Browsing by Author "Baris, SA"

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    Socioeconomic status has direct impact on asthma control: Turkish adult asthma registry
    Arslan, B; Türk, M; Hayme, S; Aydin,Ö; Gokmen, D; Buhari, GK; Sozener, ZC; Gemicioglu, B; Bulut, I; Beyaz, S; Orcen, C; Ozdemir, SK; Keren, M; Damadoglu, E; Yakut, T; Kalpaklioglu, AF; Baccioglu, A; Yalim, SA; Yilmaz, I; Kalkan, IK; Niksarlioglu, EYO; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Gelincik, AA; Dirol, H; Goksel, O; Karaoglanoglu, S; Erkekol, FO; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Seker, U; Oguzulgen, IK; Basyigit, I; Baris, SA; Ucar, EY; Erdogan, T; Polatli, M; Ediger, D; Gunaydin, FE; Pur, L; Katran, ZY; Sekibag, Y; Aykac, EF; Mungan, D; Gul, O; Cengiz, A; Akkurt, B; Ozden, S; Demir, S; Unal, D; Aslan, AF; Can, A; Gumusburun, R; Bogatekin, G; Akten, HS; Inan, S; Erdinc, M; Ogus, AC; Kavas, M; Yulug, DP; Cakmak, ME; Kaya, SB; Alpagat, G; Ozgur, ES; Uzun, O; Gulen, ST; Pekbak, G; Kizilirmak, D; Havlucu, Y; Donmez, H; Cetin, GP; Soyyigit, S; Kara, BY; Karakis, GP; Dursun, AB; Kendirlinan, R; Ozturk, AB; Sevinc, C; Simsek, GO; Abadoglu, O; Cerci, P; Yucel, T; Yorulmaz, I; Tezcaner, ZC; Tatar, EC; Suslu, AE; Ozer, S; Dursun, E; Yorgancioglu, A; Celik, GE; Uysal, MA
    BackgroundAsthma is one of the most common causes of chronic respiratory disease, and countries with low socioeconomic status have both a high prevalence of asthma and asthma-related death.ObjectiveIn this study, we aimed to determine socioeconomic levels of asthmatic patients according to a national database and investigate the effects of social markers on disease control in our region.MethodsThis is an analysis of data from 2053 adult asthma patients from a multicentre chart study in Turkey. Socioeconomic status (SES) data were collected from questionnaires and this form was sent to the patients via e-mail. Parameters related to social status and poor disease control were analyzed.ResultsIlliteracy (OR:2.687 [95% CI: 1.235-5.848]; p = 0.013) and lower household income (OR:1,76 [95% CI: 1.002-3.09]; p = 0.049) were found as independent risk factors for hospitalization in the multivariate logistic regression analysis. Therewithal, being aged between 40 and 60 (OR: 1.435 [95% CI: 1.074-1.917]; p = 0.015), illiteracy (OR: 2.188 [95% CI: 1.262-3.795]; p = 0.005) and being employed (OR: 1.466 [95% CI: 1.085-1.847]; p = 0.011) were considered as independent risk factors for systemic corticosteroid use at least 3 days within last 1 year.ConclusionAs a result of our national database, education level, household income and working status briefly socioeconomic status have impacts on asthma control. Identification of social markers in asthma and better recognition of risk factors based on the population gives us clues to provide better asthma control in the future.
