Browsing by Author "Sakar Coskun A."

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    Pneumococcal and influenza vaccination status of hospitalized adults with community acquired pneumonia and the effects of vaccination on clinical presentation
    (Taylor and Francis Inc., 2017) Demirdogen Cetinoglu E.; Uzaslan E.; Sayıner A.; Cilli A.; Kılınc O.; Sakar Coskun A.; Hazar A.; Kokturk N.; Filiz A.; Polatli M.; Tasbakan S.; Karaboğa B.; Kilic Ö.; Havlucu Y.; Tokgöz F.; Nazik S.
    Background: Previous reports have shown that vaccination rates of adult at-risk populations are low in Turkey. There are differing reports with regards to the effectiveness of the influenza and the pneumococcal polysaccharide vaccine (PPSV23) on the clinical outcomes of community acquired pneumonia (CAP). The purpose of this study was to analyze the influenza (FV) and pneumococcal vaccination (PV) status, the factors that influence the receipt of influenza/pneumococcal vaccine and the effects of prior vaccination on the clinical outcomes in adults hospitalized with CAP. Patients and Methods: Patients hospitalized with CAP between March 2009 and October 2013 and registered at the web-based Turkish Thoracic Society Pneumonia Database (TURCAP) were included in this multicentric, observational study. Of a total of 787 cases, data were analyzed for 466 patients for whom self-reported information on PV and FV was available. Results: In this adult population with CAP, the vaccination rate with both the pneumococcal and influenza vaccines was found to be 6%. Prior FV was found to be the sole variable that was associated with the receipt of PV [OR 17.8, 95% CI (25–75:8.56–37.01), p < 0.001]. Conversely, being vaccinated with PPSV23 was the only predictor of receipt of FV [OR 18.1, 95% CI (25–75:8.75–37.83), p < 0.001]. Compared to the unvaccinated cases, the chest radiograms of the vaccinated patients revealed less consolidation. The latter also reported fatigue, muscle pain and gastrointestinal symptoms less frequently. Although there was a trend for lower 30-day mortality and for lower rates of intensive care unit (ICU) admission, these did not reach statistical significance. A pneumonia severity index (PSI) score ≥ 90, CURB-65 score ≥3 and multilobar involvement, but not the vaccination status, were identified as independent determinants of ICU admission. Conclusions: This study showed that, among patients hospitalized with CAP, the FV and/or PV rates are low. Prior vaccination does not appear to significantly affect the clinical outcomes. © 2017 Taylor & Francis.
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    Prognosis of hospitalized patients with community-acquired pneumonia
    (Elsevier Doyma, 2018) Tokgoz Akyil F.; Yalcinsoy M.; Hazar A.; Cilli A.; Celenk B.; Kilic O.; Sayiner A.; Kokturk N.; Sakar Coskun A.; Filiz A.; Cakir Edis E.
    Introduction: The long-term prognosis of patients with community-acquired pneumonia (CAP) has attracted increasing interest in recent years. The objective of the present study is to investigate the short and long-term outcomes in hospitalized patients with CAP and to identify the predictive factors associated with mortality. Patients and methods: The study was designed as a retrospective, multicenter, observational study. Hospitalized patients with CAP, as recorded in the pneumonia database of the Turkish Thoracic Society between 2011 and 2013, were included. Short-term mortality was defined as 30-day mortality and long-term mortality was assessed from those who survived 30 days. Predictive factors for short- and long-term mortality were analyzed. Results: The study included 785 patients, 68% of whom were male and the mean age was 67 ± 16 (18–92). The median duration of follow-up was 61.2 ± 11.8 (37–90) months. Thirty-day mortality was 9.2% and the median survival of patients surviving 30 days was 62.8 ± 4.4 months. Multivariate analysis revealed that advanced age, the absence of fever, a higher Charlson comorbidity score, higher blood urea nitrogen (BUN)/albumin ratios and lower alanine aminotransferase (ALT) levels were all predictors of long-term mortality. Conclusion: Long-term mortality following hospitalization for CAP is high. Charlson score and lack of fever are potential indicators for decreased long-term survival. As novel parameters, baseline BUN/albumin ratios and ALT levels are significantly associated with late mortality. Further interventions and closer monitoring are necessary for such subgroups of patients. © 2017 Sociedade Portuguesa de Pneumologia
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    The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients
    (W.B. Saunders Ltd, 2021) Kokturk N.; Babayigit C.; Kul S.; Duru Cetinkaya P.; Atis Nayci S.; Argun Baris S.; Karcioglu O.; Aysert P.; Irmak I.; Akbas Yuksel A.; Sekibag Y.; Baydar Toprak O.; Azak E.; Mulamahmutoglu S.; Cuhadaroglu C.; Demirel A.; Kerget B.; Baran Ketencioglu B.; Ozger H.S.; Ozkan G.; Ture Z.; Ergan B.; Avkan Oguz V.; Kilinc O.; Ercelik M.; Ulukavak Ciftci T.; Alici O.; Nurlu Temel E.; Ataoglu O.; Aydin A.; Cetiner Bahcetepe D.; Gullu Y.T.; Fakili F.; Deveci F.; Kose N.; Tor M.M.; Gunluoglu G.; Altin S.; Turgut T.; Tuna T.; Ozturk O.; Dikensoy O.; Yildiz Gulhan P.; Basyigit I.; Boyaci H.; Oguzulgen I.K.; Borekci S.; Gemicioglu B.; Bayraktar F.; Elbek O.; Hanta I.; Kuzu Okur H.; Sagcan G.; Uzun O.; Akgun M.; Altinisik G.; Dursun B.; Cakir Edis E.; Gulhan E.; Oner Eyuboglu F.; Gultekin O.; Havlucu Y.; Ozkan M.; Sakar Coskun A.; Sayiner A.; Kalyoncu A.F.; Itil O.; Bayram H.
