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Background/aim: Gastrointestinal (GI) system cancers are frequent among older adults and it is still difficult to predict which are at increased risk for postoperative complications. Frailty and sarcopenia are increasing problems of older population and may be associated with adverse outcomes. In this study we aimed to examine the effect of sarcopenia and frailty on postoperative complications in older patients undergoing surgery for GI cancers. Materials and methods: Forty-nine patients admitted to general surgery clinic with the diagnosis of gastrointestinal system cancers were included in this cross-sectional study. Frailty status was assessed using Edmonton Frail Scale (EFS). Sarcopenia was defined due to the EWGSOP2 criteria and ultrasonography was used to evaluate muscle mass. Results: The median age of the patients was 70 (min-max: 65-87). Fourteen (28.6 %) patients were found to be sarcopenic and 16 (32. 7%) patients were frail, and 6 (37.5%) of these patients were also severe sarcopenic (p=0.04). When the postoperative complications were assessed, time to oral intake, time to enough oral intake, length of hospital stay in the postoperative period were found to be longer in frail patients (p=0.02, p=0.03, p=0.04 respectively). Postoperative complications were not different due to the sarcopenia. Conclusion: 2 Frailty, but not sarcopenia was associated with adverse outcomes in older adults undergoing GI cancer surgery. Comprehensive geriatric assessment before surgical intervention may help to identify patients who are at risk.

According to current literature and preliminary data, hydroxychloroquine (HCQ) seems potentially effective in treating patients with Covid-19 pneumonia. The concentrations of the HCQ in the lungs might be well above that of plasma. Most likely, this property of HCQ provides effective drug concentrations. HCQ has a gradual onset of action in the treatment of rheumatic diseases. This could be valid for the treatment of Covid-19 pneumonia. Reduced perfusion, somewhat distorted architecture of lung tissue and edema might reduce HCQ accumulation in pneumonic areas of the lungs in Covid-19 pneumonia. Patients having extensive lung involvement might have less HCQ concentrations in their lungs than that of patients having limited lung involvement. Furthermore, patients having extensive lung involvement might have more viral load than that of limited lung involvement. That’s why HCQ might be more effective in the treatment of mild and moderate Covid-19 pneumonia cases and might not be effective in advanced cases. Using HCQ in Covid-19 prophylaxis seems logical since providing enough accumulation of HCQ in the healthy lungs before the arrival of the SARS-CoV-2 virus, might prevent Covid-19 pneumonia. The purpose of this paper is not to recommend using or not using HCQ for the treatment or for the prophylaxis of Covid-19 pneumonia. The purpose of this paper is only to try to bring a new perspective on the role of HCQ in the treatment or in the prophylaxis of Covid-19 pneumonia. This paper proposes only hypotheses, which need further researches to be confirmed.

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