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    Picturing asthma in Turkey: results from the Turkish adult asthma registry
    Celik, GE; Aydin, O; Gokmen, D; Buhari, GK; Sozener, ZC; Gemicioglu, B; Bulut, I; Beyaz, S; Orcen, C; Ozdemir, SK; Keren, M; Damadoglu, E; Yakut, T; Kalpaklioglu, AF; Baccioglu, A; Yalim, SA; Yilmaz, I; Kalkan, IK; Uysal, MA; Niksarlioglu, EY; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Gelincik, AA; Dirol, H; Goksel, O; Karaoglanoglu, S; Erkekol, FO; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Seker, U; Oguzulgen, IK; Basyigit, I; Baris, SA; Ucar, EY; Erdogan, T; Polatli, M; Ediger, D; Gunaydin, FE; Turk, M; Pur, L; Katran, ZY; Sekibag, Y; Aykac, EF; Mungan, D; Gul, O; Cengiz, A; Akkurt, B; Ozden, S; Demir, S; Unal, D; Aslan, AF; Can, A; Gumusburun, R; Bogatekin, G; Akten, HS; Inan, S; Erdinc, M; Ogus, AC; Kavas, M; Yulug, DP; Cakmak, ME; Kaya, SB; Alpagat, G; Ozgur, ES; Uzun, O; Gulen, ST; Pekbak, G; Kizilirmak, D; Havlucu, Y; Donmez, H; Arslan, B; Cetin, GP; Soyyigit, S; Kara, BY; Karakis, GP; Dursun, AB; Kendirlinan, R; Ozturk, AB; Sevinc, C; Simsek, GO; Abadoglu, O; Cerci, P; Yucel, T; Yorulmaz, I; Tezcaner, ZC; Tatar, EC; Suslu, AE; Ozer, S; Dursun, E; Yorgancioglu, A
    IntroductionNational data on asthma characteristics and the factors associated with uncontrolled asthma seem to be necessary for every country. For this purpose, we developed the Turkish Adult Asthma Registry for patients with asthma aiming to take a snapshot of our patients, thereby assigning the unmet needs and niche areas of intervention.MethodsCase entries were performed between March 2018 and March 2022. A web-based application was used to record data. Study outcomes were demographic features, disease characteristics, asthma control levels, and phenotypes.ResultsThe registry included 2053 patients from 36 study centers in Turkey. Female subjects dominated the group (n = 1535, 74.8%). The majority of the patients had allergic (n = 1158, 65.3%) and eosinophilic (n = 1174, 57.2%) asthma. Six hundred nineteen (32.2%) of the patients had obese asthma. Severe asthma existed in 670 (32.6%) patients. Majority of cases were on step 3-5 treatment (n: 1525; 88.1%). Uncontrolled asthma was associated with low educational level, severe asthma attacks in the last year, low FEV1, existence of chronic rhinosinusitis and living in particular regions.ConclusionThe picture of this registry showed a dominancy of middle-aged obese women with moderate-to-severe asthma. We also determined particular strategic targets such as low educational level, severe asthma attacks, low FEV1, and chronic rhinosinusitis to decrease uncontrolled asthma in our country. Moreover, some regional strategies may also be needed as uncontrolled asthma is higher in certain regions. We believe that these data will guide authorities to reestablish national asthma programs to improve asthma service delivery.
