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Sili U, Ay P, Bilgin H, Topuzoğlu A, Tükenmez-Tigen E, Ertürk-Şengel B, Yağçı-Çağlayık D, Balcan B, Kocakaya D, Olgun-Yıldızeli Ş, Gül F, Bilgili B, Can-Sarınoğlu R, Karahasan-Yağcı A, Mülazimoğlu-Durmuşoğlu L, Eryüksel E, Odabaşı Z, Direskeneli H, Karakurt S, Korten V. Factors Associated with 28-day Critical Illness Development During the First Wave of COVID-19. Infect Dis Clin Microbiol 2023; 5:94-105. [PMID: 38633015 PMCID: PMC10985825 DOI: 10.36519/idcm.2023.206] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/25/2023] [Indexed: 04/19/2024]
Abstract
Objective This study aimed to define the predictors of critical illness development within 28 days postadmission during the first wave of the COVID-19 pandemic. Materials and Methods We conducted a prospective cohort study including 477 PCR-positive COVID-19 patients admitted to a tertiary care hospital in Istanbul from March 12 to May 12, 2020. Results The most common presenting symptoms were cough, dyspnea, and fatigue. Critical illness developed in 45 (9.4%; 95% CI=7.0%-12.4%) patients. In the multivariable analysis, age (hazard ratio (HR)=1.05, p<0.001), number of comorbidities (HR=1.33, p=0.02), procalcitonin ≥0.25 µg/L (HR=2.12, p=0.03) and lactate dehydrogenase (LDH) ≥350 U/L (HR=2.04, p=0.03) were independently associated with critical illness development. The World Health Organization (WHO) ordinal scale for clinical improvement on admission was the strongest predictor of critical illness (HR=4.15, p<0.001). The patients hospitalized at the end of the study period had a much better prognosis compared to the patients hospitalized at the beginning (HR=0.14; p=0.02). The C-index of the model was 0.92. Conclusion Age, comorbidity number, the WHO scale, LDH, and procalcitonin were independently associated with critical illness development. Mortality from COVID-19 seemed to be decreasing as the first wave of the pandemic advanced. Graphic Abstract Graphic Abstract.
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Affiliation(s)
- Uluhan Sili
- Department of Infectious Diseases and Clinical Microbiology,
Marmara University School of Medicine, İstanbul, Turkey
- Equal contribution
| | - Pınar Ay
- Department of Public Health, Marmara University School of
Medicine, İstanbul, Turkey
- Equal contribution
| | - Hüseyin Bilgin
- Department of Infectious Diseases and Clinical Microbiology,
Marmara University School of Medicine, İstanbul, Turkey
- Equal contribution
| | - Ahmet Topuzoğlu
- Department of Public Health, Marmara University School of
Medicine, İstanbul, Turkey
- Equal contribution
| | - Elif Tükenmez-Tigen
- Department of Infectious Diseases and Clinical Microbiology,
Marmara University School of Medicine, İstanbul, Turkey
| | - Buket Ertürk-Şengel
- Department of Infectious Diseases and Clinical Microbiology,
Marmara University School of Medicine, İstanbul, Turkey
| | - Dilek Yağçı-Çağlayık
- Department of Infectious Diseases and Clinical Microbiology,
Marmara University School of Medicine, İstanbul, Turkey
| | - Baran Balcan
- Department of Pulmonary Medicine, Marmara University School of
Medicine, İstanbul, Turkey
| | - Derya Kocakaya
- Department of Pulmonary Medicine, Marmara University School of
Medicine, İstanbul, Turkey
| | - Şehnaz Olgun-Yıldızeli
- Department of Pulmonary Medicine, Marmara University School of
Medicine, İstanbul, Turkey
| | - Fethi Gül
- Department of Anesthesiology and Intensive Care, Marmara
University School of Medicine, İstanbul, Turkey
| | - Beliz Bilgili
- Department of Anesthesiology and Intensive Care, Marmara
University School of Medicine, İstanbul, Turkey
| | - Rabia Can-Sarınoğlu
- Department of Medical Microbiology, Marmara University School of
Medicine, İstanbul, Turkey
| | | | | | - Emel Eryüksel
- Department of Pulmonary Medicine, Marmara University School of
Medicine, İstanbul, Turkey
| | - Zekaver Odabaşı
- Department of Infectious Diseases and Clinical Microbiology,
Marmara University School of Medicine, İstanbul, Turkey
| | - Haner Direskeneli
- Department of Internal Medicine, Marmara University School of
Medicine, İstanbul, Turkey
| | - Sait Karakurt
- Department of Pulmonary Medicine, Marmara University School of
Medicine, İstanbul, Turkey
| | - Volkan Korten
- Department of Infectious Diseases and Clinical Microbiology,
Marmara University School of Medicine, İstanbul, Turkey
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Arıkan Akdağlı S, Azap A, Başaran Demirkazık F, Ener B, Aşcıoğlu Hayran S, Özdemir Kumbasar Ö, Metan G, Odabaşı Z, Uzun Ö, Akan H. Diagnosis of Invasive Fungal Diseases in Hematological Malignancies: A Critical Review of Evidence and Turkish Expert Opinion (TEO-2). Turk J Haematol 2015; 31:342-56. [PMID: 25541650 PMCID: PMC4454048 DOI: 10.4274/tjh.2014.0218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
One of the most problematic issues in hematological malignancies is the diagnosis of invasive fungal diseases. Especially, the difficulty of mycological diagnosis and the necessity of immediate intervention in molds have led to the adoption of “surrogate markers” that do not verify but rather strongly suggest fungal infection. The markers commonly used are galactomannan (GM), beta-glucan, and imaging methods. Although there are numerous studies on these diagnostic approaches, none of these markers serve as a support for the clinician, as is the case in human immunodeficiency virus (HIV) or cytomegalovirus (CMV) infections. This paper has been prepared to explain the diagnostic tests. As molecular tests have not been standardized and are not used routinely in the clinics, they will not be mentioned here.
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Demirkaya S, Terzi M, Genç G, Bek S, Bek S, Odabaşı Z. PO10-TU-77 Is there a correlation between evoked potentials and clinical findings in multiple sclerosis? J Neurol Sci 2009. [DOI: 10.1016/s0022-510x(09)70826-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kaygusuz I, Odabaşı Z, Adıgüzel C, Noyan F, Birtaş E, Korten V, Fıratlı Tuğlular T, Çetiner M, Bayık M. Complete heart block in a neutropenic patient with invasive aspergillosis. Turk J Haematol 2006; 23:205-208. [PMID: 27265664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
A patient with leukemia who developed complete heart block after the diagnosis of pulmonary aspergillosis is reported. The patient had probable invasive pulmonary aspergillosis with a sudden tachypnea, dyspnea, fever, bilateral pulmonary infiltrates and acute respiratory insufficiency after chemotherapy. On the sixth day of antifungal therapy, she developed complete atrioventricular block. Complete heart block has not been reported during liposomal amphotericin B (LAMB) therapy. Local or hematogenous involvement of the myocardium with aspergillosis may be the most likely explanation of the complete heart block.
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