Macular choroidal thickness measurements in patients with obstructive sleep apnea syndrome

Uzun, Feyzahan/0000-0002-3050-0714WOS: 000349983900052PubMed: 24962956The purpose of this study is to assess macular choroidal thickness measurements in patients with different severities of obstructive sleep apnea syndrome (OSAS) versus normal controls by using enhanced depth imaging optical coherence tomography (EDI-OCT). This paper is a descriptive study. in this prospective study, the macular area of 74 patients with OSAS and 33 controls were evaluated. All subjects underwent complete ophthalmic examination and macular choroidal thickness (CT) measurements by enhanced depth imaging method of the Spectralis optical coherence tomography system. Choroidal thickness (CT) was measured at the fovea and at 1,000-mu m intervals from the foveal center in both temporal and nasal directions by two masked observers. the mean age was not significantly different between patients with OSAS and controls. Patients were grouped as mild (n = 15), moderate (n = 28), and severe (n = 31) according to apnea-hypopnea index (AHI) scores. the mean subfoveal choroidal thickness (SFCT) was 338.0 +/- 85.2 mu m in the control group versus 351.3 +/- 90, 307.8 +/- 65.5, and 325.4 +/- 110.2 mu m in mild, moderate, and severe groups, respectively (p = 0.416). There was no significant correlation between the severity of OSAS and choroidal thickness. the patients with OSAS seem to protect the choroidal thickness despite hypoxia. the role of OSAS in the pathophysiology of choroidal blood flow and choroidal structure needs further investigation

Reel 1

Crystal (Drumwright, George); Meditation #3 (Heffner, Michael); Prelude (Blumenthal, Paul); By the Waters (Helms, Art); Prelude (Johnson, George); Trio 1 for flute, cello, and piano (Nahay, Paul); Prelude (Bennett, Brian); Full Moon (Berman, Lewis); Moon and Stars (Berman, Lewis); Light of Peace (Monroe, Thomas); Spatial Elements (Chaudoir, James). Instrumentation: piccolo; flute; oboe; clarinet; trumpet; trombone; piano; percussion; vibraphone; marimba; soprano; mezzo-soprano; baritone; violin; viola; cell

Post-discharge mortality in the first wave of COVID-19 in Turkey

© 2022 Asian Pacific Journal of Tropical Medicine.Objective: To determine post-discharge mortality and associated factors of the first-wave multicenter Turkish Thoracic Society (TTD)-TURCOVID study. Methods: In this retrospective cohort study, we analyzed the data of 18 of 26 centers included in the first TTD-TURCOVID study, and 1 112 cases diagnosed with COVID-19 between 11 March and 31 July 2020 participated in the study. All causes of death after COVID-19 discharge were recorded. Results: The mean age of the patients was (51.07±16.93) years, with 57.6% male patients. In the cohort group, 89.1% of COVID-19 treatment locations were hospital wards, 3.6% were intensive care units (ICUs), and 7.2% were community outpatients. In the longterm follow-up, the in-hospital mortality rate was 3.6% (95% CI 2.64.8), the post-discharge mortality rate was 2.8% (95% CI 1.9-3.9), and the total mortality was 6.3% (95% CI 5.0-7.8). After discharge, 63.3% of mortality overall occurred during the first six months. Mortality rates in post-discharge follow-ups were 12.7% (95% CI 8.0-30.6) in cancer patients, 10.8% (95% CI 6.3-22.9) in chronic obstructive pulmonary disease patients, 11.1% (95% CI 4.4-22.7) in heart failure patients, 7.8 (95% CI 3.8-14.3) in atherosclerotic heart disease patients, and 2.3% (95% CI 0.8-5.6) in diabetes mellitus patients. In smokers/ex-smokers, the all-mortality rates were higher than in non-smokers. Conclusions: This multicenter study showed that patients over 65 years of age, males, former/active smoker, ICU stay, lung, heart disease, and malignancy should be followed up for at least the first six months after discharge due to COVID-19

The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients

© 2021 Elsevier LtdThe 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

The association of antiviral drugs with COVID-19 morbidity: The retrospective analysis of a nationwide COVID-19 cohort

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.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

The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients

© 2021 Elsevier LtdThe 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

Image_1_The association of antiviral drugs with COVID-19 morbidity: The retrospective analysis of a nationwide COVID-19 cohort.JPEG

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 (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).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.</p