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    Trends in prescribing montelukast in patients with asthma in real-life: Results from the Turkish adult asthma registry
    Beyaz, S; Erdinç, M; Hayme, S; Aslan, AF; Aydin,Ö; Gökmen, D; Buhari, GK; Sözener, ZC; Gemicioglu, B; Bulut, I; Örçen, C; Özdemir, SK; Keren, M; Damadoglu, E; Yakut, T; Kalpaklioglu, AF; Baccioglu, A; Yalim, SA; Yilmaz, I; Kalkan, IK; Uysal, MA; Niksarlioglu, EYÖ; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Gelincik, AA; Dirol, H; Göksel,Ö; Karaoglanoglu, S; Erkekol, FÖ; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Seker,Ü; Oguzülgen, IK; Basyigit, I; Baris, SA; Uçar, EY; Erdogan, T; Polatli, M; Ediger, D; Günaydin, FE; Türk, M; Pür, L; Katran, ZY; Sekibag, Y; Aykaç, EF; Mungan, D; Gül,Ö; Cengiz, A; Akkurt, B; Özden, S; Demir, S; Ünal, D; Can, A; Guemuesburun, R; Bogatekin, G; Akten, HS; Inan, S; Ögüs, AC; Kavas, M; Yulug, DP; Çakmak, ME; Kaya, SB; Alpagat, G; Özgür, ES; Uzun, O; Gülen, ST; Pekbak, G; Kizilirmak, D; Havlucu, Y; Doenmez, H; Arslan, B; Çetin, GP; Soyyigit, S; Kara, BY; Karakis, GP; Dursun, AB; Kendirlinan, R; Öztürk, AB; Sevinç, C; Simsek, GÖ; Abadoglu,Ö; Çerçi, P; Yücel, T; Yorulmaz, I; Tezcaner, ZÇ; Tatar, EÇ; Süslü, AE; Özer, S; Dursun, E; Yorgancioglu, A; Çelik, GE
    Montelukast, a leukotriene receptor antagonist (LTRA) approved for the treatment of asthma and allergic rhinitis, is widely used, though real-world data on its application in asthma management remain limited. This registry-based study evaluated the use of montelukast in adult asthma patients, examining demographic and disease characteristics, asthma control status, asthma phenotypes, presence of atopy, and treatment regimens. Among 2053 patients analyzed, 61.76% (n = 1268; mean age: 46.2 +/- 14.3 years), predominantly females (similar to 76%), received montelukast. Montelukast users showed higher rates of allergic rhinitis (P < 0.001), hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) (P = 0.008), and chronic rhinosinusitis (P = 0.008). Montelukast group also had higher atopy and total IgE levels and tended to be more eosinophilic. Montelukast was commonly preferred in allergic, eosinophilic, NSAID-exacerbated respiratory disease, and severe asthma phenotypes (P < 0.001). Patients receiving Steps 4 and 5 treatments are more likely to be prescribed montelukast (P < 0.001). Montelukast usage was higher among patients with uncontrolled asthma [ACT< 20 (OR:1.29, 95%CI:1.052-1.582, P = 0.014)]. In addition, logistic regression analyses identified the main factors associated with increased montelukast use as; female gender (OR:1.33, 95%CI:1.041-1.713, P = 0.02), presence of atopy (OR:1.46, 95%CI:1.157-1.864, P = 0.002), comorbid allergic rhinitis (OR:2.12, 95%CI:1.679-2.293, P < 0.001), and severe asthma (OR:2.18, 95%CI:1.712-2.784, P < 0.001). These findings reveal that montelukast use is prevalent among asthma patients, particularly in females, middle-aged adults, and those with comorbid allergic rhinitis, uncontrolled asthma, or specific asthma phenotypes, underscoring the factors that influence its prescription in asthma management. (c) 2025 Codon Publications. Published by Codon Publications.
