Browsing by Author "Akcay, Muserref Sule"

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Clinical Features of SARS-CoV-2 Infection in Patients Undergoing Solid-Organ Transplant: Baskent University Experience
(2023) Yuce, Gulbahar Darilmaz; Ulubay, Gaye; Tek, Korhan; Bozbas, Serife Savas; Erol, Cigdem; Buyukasik, Piril; Haberal, Kemal Murat; Arslan, Ayse Hande; Akcay, Muserref Sule; Haberal, Mehmet; 0000-0002-2535-2534; 34635037; AAJ-1219-2021
Objectives: The clinical features and treatment approaches, outcomes, and mortality predictors of COVID-19 in solid-organ transplant recipients have not been well defined. This study investigated the clinical features of COVID-19 infection in solid-organ transplant recipients at our center in Turkey. Materials and Methods: Our study included 23 solid-organ transplant recipients and 336 nontransplant individuals (143 previously healthy and 193 patients with at least 1 comorbidity) who were hospitalized due to COVID-19 disease in our hospital between March 2020 and January 2021. Demographic, clinical, and laboratory data of patients were compared. We used SPSS version 20.0 for statistical analysis. All groups were compared using chi-square and Mann-Whitney U tests. P <.05 was considered statistically significant. Results: Mean age of solid-organ transplant recipients was 49.8 +/- 13.7 years (78.3% men, 21.7% women). Among the 23 recipients, 17 (73.9%) were kidney and 6 (26.1%) were liver transplant recipients. Among nontransplant individuals, 88.7% (n = 298) had mild/moderate disease and 11.3% (n = 38) had severe disease. Among transplant recipients, 78.3% (n = 18) had mild/moderate disease and 21.7% (n = 5) had severe disease (P =.224). Transplant recipients had greater requirements for nasal oxygen (P =.005) and noninvasive mechanical ventilation (P =.003) and had longer length of intensive care unit stay (P =.030) than nontransplant individuals. No difference was found between the 2 groups in terms of mortality (P =.439). However, a subgroup analysis showed increased mortality in transplant recipients versus previously healthy patients with COVID-19 (P <.05). Secondary infections were major causes of mortality in transplant recipients. Conclusions: COVID-19 infection resulted in higher mortality in solid- organ transplant recipients versus that shown in healthy patients. More attention on secondary infections is needed in transplant recipients to reduce mortality.
Comparative analysis of the patients with community-acquired pneumonia (CAP) and health care-associated pneumonia (HCAP) requiring hospitalization
(2019) Kara, Sibel; Akcay, Muserref Sule; Ekici, Unsal Zuhal; Bozkurt Yilmaz, Hatice Eylul; Habesoglu, Mehmet Ali; 31414641
Introduction: The recently introduced concept of health care-associated pneumonia (HCAP), referring to patients with frequent healthcare contacts and at higher risk of contracting resistant pathogens is controversial. Materials and Methods: A prospective study comparing patients with HCAP and community-acquired pneumonia (CAP) in the our center. The primary outcome was 30 day mortality. Results: A total of the 169 patients HCAP 36 (21.3%); CAP 133 (78.7%) were evaluated. HCAP patients were older than patients with CAP [median age was 72.5 (43-96), 60.0 (18-91) years p< 0.05]. The most common Klebsiella pneumoniae (16.6%) and Pseudomonas aeruginosa (8.3%) were gram-negative bacteria in the SBIP group; In the TGP group, gram-positive bacteria were more frequently isolated. Polymicrobial agents (22.2% vs. 3.7% p< 0.05) and MDR pathogens (57.1% vs. 24% p< 0.05) were more common in patients with HCAP. Mortality rate (22.2% vs. 6% p< 0.05) was also higher in HCAP more than CAP. Conclusion: HCAP was common among patients with pneumonia requiring hospitalization and mortality rate was high. The patients with HCAP were different from CAP in terms of demographic and clinical features, etiology, outcome.
