Browsing by Author "Duyu M."

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    Detection of human metapneumovirus prevalence in pediatric patients with lower respiratory tract infections; [Alt solunum yolu enfeksiyonu olan pediatrik hastalarda insan metapnömovlrus prevalansinin saptanmasi]
    (2012) Gökmen A.A.; Çiçek C.; Saz E.U.; Özananar Y.; Duyu M.
    Human metapneumovirus (hMPV) which is classified in Paramyxoviridae family has been identified in 2001 as the etiological agent of lower respiratory tract infection (LRTI) especially in children. Previous studies indicated that hMPV prevalence in LRTI is between 2-25%, being resposible for 10% of childhood LRTIs and its isolation rate is approximately 6% in hospitalized patients under age three years. The aim of this study was to investigate the hMPV prevalence in children with LRTI in our region. A total of 100 patients (41 female, 59 male) ages between 0-10 years old (median age: 4.8) and who were admitted to Pediatric Clinics of Ege University Medical Faculty Hospital with the diagnosis of LRTI between )a-nuary-December 2009 were included in the study. Nasopharyngeal swab samples were taken from those patients during the first three days of their symptoms. The presence of hMPV in the samples were investigated by rapid (shell vial) cell culture method using HEp-2 cell line and by real-time reverse transcriptase polymerase chain reaction (rRT-PCR). The methods were performed to the clinical samples simultaneously. In both methods, a standard strain of hMPV provided by Erasmus University was used as positive control and QCMD-2009 hMPV panel was used as external quality control. In our study, 11 and 2 samples were found positive with cell culture and rRT-PCR methods, respectively. Two of rRT-PCR positive samples were also positive in cell culture, while the other nine were positive by only cell culture method. Both of the methods were performed twice due to inconsistent results, however, the same results were obtained in both runs. Studies with QCMD-2009 panel yielded compatible results for five samples, however a positive standard sample (hMPV A subtype, Ct value: 37.31) was found as negative by rRT-PCR test used in this study (RealAccurateTM, Pathofinder, The Netherlands). Our data showed that the prevalence of hMPV detected by rapid cell culture method was 11 % in pediatric patients with LRTIs, the age range of hMPV positive cases was 6 months to 7 years old (median age: 20 months), the majority of the admissions was in winter season and the main clinical picture was bronchiolitis. In addition, rRT-PCR assay used in this study was thought to be insufficient to detect the viral RNA in the event of low levels of hMPV A subtypes. Thereby the cell culture method should be used in addition to the new developing molecular methods for the detection of hMPV until standardization is achieved.
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    COVID-19 disease in children presenting to the pediatric emergency department: A multicenter study with 8886 cases from Turkey
    (W.B. Saunders, 2022) Duman M.; Şık N.; Tekşam Ö.; Akça H.; Kurt F.; Çağlar A.A.; Yıldız L.A.; Taşar M.A.; Fidancı İ.; Yayla B.C.C.; Yılmaz D.; Güngör E.; Demir Ş.; Çokuğraş H.; Cebeci S.O.; Önal P.; Saz E.U.; Yurtseven A.; Uysalol M.; Yıldız R.; Gümüş S.; Bal A.; Bayturan S.Ş.; Zengin N.; Atik S.; Çiftdoğan D.Y.; Berksoy E.; Çiçek A.; Şahin S.; Kızıl M.C.; Kara Y.; Apa H.; Ulusoy E.; Kara A.A.; Yesil E.; Erdem M.; Turan C.; Arslanoglu S.; Duyu M.; Besli G.E.; Arslan G.; Oflu A.T.; Çeleğen M.; Buldu E.; Pişkin İ.E.; Kardeş H.; Yılmaz H.L.; Yıldızdaş D.; Gökulu G.; Çay P.; Özer U.; Güleryüz O.D.; Çolak Ö.; Güneysu S.T.