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    Factors influencing the prescription of add-on long-acting muscarinic antagonists in real-world asthma management: Insights from a national registry
    Gemicioglu, B; Gokmen, D; Can, A; Sevinc, C; Oguzulgen, IK; Soyyigit, S; Yakut, T; Havlucu, Y; Aydin, O; Buhari, GK; Sozener, ZC; Bulut, I; Beyaz, S; Orcen, C; Ozdemir, SK; Keren, M; Damadoglu, E; Kalpaklioglu, AF; Baccioglu, A; Yalim, SA; Yilmaz, I; Kalkan, IK; Uysal, MA; Niksarlioglu, EYO; Kalyoncu, AF; Karakaya, G; Erbay, M; Nayci, S; Tepetam, FM; Gelincik, A; Dirol, H; Goksel, O; Karaoglanoglu, S; Erkekol, FO; Isik, SR; Yildiz, F; Yavuz, Y; Karadogan, D; Bozkurt, N; Seker, U; Basyigit, I; Baris, SA; Ucar, EY; Erdogan, T; Polatli, M; Ediger, D; Gunaydin, FE; Turk, M; Pur, L; Katran, ZY; Sekibag, Y; Aykac, EF; Mungan, D; Gul, O; Cengiz, A; Akkurt, B; Ozden, S; Demir, S; Unal, D; Aslan, AF; Gumusburun, R; Bogatekin, G; Akten, HS; Inan, S; Erdinc, M; Ogus, AC; Kavas, M; Yulug, DP; Cakmak, ME; Kaya, SB; Alpagat, G; Ozgur, ES; Uzun, O; Gulen, ST; Pekbak, G; Kizilirmak, D; Donmez, H; Arslan, B; Cetin, GP; Kara, BY; Dursun, AB; Karakis, GP; Kendirlinan, R; Ozturk, AB; Simsek, GO; Abadoglu, O; Cerci, P; Yucel, T; Yorulmaz, I; Tezcaner, ZC; Tatar, EC; Suslu, AE; Ozer, S; Dursun, E; Yorgancioglu, A; Çelik, GE
    Current guidelines recommend adding long-acting muscarinic antagonists (LAMAs) in patients with uncontrolled asthma, despite the use of moderate to high doses of inhaled steroid-long-acting beta agonists (ICS/LABA). This study aims to analyze the factors related to the prescription of add-on LAMA in clinical practice for asthma patients, shedding light on physicians' preferences. This study included adult asthma patients on add-on LAMA and ICS/LABA monitored for at least one year in a national registry comprising 2053 asthmatics. Patients' characteristics and disease profiles were analyzed to identify factors associated with the prescription of add-on LAMA across the entire cohort. A comparative analysis was performed among three groups: MART (ICS/formoterol as a maintenance and reliever therapy) plus LAMA, Conventional (ICS/LABA as a maintenance and short-acting beta agonist as reliever) plus LAMA and Triple (ICS/ LABA/LAMA single inhaler). LAMAs were added to ICS/LABA in 11.7 % of patients in the national registry. Logistic regression analysis revealed that older age, low FEV1 (%), Asthma Control Test (ACT) scores less than 20, and severe exacerbation were the main factors influencing the initiation of LAMA in our registry. However, demographic characteristics of asthma, control status, pulmonary function test results were similar among the three groups of LAMA users (p > 0.05). Physicians used LAMAs without phenotyping based on allergic status or eosinophil levels (p > 0.05). Mepolizumab was added after LAMA in all patients, while omalizumab was initiated before LAMA in 16.9 % of the patients receiving LAMA along with biologics. Add-on LAMAs were predominantly prescribed for older, uncontrolled, and exacerbated asthma patients with low FEV1.
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    Are elderly and aged asthma different diseases? Results of a multicenter study
    Celebioglu, E; Aktas, OO; Gemicioglu, B; Yilmaz, N; Bozkus, F; Ayhan, V; Kalpaklioglu, F; Erkekol, FO; Havlucu, Y; Erel, F; Aydin, O; Ekici, A; Baccioglu, A; Baris, SA; Buhari, GK; Ceyhan, B; Goksel, O; Kose, M; Dursun, AB; Yildiz, F; Yorgancioglu, A; Isik, SR; Ediger, D; Oguzulgen, IK; Karakaya, G; Kalyoncu, AF