    The COVID-19-related death rate varies between countries and is affected by various risk factors. This multicenter 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. © 2021 Elsevier Ltd
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    The association of antiviral drugs with COVID-19 morbidity: The retrospective analysis of a nationwide COVID-19 cohort
    (Frontiers Media S.A., 2022) Babayigit C.; Kokturk N.; Kul S.; Cetinkaya P.D.; Atis Nayci S.; Argun Baris S.; Karcioglu O.; Aysert P.; Irmak I.; Akbas Yuksel A.; Sekibag Y.; Baydar Toprak O.; Azak E.; Mulamahmutoglu S.; Cuhadaroglu C.; Demirel A.; Kerget B.; Baran Ketencioglu B.; Ozger H.S.; Ozkan G.; Ture Z.; Ergan B.; Avkan Oguz V.; Kilinc O.; Ercelik M.; Ulukavak Ciftci T.; Alici O.; Nurlu Temel E.; Ataoglu O.; Aydin A.; Cetiner Bahcetepe D.; Gullu Y.T.; Fakili F.; Deveci F.; Kose N.; Tor M.M.; Gunluoglu G.; Altin S.; Turgut T.; Tuna T.; Ozturk O.; Dikensoy O.; Yildiz Gulhan P.; Basyigit I.; Boyaci H.; Oguzulgen I.K.; Borekci S.; Gemicioglu B.; Bayraktar F.; Elbek O.; Hanta I.; Kuzu Okur H.; Sagcan G.; Uzun O.; Akgun M.; Altinisik G.; Dursun B.; Cakir Edis E.; Gulhan E.; Oner Eyuboglu F.; Gultekin O.; Havlucu Y.; Ozkan M.; Sakar Coskun A.; Sayiner A.; Kalyoncu A.F.; Itil O.; Bayram H.
    Background and objectives: Although 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. Methods: Patients 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. Results: We 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 (β [95% CI]: 4.71 [2.31–7.11]; p = 0.001), favipiravir (β [95% CI]: 3.55 [2.56–4.55]; p = 0.001) and HCQ (β [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). Conclusion: Our 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. Copyright © 2022 Babayigit, Kokturk, Kul, Cetinkaya, Atis Nayci, Argun Baris, Karcioglu, Aysert, Irmak, Akbas Yuksel, Sekibag, Baydar Toprak, Azak, Mulamahmutoglu, Cuhadaroglu, Demirel, Kerget, Baran Ketencioglu, Ozger, Ozkan, Ture, Ergan, Avkan Oguz, Kilinc, Ercelik, Ulukavak Ciftci, Alici, Nurlu Temel, Ataoglu, Aydin, Cetiner Bahcetepe, Gullu, Fakili, Deveci, Kose, Tor, Gunluoglu, Altin, Turgut, Tuna, Ozturk, Dikensoy, Yildiz Gulhan, Basyigit, Boyaci, Oguzulgen, Borekci, Gemicioglu, Bayraktar, Elbek, Hanta, Kuzu Okur, Sagcan, Uzun, Akgun, Altinisik, Dursun, Cakir Edis, Gulhan, Oner Eyuboglu, Gultekin, Havlucu, Ozkan, Sakar Coskun, Sayiner, Kalyoncu, Itil and Bayram.