Turkish Thoracic Journal最新文献

Objective: Tuberculosis and COVID-19 diseases occur more frequently in people with similar risk factors. This study aimed to share the data on active tuberculosis patients during the severe acute respiratory syndrome coronavirus 2 pandemic.

Material and methods: The registration information of TB outpatient clinic between November 1, 2019, and April 20, 2020, was screened. A 7-question survey was administered to the patients who were diagnosed with active tuberculosis and who were agreed to participate in the study.

Results: A total of 309 patients with active tuberculosis were evaluated, the average age of the patients was 42.5 ± 18.5 years, and 70% were male. The percentage of having at least 1 comorbidity was 30.4%. The percentage of coronavirus disease 2019 disease in our study population was 1.9%; none of the patients of coronavirus disease 2019 were taken into the intensive care unit or dead due to clinical deterioration and/or respiratory failure. On the other hand, in this process it was announced that 146 457 cases were diagnosed with coronavirus disease 2019 throughout the country, of which 72% had inpatient treatment, 2% died, and 944 patients were still being treated in the intensive care unit, of which 490 were intubated. The positivity ratio of the reverse transcription-polymerase chain reaction test was 20.0% in the study group, while 20.3% in the İstanbul population.

Conclusion: Tuberculosis patients might be more disadvantageous than the normal population in terms of the risk of exposure to severe acute respiratory syndrome coronavirus 2, but this does not cause an increase in the frequency and severity of coronavirus disease 2019 disease in active tuberculosis patients.

Objective: Granulomatous inflammation showing "caseification necrosis" is considered pathognomonic for tuberculosis. This study aimed to evaluate patients with granulomatous inflammation and some characteristics to diagnose tuberculosis.

Material and methods: This is a cross-sectional descriptive study. The study includes all pathology laboratories in Samsun between the years 2012 and 2017. Pathology reports that contained the term granulomatous were selected between all patient reports of these laboratories. The patient reports were examined by comparing the dispensary records and the presence of a diagnosis of tuberculosis.

Results: In the 703 pathology reports, it was found that 38% were only granulomatous and 33% were caseous granulomatosis lesions. When the prevalence of tuberculosis according to the presence of microscopic necrosis was observed in granulomatous tissue samples, 85% tuberculosis was found in patients with necrotic granulomatous tissue and 14% tuberculosis was found with non-necrotic lesions. The presence of tuberculosis in necrotic granulomatous tissues was statistically significantly higher (P < .00001).

Conclusion: As a result, when examining a pathology report for the presence of tuberculosis, the existence of a granulomatous reaction should be considered first. Getting stuck on the definition of caseification necrosis will cause the case to be skipped. An indication of necrosis in the pathologic evaluation will guide the diagnosis of tuberculosis.

Objective: Data about Turkish coronavirus disease 2019 patients are limited. We evaluated hospitalized coronavirus disease 2019 patients who were followed up in the first 3 months of the pandemic.

Material and methods: This retrospective, single-center, observational study included 415 confirmed hospitalized coronavirus disease 2019 patients. The patients were divided into groups, namely, mild, moderate, and critically ill patients. Symptoms at the time of admission, clinical, laboratory, and imaging findings were examined.

Results: In our study, 6.74% of coronavirus disease 2019 patients had severe disease, 59.5% were male, and the mortality rate was 11.3%. Diabetes mellitus and chronic obstructive pulmonary disease were more frequently seen in critically ill patient groups and hypertension in moderate patient groups. Anemia and aspartate aminotransferase levels were higher in non-survivors among mild coronavirus disease 2019 patients. In the moderate patients' group, aspartate aminotransferase, lactate dehydrogenase, international normalized ratio, ferritin, and D-dimer levels were higher and lymphocyte, hemoglobin levels were lower; in the critically ill patients' group, platelets were lower and uric acid levels were higher in non-survivor patients.