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    Lung cancer from suspicion to treatment: An indicator of healthcare access in Turkey
    Kizilirmak, D; Kaya, ZY; Gökçimen, G; Havlucu, Y; Özyurt, BC; Gündogus, B; Esendagli, D; Kaya, BS; Yilmam, I; Aydemir, Y; Çolak, M; Afsin, E; Çetin, N; Idikut, A; Degirmenci, C; Tapan, ÖO; Gürkan, CG; Kocatürk, CI; Simsek, GÖ; Kalafat, CE; Niksarlioglu, EYÖ; Serdaroglu, ME; Karcioglu, O; Özyurt, S; Madran, EK; Bayrak, BY; Alasgarova, Z; Toprak, OB; Uçar, EY; Topal, BN; Baris, SA; Guliyev, E; Güzel, E; Küçük, S; Ocakli, B; Ketencioglu, BB; Selçuk, NT; Akyüz, MS; Özgür, ES; Yetkin, NA; Çetinkaya, PD; Deniz, PP; Atli, S; Çetindogan, H; Karakas, FG; Yilmaz, ES; Ergün, D; Ergcn, R; Tulay, CM; Ünsal, M; Demirkaya, I; Marim, F; Kaya, I; Demirdögen, E; Dilektasli, AG; Ursavas, A; Çelik, P
    Background: Lung cancer is the leading cause of cancer-related deaths worldwide. Before beginning lung cancer treatment, it is necessary to complete procedures such as suspecting lung cancer, obtaining a pathologic diagnosis, and staging. This study aimed to investigate the processes from suspicion of lung cancer to diagnosis, staging, and treatment initiation. Metbods: The study was designed as a multicenter and cross-sectional study. Patients with lung cancer from various health institutions located in all geographic regions of Turkey were included in the study. The socio-demographic and clinical characteristics of the patients, the characteristics of the health institutions and geographic regions, and other variables of the lung cancer process were recorded. The time from suspicion of lung cancer to pathologic diagnosis, radiologic staging, and treatment initiation, as well as influencing factors, were investigated. Results: The study included 1410 patients from 29 different medical centers. The mean time from the initial suspicion of lung cancer to the pathologic diagnosis was 48.0 +/- 52.6 days, 39.0 +/- 52.7 days for radiologic staging, and 74.9 +/- 65.5 days for treatment initiation. The residential areas with the most suspected lung cancer cases were highly developed socioeconomic zones. Primary healthcare services accounted for only 0.4% of pa-tients with suspected lung cancer. The time to pathologic diagnosis was longer in the Marmara region, and the wait time for staging and treatment initiation was longer in Eastern and Southeastern Anatolia. Patients who presented to chest disease referral hospitals with peripheral lesions, those with early-stage disease, and those who were diagnosed surgically had significantly longer wait times. Conclusion: The time between pathologic diagnosis, staging, and treatment initiation in lung cancer was longer than expected. Increasing the role of primary healthcare services and distributing socioeconomic resources more equally will contribute to shortening the time to diagnosis and improve treatment processes for lung cancer.
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    The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients
    Kokturk, N; Babayigit, C; Kul, S; Cetinkaya, PD; Nayci, SA; Baris, SA; Karcioglu, O; Aysert, P; Irmak, I; Yuksel, AA; Sekibag, Y; Toprak, OB; Azak, E; Mulamahmutoglu, S; Cuhadaroglu, C; Demirel, A; Kerget, B; Ketencioglu, BB; Ozger, HS; Ozkan, G; Yuce, ZT; Ergan, B; Oguz, VA; Kilinc, O; Ercelik, M; Ciftci, TU; Alici, O; Temel, EN; Ataoglu, O; Aydin, A; Bahcetepe, DC; Gullu, YT; Fakili, F; Deveci, F; Kose, N; Tor, MM; Gunluoglu, G; Altin, S; Turgut, T; Tuna, T; Ozturk, O; Dikensoy, O; Gulhan, PY; Basyigit, I; Boyaci, H; Oguzulgen, IK; Borekci, S; Gemicioglu, B; Bayraktar, F; Elbek, O; Hanta, I; Okur, HK; Sagcan, G; Uzun, O; Akgun, M; Altinisik, G; Dursun, B; Edis, EC; Gulhan, E; Eyuboglu, FO; Gultekin, O; Havlucu, Y; Ozkan, M; Sakar, A; Sayiner, A; Kalyoncu, AF; Itil, O; Bayram, H
