Person: BOLUKÇU, SİBEL
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Publication Open Access Tocilizumab treatment in severe COVID-19: a multicenter retrospective study with matched controls(2021-09-01T00:00:00Z) Mert, Ali; VAHABOĞLU, HALUK; ARSLAN, FERHAT; Batirel, Ayse; Saracoglu, Kemal Tolga; Bastug, Aliye; Cagatay, Atahan; IRMAK, İLİM; TELLİ DİZMAN, GÜLÇİN; Ertenli, Ihsan; Altunal, Lutfiye Nilsun; ERTÜRK ŞENGEL, BUKET; Bayram, Mehmet; Omma, Ahmet; Amikishiyev, Shirkhan; Aypak, Adalet; Bes, Cemal; BOLUKÇU, SİBEL; Icten, Sacit; TOPELİ İSKİT, ARZU; Bektas, Murat; Arslan, Birsen Yigit; Ozturk, Sinan; Comoglu, Senol; Aydin, Selda; Kucuksahin, Orhan; Icacan, Ozan Cemal; Ince, Burak; Aghamuradov, Sarvan; Mutlu, Melek Yalcin; Simsek, Funda; Emre, Salih; Ustun, Cemal; Ergen, Pinar; Aydin, Ozlem; MERİÇ KOÇ, MELİHA; Sevindik, Omur Gokmen; ODABAŞI, ZEKAVER; KORTEN, VOLKAN; Bodur, Hurrem; Guner, Rahmet; ÜNAL, SERHAT; Kocak, Mehmet; Gül, Ahmet; BOLUKÇU, SİBEL; MERİÇ KOÇ, MELİHACoronavirus disease-2019 (COVID-19) associated pneumonia may progress into acute respiratory distress syndrome (ARDS). Some patients develop features of macrophage activation syndrome (MAS). Elevated levels of IL-6 were reported to be associated with severe disease, and anti-IL-6R tocilizumab has been shown to be effective in some patients. This retrospective multicenter case-control study aimed to evaluate the efficacy of tocilizumab in hospitalized COVID-19 patients, who received standard of care with or without tocilizumab. Primary outcome was the progression to intubation or death. PSMATCH (SAS) procedure was used to achieve exact propensity score (PS) matching. Data from 1289 patients were collected, and study population was reduced to 1073 based on inclusion-exclusion criteria. The composite outcome was observed more frequently in tocilizumab-users, but there was a significant imbalance between arms in all critical parameters. Primary analyses were carried out in 348 patients (174 in each arm) after exact PS matching according to gender, ferritin, and procalcitonin. Logistic regression models revealed that tocilizumab significantly reduced the intubation or death (OR 0.40, p = 0.0017). When intubation is considered alone, tocilizumab-users had > 60% reduction in odds of intubation. Multiple imputation approach, which increased the size of the matched patients up to 506, provided no significant difference between arms despite a similar trend for intubation alone group. Analysis of this retrospective cohort showed more frequent intubation or death in tocilizumab-users, but PS-matched analyses revealed significant results for supporting tocilizumab use overall in a subset of patients matched according to gender, ferritin and procalcitonin levels.Publication Metadata only A novel id-iri score: development and internal validation of the multivariable community acquired sepsis clinical risk prediction model(2020-04-01T00:00:00Z) Diktas, Husrev; Uysal, Serhat; Erdem, Hakan; Cag, Yasemin; Miftode, Egidia; Durmus, Gul; ULU KILIÇ, AYŞEGÜL; Alabay, Selma; Szabo, Balint Gergely; Lakatos, Botond; Fernandez, Ricardo; Korkmaz, Pinar; Caliz, Michael Cruz; Argemi, Xavier; Kulzhanova, Sholpan; Kormaz, Fatime; Yilmaz-Karadag, Fatma; Ergen, Pinar; Atilla, Aynur; Puca, Edmond; Dogan, Mustafa; Mangani, Francesca; Sahin, Suzan; Grgic, Svjetlana; Grozdanovski, Krsto; Yilmaz, Gul Ruhsar; Del-Vecchio, Rosa