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Başkol Elik D, Kaya Ş, Alkan S, Demirdal T, Sener A, Kaya S, Güzel Tunçcan Ö, Kayaaslan B, Güner R, Eser F, Kahraman H, Birengel S, Sarıcaoğlu EM, Eroğlu E, Çölkesen F, Öztürk E, Berk Cam H, Mermutluoğlu Ç, Özer Balin Ş, Sincan G, Altın N, Sili U, Suntur BM, Arslan Gülen T, Deveci B, Saba R, İncecik Ş, Eser Karlıdağ G, Hakko E, Akdağ D, Erdem HA, Sipahi H, Çicek C, Taşbakan MS, Taşbakan M, Pullukçu H, Yamazhan T, Arda B, Ulusoy S, Sipahi OR. The clinical features, treatment and prognosis of neutropenic fever and Coronavirus disease 2019 results of the multicentre teos study. Sci Rep 2024; 14:5218. [PMID: 38433274 PMCID: PMC10909849 DOI: 10.1038/s41598-024-55886-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 02/28/2024] [Indexed: 03/05/2024] Open
Abstract
This multicentre (22 centres in Turkey) retrospective cohort study aimed to assess the clinical outcomes of patients with neutropenic fever and SARS-CoV-2 positivity. Study period was 15 March 2020-15 August 2021. A total of 170 cases (58 female, aged 59 ± 15.5 years) that fulfilled the inclusion criteria were included in the study. One-month mortality rate (OMM) was 44.8%. The logistic regression analysis showed the following significant variables for the mentioned dependent variables: (i) achieving PCR negativity: receiving a maximum of 5 days of favipiravir (p = 0.005, OR 5.166, 95% CI 1.639-16.280); (ii) need for ICU: receiving glycopeptide therapy at any time during the COVID-19/FEN episode (p = 0.001, OR 6.566, 95% CI 2.137-20.172), the need for mechanical ventilation (p < 0.001, OR 62.042, 95% CI 9.528-404.011); (iii) need for mechanical ventilation: failure to recover from neutropenia (p < 0.001, OR 17.869, 95% CI 3.592-88.907), receiving tocilizumab therapy (p = 0.028, OR 32.227, 95% CI 1.469-707.053), septic shock (p = 0.001, OR 15.4 96% CI 3.164-75.897), and the need for ICU (p < 0.001, OR 91.818, 95% CI 15.360-548.873), (iv) OMM: [mechanical ventilation (p = 0.001, OR 19.041, 95% CI 3.229-112.286) and septic shock (p = 0.010, OR 5.589,95% CI 1.509-20.700)]. Although it includes a relatively limited number of patients, our findings suggest that COVID-19 and FEN are associated with significant mortality and morbidity.
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Affiliation(s)
- Dilşah Başkol Elik
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey.
- Infectious Disease and Clinical Microbiology, Turgutlu State Hospital, Manisa, Turkey.
| | - Şafak Kaya
- Department of Infectious Diseases, Gazi Yaşargil Training and Research Hospital, University of Health Sciences, Diyarbakir, Turkey
| | - Sevil Alkan
- Department of Infectious Disease, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Tuna Demirdal
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | - Alper Sener
- Department of Infectious Disease, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | - Selçuk Kaya
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Özlem Güzel Tunçcan
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Bircan Kayaaslan
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara Yıldırım Beyazit University, Ankara, Turkey
| | - Rahmet Güner
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara Yıldırım Beyazit University, Ankara, Turkey
| | - Fatma Eser
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara Yıldırım Beyazit University, Ankara, Turkey
| | - Hasip Kahraman
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Serhat Birengel
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Elif Mukime Sarıcaoğlu
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Esma Eroğlu
- Department of Infectious Disease and Clinical Microbiology, Konya Meram State Hospital, Konya, Turkey
| | - Fatma Çölkesen
- Department of Infectious Disease and Clinical Microbiology, Konya Meram State Hospital, Konya, Turkey
| | - Erman Öztürk
- Department of Hematology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Hande Berk Cam
- Department of Infectious Disease and Clinical Microbiology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Çiğdem Mermutluoğlu
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Şafak Özer Balin
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Gülden Sincan
- Department of Hematology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Nilgün Altın
- Department of Infectious Disease and Clinical Microbiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Uluhan Sili
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Bedia Mutay Suntur
- Infectious Diseases, Adana City Training and Research Hospital, Adana, Turkey
| | - Tuğba Arslan Gülen
- Infectious Diseases, Adana City Training and Research Hospital, Adana, Turkey
| | - Burak Deveci
- Department of Hematology and Stem Cell Transplant Unit, Medstar Antalya Hospital, Antalya, Turkey
| | - Rabin Saba
- Department of Hematology and Stem Cell Transplant Unit, Medstar Antalya Hospital, Antalya, Turkey
| | - Şaban İncecik
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Van Yüzüncü Yıl University, Van, Turkey
| | - Gülden Eser Karlıdağ
- Department of Infectious Disease and Clinical Microbiology, Elazığ Fethi Sekin City Hospital, University of Health Sciences, Elazig, Turkey
| | - Elif Hakko
- Department of Infectious Disease and Clinical Microbiology, Anadolu Medical Center, Istanbul, Turkey
| | - Damla Akdağ
- Department of Infectious Diseases and Clinical Microbiology, Basaksehir Cam Sakura City Hospital, Istanbul, Turkey
| | - Hüseyin Aytaç Erdem
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Hilal Sipahi
- Bornova Directorate of Health, Bornova, Izmir, Turkey
| | - Candan Çicek
- Department of Medical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Mehmet Sezai Taşbakan
- Department of Chest Diseases, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Meltem Taşbakan
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Hüsnü Pullukçu