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    The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients
    Kokturk, N; Babayigit, C; Kul, S; Cetinkaya, PD; Nayci, SA; Baris, SA; Karcioglu, O; Aysert, P; Irmak, I; Yuksel, AA; Sekibag, Y; Toprak, OB; Azak, E; Mulamahmutoglu, S; Cuhadaroglu, C; Demirel, A; Kerget, B; Ketencioglu, BB; Ozger, HS; Ozkan, G; Ture, Z; Ergan, B; Oguz, VA; Kilinc, O; Ercelik, M; Ciftci, TU; Alici, O; Temel, EN; Ataoglu, O; Aydin, A; Bahcetepe, DC; Gullu, YT; Fakili, F; Deveci, F; Kose, N; Tor, MM; Gunluoglu, G; Altin, S; Turgut, T; Tuna, T; Ozturk, O; Dikensoy, O; Gulhan, PY; Basyigit, I; Boyaci, H; Oguzulgen, IK; Borekci, S; Gemicioglu, B; Bayraktar, F; Elbek, O; Hanta, I; Okur, HK; Sagcan, G; Uzun, O; Akgun, M; Altinisik, G; Dursun, B; Edis, EC; Gulhan, E; Eyuboglu, FO; Gultekin, O; Havlucu, Y; Ozkan, M; Coskun, AS; Sayiner, A; Kalyoncu, AF; Itil, O; Bayram, H
    The COVID-19-related death rate varies between countries and is affected by various risk factors. This multi-center registry study was designed to evaluate the mortality rate and the related risk factors in Turkey. We retrospectively evaluated 1500 adults with COVID-19 from 26 centers who were hospitalized between March 11 and July 31, 2020. In the study group, 1041 and 459 cases were diagnosed as definite and highly probable cases, respectively. There were 993 PCR-positive cases (66.2%). Among all cases, 1144 (76.3%) were diagnosed with non-severe pneumonia, whereas 212 (14.1%) had severe pneumonia. Death occurred in 67 patients, corresponding to a mortality rate of 4.5% (95% CI:3.5-5.6). The univariate analysis demonstrated that various factors, including male sex, age >= 65 years and the presence of dyspnea or confusion, malignity, chronic obstructive lung disease, interstitial lung disease, immunosuppressive conditions, severe pneumonia, multiorgan dysfunction, and sepsis, were positively associated with mortality. Favipiravir, hydroxychloroquine and azithromycin were not associated with survival. Following multivariate analysis, male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were found to be independent risk factors for mortality. Among the biomarkers, procalcitonin levels on the 3rd-5th days of admission showed the strongest associations with mortality (OR: 6.18; 1.6-23.93). This study demonstrated that the mortality rate in hospitalized patients in the early phase of the COVID-19 pandemic was a serious threat and that those patients with male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were at increased risk of mortality; therefore, such patients should be closely monitored.
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    COVID-19: booster(s) vs. hospitalization and Intensive Care Unit admission
    Toprak, OB; Akpolat, T; Uzun, O; Deniz, PP; Kokturk, N; Varol, A; Guzel, E; Ercelik, M; Gultekin, O; Guner, R; Turan, S; Bekta, SG; Coskun, N; Bakan, N; Yakar, MN; Kutsoylu, OE; Ergan, B; Baris, SA; Basyigit, I; Boyaci, H; Cetinkaya, F; Colak, H; Aykac, N; Ketencioglu, BB; Yüce, ZT; Isik, SA; Yilmaz, ES; Karaoglanoglu, S; Safgi, SB; Ozkan, G; Kose, N; Kizilirmak, D; Havlucu, Y; Nural, S; Kerget, F; Sunal, O; Yuksel, A; Dursun, ZB; Deveci, F; Kuluozturk, M; Ataoglu, O; Dursun, M; Keskin, S; Sezgin, ME; Sezgin, ENA; Eser, F; Akyildiz, L; Almaz, MS; Kayaaslan, B; Hasanoglu, I; Bayrak, M; Gümüs, A; Sagcan, G; Cuhadaroglu, C; Kucuk, H; Onyilmaz, T; Mete, B; Kilinc, O; Itil, BO
