No abstract

Coronavirus disease 2019 (COVID-19) is a rapidly spreading deadly respiratory disease that emerged in the city of Wuhan in December 2019. As a result of its rapid and widespread transmission, the WHO declared a pandemic on March 11, 2020 and studies evaluating mortality and prognosis in COVID-19 gained importance. The aim of this study was to determine the factors affecting the survival of COVID-19 patients followed up in a tertiary intensive care unit (ICU) and undergoing chest computed tomography (CT) scoring. This retrospective cross-sectional study was conducted with the approval of Uşak University Medical Faculty Ethics Committee between July and September 2020. It included 187 symptomatic patients (67 females, 120 males) with suspected COVID-19 who underwent chest CT scans in the ICU. Demographics, acute physiology and chronic health evaluation (APACHE II), chest CT scores, COVID-19 real-time polymerase chain reaction (RT PCR) results, and laboratory parameters were recorded. SPSS 15.0 for Windows was used for the data analysis. The ages of the patients ranged from 18 to 94 and the mean age was 68.0 ± 13.9 years. The COVID-19 RT PCR test was positive in 86 (46.0%) patients and 110 patients (58.8%) died during the follow-up. ICU stay (P = .024) and total invasive mechanical ventilation time (P < .001) were longer and blood urea nitrogen (BUN) was higher (P < .001) in the nonsurvivors. Patients with an APACHE II score of 23 and above had a 1.12-fold higher mortality rate (95% CI 0.061-0.263). There was no significant difference in total chest CT score between the survivors and nonsurvivors (P = .210). Chest CT score was not significantly associated with mortality in COVID-19 patients. Our idea that COVID-19 will cause greater mortality in patients with severe chest CT findings has changed. More studies on COVID-19 are needed to reveal the markers that affect prognosis and mortality in this period when new variants are affecting the world.Abbreviations: APACHE = acute physiology and chronic health evaluation, BUN = blood urea nitrogen, COVID-19 = coronavirus disease 2019, CT = computed tomography, ICU = intensive care unit, MV = mechanical ventilation, RT PCR = real-time polymerase chain reaction, SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2, WHO = World Health Organization.

Aim: In patients with Coronavirus disease 2019 (COVID-19) infection, a situation called cytokine storm and an increase in proinflammatory cytokines such as interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-1 (IL-1) in the blood has been observed and it has been found that this is clinically related to the development of severe disease. Therefore, tocilizumab (TCZ) therapy that blocks IL-6 will reduce the immunological response and thus potentially harm caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of this study is to determine the effect of TCZ treatment on length of hospital stay, need for invasive mechanical ventilation and mortality in COVID-19 patients followed in the tertiary intensive care unit.Material and Method: This retrospective cross-sectional study was conducted among patients hospitalized with the diagnosis of COVID-19 pneumonia between 01.09.2020 and 01.01.21 in intensive care units. Data were analyzed and evaluated separately in patients who received and did not receive TCZ treatment. Patients older than 18 years of age, who were hospitalized for at least 24 hours with the diagnosis of COVID-19 pneumonia and needed ≥36 hours of oxygen therapy, were not referred to another health center, were included in this study. Pregnant and lactating women were not included in the study. Patients with missing at least one data in the parameters to be evaluated were excluded from the study. Patients treated with an IL-6 inhibitor other than TCZ were excluded.Results: After excluding patients who did not meet the inclusion criteria, 565 patients were included in the study. It was found that patients who received TCZ treatment after propensity score matching (PSM) had a significantly higher mean age (P&lt;0.001) and lower obesity rates (P=0.002). There was no significant difference between the patients who received and did not receive TCZ treatment in terms of mechanical ventilation need, length of hospital stay and mortality (P=0.505, P=0.661, P=0.834).Conclusion: As a result of our research, it was seen that TCZ treatment did not affect the need for invasive mechanical ventilation, hospital and intensive care unit stay, and mortality.

Günümüzde venöz port kateter sistemleri kanser hastalarının uzun süreli kemoterapi tedavisinde aralıklı infüzyon için yaygın olarak kullanılmaktadır. Bu girişimsel işlemin uygulama yerine bağlı olarak enfeksiyon, hematom, kataterin kırılması, arter yaralanmaları, kateterin yer değiştirmesi, pnömotoraks, venöz tromboz gibi komplikasyonlar ortaya çıkmaktadır. Subklavian venöz port kateter işlemi diğer anatomik alanlara göre daha fazla tek taraflı pnömotoraks riski taşımaktadır. Mide malign neoplazm tanısı olan 37 yaşında kadın hasta acil servise üç gündür devam eden bilateral yan ağrısı ve dizüri şikayeti ile başvurdu. Dört gün önce bilateral subklavian venöz port girişim öyküsü olan hastada nefes darlığı ve oksijen satürasyon düşüklüğü saptanmadı. Burada atipik klinikle acil servise başvuran, insidental olarak tanı konan iyatrojenik bilateral masif pnömotoraks olgusunu sunmayı amaçladık.