Fontana; Demirel, Aslihan; SIRMATEL, FATMA; ŞENER, ALPER; Sacar, Suzan; Aydin, Emsal; Batirel, Ayse; Dragovac, Gorana; El-Sokkary, Rehab; Alexandru, Crisan; Arslan-Ozel, Selcan; BOLUKÇU, SİBEL; Ozkaya, H. Deniz; Nayman-Alpat, Saygin; Inan, Asuman; Al-majid, Fahad; Kaya-Ugur, Berna; Rello, Jordi; BOLUKÇU, SİBELWe aimed to develop a scoring system for predicting in-hospital mortality of community-acquired (CA) sepsis patients. This was a prospective, observational multicenter study performed to analyze CA sepsis among adult patients through ID-IRI (Infectious Diseases International Research Initiative) at 32 centers in 10 countries between December 1, 2015, and May 15, 2016. After baseline evaluation, we used univariate analysis at the second and logistic regression analysis at the third phase. In this prospective observational study, data of 373 cases with CA sepsis or septic shock were submitted from 32 referral centers in 10 countries. The median age was 68 (51-77) years, and 174 (46,6%) of the patients were females. The median hospitalization time of the patients was 15 (10-21) days. Overall mortality rate due to CA sepsis was 17.7% (n = 66). The possible predictors which have strong correlation and the variables that cause collinearity are acute oliguria, altered consciousness, persistent hypotension, fever, serum creatinine, age, and serum total protein. CAS (%) is a new scoring system and works in accordance with the parameters in third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). The system has yielded successful results in terms of predicting mortality in CA sepsis patients.Publication Open Access Investigation the Relationship Between Body Mass Index and Mortality in COVID-19 Patients(2021-02-01T00:00:00Z) BOLUKÇU, SİBEL; ÖZMEN, MEHMET EMİN; EKŞİ, ÇAĞLA; OKAY, GÜLAY; SÜMBÜL, BİLGE; KAÇMAZ, ASİYE BAHAR; DURDU, BÜLENT; AKKOYUNLU, YASEMİN; MERİÇ KOÇ, MELİHA; BOLUKÇU, SİBEL; ÖZMEN, MEHMET EMİN; EKŞİ, ÇAĞLA; OKAY, GÜLAY; SÜMBÜL, BİLGE; KAÇMAZ, ASİYE BAHAR; DURDU, BÜLENT; AKKOYUNLU, YASEMİN; MERİÇ KOÇ, MELİHAObjective: Obesity might be a risk factor for patients with Coronavirus disease-19 (COVID-19). We aimed to investigate the association of the obesity with intensive care need and mortality caused by severe acute respiratory syndrome-CoV-2 (SARS-CoV-2) infection in this retrospective cohort. Methods: Between March 11th and May 1st, 135 patients, who were treated in our clinic, were enrolled in the study. Body mass index (BMIs) of the patients were grouped according as WHO criteria (<25 kg/m(2): normal, 25 30 kg/m(2): overweight, >30 kg/m(2): obese). Results: Of our patients, 34.1% (n=46) were obese. Mean BM! of the mortality group was 31.2 kg/m(2) and was not different from that of the survivors (p=0.09), However, mean BMI of the patients, in whom intensive care was needed, teas 31.2 kg/m(2) and higher than that of those intensive care was nut needed (p=0.04). In subgroup analyses, obesity (BMI >31) kg/m(2)) was more common among mortality group versus survivors in males older than 60 years old (p=0.03). Conclusion: Obesity with associated disorders are negative prognostic factors for COVID-19 and should be tackled as the end of the pandemic is obscure.Publication Open Access COVID-19 and Influenza Coexistence(2021-02-01T00:00:00Z) Uslu Ersoz, Ayse Betul; BOLUKÇU, SİBEL; Andic, Nurgul; Karakus, Dilara; OKAY, GÜLAY; SÜMBÜL, BİLGE; KAÇMAZ, ASİYE BAHAR; DURDU, BÜLENT; AKKOYUNLU, YASEMİN; MERİÇ KOÇ, MELİHA; USLU, AYŞE