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  • Küçük Resim
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    Clinical differences between elderly and non-elderly patients with COVID-19
    (Aves, 2022) Ucsular, Fatma Demirci; Karadeniz, Gulistan; Polat, Gulru; Ayrancı, Aysu; Yalniz, Enver; Kazankaya, Fatmanur; Guldaval, Filiz
    OBJECTIVE: Comorbidity frequency and mortality rates are higher in elderly patients with COVID-19. The disease is also more severe in elderly patients. This study aims to examine the characteristics of the COVID-19 disease, severity, comorbidities, and mortality rates in elderly patients by comparing them with nonelderly patients. MATERIAL AND METHODS: This study was designed as a retrospective study. 469 patients who were followed up in outpatient, inpatient, and intensive care units with the diagnosis of COVID-19 between March 11, 2020, and June 01, 2020, were retrospectively included in the study. Patients were divided into two groups who were >= 65 years named as the elderly group and <65 years referred to as nonelderly. Survival data was generated from the death notification system on August 02, 2020. RESULTS: A total of 469 patients including elderly(n=101) and nonelderly(n=368) were included in the study retrospectively. The incidence of severe pneumonia(31%/12.6%) and critical illness(16%/5.8%), comorbidity (85%/37.2%) and hospitalization time(8/5 days) were significantly higher in the elderly group(p<0.05). 23 (22.8%) of elderly patients and 27(7.3%) of nonelderly patients died (p=0.000). Mortality was found to be 3.5 times higher than in the non-elderly group. The expected survival time was 145.85 days(CI 95%:133-158.66) in the elderly patients and 170.36 days(CI 95%:166-174.6) in the nonelderly patients (p<0.000). In ROC analysis, the sensitivity of age was 86%(73.3-94.2), specificity was 66.83%(62.1-71.3), and the cut-off>56 (AUC:0.775; p <0.001) in predicting mortality. CONCLUSION: Mortality is high, comorbidities are more frequent, and the disease is more severe in elderly patients with COVID-19. Age above 56 can be used as a cut-off to predict mortality.
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    The comparison of exacerbation and pneumonia before and after conjugated pneumococcal vaccination in patients with chronic obstructive pulmonary disease, and the effect of inhaled corticosteroid use on results
    (Turkish Assoc Tuberculosis & Thorax, 2022) Sahin, Gorkem Vayisoglu; Karadeniz, Gulistan; Polat, Gulru; Yalniz, Enver; Ayrancı, Aysu; Ucsular, Fatma Demirci; Gucsav, Mutlu Onur
    The comparison of exacerbation and pneumonia before and after conjugated pneumococcal vaccination in patients with chronic obstructive pulmonary disease, and the effect of inhaled corticosteroid use on results Introduction: Pneumococcal infections and exacerbations are important causes of mortality and morbidity in chronic obstructive pulmonary disease (COPD). The use of inhaled corticosteroids and pneumococcal vaccination are suggested for the control of the disease progression and exacerbations. The aim of this study is to assess the effect of pneumococcal conjugate vaccine on pneumonia and exacerbation in COPD patients using inhaled corticosteroids (ICSs). The secondary aim is to analyze the effect of ICS use and different ICS types, if administered, on exacerbation and pneumonia incidence in the study population. Materials and Methods: Medical records of 108 adult patients with COPD who were vaccinated with the pneumococcal conjugate vaccine (PCV13) were retrospectively evaluated. The number of acute exacerbations and pneumonia within one year before and after vaccination were evaluated in all included COPD patients. The comparison analysis was also performed based on the ICS types. Results: There were statistically significant differences between the mean numbers of pneumonia and exacerbations before and after vaccination (p< 0.05). There were no significant differences in the mean pneumonia attacks and acute exacerbations between patients using ICS and not using ICS (p> 0.05). Conclusion: This study revealed that PCV13 provides a significant decrease in both exacerbation and pneumonia episodes in COPD patients. On the other hand, the use of ICSs and the types of ICSs were not found to have adverse effects on pneumonia and acute exacerbations in vaccinated COPD patients.