Objectives We aimed to evaluate the characteristics and management outcomes of patients who developed tracheal stenosis after invasive mechanical ventilation (IMV) due to COVID-19 in this study. Design, settings and participants The data of 7 patients with tracheal stenosis and 201 patients without tracheal stenosis after IMV due to COVID-19 between March 2020 and October 2021 were retrospectively analyzed. Interventions Flexible bronchoscopy was performed for the diagnosis of tracheal stenosis and the evaluation of the treatment's effectiveness and rigid bronchoscopy was applied for the dilatation of tracheal stenosis. Measurements and Main Results In the follow-up period, tracheal stenosis was observed in 7 of 208 patients (2 women, 5 men, 3.3%). The patients were divided into two groups as patients with tracheal stenosis (n=7) and patients without tracheal stenosis (n=201). There was no statistically significant difference between the two groups in terms of age, gender, body mass index (BMI) and comorbidities (p > 0.05). The mean duration of IMV of the patients with tracheal stenosis was longer than patients without tracheal stenosis (27.9 ± 13 vs 11.2 ± 9 days, p < 0.0001, respectively). Three (43%) of the stenoses were web-like and four (57%) of them were complex type stenosis. The mean length of the stenoses was 1.81 ± 0.82 cm. Three of the patients were successfully treated with bronchoscopic dilatation and four of them were treated with tracheal resection. Conclusions Tracheal stenosis developed in 7 (3.3%) of 208 patients with COVID-19 who were treated with IMV. The most important characteristics of patients with tracheal stenosis was prolonged IMV support.

BACKGROUND: Pneumonia is among the most serious infections in the elderly. The evaluation of prognosis and predicting the outcome is essential in managing the treatment of patients with pneumonia. OBJECTIVE: Evaluate factors that might affect the mortality of elderly patients hospitalized for community-acquired pneumonia (CAP) in two age groups. DESIGN: Medical record review. SETTINGS: Tertiary care hospital. PATIENTS AND METHODS: The study included CAP patients who were hospitalized during the period from January 2017 and December 2019. The CURB-65 scale was chosen to assess the severity of pneumonia on admission. Multivariate analyses were conducted separately for patients younger than 75 years and 75 years or older. MAIN OUTCOME MEASURES: 30-day mortality, factors associated with mortality. SAMPLE SIZE AND CHARACTERISTICS: 1603 patients with a median age of 74, including 918 women (57%). RESULTS: The 30-day mortality rate was 6.5%. Patients with carbapenem-resistant gram-negative bacteria had lower survival rates ( P <.0001). In the multivariate analysis, age, lung cancer, CURB-65, carbapenem resistance, and duration of hospital stay were associated with mortality in patients aged 75 years or older. Lung cancer, malignant disease, carbapenem resistance, duration of hospital stay and procalcitonin level were associated with mortality under the age of 75. Of 640 sputum cultures tested, P aeruginosa (42%) was the most common pathogen. CONCLUSION: The risk factors that affected mortality differed among patients aged 75 years or older versus younger patients. Our findings are important in determining factors associated with mortality in managing the treatment and follow up of hospitalized CAP patients younger or 75 years of age or older. LIMITATIONS: Single-center, retrospective. CONFLICT OF INTEREST: None.

Aims: Metabolic Syndrome has become the greatest health hazard in the modern world, along with infectious diseases. We aimed to evaluate the effects of metabolic syndrome on disease course, laboratory values and mortality in patients with COVID 19 pneumonia. Methods: COVID 19 pneumonia patients with and without metabolic syndrome were compared in terms of laboratory parameters, clinical results and mortality rates retrospectively. Results: A total of 194 patients hospitalized with COVID 19 pneumonia (with and without metabolic syndrome n = 93 and 101, respectively) were included in the study. Patients with metabolic syndrome had lower oxygen saturation at the time of admission (88.76 vs 93.66 p <0.0001), higher neutrophil (5.85 vs 4.81 p = 0.02) and CRP levels (88.36 vs 62.93 p = 0.009) and COVID 19 involvement was more common in lung tomography (12.3 vs 7.7 p <0.0001). Total length of stay (12.3 vs 6.5 days p <0.0001) and clinical length of stay (7.8 vs 5.9 days p = 0.003) were longer in patients with metabolic syndrome. Requirement of intensive care (45.2% vs 4.9% p <0.0001) and mortality rates (24.7% vs 0.9% p <0.0001) were higher in patients with metabolic syndrome. Presence of metabolic syndrome (OR 32.86, 95% CI 4.34 to 249 p<0.05) were significantly associated with increased mortality. Discussion and conclusion: Our results demonstrated that patients with metabolic syndrome that were hospitalized with COVID 19 pneumonia had significantly higher mortality and intensive care requirement. They have lower oxygen saturations, higher CRP levels and more widespread radiological involvement. Keywords: Covid 19 - Metabolic syndrome – Pneumonia - Mortality

Background:The disease SARS-COV-2, which started in Wuhan city of China and caused pandemic, created an increasing number of intensive care needs due to its severe respiratory failure. The factors that determine the course of patients followed in intensive care are different. Therefore, our aim was to determine the factors that predict mortality and affect prognosis by evaluating the patients admitted to our intensive care unit. Material and Method: This study is a single-center retrospective study involving 156 patients admitted to our intensive care unit , who was diagnosed with SARS-COV-2 between 20 March and 8 June 2020. The data including characteristics, symptoms and laboratory findings of the patients were recorded and their relationships to mortality were evaluated Results: The mean age was 69±15 years and 63% were male. The most common symptom was dyspnea (69.9%) and fever (60.9%), respectively. Comorbidity was present in 82% and the most common comorbidity was HT and DM, respectively. All patients were admitted to the intensive care unit with (due to) hypoxemic respiratory failure. 106 patients (68.8%) were connected to mechanical ventilation, which was associated with mortality (p<0.0001). High flow oxygen therapy was delivered in 31 patients and was associated with survival (p<0.05). Tocilizumab, given in addition to the treatments increased the survival (p<0.05). Conclusion:We saw in our study that many parameters will be effective in predicting survival. As the most determining factors, not being intubated during admission and/or follow-up was observed to be effective on survival and was found to be associated with mortality.

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