Conclusion: In mild patients, anemia, lymphopenia, and increased aspartate aminotransferase levels; in moderate patients, leukopenia, anemia, and increased aspartate aminotransferase, lactate dehydrogenase, international normalized ratio, ferritin, and D-dimer levels; in the critically ill patient group, lower platelet and increased uric acid levels should be followed closely as they are mortality predictors.

Objective: The aim of this study was to determine the prevalence and the characteristics of coronavirus disease 2019 (COVID-19) in a tertiary outpatient clinic of asthma patients, find the predisposing asthma phenotype to COVID-19, and to see their adherence to asthma treatment.

Material and methods: A retrospective, cross-sectional, real life study was conducted via phone interviews with the patients being followed in the asthma outpatient clinic. From the files of the patient information was obtained about their demographics, asthma phenotype, co-morbidity, prick tests, spirometry test results and their medications at the last visit before the COVID-19 pandemic. Information's about asthma exacerbations, ACT, asthma treatment adherence and history of COVID-19 were obtained via telephone interviews.

Results: Of the 573 patients with asthma, 13 (2.26%) had COVID-19 history. The mean age of patients with asthma and COVID-19 was 51.84±14.92 year. Two patients were on mepolizumab and one was on omalizumab treatment. Mean ACT was 19.84±2.73. Lack of adherence was reported in 8% of all patients with asthma compared to 23% in the patients who had COVID-19. Asthma exacerbation was seen during the course of SARS-CoV2 infection in 3 of 13 patients with asthma. Asthma exacerbations were reported during the period of one month following COVID-19 in 2 patients.

Conclusion: The most common asthma phenotype in the cases of COVID-19 was obese phenotype. Rates of using biological agents and non-adherence to the treatment were found to be higher. Asthma exacerbation may be seen during course of COVID-19 albeit being less common.

Objective: To show the effect of programmed cell death protein-1ligand (PDL-1) level on survival times in patients with metastatic non-small cell lung cancer (mNSCLC) receiving chemotherapy, to determine the relationship between PDL-1 level, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR).

Material and methods: The data of 158 patients who received chemotherapy for mNSCLC were evaluated retrospectively. Clinical and demographic data, PDL-1 expression levels and follow-up periods of the patients were recorded. The patients were divided into 2 groups according to PDL-1 levels.

Results: In all patients, progression free survival (PFS) was 5.6 months and overall survival (OS) was 18.8 months. Patients with low PDL-1 had a longer PFS than patients with high PDL-1 (p:0.038). In the gemcitabine and taxane groups, patients with low PDL-1 had a longer PFS than patients with high PDL-1 (p:0.047). There was a significant correlation between NLR and PDL-1 levels. In the groups with high PDL-1, patients with low NLR levels had higher OS than patients with high NLR level (p:0.043). Also, there was a significant difference between the OS patients with low and high PLR levels (p:0.520).

Conclusion: In patients with mNSCLC whose PDL-1 levels and NLR levels are low, immunogenic chemotherapies such as gemcitabine and taxane can be tried as an alternative treatment.

Objective: The recently emerged coronavirus 2019 disease is an infectious disease that predominantly affects the respiratory system. In this study, we aimed to evaluate the persistent post-COVID symptoms and the related factors.

Material and methods: This study was conducted on 396 post-COVID patients. The demographic (age, gender, body mass index, smoking, location and duration of treatment, and date of post-COVID follow-up visit) and clinical (symptoms during and after the infection, comorbidities) data were evaluated by interview and a questionnaire.

Results: The mean age of the patients was 50.25 years (min-max: 19-85). There were equal numbers of males (n = 198) and females (n = 198) in the study. The mean body mass index was 27.94 (min-max: 17.90-44.92). The majority of patients (n = 222, 56.1%) had been treated at home, while the rates of patients admitted to ward and intensive care unit were 37.1% (n = 147) and 6.8% (n = 27), respectively. The number of patients with at least 1 persistent symptom during post-COVID follow-up visit was 348 (87.9%). The symptoms during the infection included fatigue (n = 339, 85.6%), cough (n = 373, 68.9%), joint pain (n = 267, 67.4%), appetite loss (n = 234, 59.1%), dyspnea (n = 231, 58.3%), while the persistent post-COVID symptoms were fatigue (n = 222, 56.1%), cough (n = 174, 43.9%), dyspnea (n = 171, 43.2%), and chest pain (n = 171, 43.2%). No significant relationships between post-COVID symptoms and age, body mass index, comorbidity, duration from diagnosis to a follow-up visit, and COVID-19 pneumonia during the infection were found, while a statistically significant relationship regarding gender was found.