    OBJECTIVE: As the pandem-ic continues, different vaccine protocols have been implemented to maintain the protection of vaccines and to provide protection against new variants. The aim of this study was to as-sess hospitalized patients' vaccination status and document the efficacy of boosters.PATIENTS AND METHODS: The patients that were hospitalized due to COVID-19 were enrolled from 28 hospitals in Turkey for five months from September 2021. 5,331 confirmed COVID-19 pa-tients from collaborating centers were random-ly enrolled to understand/estimate the distri-bution of vaccination status in hospitalized pa-tients and to compare the efficacy of vaccina-tion/booster protocols.RESULTS: 2,779 men and 2,552 women of which 2,408 (45.2%) were admitted to Intensive Care Units participated in this study. It was found that the highest risk reduction for all age groups was found in groups that received 4 doses. Four doses of vaccination for every 3.7 people under 50 years of age, for every 5.7 people in the 50-64 age group, and for every 4.3 people over 65 years of age will prevent 1 patient from being admitted to intensive care. Regardless of the type of vaccine, it was found that the risk of ICU hospitalization decreased in those who were vaccinated compared to those who were not vaccinated. Regardless of the type of vaccine, the ICU risk was found to decrease 1.25-fold in those who received 1 or 2 doses of vaccine, 1.18-fold in those who received 3 dos-es, and 3.26-fold in those who received 4 doses.CONCLUSIONS: The results suggested that the addition of a fourth dose is more effective in preventing intensive unit care even in disad-vantaged.
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    The association of antiviral drugs with COVID-19 morbidity: The retrospective analysis of a nationwide COVID-19 cohort
    Babayigit, C; Kokturk, N; Kul, S; Cetinkaya, PD; Nayci, SA; Baris, SA; Karcioglu, O; Aysert, P; Irmak, I; Yuksel, AA; Sekibag, Y; Toprak, OB; Azak, E; Mulamahmutoglu, S; Cuhadaroglu, C; Demirel, A; Kerget, B; Ketencioglu, BB; Ozger, HS; Ozkan, G; Ture, Z; Ergan, B; Oguz, VA; Kilinc, O; Ercelik, M; Ciftci, TU; Alici, O; Temel, EN; Ataoglu, O; Aydin, A; Bahcetepe, DC; Gullu, YT; Fakili, F; Deveci, F; Kose, N; Tor, MM; Gunluoglu, G; Altin, S; Turgut, T; Tuna, T; Ozturk, O; Dikensoy, O; Gulhan, PY; Basyigit, I; Boyaci, H; Oguzulgen, IK; Borekci, S; Gemicioglu, B; Bayraktar, F; Elbek, O; Hanta, I; Okur, HK; Sagcan, G; Uzun, O; Akgun, M; Altinisik, G; Dursun, B; Edis, EC; Gulhan, E; Eyuboglu, FO; Gultekin, O; Havlucu, Y; Ozkan, M; Coskun, A; Sayiner, A; Kalyoncu, AF; Itil, O; Bayram, H
    Background and objectivesAlthough several repurposed antiviral drugs have been used for the treatment of COVID-19, only a few such as remdesivir and molnupiravir have shown promising effects. The objectives of our study were to investigate the association of repurposed antiviral drugs with COVID-19 morbidity. MethodsPatients admitted to 26 different hospitals located in 16 different provinces between March 11-July 18, 2020, were enrolled. Case definition was based on WHO criteria. Patients were managed according to the guidelines by Scientific Board of Ministry of Health of Turkey. Primary outcomes were length of hospitalization, intensive care unit (ICU) requirement, and intubation. ResultsWe retrospectively evaluated 1,472 COVID-19 adult patients; 57.1% were men (mean age = 51.9 +/- 17.7years). A total of 210 (14.3%) had