    Background: The aim was to evaluate the epidemiological, clinical, laboratory, and radiologic data of children with SARS-CoV-2 positivity by polymerase chain reaction (PCR) together with treatment strategies and clinical outcomes and to evaluate cases of multisystem inflammatory syndrome in children (MIS-C) in this population. Methods: This was a multicenter retrospective observational cohort study performed in the pediatric emergency departments of 19 tertiary hospitals. From March 11, 2020, to May 31, 2021, children who were diagnosed with confirmed nasopharyngeal/tracheal specimen SARS-CoV-2 PCR positivity or positivity for serum-specific antibodies against SARS-CoV-2 were included. Demographics, presence of chronic illness, symptoms, history of contact with SARS-CoV-2 PCR-positive individuals, laboratory and radiologic investigations, clinical severity, hospital admissions, and prognosis were recorded. Results: A total of 8886 cases were included. While 8799 (99.0%) cases resulted in a diagnosis of SARS-CoV-2 with PCR positivity, 87 (1.0%) patients were diagnosed with MIS-C. Among SARS-CoV-2 PCR-positive patients, 51.0% were male and 8.5% had chronic illnesses. The median age was 11.6 years (IQR: 5.0–15.4) and 737 (8.4%) patients were aged <1 year. Of the patients, 15.5% were asymptomatic. The most common symptoms were fever (48.5%) and cough (30.7%) for all age groups. There was a decrease in the rate of fever as age increased (p < 0.001); the most common age group for this symptom was <1 year with the rate of 69.6%. There was known contact with a SARS-CoV-2 PCR-positive individual in 67.3% of the cases, with household contacts in 71.3% of those cases. In terms of clinical severity, 83 (0.9%) patients were in the severe-critical group. There was hospital admission in 1269 (14.4%) cases, with 106 (1.2%) of those patients being admitted to the pediatric intensive care unit (PICU). Among patients with MIS-C, 60.9% were male and the median age was 6.4 years (IQR: 3.9–10.4). Twelve (13.7%) patients presented with shock. There was hospital admission in 89.7% of these cases, with 29.9% of the patients with MIS-C being admitted to the PICU. Conclusion: Most SARS-CoV-2 PCR-positive patients presented with a mild clinical course. Although rare, MIS-C emerges as a serious consequence with frequent PICU admission. Further understanding of the characteristics of COVID-19 disease could provide insights and guide the development of therapeutic strategies for target groups. © 2022 Elsevier Inc.
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    Mortality risk factors among critically ill children with MIS-C in PICUs: a multicenter study
    (Springer Nature, 2023) Sık G.; Inamlık A.; Akçay N.; Kesici S.; Aygun F.; Kendırlı T.; Atay G.; Sandal O.; Varol F.; Ozkaya P.Y.; Duyu M.; Bırbılen A.Z.; Ozcan S.; Arslan G.; Kangın M.; Bayraktar S.; Altug U.; Anıl A.B.; Havan M.; Yetımakman A.F.; Dalkıran T.; Zengın N.; Oto A.; Kıhtır H.S.; Gırgın F.İ.; Telhan L.; Yıldızdas D.; Yener N.; Yukselmıs U.; Alakaya M.; Kılınc M.A.; Celegen M.; Dursun A.; Battal F.; Sarı F.; Ozkale M.; Topal S.; Kocaoglu C.; Yazar A.; Alacakır N.; Odek C.; Yaman A.; Cıtak A.; Bıngol I.; Annayev A.; Sevketoglu E.; Katlan B.; Durak C.; Gun E.; Erdogan S.; Seven P.; Sahın E.; Arı H.F.; Boyraz M.; Durak F.; Emeksız S.; Ozdemır G.; Duman M.; Talay M.N.; Yener G.O.; Luleyap D.; Harmanogulları S.; Başar E.Z.; Mercan M.; Bal A.; Kılıc N.; Ongun E.A.; Ozturk M.N.; Ekıncı F.; Udurgucu M.; Arslankoylu A.E.; Kutlu N.O.; Bukulmez A.; Özsoylu S.; Celık T.; Ozkale Y.; Kılıc A.O.
