Can the ADO Index Be Used as a Predictor of Mortality from COVID-19 in Patients with COPD?

Esra Ertan Yazar,1 Gulsah Gunluoglu,2 Burcu Arpinar Yigitbas,1 Mukadder Calikoglu,3 Gazi Gulbas,4 Nilgün Y&inodot;lmaz Demirci,5 Nurhan Sarioglu,6 Fulsen Bozkus,7 Nevin Taci Hoca,5 Nalan Ogan,8 Seda Tural Onur,2 Muzaffer Onur Turan,9 Filiz Kosar,2 Evrim Eylem Akpinar,8 Burak Mete,10 Can Ozturk5 1Department of Chest Diseases, Istanbul Medeniyet University, Medical Faculty, Istanbul, Turkey; 2Department of Chest Diseases, Yedikule Chest Disease and Chest Surgery Research and Training Hospital, Istanbul, Turkey; 3Department of Chest Diseases, Mersin University, Medical Faculty, Mersin, Turkey; 4Department of Chest Diseases, Inonu University, Medical Faculty, Malatya, Turkey; 5Department of Chest Diseases, Gazi University, Medical Faculty, Ankara, Turkey; 6Department of Chest Diseases, Balikesir University, Medical Faculty, Balikesir, Turkey; 7Department of Chest Diseases, Kahramanmaras Sutcu Imam University, Medical Faculty, Kahramanmaras, Turkey; 8Department of Chest Diseases, Ufuk University, Medical Faculty, Ankara, Turkey; 9Department of Chest Diseases, Prof Dr, Izmir Katip Celebi University, Atatürk Research and Training Hospital, Izmir, Turkey; 10Department of Public Health Çukurova University, Medical Faculty, Adana, TurkeyCorrespondence: Esra Ertan Yazar, Istanbul Medeniyet University, Medical Faculty, Department of Chest Diseases, Istanbul, Turkey, Email [email protected]: Several studies have shown that the risk of mortality due to COVID-19 is high in patients with COPD. However, evidence on factors predicting mortality is limited.Research Question: Are there any useful markers to predict mortality in COVID-19 patients with COPD?.Study Design and Methods: A total of 689 patients were included in this study from the COPET study, a national multicenter observational study investigating COPD phenotypes consisting of patients who were followed up with a spirometry-confirmed COPD diagnosis. Patients were also retrospectively examined in terms of COVID-19 and their outcomes.Results: Among the study patients, 105 were diagnosed with PCR-positive COVID-19, and 19 of them died. Body mass index (p= 0.01) and ADO (age, dyspnoea, airflow obstruction) index (p= 0.01) were higher, whereas predicted FEV1 (p< 0.001) and eosinophil count (p= 0.003) were lower in patients who died of COVID-19. Each 0.755 unit increase in the ADO index increased the risk of death by 2.12 times, and each 0.007 unit increase in the eosinophil count decreased the risk of death by 1.007 times. The optimum cut-off ADO score of 3.5 was diagnostic with 94% sensitivity and 40% specificity in predicting mortality.Interpretation: Our study suggested that the ADO index recorded in the stable period in patients with COPD makes a modest contribution to the prediction of mortality due to COVID-19. Further studies are needed to validate the use of the ADO index in estimating mortality in both COVID-19 and other viral respiratory infections in patients with COPD.Keywords: body mass index, COVID-19, eosinophils, FEV1, mortality, pneumonia, pulmonary disease, chronic obstructiv

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

Aim The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. Methods This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. Results Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P &lt; 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. Conclusion One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Survey of married women’s choices of family planning methods in BingÖl, Turkey

Family planning allows women to choose their when they have children. The aim of this study was to determine the family planning methods used by women in Bingöl, Turkey in order to inform family planning promotion programs in the study area. Study subjects were married women aged 18-49 years living in Bingöl, Turkey who presented to Family Health Centers and were willing to participate in the study. Each subject was asked to fill out a 40 question questionnaire asking about demographics and family planning. A total of 295 subjects were included in the study. Thirty-seven point six percent had a university education and 32.9% had a high school education level. Fifty-five point nine percent were housewives and 40.0% were officers. Seventy-three point two percent of subjects used modern methods of contraception and 11.9% preferred traditional contraception methods. Among the women using modern methods, 25.4% used condoms and 24.4% used pills. Among women using traditional contraception methods, 16.9% used the withdrawal method and 7.5% used the calendar method. There were no general factors significantly associated with method of contracep-tion. Fifty-six point five percent of women using modern contraception methods were unemployed while 48.6% of subjects who used traditional family planning methods were unemployed but the difference between the modern and traditional method employed were not significant. Our study shows the commonly used contraception methods used by women for family planning in the study popula-tion. This can inform family planning promotion programs who can discuss these methods for appropriate subject groups. © 2019, SEAMEO TROPMED Network. All rights reserved

UCAI 2020: Workshop on User-Centered Artificial Intelligence

Contains fulltext : 222060.pdf (publisher's version ) (Open Access)UCAI'20: - Workshop on User-Centered Artificial Intelligence, Magdeburg, Germany, 9th September 202