Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item The Clinical Outcomes Of Covid-19 Disease In Patients With Solıid Organ Transplantation(2021) Yuce, Gulbahar Darilmaz; Ulubay, Gaye; Karakaya, Emre; Tek, Korhan; Akdur, Aydincan; Bozbas, Serife Savas; Gedik, Ender; Kupeli, Elif; Erol, Cigdem; Arslan, Hande; Akcay, Sule; Haberal, Mehmet; 0000-0002-8726-3369; 0000-0002-2535-2534; 0000-0002-5708-7915; 0000-0002-3462-7632; AAA-3068-2021; AAJ-1219-2021; ABG-7034-2021; AAJ-8097-2021Item Immunogenicity after two doses of inactivated virus vaccine in healthcare workers with and without previous COVID-19 infection: Prospective observational study(2021) Yalcin, Tugba Y.; Topcu, Deniz, I; Sari, Nuran; Erol, Cigdem; Azap, Ozlem K.; Arslan, Hande; 0000-0002-3165-4520; 0000-0001-5996-8639; 0000-0002-2535-2534; 0000-0002-5708-7915; 0000-0002-3171-8926; 34468990; ABA-1149-2021; AAA-4708-2022; AAJ-1219-2021; ABG-7034-2021; AAK-4089-2021Vaccines have been seen as the most important solution for ending the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study is to evaluate the antibody levels after inactivated virus vaccination. We included 148 healthcare workers (74 with prior COVID-19 infection and 74 with not). They received two doses of inactivated virus vaccine (CoronaVac). Serum samples were prospectively collected three times (Days 0, 28, 56). We measured SARS-CoV-2 IgGsp antibodies quantitatively and neutralizing antibodies. After the first dose, antibody responses did not develop in 64.8% of the participants without prior COVID-19 infection. All participants had developed antibody responses after the second dose. We observed that IgGsp antibody titers elicited by a single vaccine dose in participants with prior COVID-19 infection were higher than after two doses of vaccine in participants without prior infection (geometric mean titer: 898 and 607 AU/ml). IgGsp antibodies, participants with prior COVID-19 infection had higher antibody levels as geometric mean titers at all time points (p < 0.001). We also found a positive correlation between IgGsp antibody titers and neutralizing capacity (r(s) = 0.697, p < 0.001). Although people without prior COVID-19 infection should complete their vaccination protocol, the adequacy of a single dose of vaccine is still in question for individuals with prior COVID-19. New methods are needed to measure the duration of protection of vaccines and their effectiveness against variants as the world is vaccinated. We believe quantitative IgGsp values may reflect the neutralization capacity of some vaccines.Item Differences in Antibody Responses Between an Inactivated SARS-CoV-2 Vaccine and the BNT162b2 mRNA Vaccine in Solid-Organ Transplant Recipients(2021) Erol, Cigdem; Yalcin, Tugba Yanik; Sari, Nuran; Bayraktar, Nilufer; Soy, Ebru Ayvazoglu; Colak, Meric Yavuz; Azap, Ozlem; Arslan, Hande; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-2535-2534; 0000-0002-0993-9917; 0000-0002-5708-7915; 0000-0001-5996-8639; 0000-0002-3165-4520; 34951350; AAJ-1219-2021; AAC-5566-2019; AAJ-8097-2021; ABG-7034-2021; AAA-4708-2022Objectives: Vaccination against SARS-CoV-2 may reduce COVID-19 mortality and complications in solidorgan transplant recipients, and we evaluated the associated antibody responses and adverse effects in this high-risk population. Materials and Methods: This prospective observational study (April-June 2021) included 10 liver and 38 kidney transplant recipients who received 2 vaccine doses (Sinovac, n = 31; or BioNTech, n = 17) and 56 healthy adults (Sinovac), all of whom provided 3 blood samples (prevaccination, 4 weeks after first dose, and 4-6 weeks after second dose) for quantitative tests (Abbott Quant assay for immunoglobulin G antibodies against SARS-CoV-2 spike protein). Type I error was alpha = .05 in all statistical analyses (SPSS, version 25). Results: We analyzed demographic data, antibody responses, and adverse events after 2 doses of SARS-CoV-2 vaccine, compared immune responses from solidorgan transplant recipients (median age, 36.5 years) versus healthy patients (median age, 37.5 years), and observed significantly higher seropositivity in healthy versus transplant patients after Sinovac vaccination (100% vs 67.5%; P = .001). However, we observed no significant seropositive differences for Sinovac versus BioNTech second doses in transplant recipients. Median SARS-CoV-2 immunoglobulin G level after second dose was significantly