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    Applicability of the ROX index in decision-making for hospitalization in COVID-19 patients
    (Bayrakol Medical Publisher, 2022) Kasapoglu, Umut Sabri; Selcuk, Engin Burak; Yalcinsoy, Murat; Uckac, Kadir; Sahin, Abdullah Fahri; Bentli, Recep
    Aim: Data on the outpatient follow-up of COVID-19 cases is still scarce. Also, the significance of the ROX index in decision-making for hospitalization in the ambulatory COVID-19 cases remains unknown. The aim of this study is to determine the general characteristics of COVID-19 patients treated as outpatients and to investigate whether the ROX index is applicable in hospitalization decisions.Material and Methods: This retrospective cohort study was conducted in confirmed adult COVID-19 cases between 15 October 2020 and 01 March 2021. A total of 5240 confirmed COVID-19 patients were included in the present study. Factors affecting hospitalization were investigated.Results: The study population was divided into two groups as those who require hospitalization (n=672) and those who did not (n=4568). The number of male patients and the mean age of the patients were significantly higher in hospitalized patients group (p=0.046, p<0.001). ROX index that was calculated at the home visit on the third day of disease was found significantly lower in the group of hospitalized patients (p<0.001). There was a significant correlation between ROX index and inflammatory biomarkers in the present study (p<0.001). The ROX index was found the most accurate parameter for decision-making for hospitalization in ambulatory COVID-19 patients (AUC=0.794 CI=0.773-0.814, p<0.001).Discussion: The ROX index can be a useful and objective clinical tool for decision making for hospitalization in the ambulatory COVID-19 cases.
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    Can Pneumothorax Developing in COVID-19 Patients be a Mortality Marker?
    (2022) OTERKUS, MESUT; Delen, Leman Acun; Kasapoglu, Umut Sabri
    Objectives: The purpose of this study is to investigate the effects of pneumothorax (PX), a rare complication of COVID-19, on mortality. Methods: All patients admitted to our hospital with the diagnosis of COVID-19 were screened, and patients who developed PX were includ- ed in the study. Patient demographics data, number of days of hospital- ization for comorbidities, day and duration of thorax tube insertion, and laboratory findings during hospitalization were recorded by scanning the hospital automation system and patient records. Results: For our study, 7485 patients hospitalized with the diagno- sis of COVID-19 were screened in intensive care unit. PX was de - tected in 32 (0.296%) of the patients. About 59.4% of these patients included in the study were male. DM was the most common co - morbid condition at 56.3%. In these patients, the mortality rate was found to be 90.6%. Conclusion: The data obtained indicate that PX, a COVID-19 complica- tion, leads to a serious increase in mortality. We believe that using pro- tective ventilation methods to avoid the development of pneumotarax will help to reduce mortality.
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    EFFECTS OF HYDROXYCHLOROQUINE PLUS FAVIPIRAVIR TREATMENT ON THE CLINICAL COURSE AND BIOMARKERS IN HOSPITALIZED COVID-19 PATIENTS WITH PNEUMONIA
    (Sestre Milosrdnice Univ Hospital, 2022) Delen, Leman Acun; Gok, Abdullah; Kasapoglu, Umut Sabri; Cagasar, Ozlem; Gok, Zarife; Berber, Nurcan; Derya, Serdar
    Background: The novel coronavirus disease 2019 (COVID-19) has a broad spectrum of clin-ical manifestations, the most common serious clinical manifestation of the coronavirus infection being pneumo-nia. Unfortunately, the optimal treatment approach is still uncertain. However, many studies have been conducted on the effectiveness of several medications in the treatment of COVID-19 infection. The aim of this study was to evaluate the effectiveness of the hydroxychloroquine (HCQ) + favipiravir (FAV) treatment regimen and HCQ alone by comparing the patient's clinical response and laboratory results on the fifth day of treatment in patients hospitalized due to COVID-19 infection.Patients and methods: This retrospective cohort study was conducted in Malatya Training and Research Hospital between March 2020 and July 2020. The study included 69 patients with confirmed COVID-19 with pneumonia. The patients were divided into 2 groups, those receiving HCQ alone and those receiving the HCQ + FAV combination.Results: A total of 69 patients were included in the study, and the mean age was 60.09 +/- 15.56 years. A statisti-cally significant decrease was observed in C-reactive protein (CRP) levels, at the end of the fifth day, in patients who received HCQ + FAV treatment (p=0.002), whereas there was no decrease in CRP levels in patients who received HCQ treatment alone. In addition, an increase in lymphocyte count and a better fever response was observed at the end of the fifth day in patients who received HCQ + FAV (p=0.008). However, there was no statistical difference between both treatment regimens in terms of hospital stay and treatment results (p=0.008, p=0.744, p=0.517).Conclusion: Although the combination of HCQ + FAV treatment was observed to be effective on CRP levels and fever response in patients with COVID-19 pneumonia, there was no difference in terms of hospital stay and discharge.