Conclusion: There is still a lack of knowledge about the long-term consequences of coronavirus 2019 disease. Moreover, no standardized method exists for categorizing patients into post-COVID controls.

Objective: The COVID-19 pandemic has demonstrated that the social determinants of health play a fundamental role in the course of the pandemic. This article aims to reveal the class dynamics of the COVID-19 epidemic in İstanbul, Turkey.

Material and methods: Spatial analysis and geographic information system data provided by İstanbul Metropolitan Municipality for March and April 2020 were used. Public transport mobility and turnstile data were analyzed. The data obtained were collated into thematic maps.

Results: Between March 16 and 24, 2020, the use of public transportation declined with the tightening of movement restrictions. However, despite the restrictions, an increase in transportation density was observed between 6 and 9 am and between 5 and 7 pm. Although the overall mobility toward outside the city has fallen due to travel restrictions, it has been observed that exit mobility continued between Gebze and Kocaeli, both industrial centers where blue-collar jobs dominate. Most of the mobility in the city is observed in Avcılar, Bahçelievler, Esenyurt, and Küçükçekmece, which are mostly blue-collar residential districts. On the Asian side, activity was observed in Kurtköy, Pendik, Samandıra, Ümraniye, and Tuzla, areas where blue-collar workers predominantly reside. From March 25 to April 7, 2020, it was determined that the most intense activity areas of the blue-collar workers were Avcılar, Bahçelievler, Bağcılar, Çekmeköy, Esenyurt, Küçükçekmece, Ümraniye, and D-100 highway line.

Conclusion: The density in the use of public transportation rose during the hours corresponding to the working hours of the workers who had to continue working despite the pandemic. In addition, the physical movement of blue-collar workers continued despite the travel restrictions imposed along the city borders where they worked and resided. Our data point to the importance of social protection measures for workers in general, and blue-collar workers in particular, for the management of the pandemic.

Objective: The study aims to evaluate the awareness and knowledge of COVID-19 among healthcare workers.

Material and methods: A questionnaire was applied to healthcare workers working at Kocaeli University Faculty of Medicine and University of Kyrenia, Dr. Suat Günsel Hospital, to evaluate the coronavirus disease 2019 awareness and level of knowledge.

Results: A total of 598 healthcare workers participated in the study. Two-thirds of the respondents were from Turkey, while one-third were from the Turkish Republic of Northern Cyprus. The general symptoms of coronavirus disease 2019 were well known in the general population. Awareness of most symptoms was significantly lower in the Turkish Republic of Northern Cyprus group. It was well known that coronavirus disease 2019 can be asymptomatic in some patients and it can be contagious. The necessity of wearing surgical masks on sick individuals was less known in the Turkish Republic of Northern Cyprus group (96.6% vs 61.6%; P = .000). While handwashing was found similar in both groups for protection from coronavirus disease 2019 transmission, social distance and mask recommendations were lower in the Turkish Republic of Northern Cyprus group (P < .05). The concern about transmitting the virus to themselves and their relatives was more significant in the Turkish Republic of Northern Cyprus group than the Turkey group (84.4% vs 96.5%; P = .000). And 92.2% of the healthcare workers thought they should stay in an alternative place instead of their homes.

Conclusion: The awareness and knowledge level of coronavirus disease 2019 is higher in Turkey than in Turkish Republic of Northern Cyprus related to the increased number of coronavirus disease 2019 cases in Turkey. Continuous education programs can contribute to improving the level of knowledge and reducing anxiety.