severe pneumonia, 115 (7.8%) were admitted to ICUs, and 69 (4.7%) were intubated during hospitalization. The median (interquartile range) of duration of hospitalization, including ICU admission, was 7 (5-12) days. Favipiravir (n = 328), lopinavir/ritonavir (n = 55), and oseltamivir (n = 761) were administered as antiviral agents, and hydroxychloroquine (HCQ, n = 1,382) and azithromycin (n = 738) were used for their immunomodulatory activity. Lopinavir/ritonavir (beta [95% CI]: 4.71 [2.31-7.11]; p = 0.001), favipiravir (beta [95% CI]: 3.55 [2.56-4.55]; p = 0.001) and HCQ (beta [95% CI]: 0.84 [0.02-1.67]; p = 0.046) were associated with increased risk of lengthy hospital stays. Furthermore, favipiravir was associated with increased risks of ICU admission (OR [95% CI]: 3.02 [1.70-5.35]; p = 0.001) and invasive mechanical ventilation requirement (OR [95% CI]: 2.94 [1.28-6.75]; p = 0.011). ConclusionOur findings demonstrated that antiviral drugs including lopinavir, ritonavir, and favipiravir were associated with negative clinical outcomes such as increased risks for lengthy hospital stay, ICU admission, and invasive mechanical ventilation requirement. Therefore, repurposing such agents without proven clinical evidence might not be the best approach for COVID-19 treatment.
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    COVID-19: vaccination vs. hospitalization
    Uzun, O; Akpolat, T; Varol, A; Turan, S; Bektas, SG; Cetinkaya, PD; Dursun, M; Bakan, N; Ketencioglu, BB; Bayrak, M; Baris, SA; Guner, R; Gunal, O; Nural, S; Deniz, PP; Toprak, OB; Ozkan, G; Gumus, A; Kerget, F; Ercelik, M; Ataoglu, O; Yuksel, A; Ates, G; Kutsoylu, OE; Kose, N; Kizilirmak, D; Keskin, S; Gultekin, O; Coskun, N; Yilmaz, ES; Uslu, S; Basyigit, I; Ergan, B; Deveci, F; Yakar, MN; Zuhur, C; Sagcan, G; Yuce, ZT; Kuluozturk, M; Sezgin, ME; Sezgin, ENA; Havlucu, Y; Cuhadaroglu, C; Kilinc, O; Boyaci, H; Altunay, H; Akti, M; Dursun, ZB; Kalem, AK; Isik, SA; Akyildiz, L; Aykac, N; Almaz, MS; Kokturk, N; Itil, O
    Objective Vaccination is the most efficient way to control the coronavirus disease 2019 (COVID-19) pandemic, but vaccination rates remain below the target level in most countries. This multicenter study aimed to evaluate the vaccination status of hospitalized patients and compare two different booster vaccine protocols. Setting Inoculation in Turkey began in mid-January 2021. Sinovac was the only available vaccine until April 2021, when BioNTech was added. At the beginning of July 2021, the government offered a third booster dose to healthcare workers and people aged > 50 years who had received the two doses of Sinovac. Of the participants who received a booster, most chose BioNTech as the third dose. Methods We collected data from 25 hospitals in 16 cities. Patients hospitalized between August 1 and 10, 2021, were included and categorized into eight groups according to their vaccination status. Results We identified 1401 patients, of which 529 (37.7%) were admitted to intensive care units. Nearly half (47.8%) of the patients were not vaccinated, and those with two doses of Sinovac formed the second largest group (32.9%). Hospitalizations were lower in the group which received 2 doses of Sinovac and a booster dose of BioNTech than in the group which received 3 doses of Sinovac. Conclusion Effective vaccinations decreased COVID-19-related hospitalizations. The efficacy after two doses of Sinovac may decrease over time; however, it may be enhanced by adding a booster dose. Moreover, unvaccinated patients may be persuaded to undergo vaccination.