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Background and objectives: although 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. Methods: patients 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. Results: we 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 (? [95% CI]: 4.71 [2.31–7.11]; p = 0.001), favipiravir (? [95% CI]: 3.55 [2.56–4.55]; p = 0.001) and HCQ (? [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). Conclusion: Our 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., The study was partially funded by the Turkish Thoracic Society.

Objective: to evaluate long-term effects of COVID-19, and to determine the risk factors in long-COVID in a cohort of the Turkish Thoracic Society (TTS)-TURCOVID multicenter registry.Methods: thirteen centers participated with 831 patients; 504 patients were enrolled after exclusions. The study was designed in three-steps: (1) Phone questionnaire; (2) retrospective evaluation of the medical records; (3) face-to-face visit. Results: in the first step, 93.5% of the patients were hospitalized; 61.7% had a history of pneumonia at the time of diagnosis. A total of 27.1% reported clinical symptoms at the end of the first year. Dyspnea (17.00%), fatigue (6.30%), and weakness (5.00%) were the most prevalent long-term symptoms. The incidence of long-term symptoms was increased by 2.91 fold (95% CI 1.04-8.13, P=0.041) in the presence of chronic obstructive pulmonary disease and by 1.84 fold (95% CI 1.10-3.10, P=0.021) in the presence of pneumonia at initial diagnosis, 3.92 fold (95% Cl 2.29-6.72, P=0.001) of dyspnea and 1.69 fold (95% Cl 1.02-2.80, P=0.040) fatigue persists in the early-post-treatment period and 2.88 fold (95% Cl 1.52- 5.46, P=0.001) in the presence of emergency service admission in the post COVID period. In step 2, retrospective analysis of 231 patients revealed that 1.4% of the chest X-rays had not significantly improved at the end of the first year, while computed tomography (CT) scan detected fibrosis in 3.4%. In step 3, 138 (27.4%) patients admitted to face-to-face visit at the end of first year; at least one symptom persisted in 49.27% patients. The most common symptoms were dyspnea (27.60%), psychiatric symptoms (18.10%), and fatigue (17.40%). Thorax CT revealed fibrosis in 2.4% patients. Conclusions: COVID-19 symptoms can last for extended lengths of time, and severity of the disease as well as the presence of comorbidities might contribute to increased risk. Long-term clinical issues should be regularly evaluated after COVID-19., NA

Bu çalışma, 2015-2017 yıllarında hastanemize pnömokonyoz maluliyet değerlendirmesi için başvuran ve Bülent Ecevit Üniversitesi (BEÜ) Göğüs Hastalıkları Ana Bilim Dal'ında pnömokonyoz heyetinde üç ILO okuyucusu tarafından ILO kriterlerine göre pnömokonyoz tanısı konmuş madencilerde solunum fonksiyon parametreleri ile bunların klinik radyolojik korelasyonlarının değerlendirilmesi amacı ile yapılmıştır. Toplam 613 dosyadan SFT yapamamış hastalar, Kömür İşçisi Pnömokonyozu (KİP) tanısına ek olarak tüberküloz ve kanser tanısı olanlar ve SFT- DLCO- vücut pletismografi tetkiklerinden biri eksik olan dosyalar çalışmadan çıkarıldı. 144 olgu çalışmaya dahil edildi. 20 olguda KİP saptanmadı ve bu olgular kontrol grubu olarak belirlendi. KİP tanısı alan ve almayan grup arasında demografik özellikler ve SFT parametreleri açısından istatistiksel olarak anlamlı fark saptanmadı. KİP tanısı alanlarda alt kategorik değerlendirmelere göre SFT parametrelerinde bir takım anlamlı farklılıklar izlendi ve bunların en belirgini kategori 1 basit KİP ile kategori B+C komplike KİP arasındaydı. KİP tanısı alan olgularda sigara içme öyküsü olan ve olmayan gruplar karşılaştırıldığında SFT sonuçları açısından anlamlı fark saptanmadı. KİP gelişimi açısından yaş, VKİ, yer altında çalışma süresi ve sigara içme öyküsü bakımından istatistiksel olarak anlamlı bir risk faktörü saptanmadı. Sonuç olarak; her ne kadar KİP tanısı alan ve almayan grup arasında SFT parametreleri açısından anlamlı fark saptanmasa da KİP kategorisi arttıkça, özellikle FEV1/FVC ve %MMEF değerleri olmak üzere tüm akciğer fonksiyonlarında kötüleşme olabilmektedir. Bu nedenle kömür madeni işçileri radyografik olarak takip edilmesinin yanında spirometrik olarak da kötüleşme olup olmadığının takibi yapılmalı ve mutlaka sigara bırakma programlarına yönlendirilmelidirler.Anahtar Kelimeler: Pnömokonyoz, spirometri, obstrüksiyon In this study, we retrospectively evaluated pulmonary function test results and their correlation with the radiological pneumoconiosis category in underground coal miners referred to Bulent Ecevit University Hospital between 2015 and 2017 for pneumoconosis confirmation and disability compensation purposes. In our institution there is a pneumoconiosis team comprised of three pulmonologists who are also certified ILO pneuoconiosis readers. We retrospectively evaluated 613 patient files initially, The ones who were lacking full set of pulmonary function results in the electronic files for any reason (unaccessible or unable to perform any part of the pulmonary function tests (spirometry, diffusion or body plethsmography)) and those diagnosed with cancer or tuberculosis were excluded from the study. 144 coal miners were included in the study eventually. Of them 124 were confirmed as coal workers pneumoconiosis (CWP) and 20 were not. These non-CWP cases were designated as control group. There were no signifant difference between CWP and non-CWP groups with respect to demographic factors and pulmonary function parameters. We found significant differences between pulmonary function parameters and radiological pneumoconiosis category. The most significant difference was reported between simple CWP category 1 and complicated CWP ( categories B and C combined). Pulmonary function test results did not differ significantly between smoker and nonsmoker CWP cases. Although smoking increased CWP risk by 2.15 times according to regression analysis, there were no significant difference for all other demographic factors. In conclusion, although there were insignifant differences between CWP and non-CWP groups with respect to pulmonary function parameters, we found with worsening CWP category there was a worsening in all parameters especially in FEV1/FVC and %MMEF, excluding %TLC. We suggest spirometry should be included in periodic exams and surveillance of coal miners in addition to roentgenograms and smoking cessation programs should be initiated for coal miners.Keywords: Pneumoconiosis, spirometry, obstruction 55

