exacerbations (per year) and inhaler therapy adherence were the factors that affect FEV1 decline in COPD patients (p=0.007, 0.001 ve 0.003, respectively).   CONCLUSION: Smoking is the major parameter that affects FEV1 value in COPD. Inhaler adherence may directly affect FEV1 change. Smoking cessation, preventing COPD exacerbations and increasing inhaler therapy adherence may decrease FEV1 declines of COPD patients in one-year period.    
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    GÖĞÜS HASTALIKLARI UZMANLARINA DÜZENLİ KONTROLE GİTMEYEN KOAH HASTALARININ DEĞERLENDİRİLMESİ
    (2016) Turan, Muzaffer Onur; Turan, Pakize Ayşe; Mirici, Arzu
    AMAÇ: Kronik obstrüktif akciğer hastalığı (KOAH), komplike bir hastalık olup hastalarda risk faktörlerine maruziyet, mevcut hastalık durumu, semptomlar, tedavi etkinliğininin düzenli olarak değerlendirilmesi ve bu izleme dayalı olarak tedavinin düzenlenmesi gerekmektedir. Göğüs hastalıkları polikliniğine ilaç yazdırmaya gelen veya rapor için başvuran, düzenli poliklinik kontrollerine gelmeyen KOAH hastalarında mevcut hastalık durumu ve tedavinin değerlendirilmesi amaçlandı. YÖNTEM-GEREÇ: Çalışmaya, Ocak-Haziran 2015 tarihleri arasında Gelibolu Devlet Hastanesi göğüs hastalıkları polikliniğine, sadece ilaç yazdırmak için başvuran ve son 1 yıl içerisinde göğüs hastalıkları doktorları tarafından değerlendirilmemiş hastalar (çalışma grubu) ve kontrol amaçlı düzenli gelen hastalar (karşılaştırma grubu) dahil edildi. Hastalara solunum fonksiyon testi (SFT) ve inhaler cihaz kullanım becerisini değerlendiren bir test uygulandı. BULGULAR: Çalışma grubunda 70, karşılaştırma grubunda 60 olmak üzere toplam 130 KOAH hastası çalışmaya alındı. Çalışma grubu hastalarının %40'ı sigara içmeye devam etmekteydi. Bu hastalara SFT en son 1.67±0.98 yıl önce yapılmışken, doktor tarafından KOAH ilaç eğitimi de son olarak 1.44±0.89 yıl önce verilmişti. Çalışma grubundaki hastalara son KOAH ilaç eğitimi ve SFT uygulanmasından sonra geçen süre, karşılaştırma grubu hastalarına göre anlamlı olarak daha uzundu (p<0.001). İki grubun hastaları arasında, kullandıkları ilaçların KOAH'da birleşik değerlendirme sınıflamasına uygunluğu açısından da anlamlı fark tespit edildi (p=0.002). Çalışma grubu hastalarının inhaler cihaz beceri puanları da istatistiki açıdan anlamlı olacak şekilde daha düşüktü (p=0.035). SONUÇ: KOAH hastalarının izlemi konusunda standart bir yaklaşım olmasa da, solunum fonksiyon testi, kullandığı ilaçların uygunluğu ve inhaler tedavi uyumu gibi parametreler düzenli aralıklarla değerlendirilmelidir. Bu yüzden, herhangi bir sebeple göğüs hastalıkları polikliniğine başvuran hastalarda bu değerlendirmelerin en son ne zaman yapıldığının sorgulanması ve hastanın bütünüyle irdelenmesi önemlidir.