Browsing by Author "Unsal, Zuhal Ekici"

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Characteristics of hospitalised COVID-19 patients and parameters associated with severe pneumonia
(2021) Turan, Onur; Mirici, Arzu; Akcali, Serap Duru; Turan, Pakize Ayse; Batum, Ozgur; Sengul, Aysun; Unsal, Zuhal Ekici; Kabakoglu, Nalan Isik; Ogan, Nalan; Torun, Serife; Ak, Guntulu; Akcay, Sule; Komurcuoglu, Berna; Sen, Nazan; Mutlu, Pinar; Yilmaz, Ulku; 34480831
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.
Characteristics of hospitalized COVID-19 patients and parameters associated with severe pneumonia
(2021) Turan, Muzaffer Onur; Mirici, Arzu; Akcali, Serap Duru; Turan, Pakize Ayse; Batum, Ozgur; Sengul, Aysun; Unsal, Zuhal Ekici; Kabakoglu, Nalan Isik; Ogan, Nalan; Torun, Serife; Ak, Guntulu; Akcay, Sule; Komurcuoglu, Berna; Sen, Nazan; Mutlu, Pinar; Yilmaz, Ulku
Characteristics Of Our Hypoxemic COVID-19 Pneumonia Patients Receiving Corticosteroids And Mortality-Associated Factors
(2022) Sengul, Aysun; Mutlu, Pinar; Ozdemir, Ozer; Satici, Celal; Turan, Muzaffer Onur; Arslan, Sertac; Ogang, Nalan; Unsal, Zuhal Ekici; Bozkus, Fulsen; Capraz, Aylin; Demirkol, Mustafa Asim; Mutlu, Levent Cern; Gulhanm, Pinar Yildiz; Alkilinc, Ersin; Fazlioglu, Nevin; Soyler, Yasemin; Kabalak, Pinar Akin; Kizilgoz, Derya; Turan, Pakize Ayse; Yildirim, Fatma; Aydemir, Yusuf; Sen, Nazan; Mirici, Arzu; 35839345
Background COVID-19 is a disease associated with diffuse lung injury that has no proven effective treatment yet. It is thought that glucocorticoids may reduce inflammation-mediated lung injury, disease progression, and mortality. We aimed to evaluate our patient's characteristics and treatment outcomes who received corticosteroids for COVID-19 pneumonia. Methods We conducted a multicenter retrospective study and reviewed 517 patients admitted due to COVID-19 pneumonia who were hypoxemic and administered steroids regarding demographic, laboratory, and radiological characteristics, treatment response, and mortality-associated factors. Results Of our 517 patients with COVID-19 pneumonia who were hypoxemic and received corticosteroids, the mortality rate was 24.4% (n = 126). The evaluation of mortality-associated factors revealed that age, comorbidities, a CURB-65 score of >= 2, higher SOFA scores, presence of MAS, high doses of steroids, type of steroids, COVID-19 treatment, stay in the intensive care unit, high levels of d-dimer, CRP, ferritin, and troponin, and renal dysfunction were associated with mortality. Conclusion Due to high starting and average steroid doses are more associated with mortality, high-dose steroid administration should be avoided. We believe that knowing the factors associated with mortality in these cases is essential for close follow-up. The use of CURB-65 and SOFA scores can predict prognosis in COVID-19 pneumonia.
Evaluation of Subclinical Atherosclerosis with Carotid Intima-Media and Epicardial Fat Thickness in Patients with Sarcoidosis
(2020) Yilmaz, Hatice Eylul Bozkurt; Yilmaz, Mustafa; Erol, Tansel; Sen, Nazan; Unsal, Zuhal Ekici; Kara, Sibel; Habesoglu, Mehmet Ali; Akcay, Sule; 0000-0002-3628-4661; 0000-0002-2557-9579; 0000-0002-8360-6459; 0000-0003-3225-2686; 0000-0002-4171-7484; 32584234; AAN-5153-2021; S-6973-2016; AAI-8069-2021; AAB-5175-2021; AAD-5602-2021; AAI-8947-2021
OBJECTIVES: Since many similar mechanisms may play a role in the pathophysiology of sarcoidosis and atherosclerosis, the risk of subclinical atherosclerosis may be increased in patients with sarcoidosis. The aim of this study was to evaluate known markers of subclinical atherosclerosis, namely epicardial fat thickness (EFT) and carotid intima-media thickness (CIMT) in patients with sarcoidosis. MATERIALS AND METHODS: This cross-sectional study included a total of 183 subjects, including 94 patients with sarcoidosis (patient group) and a control group of 89 healthy individuals. Measurements of EFT and CIMT were taken from all subjects and recorded. The groups were compared, and differences were analyzed statistically. RESULTS: EFT was higher in patients than in control subjects (6.42 +/- 1.12 mm vs 7.13 +/- 1.41 mm, p<0.001). CIMT was higher in patients than in control subjects (0.51 +/- 0.02 mm vs 0.52 +/- 0.02 mm, p=0.003). CONCLUSION: EFT and CIMT were found to be higher in patients with sarcoidosis than in healthy people. These results indicate that the risk of subclinical atherosclerosis might be increased in these patients.
