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Although COVID-19 infection is an immunosuppressant disease, many immunosuppressant agents, such as pulse methylprednisolone (PMP), dexamethasone (DXM), and tocilizumab (TCZ), were used during the pandemic. Secondary infections in patients with COVID-19 have been reported recently. This study investigated these agents' effects on secondary infections and outcomes in patients with COVID-19 in intensive care units (ICUs). This study was designed retrospectively, and all data were collected from the tertiary intensive care units of six hospitals between March 2020 and October 2021. All patients were divided into three groups: Group I [GI, PMP (−), DXM (−) and TCZ (−)], Group II [GII, PMP (+), DXM (+)], and Group III [GIII, PMP (+), DXM (+), TCZ (+)]. Demographic data, PaO/FiO2 ratio, laboratory parameters, culture results, and outcomes were recorded. To compare GI-GII and GI-GIII, propensity score matching (PSM) was used by matching 14 parameters. Four hundred twelve patients with COVID-19 in the ICU were included in the study. The number of patients with microorganisms ≥ 2 was 279 (67.7%). After PSM, in GII and GIII, the number of (+) tracheal cultures and (+) bloodstream cultures detected different microorganisms ≥ 2 during the ICU period, neuropathy, tracheotomized patients, duration of IMV, and length of ICU stay were significantly higher than GI. The mortality rate was similar in GI and GII, whereas it was significantly higher in GIII than in GI. The use of immunosuppressant agents in COVID-19 patients may lead to an increase in secondary infections. In addition, increased secondary infections may lead to prolonged ICU stay, prolonged IMV duration, and increased mortality. [ABSTRACT FROM AUTHOR]

In this study, it was aimed to assess the microstructural changes in the main central auditory pathway in cases with subjective tinnitus. In total, 101 subjects (52 cases with bilateral subjective non-pulsatile tinnitus and 49 healthy cases as the control group) were included in the study. Participants underwent pure tone audiogram and Diffusion Tensor Imaging-Magnetic Resonance Imaging (DTI-MRI) examination with a 3 Tesla MRI device. The number of tracts, tract length, volume, and quantitative anisotropy (QA) and normalized quantitative anisotropy' (nQA) values were calculated by plotting cochleocortical pathways from the cochlear nerve to ipsilateral and contralateral Heschl's gyrus (HG). In pure tone audiometry, the control group had lower hearing thresholds than cases with tinnitus. Fibres and nQA values from the right cochlear nerve to the right HG were significantly lower in the tinnitus group than in the control group. Cochlear nuclei voxel counts were significantly decreased in the tinnitus group. Both cochlear nucleus volumes were higher in the tinnitus group than in the control group. nQA values in both cochlear nuclei were decreased in the tinnitus group. This study showed that the most commonly affected part in subjective non-pulsatile tinnitus cases is the cochlear nucleus. Therefore, the cochlear nucleus should be evaluated more carefully in cases presenting with subjective tinnitus. [ABSTRACT FROM AUTHOR]