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Öğe The association of antiviral drugs with COVID-19 morbidity: The retrospective analysis of a nationwide COVID-19 cohort(Frontiers Media Sa, 2022) Babayigit, Cenk; Kokturk, Nurdan; Kul, Seval; Cetinkaya, Pelin Duru; Nayci, Sibel Atis; Baris, Serap Argun; Karcioglu, OguzBackground 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 (beta [95% CI]: 4.71 [2.31-7.11]; p = 0.001), favipiravir (beta [95% CI]: 3.55 [2.56-4.55]; p = 0.001) and HCQ (beta [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.Öğe Comparison of GAM and DLNM Methods for Disease Modeling in Environmental Epidemiology(2021) Karadağ, Mehmet; Kul, Seval; Yoloğlu, Saim; Boğan, Mustafa; Al, BehçetABSTRACT Objective: In this study, it was aimed to compare the performance results of the methods modeled by using generalized additive models (GAM) and distributed lag non-linear models (DLNM) methods from real data of three different outcome variables of three separate diseases related to air pollution. Material and Methods: The data were retrospectively obtained from three hospitals under the General Secretariat of Gaziantep province public hospitals for a total of 1,916 days between 01 January 2009 and 31 March 2014. Response variables were number of the emergency unit admission, hospitalization and mortality due to asthma, chronic obstructive pulmonary disease (COPD) and pneumonia. The response variables were estimated by GAM and DLNM methods by building four different models and the performances of the models were compared. Results: When the estimation performances of GAM and DLNM methods are compared for each of the dependent variables in the prediction of hospitalizations due to asthma, GAM model IV [Akaike Information Criteria (AIC) (4,280.63)] values were found to perform the best. It was observed that DLNM method performed better than GAM in models established for the prediction of almost all other dependent variables. For when compare the odds ratio (OR) plot estimated on particulate matter (PM10); it was seen that GAM method made predictions with lower standard error compared to DLNM methods. Conclusion: When the models created with each dependent variable were compared; it was generally observed that superior performance was obtained from the DLNM method. However, the lowest standard error in the OR charts were observed in the models using the GAM method.Öğe COVID-19 pandemic and the global perspective of Turkish Thoracic Society(Turkish Thoracic Society, 2020) Köktürk, Nurdan; İtil, Bahriye Oya; Altınışık, Göksel; Adıgüzel, Nalan; Akgün, Metin; Akyıldız, Levent; Altın, Sedat; Arıkan, Hüseyin; Ateş, Güngör; Ay, Pınar; Aykaç, Nilüfer; Babayiğit, Cenk; Bostan, Pınar; Cinel, Güzin; Çalışır, Haluk Celaleddin; Çelik, Pınar; Çetinkaya, Pelin Duru; Dağlı, Elif; Demir, Ahmet Uğur; Demir, Canan; Dikensoy, Öner; Çakır Edis, Ebru; Elbek, Osman; Erdinç, Münevver; Ergan, Begüm; Öner Eyüboğlu, Ayşegül Füsun; Gemicioğlu, Bilun; Göksel, Tuncay; Gülhan, Erkmen; Gültekin, Ökkeş; Gündüz Gürkan, Canan; Gürgün, Alev; Havlucu, Yavuz; Kaçmaz Başaoğlu, Özen; Karakurt, Sait; Karakurt, Zuhal; Kılınç, Oğuz; Kocabaş, Ali; Kul, Seval; Müsellim, Benan; Naycı, Sibel; Özkan, Metin; Pınarer, Özgün; Saltürk, Cüneyt; Sandal, Abdulsamet; Sayıner, Abdullah; Şen, Elif; Ömeroğlu Şimşek, Gökçen; Karadağ, Bülent Taner; Tokgöz Akyıl, Fatma; Töreyin, Zehra Nur; Uçan, Eyüp Sabri; Uyanusta Küçük, Filiz Çağla; Varol, Ayhan; Yasin, Yeşim; Yıldız, Tekin; Yorgancıoğlu, Ayşe Arzu; Bayram, HasanIt has been more than 3 months now since the first case of COVID-19 was reported in Turkey. Globally, the number of confirmed cases and deaths reached 9,653,048 and 491,128 respectively, as reported by 216 countries by June 27, 2020. Turkey had 1,396 new cases, 194,511 total cases, and 5,065 deaths by the same date. From the first case until today, the Turkish Thoracic Society (TTS) has been very proactive in educating doctors, increasing public awareness, undertaking academic studies, and assisting with public health policies. In the present report, social, academic, and management perspectives of the pandemic are presented under appropriate subtitles. During this critical public health crisis, TTS has once again demonstrated its readiness and constructive stance by supporting public health, healthcare workers, and the environment. This review summarizes the perspective of TTS on each aspect of the COVID-19 pandemic and casts light on its contributions.Öğe Evaluation of effects of periodontal diseases on social anxiety level(Cumhuriyet Üniversitesi, 2019) Sarı, Ayşegül; Şenyurt, Süleyman Ziya; Üstün, Kemal; Kul, Seval; Erciyas, KamileObjectives: The aim of this study was to determine the level of social anxiety in patients with periodontal disease, and to examine its relationship with the clinical characteristics of periodontal disease. Materials and Methods: This study investigated 200 patients in a cross-sectional design. Sociodemographic data, clinical periodontal parameters and patient complaints were recorded. Patients were divided into four groups according to their clinical periodontal index values: chronic periodontitis (CP), aggressive periodontitis (AP), gingivitis (G), and periodontally healthy (PH). Social anxiety levels of the patients were assessed based on the Liebowitz Social Anxiety Scale (LSAS). Results: A negative relationship was observed between LSAS scores and age, a positive relationship was observed with education level (p0.05). The Liebowitz total score and total anxiety, socially related anxiety and total avoidance levels of patients with halitosis complaints were found significantly higher (p0.05). LSAS scores for patients with complaints of aesthetics and mobility were significantly higher for all seven sub-items (p0.05). Total avoidance and performance avoidance values were significantly higher in patients with complaints of gingival bleeding (p0.05). All of the LSAS scores were higher in the AP and CP groups compared to the PH group and higher in the AP group than in the CP and G groups (p0.05). In the G group, the performance-related avoidance level was significantly higher than in the PH group (p0.05). Conclusions: Periodontal diseases may negatively affect the psychological and emotional states of dental patients.Öğe The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients(W B Saunders Co Ltd, 2021) Kokturk, Nurdan; Babayigit, Cenk; Kul, Seval; Cetinkaya, Pelin Duru; Nayci, Sibel Atis; Baris, Serap Argun; Karcioglu, OguzThe COVID-19-related death rate varies between countries and is affected by various risk factors. This multi-center 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.