higher in BioNTech (1388.6 AU/mL) versus Sinovac patients (136.6 AU/mL) (P = .012). The seropositivity difference between the 2 vaccines was significant in participants 24 to 44 years old (P = .040). The rate of at least 1 side effect was 82.4% (n = 14) for BioNTech vaccine and 32.3% (n = 10) for Sinovac vaccine, and the difference was statistically significant. The most common side effect was arm pain (significantly higher in BioNTech group). Conclusions: Solid-organ transplant recipients demonstrated inadequate vaccine responses (higher risk of complications and mortality) versus healthy patients. Furthermore, immune responses may differ between vaccines. Therefore, additional vaccine doses and strict control measures remain crucial.Item Propensity Score and Desirability of Outcome Ranking Analysis of Ertapenem for Treatment of Nonsevere Bacteremic Urinary Tract Infections Due to Extended-Spectrum-Beta-Lactamase-Producing Enterobacterales in Kidney Transplant Recipients(2021) Arslan, Hande; 0000-0002-5708-7915; 34370578; ABG-7034-2021There are scarce data on the efficacy of ertapenem in the treatment of bacteremia due to extended-spectrum-beta-lactamase (ESBL)-producing Enterobacterales (ESBL-E) in kidney transplant (KT) recipients. We evaluated the association between treatment with ertapenem or meropenem and clinical cure in KT recipients with nonsevere bacteremic urinary tract infections (B-UTI) caused by ESBL-E. We performed a registered, retrospective, international (29 centers in 14 countries) cohort study (INCREMENT-SOT, NCT02852902). The association between targeted therapy with ertapenem versus meropenem and clinical cure at day 14 (the principal outcome) was studied by logistic regression. Propensity score matching and desirability of outcome ranking (DOOR) analyses were also performed. A total of 201 patients were included; only 1 patient (treated with meropenem) in the cohort died. Clinical cure at day 14 was reached in 45/100 (45%) and 51/101 (50.5%) of patients treated with ertapenem and meropenem, respectively (adjusted OR 1.29; 95% CI 0.51 to 3.22; P = 0.76); the propensity score-matched cohort included 55 pairs (adjusted OR for clinical cure at day 14, 1.18; 95% CI 0.43 to 3.29; P = 0.74). In this cohort, the proportion of cases treated with ertapenem with better DOOR than with meropenem was 49.7% (95% CI, 40.4 to 59.1%) when hospital stay was considered. It ranged from 59 to 67% in different scenarios of a modified (weights-based) DOOR sensitivity analysis when potential ecological advantage or cost was considered in addition to outcome. In conclusion, targeted therapy with ertapenem appears as effective as meropenem to treat nonsevere B-UTI due to ESBL-E in KT recipients and may have some advantages.Item Coronavirus Disease (COVID-19) in Kidney and Liver Transplant Patients: A Single-Center Experience(2020) Akdur, Aydincan; Karakaya, Emre; Soy, Ebru H. Ayvazoglu; Alshalabi, Omar; Kirnap, Mahir; Arslan, Hande; Ulubay, Gaye; Hekimoglu, Koray; Moray, Gokhan; Haberal, Mehmet; 0000-0002-0993-9917; 0000-0002-0805-0841; 0000-0002-3462-7632; 0000-0003-2478-9985; 0000-0003-2498-7287; 0000-0002-8726-3369; 0000-0002-4879-7974; 32519617; AAC-5566-2019; AAD-9097-2021; AAJ-8097-2021; AAB-5064-2021; AAE-1041-2021; AAA-3068-2021; AAD-5466-2021Objectives: The novel 2019 coronavirus (COVID-19) was first described in December 2019 in Wuhan, China and subsequently announced as a pandemic on March 12, 2020. In several studies, solid-organ transplant recipients were reported to have higher risk for COVID-19. Here, we aimed to determine the frequency of COVID-19 in our kidney and liver transplant patients. Materials and Methods: Our study included 583 transplant patients who were admitted to our outpatient transplant clinics and emergency departments between March 1 and May 1, 2020. Seventy-four of them were liver transplant recipients (46 male, 28 female, of which 14 were pediatric and 60 were adult patients) and 509 of them were kidney transplant recipients (347 male, 162 female, of which 16 were pediatric and 493 were adult patients). We retrospectively evaluated demographic characteristics, currently used immunosuppressant treatment, present complaints, treatment and diagnosis of comorbid diseases, and results of COVID-19 tests. Results: Of 583 transplant recipients, 538 were seen in our outpatient transplant clinics and 45 were seen in our emergency departments. Of these, 18 patients