Cross-Sectional Analysis Of Tobacco Addiction In Hospitalized COVID-19 Patients
(2022) Darilmaz Yuce, Gulbahar; Torun, Serife; Hekimoglu, Koray; Tuna, Derin; Sozbilici, Betul Rana; Cetin, Hikmet Oguz; Narlioglu, Mehmet Emin; Balli, Murat; Ozyesil, Ahmet Suheyl; Yavuz Colak, Meric; Ulubay, Gaye; Akcay, Muserref Sule; https://orcid.org/0000-0002-0805-0841; 36164949; AAD-9097-2021
Introduction: The COVID-19 pandemic has become an important health issue with consequences for special populations since 2019. Tobacco use is an important public health issue and tobacco users are a risk group for lung infections.Materials and Methods: The aim of this study is to obtain information about disease prevalence and severity, laboratory parameters, and changes in radio-logical findings between smokers and non-smokers who were hospitalized, followed up, and treated for COVID-19, and to find answers to critical questi-ons regarding the response to antiviral and supportive therapy. Two hundred eighty-six patients who were hospitalized and treated between March 2020-February 2021 in the COVID-19 Isolation Ward of Baskent University Hospital were included in the study. The patients were grouped as current smokers, non-smokers, and ex-smokers. The groups were compared in terms of symptoms, laboratory findings, radiological findings, and treatment respon-se.Results: The median age of the patients included in the study was 59 (IQR= 32). Of the patients, 40.6% were female and 59.4% were male. In our study, we discovered that there were fewer female smokers (p< 0.001). When the current smokers (n= 56), non-smokers (n= 159), and ex-smokers (n= 71) were compared based on their findings, it was found that dyspnea was more common in current smokers (p= 0.009). Lung involvement was found to be more common (p= 0.002) and multifocal in the current smokers group (p= 0.038). The levels of oxygen saturation at the times of admission and discharge were lower in current smokers (p= 0.002 and p= 0.038). The need for nasal oxygen and noninvasive mechanical ventilation was also found to be higher in current smokers (p= 0.008 and p= 0.039). Systemic steroid requirement was higher in current smokers (p= 0.013). There was no statistically significant differen-ce in terms of mortality between current smokers, ex-smokers, and non-smokers (p= 0.662).Conclusion: The analysis of the findings of the patients hospitalized in the COVID-19 isolation ward indicated that COVID-19 leads to a more serious course in patients with a history of smoking.
Pneumococcal and Influenza Vaccines in Dialysis Patients: Vaccination Information, Rates, and Patient Awareness
(2022) Kara, Sibel; Torun, Dilek; Oruc, Ebru; Habesoglu, Mehmet Ali; Akcay, Muserref Sule; GVT-0626-2022
Objective: Pneumococcal and influenza vaccination rates are still far below the desired levels in dialysis patients. We aimed to determine the pneumococcal and influenza vaccination information, rates, and knowledge levels of dialysis patients. Methods: The study is a descriptive cross-sectional study in which 307 dialysis patients between 2020 and 2021 were analyzed retrospectively. Demographic characteristics of all patients and vaccination information were obtained from the face-to-face questionnaire and hospital medical records. Results: Of the participants, 52.4% were males, and the mean age was 56 +/- 15.45 years. The pneumococcal vaccination rate was 37.1%, and the influenza vaccination rate was 58.6%. Of 114 patients who had received a pneumococcal vaccine, 91.2% had received a single dose of the vaccine. While the type of vaccine could not be determined in 86.8% of the patients in this group, the rate of vaccination with the 2 types of the pneumococcal vaccine was only 8.8%. Annual vaccination was given to all those who were vaccinated against influenza. In the whole group, the rate of those who had never heard of the pneumococcal vaccine was 24.4%, while this rate was 6.5% for the influenza vaccine. The patients had a very low level of knowledge of both vaccines (41% and 53.7%, respectively). Conclusion: Pneumococcal and influenza vaccination rate of dialysis patients was low. Influenza vaccination had been performed in compliance with the recommended scheme, but the doses of the pneumococcal vaccine were incomplete. Although the level of patient knowledge was low for both vaccines, patients were more aware of the influenza vaccine.