    Background: This study evaluated of clinical characteristics, outcomes, and mortality risk factors of a severe multisystem inflammatory syndrome in children admitted to a the pediatric intensive care unit. Methods: A retrospective multicenter cohort study was conducted between March 2020 and April 2021 at 41 PICUs in Turkey. The study population comprised 322 children diagnosed with multisystem inflammatory syndrome. Results: The organ systems most commonly involved were the cardiovascular and hematological systems. Intravenous immunoglobulin was used in 294 (91.3%) patients and corticosteroids in 266 (82.6%). Seventy-five (23.3%) children received therapeutic plasma exchange treatment. Patients with a longer duration of the PICU stay had more frequent respiratory, hematological, or renal involvement, and also had higher D-dimer, CK-MB, and procalcitonin levels. A total of 16 patients died, with mortality higher in patients with renal, respiratory, or neurological involvement, with severe cardiac impairment or shock. The non-surviving group also had higher leukocyte counts, lactate and ferritin levels, and a need for mechanical ventilation. Conclusions: In cases of MIS-C, high levels of D-dimer and CK-MB are associated with a longer duration of PICU stay. Non-survival correlates with elevated leukocyte counts and lactate and ferritin levels. We were unable to show any positive effect of therapeutic plasma exchange therapy on mortality. Impact: MIS-C is a life-threatening condition.Patients need to be followed up in the intensive care unit.Early detection of factors associated with mortality can improve outcomes.Determining the factors associated with mortality and length of stay will help clinicians in patient management.High D-dimer and CK-MB levels were associated with longer PICU stay, and higher leukocyte counts, ferritin and lactate levels, and mechanical ventilation were associated with mortality in MIS-C patients.We were unable to show any positive effect of therapeutic plasma exchange therapy on mortality. © 2023, The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.
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    A snapshot of pediatric inpatients and outpatients with COVID-19: a point prevalence study from Turkey
    (Springer Science and Business Media Deutschland GmbH, 2023) Yılmaz D.; Üstündağ G.; Büyükçam A.; Salı E.; Çelik Ü.; Avcu G.; Belet N.; Çakmak Taşkın E.; Öcal Demir S.; Birbilen A.Z.; Kılıç Ö.; Metin Akcan Ö.; Tekin Yılmaz A.; Aldemir Kocabaş B.; Hatipoğlu N.; Karbuz A.; Çakır D.; Sütçü M.; Aygün F.D.; Çelik T.; Bayturan Şen S.; Dalgıç N.; Ümit Z.; Kara S.S.; Karadağ Öncel E.; Bolat A.; Kılıç Çil M.; Turan C.; Çakıl Güzin A.; Topal S.; Esen Besli G.; Doğan G.; Şahin S.; Akın F.; Bildirici Y.; Timurtaş Dayar G.; Ergül Sarı E.; Kızmaz İşançlı D.; Kara M.; Önal P.; Aylaç H.; Lüleci D.; Yaşar B.; Dede E.; Çağlar A.; Akova S.; Afat Turgut E.; Yazıcı Özkaya P.; Kandemir Gülmez T.; Ulusoy E.; Duyu M.; Kara Y.; Çeliktaş H.; Tekeli O.; Çağlar F.; Gül D.; Oral Cebeci S.; Battal F.; Bal A.; Aygün E.; Uysalol M.; Arslan G.; Özkavaklı A.; Kızıl M.C.; Yazar A.; Aygün F.; Somer A.; Kuyucu N.; Dinleyici E.Ç.; Kara A.
    This multi-center point prevalence study evaluated children who were diagnosed as having coronavirus disease 2019 (COVID-19). On February 2nd, 2022, inpatients and outpatients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in the study from 12 cities and 24 centers in Turkey. Of 8605 patients on February 2nd, 2022, in participating centers, 706 (8.2%) had COVID-19. The median age of the 706 patients was 92.50 months, 53.4% were female, and 76.7% were inpatients. The three most common symptoms of the patients with COVID-19 were fever (56.6%), cough (41.3%), and fatigue (27.5%). The three most common underlying chronic diseases (UCDs) were asthma (3.4%), neurologic disorders (3.3%), and obesity (2.6%). The SARS-CoV-2-related pneumoniae rate was 10.7%. The COVID-19 vaccination rate was 12.5% in all patients. Among patients aged over 12 years with access to the vaccine given by the Republic of Turkey Ministry of Health, the vaccination rate was 38.7%. Patients with UCDs presented with dyspnea and pneumoniae more frequently than those without UCDs (p < 0.001 for both). The rates of fever, diarrhea, and pneumoniae were higher in patients without COVID-19 vaccinations (p = 0.001, p = 0.012, and p = 0.027). Conclusion: To lessen the effects of the disease, all eligible children should receive the COVID-19 vaccine. The illness may specifically endanger children with UCDs. What is Known: • Children with COVID-19 mainly present with fever and cough, as in adults. • COVID-19 may specifically threaten children with underlying chronic diseases. What is New: • Children with obesity have a higher vaccination rate against COVID-19 than children without obesity. • Among unvaccinated children, fever and pneumoniae might be seen at a higher ratio than among vaccinated children. © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.