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Tansu Yamazhan
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Bilgin Arda
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Sercan Ulusoy
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Oguz Resat Sipahi
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
- Department of Infectious Diseases, Bahrain Oncology Center, King Hamad University Hospital, Muharraq, Bahrain
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Yenilmez E, Kakalicoglu D, Bozkurt F, Filiz M, Akkol Camurcu A, Damar Midik EO, Berk Cam H, Arkali E, Bilgic Atli S, Sahin A, Yorulmaz Goktas S, Erkan H, Ceylan MR, Kacar Eker M, Kaya H, Karacaer Z, Tural E, Dokmetas İ, Gorenek L, Kose S. Fever of unknown origin (FUO) on a land on cross-roads between Asia and Europa; a multicentre study from Turkey. Int J Clin Pract 2021; 75:e14138. [PMID: 33683769 DOI: 10.1111/ijcp.14138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/27/2020] [Accepted: 03/04/2021] [Indexed: 02/05/2023] Open
Abstract
AIMS The differential diagnosis of Fever of Unknown Origin (FUO) is still a major clinical challenge despite the advances in diagnostic procedures. In this multicentre study, we aimed to reveal FUO aetiology and factors influencing the final diagnosis of FUO in Turkey. METHODS A total of 214 patients with FUO between the years 2015 and 2019 from 13 tertiary training and research hospitals were retrospectively evaluated. RESULTS The etiologic distribution of FUO was infections (44.9%), malignancies (15.42%), autoimmune/inflammatory (11.68%) diseases, miscellaneous diseases (8.41%) and undiagnosed cases (19.62%). Brucellosis (10.25%), extrapulmonary tuberculosis (6.54%) and infective endocarditis (6.54%) were the most frequent three infective causes. Solid malignancies (7.1%) and lymphoma (5.6%), adult-onset still's disease (6.07%) and thyroiditis (5.14%) were other frequent diseases. The aetiological spectrum did not differ in elderly people (P < .05). Infections were less frequent in Western (34.62%) compared with Eastern regions of Turkey (60.71%) (P < .001, OR: 0.31, 95% Cl: 0.19 to 0.60). The ratio of undiagnosed aetiology was significantly higher in elderly people (p: 0.046, OR: 2.34, 95% Cl: 1.00 to 5.48) and significantly lower in Western Turkey (P: .004, OR: 3.07, 95% Cl: 1.39 to 6.71). CONCLUSIONS Brucellosis, extrapulmonary tuberculosis and infective endocarditis remain to be the most frequent infective causes of FUO in Turkey. Solid tumours and lymphomas, AOSD and thyroiditis are the other common diseases. The aetiological spectrum did not differ in elderly people, on the other hand, infections were more common in Eastern Turkey. A considerable amount of aetiology remained undiagnosed despite the state-of-the-art technology in healthcare services.
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Affiliation(s)
- Ercan Yenilmez
- Department of Infectious Diseases and Clinical Microbiology, Sultan Abdulhamid Han Training and Research Hospital, University of Health Sciences, Uskudar, Turkey
| | - Deniz Kakalicoglu
- Department of Infectious Diseases and Clinical Microbiology, Sultan Abdulhamid Han Training and Research Hospital, University of Health Sciences, Uskudar, Turkey
| | - Fatma Bozkurt
- Department of Infectious Diseases and Clinical Microbiology, Gazi Yasargil Training and Research Hospital, University of Health Sciences, Diyarbakir, Turkey
| | - Mine Filiz
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Aysegul Akkol Camurcu
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Training and Research Hospital, University of Health Sciences, Uskudar, Turkey
| | - Elif Ozge Damar Midik
- Department of Infectious Diseases and Clinical Microbiology, Kartal Lutfi Kirdar City Hospital, University of Health Sciences, Uskudar, Turkey
| | - Hande Berk Cam
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Eren Arkali
- Department of Infectious Diseases and Clinical Microbiology, Tepecik Training and Research Hospital, University of Health Sciences, Konak, Turkey
| | - Seval Bilgic Atli
- Department of Infectious Diseases and Clinical Microbiology, Gazi Yasargil Training and Research Hospital, University of Health Sciences, Diyarbakir, Turkey
| | - Ahmet Sahin
- Department of Infectious Diseases and Clinical Microbiology, Mehmet Akif Inan Training and Research Hospital, University of Health Sciences, Sanliurfa, Turkey
| | - Sibel Yorulmaz Goktas
- Department of Infectious Diseases and Clinical Microbiology, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Halil Erkan
- Department of Infectious Diseases and Clinical Microbiology, Bozyaka Training and Research Hospital, University of Health Sciences, Konak, Turkey
| | - Mehmet Resat Ceylan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Merve Kacar Eker
- Department of Infectious Diseases and Clinical Microbiology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Uskudar, Turkey
| | - Hava Kaya
- Department of Infectious Diseases and Clinical Microbiology, Adana City Hospital, University of Health Sciences, Adana, Turkey
| | - Zehra Karacaer
- Department of Infectious Diseases and Clinical Microbiology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ersin Tural
- Department of Infectious Diseases and Clinical Microbiology, Sultan Abdulhamid Han Training and Research Hospital, University of Health Sciences, Uskudar, Turkey
| | - İlyas Dokmetas
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Uskudar, Turkey
| | - Levent Gorenek
- Department of Infectious Diseases and Clinical Microbiology, Sultan Abdulhamid Han Training and Research Hospital, University of Health Sciences, Uskudar, Turkey
| | - Sukran Kose
- Department of Infectious Diseases and Clinical Microbiology, Tepecik Training and Research Hospital, University of Health Sciences, Konak, Turkey
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