Factors Affecting Mortality In Geriatric Patients Diagnosed With Community-Acquired Pneumonia Treated In Intensive Care Units
(2021) Bozkurt Yilmaz, Hatice Eylul; Unsal, Zuhal Ekici; Habesoglu, Mehmet Ali; Kara, Sibel; Sen, Nazan
Introduction: The aim of this study was to determine the factors affecting mortality in elderly patients with community-acquired pneumonia who were receiving intensive care unit. Materials and Methods: The study was retrospective, cross-sectional, and descriptive. The medical records of patients over 65 years of age who were admitted to the intensive care unit with a diagnosis of community-acquired pneumonia between January 1, 2013 and February 29, 2020 were reviewed. The factors associated with mortality in the patients who had died were examined. Results: A total of 208 patients with a mean age of 75.11 +/- 5.59 years, 78 of whom were women (37.5%), were included in the study. During the follow-up 35 (16.82%) of 208 patients had died from pneumonia or complications due to pneumonia. According to multiple linear regression analysis, the following parameters were found to be predictors of mortality: Charlson comorbidity index value (odds ratio: 1.44, 95% confidence interval: 1.132-1.1841, p=0.003), chronic obstructive pulmonary disease (odds ratio: 0.292, 95% confidence interval: 0.094-1.149, p=0.038), congestive heart failure (odds ratio: 0.199, 95% confidence interval: 0.051-0.782, p=0.021), saturation value in arterial blood gas (odds ratio: 0.569, 95% confidence interval: 0.804-0.939, p<0.001), intubation duration (odds ratio: 3.476, 95% confidence interval: 1.880-6.425, p<0.001), hypertension (odds ratio: 3.449, 95% confidence interval: 0.941-12.649, p=0.042), and the presence of diabetes mellitus (odds ratio: 3.116, 95% confidence interval: 2.673-59.021, p=0.046). Conclusion: Community-acquired pneumonia requiring intensive care unit is a clinical condition with high mortality in the elderly patient population. The presence of comorbid diseases and prolonged intubation time may be associated with higher mortality.
IgG Neutralizing Antibodies to SARS-CoV-2 Among Healthcare Workers Who Frequently Encountered Patients with COVID-19
(2022) Yesilagac, Hasan; Aliskan, Hikmet Eda; Gumus, Hatice Hale; Odemis, Ilker; Unsal, Zuhal Ekici; 0000-0003-2638-0163; 0000-0001-9071-9606; AAD-1638-2019; AAJ-2108-2021
Introduction: Since the Severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) first emerged in Wuhan, on 12 December 2019, it has spread rapidly across the world and developed into a pandemic. As healthcare workers are frequently in contact with Coronavirus disease-2019 (COVID-19) patients, they can be affected more often than the general population. In this study we aimed to investigate the SARS-CoV-2 seroprevalence and the IgG antibody levels among healthcare workers who frequently encountered COVID-19 patients in our hospital.Materials and Methods: In total, 182 healthcare workers were identified from database and their data was retrospectively analyzed. Participants with previous PCR positivity, pregnant, autoimmune disease history or immunosuppressive treatment history were excluded. Participants were grouped depending on their frequency of contact with COVID-19 patients (high and medium risk). All the samples were tested simultaneously for anti-SARS-CoV-2-IgG antibodies by the ELISA method. A chi-square test was used to compare categorical variables. A t-test and an ANOVA test were carried out to where appropriate.Results: Serological testing of 182 HCWs exposed to SARS-CoV-2 patients illustrated that 13.2% of them (24 out of 182) might have experienced an asymptomatic or subclinical SARS-CoV-2 infection. High risk participants, anosmia, and ageusia were statistically significant risk factors. The rate of detection of antibody positivity among doctors (p=0.030) and patients with anosmia, and ageusia (p=0.047) were found significantly higher than the others. In addition, SARS-CoV-2 antibody ratio results were found significantly higher in the groups of high risk participants (p=0.046), patients with clinical signs (p=0.008), myalgia (p=0.039), anosmia, and ageusia (p=0.025), respectively.Conclusion: Our study showed that serological testing is useful for determining asymptomatic or subclinical infections prevelance of SARS-CoV-2 among those with close contact with COVID-19 patients. Serological tests can be helpful determining the prevelance COVID-19 infection, especially among the HCWs.
Investigation of the Relationship between Asthma and Visceral Obesity by Epicardial Fat Thickness Measurement
(2019) Yilmaz, Hatice Eylul Bozkurt; Yilmaz, Mustafa; Sen, Nazan; Unsal, Zuhal Ekici; Eyuboglu, Fusun Oner; Akcay, Sule; 0000-0003-3225-2686; 0000-0002-8360-6459; AAB-5175-2021; 30664419; AAR-4338-2020; AAD-5602-2021
OBJECTIVES: Obesity is a risk factor defined in recent years for asthma. It is associated not only with asthma but also with many cardiovascular diseases. Visceral obesity is a more significant risk factor than general obesity in cardiovascular diseases. Although the association of visceral obesity with cardiovascular diseases is well known, the relationship in patients with asthma is not fully understood. The aim of the present study was to investigate whether there is a relationship between asthma and visceral fat by using epicardial fat thickness (EFT) measurement. MATERIALS AND METHODS: A total of 401 subjects (229 patients with persistent asthma and 172 controls) were enrolled in the study. In our study, EFT was measured, recorded by echocardiography, and was evaluated whether there was a statistical significant difference between the two groups. RESULTS: The mean EFT was 5.84 +/- 0.79 mm in the patient group and 5.71 +/- 0.93 mm in the control group. There was no statistically significant difference between the groups (p=0.145). Similarly, when we compared control and asthma severity subgroups, we did not find statistically significant differences (control group mean 5.71 +/- 0.93 mm, mild group mean 5.86 +/- 0.81 mm, moderate group mean 5.8 +/- 0.84 mm, and severe group mean 5.83 +/- 0.67 mm, p=0.505). CONCLUSION: In the present study, we observed that the EFT did not increase in patients with asthma compared with the normal population. Based on our results, we suggest that visceral obesity may not be a significant risk factor for asthma.