who had had cough and fever were evaluated by respiratory clinic doctors, and nasopharyngeal swab samples were taken. One kidney transplant recipient had a positive COVID-19 test; he was followed with home isolation. He received treatment with hydroxychloroquine (400 mg/day). The other 17 patients had negative tests. There were no mortalities due to COVID-19. Conclusions: Transplant patients also got affected during the COVID-19 pandemic. According to the data of our centers, this effect is not much more different from the normal population. We recommend that transplant recipients should be warned in terms of personal hygiene and should be closely monitored by organ transplant centers. If there is an indication for hospitalization, they should be followed in an isolated unit, with no aggressive changes made to immunosuppressive doses unless necessaryItem Incidence and Immunologic Analysis of Coronavirus Disease (COVID-19) in Hemodialysis Patients: A Single-Center Experience(2020) Arslan, Hande; Musabak, Ugur; Soy, Ebru H. Ayvazoglu; Azap, Ozlem Kurt; Sayin, Burak; Akcay, Sule; Haberal, K. Murat; Akdur, Aydincan; Yildirim, Sedat; Haberal, Mehmet; 0000-0001-8287-6572; 0000-0003-1511-7634; 0000-0002-5735-4315; 0000-0002-0993-9917; 0000-0002-8726-3369; 0000-0002-3171-8926; 0000-0002-8360-6459; 0000-0002-3462-7632; 0000-0002-8211-4065; 32519618; J-3707-2015; AAU-1810-2020; AAF-4610-2019; AAC-5566-2019; AAA-3068-2021; AAK-4089-2021; AAB-5175-2021; AAJ-8097-2021; R-9398-2019Objectives: COVID-19 is a great threat to the modern world and significant threat to immunocompromised patients, including patients with chronic renal failure. We evaluated COVID-19 incidence among our hemodialysis patients and investigated the most probable immune mechanisms against COVID-19. Materials and Methods: Baskent University has 21 dialysis centers across Turkey, with 2420 patients on hemodialysis and 30 on peritoneal dialysis. Among these, we retrospectively evaluated 602 patients (257 female/345 male) with chronic renal failure receiving hemodialysis as renal replacement therapy; 7 patients (1.1%) were infected with SARS-CoV-2. We retrospectively collected patient demographic characteristics, clinical data, and immunological factors affecting the clinical course of the disease. We divided patients into groups and included 2 control groups ( individuals with normal renal functions): group I included COVID-19-positive patients with normal renal function, group II included COVID-19-positive hemodialysis patients, group III included COVID-19-negative hemodialysis patients, and group IV included COVID-19-negative patients with normal renal function. Lymphocyte subsets in peripheral blood and typing of human leukocyte antigens were analyzed in all groups, with killer cell immunoglobulin-like receptor genes analyzed only in COVID-19-positive patients and healthy controls. Results: No deaths occurred among the 7 COVID-19-positive hemodialysis patients. Group I patients were significantly older than patients in groups II and III ( P = .039, P = .030, respectively) but not significantly different from group IV (P = .060). Absolute counts of natural killer cells in healthy controls were higher than in other groups (but not significantly). Activated T cells were significantly increased in both COVID-19-positive groups versus COVID-19-negative groups. Groups showed significant differences in C and DQ loci with respect to distribution of alleles in both HLA classes. Conclusions: Although immunocompromised patients are at greater risk for COVID-19, we found lower COVID-19 incidence in our hemodialysis patients, which should be further investigated in in vitro and molecular studies.Item LAST TWO INFLUENZA SEASON: EVALUATION OF SOLID ORGAN TRANSPLANT RECIPIENTS(2020) Yalcin, Tugba Yanik; Erol, Cigdem; Sari, Nuran; Arslan, Hande; Karakaya, Emre; Haberal, Mehmet A.Item URINARY TRACT INFECTIONS IN RENAL TRANSPLANT RECIPIENTS IN THREE YEARS(2020) Sari, Nuran; Erol, Cigdem; Yalcin, Tugba Yanik; Arslan, Hande; Haberal, Mehmet A.Item TEN YEAR CHALLENGE: HOW THE ETIOLOGY AND RESISTANCE PATTERNS OF BLOOD STREAM INFECTIONS IN SOLID ORGAN TRANSPLANTATION RECIPIENTS HAVE CHANGED?(2020) Erol, Cigdem; Yanik, Tugba Yanik; Sari, Nuran; Karakaya, Emre; Arslan, Hande; Haberal, Mehmet A.Item GUILLAIN-BARRE SYNDROME DURING INFLUENZA ATTACK IN RENAL TRANSPLANT RECIPIENT(2019) Yalcin, Tuba Yanik; Akdur, Aydincan; Arslan, Hande; Haberal, Mehmet