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    Morbidity and mortality results of COVID-19 variant in COVID-19 positive patients treated in the intensive care unit
    (Bayrakol Medical Publisher, 2023) Aydin, Ahmet; Koca, Erdinc; Kutlusoy, Sevgi; Kasapoglu, Umut Sabri
    Aim: COVID-19 has the potential to affect many systems and organs, resulting in serious clinical symptoms that necessitate admission to the intensive care unit. The purpose of this study was to examine the relationship between CAR, other laboratory findings, comorbidities, and mortality in patients infected with the original SARSCoV-2 or other variants.Materials and Methods: The data of 368 patients admitted to the intensive care unit with COVID-19 pneumonia between March 2020 and July 2021 were analyzed. These patients were divided into two groups. The first group included [(OC) Original SARSCoV-2 ] COVID-19 infected patients in the first period of the pandemic. The second group [(OV) Other Variants] included patients with COVID-19 infection due to other variants.Results: The mean age (Mean +/- SD) in the OC group was 69.79 +/- 11.77 years. The mean age of the patients in OC was higher than in the OV group (p=0.001). The most common comorbid disease in both groups was Hypertension (54.1%, 48.8%), followed by diabetes mellitus (DM) (30.2%, 31.6%). The mean age of the survivors in the OC and OV groups was lower (64.53 +/- 13.04, 57.85 +/- 16.78, p=0.001, p=0.001, respectively). It was observed that albumin and lymphocyte counts were lower in the deceased, while LDH, CRP, Neutrophil, procalcitonin, NLR and CAR were higher (p<0.05). Discussion: In critically ill COVID-19 patients, high CAR and NLR are good predictors of mortality. In the period when the variants were dominant, the mean age of the patients and the length of stay in the intensive care unit were lower.
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    PROGNOSIS OF GERIATRIC COVID-19 PATIENTS ADMITTED TO INTENSIVE CARE UNIT ACCORDING TO VACCINATION STATUS
    (Turkish Geriatrics Soc, 2022) Aydin, Ahmet; Kacmaz, Osman; Koca, Erdinc; Kutlusoy, Sevgi; Kasapoglu, Umut Sabri; Oterkus, Mesut
    Introduction: As of June 27, 2022, the COVID-19 pandemic has caused over 540 million infections and 6.3 million deaths. We aimed to investigate the effect of the vaccine on the clinical course of elderly patients hospitalized in the intensive care unit and to determine the prognosis of the patients according to their vaccination status. Materials and Methods: The study included 157 patients over the age of 65. Patients were divided into two groups. The first group consisted of patients who were vaccinated with two doses of CoronaVac, and the second group consisted of patients who were not vaccinated. Demographic data of the patients, prehospital clinical frailty scales, Charlson Comorbidity Indexes, APACHE II scores, laboratory values, and patient prognoses were recorded. Results: Of the 157 patients, 93 (59.2%) were female, and the median age was 76 years (65-99). 96 (61.1%) patients were vaccinated and 61 (38.9%) patients were unvaccinated. Patients were grouped as survivors (n=26) and deceased. We found that APACHE II, prehospital clinical frailty scales, and Charlson Comorbidity Indexes scores were higher in patients who died. There was a significant difference between blood lymphocyte and ferritin levels and survival. The 28-day survival rate was higher and intensive care unit overall survival time were longer in the vaccinated group. Conclusions: We observed that the vaccinated patients had higher survival times and lower mortality rates than those who were not vaccinated. We think that it is important to vaccinate elderly patients and that additional doses may be needed.