Kronik obstrüktif akciğer hastalığı (KOAH) heterojen, multifaktoriyel ve kompleks bir hastalıktır. Hastalığın şiddeti ve prognozunu gösteren belirteç olarak en sık kullanılan parametre 1.saniyede zorlu ekspiratuar volüm (FEV1)'dir ancak FEV1'in semptomlar ve hastalığın prognuzunu gösteren parametreler ile korelasyonu zayıftır. Bu nedenle tanı, risk planlaması ve tedavi seçenekleri için başka belirteçlerin tanımlanmasına ihtiyaç vardır. Bu çalışmada KOAH klinik-radyolojik fenotiplerinin serum biyobelirteçleri ile olan ilişkisinin değerlendirilmesi, uzun süredir bilinen fenotip kavramının özellikle solunum hastalıklarında, hastalık prezentasyonunu ve prognozu etkilediği fikrinden yola çıkarak, öncelikle polikliniğimizde izlenen stabil KOAH hastalarının fenotipik özelliklerini ortaya konması amaçlandı. Çalışmaya Bülent Ecevit Üniversitesi (BEÜ) Uygulama ve Araştırma Hastanesi Göğüs Hastalıkları Polikliniği'ne başvuran, KOAH tanısı olan ya da başvuruda KOAH tanısı stabil olan 40 hasta ve 40 sağlıklı kontrol (20 sigara içen/içmiş bırakmış ve 20 sigara içmemiş) alındı. Tüm olguların spirometrik ölçümleri yapıldı, YRBT çekildi, YRBT görüntülerinden -950 HU altında dansiteye sahip alanların yüzdesi ve bronş duvar kalınlığı hesaplandı, St. George Solunum Anketi (SGRQ) uygulandı, Modified Medical Research Council (mMRC) dispne skoru sorgulandı, 6 dakika yürüme testi (6 DYT) uygulandı., KOAH değerlendirme testi (CAT) uygulandı, www.clipcopd.com verilerine göre klinik fenotip, klinik, radyolojik değerlendirmeye göre ise hekim fenotipi belirlendi, kanda C-reaktif protein (CRP), fibrinojen, sedimentasyon, Tümör nekrozis faktör α (TNF α), interlökin-3 (IL-3), interlökin-6 (IL-6), interlökin-8 (IL-8), lökosit sayısı, nötrofil (%) ve eosinofil (%) düzeyleri ölçüldü. CRP hasta grubunda, kontrol gruplarına göre anlamlı yüksek saptandı (p