BETÜL; BOLUKÇU, SİBEL; ANDIÇ, NURGÜL; OKAY, GÜLAY; SÜMBÜL, BİLGE; KAÇMAZ, ASİYE BAHAR; DURDU, BÜLENT; AKKOYUNLU, YASEMİN; MERİÇ KOÇ, MELİHAObjective: Viral pneumonia cases occur quite frequently in the community. The rate of viral infections in community-acquired pneumonia is about 25%. severe acute respiratory syndrome coronas i rus-2 (SARS-CoV-2) and influenza are also viruses that can cause pneumonia. In this study. we aimed to determine the rate of influenza co-infection in Coronavirus disease-19 (COVID-19) Cases. Methods: The data of adult patients who applied to Bezmialem Vakif University Hospital between March 6, 2020, and May 21, 2020, which were positive with the SARS-CoV-2 polymerase chain reaction (PCR) test and influenza antigen test were retrospectively scanned from the hospital automation system. Results: SARS-CoV-2 PCR test was found positive in 498 adult patients who applied to our hospital. Two hundrend-sixty of these patients were hospitalized and 238 were followed up on an outpatient basis. In 88 patients SARS-CoV-2 PCR and influenza antigen were studied, and 6 of them had positive influenza antigen. COVID-19 and influenza co- i n feet ion was not detected. Conclusion: In order to determine the exact rate of influenza and COVID-19 co-infection, it is necessary to evaluate the patients who applied with the appropriate clinical picture from the beginning of the seasonal influenza period by using reverse transcription-PCR fur these two viral infections, if possible. Further research is needed in this area.Publication Metadata only Investigation of the changing etiology and risk factors of prosthetic joint infections : a university hospital surveillance study from 2011-2017(2020-03-01T00:00:00Z) Gultepe, Bilge Sumbul; OKAY, GÜLAY; Bolukcu, Sibel; DURDU, BÜLENT; Koc, Meliha Meric; TUNCAY, İBRAHİM; BOLUKÇU, SİBEL; DURDU, BÜLENT; SÜMBÜL, BİLGE; TUNCAY, İBRAHİM; MERİÇ KOÇ, MELİHAWe sought to characterize the causative pathogens of prosthetic joint infections (PJIs), evaluate the trends in microbial etiologies, and identify potential risk factors for PJI. This was a retrospective study analyzing 70 patients with PJI following 3,253 total joint arthroplasties between 2011 and 2017. Staphylococci were the most common cause of infection (52.9%). There was a significant trend in the percentage of carbapenem-resistant gram-negative bacilli (GNB) (increased to 66.7% in 2016 from 0.0% in 2011) (p=0.021). GNB and polymicrobial etiology were found at significantly high levels in cases involving early PJIs (p=0.005 and p=0.048, respectively). While staphylococci were significantly higher in PJIs after total knee arthroplasty (75%), GNB were significantly higher in PJIs after total hip arthroplasty (49.1%) (p<0.001 and p=0.001, respectively). Binary logistic regression analysis showed that the risk of PJI was significantly higher in cases with fracture and diabetes mellitus (odds ratio [OR], 4.3, 95% confidence interval [CI], 1.78-10.5; OR, 4.1, 95% CI, 1.66-10.5, respectively). These results suggest that the empirical and targeted antimicrobial treatment of PJIs may become more difficult in the future.Publication Metadata only Efficacy and safety of co-formulated elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide in HIV-positive patients: real-world data(2021-02-01T00:00:00Z) TABAK, Ömer Fehmi; Zerdali, Esra; Altuntas, Ozlem; Gunduz, Alper; BOLUKÇU, SİBEL; METE, Bilgül; Nakir, Inci Y.; Kumbasar Karaosmanoglu, Hayat; Yildiz, Dilek S.; MERİÇ KOÇ, MELİHA; Dokmetas, Ilyas; BOLUKÇU, SİBEL; MERİÇ KOÇ, MELİHAObjectives: Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) is a recommended and widely used regimen for HIV infection. In this study, we aimed to determine the efficacy and safety of E/C/F/TAF in people living with HIV (PLWH), who are either treatment-naive or switched from any tenofovir disoproxil fumarate-containing regimen. For switched patients, we aimed to determine the impact of switching from tenofovir disoproxil fumarate (TDF) to TAF on lipid profile and kidney functions. Methods: ACTHIV-IST Study Group produced a database, and five dedicated HIV centres in Istanbul entered data of PLWH who switched from any TDF-containing regimen to E/C/F/TAF and treatment-naive patients who were initiated with the E/C/F/TAF regimen between January 2017 and December 2019. Clinical findings, viral parameters, lipid studies, renal function tests, adverse events and adherence to the treatment were recorded in this prospective observational study. Results: The study included a total of 614 switched and treatment-naive patients. Of 430 treatment-experienced patients, 89% (382) were men, and the mean age was 42 +/- 12 years. Among them, 47% (181/382) self-identified as men who have sex with men (MSM). The median duration of HIV diagnosis was 54 +/- 29 months. The median duration of E/C/F/TAF use was 20 +/- 36 months and that of previous treatment was 23 +/- 18 months. HIV-RNA was undetectable at baseline and month 12 in 84.1% (360/428) and 86.1% (328/381) of patients, respectively (p > 0.05). Mean CD4 counts were 708 +/- 287 cells/mu L and 802 +/- 305 cells/mu L at baseline and month 12, respectively (p < 0.001). Serum creatinine levels remained stable during the treatment period. Mean total cholesterol levels at baseline and month 12 were 172 and 211 mg/dL (p < 0.01), LDL-cholesterol 104 and 138 mg/dL (p < 0.01), HDL-cholesterol 39 and 49 mg/dL (p < 0.01) and triglycerides 134 and 174 mg/dL (p < 0.01), respectively. The treatment was generally well tolerated. Eight patients discontinued the therapy (drug interaction: 3; lost to follow-up: 1; pregnancy: 1; pulmonary tuberculosis: 1; side effect: 1; patient-s decision: 1). Of 184 treatment-naive patients, 88% (162) were men, and the mean age was 36.5 +/- 12 years. Among them, 50% (81/162) self-identified as MSM. The mean duration of HIV infection was 21.6 +/- 17.1 months. The mean duration of E/C/F/TAF use was 16 +/- 4 months. HIV-RNA was undetectable at baseline and month 12 in 1% and 89.1% of patients, respectively. Mean CD4 counts at baseline and month 12 were 469 +/- 223 cells/mu L and 740 +/- 298 cells/mu L, respectively. During the treatment period, creatinine levels remained stable. Total cholesterol, LDL-cholesterol, triglyceride and also HDL-cholesterol levels increased. Mean total cholesterol levels at baseline and month 12 were 167 and 211 mg/dL (p < 0.01), LDL-cholesterol 108 and 143 mg/dL (p < 0.01), HDL-cholesterol 41 and 47 mg/dL (p < 0.01) and triglycerides 136 and 172 mg/dL, respectively (p < 0.01). The treatment was generally well tolerated. Three patients discontinued the therapy (drug interaction: 1; non-responder: 1; patient-s decision: 1). Conclusion: Starting with or switching to E/C/F/TAF in PLWH effectively suppresses HIV infection, is associated with an increase in CD4 cell count and is well tolerated in a real-life setting. Renal functions remained stable during the treatment.