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Objective: To evaluate the long-term outcomes of hepatitis delta patients, including cirrhosis and hepatocellular carcinoma (HCC), based on clinical and laboratory data., Methodology: A retrospective evaluation was conducted on patients diagnosed with hepatitis delta. The patients were formed into four groups: no-treatment, pegylated interferon, oral antiviral, and combined treatment., Results: A total of 93 patients, 48 women and 45 men, were evaluated in the study. The mean follow-up time was 4.38 ± 2.7 years. Of those, 43 were in the no-treatment group, 22 received combination therapy including pegylated interferon and oral antiviral treatment for chronic hepatitis B (the combined treatment group), 19 received only oral antiviral treatment for chronic hepatitis B (the oral antiviral group), and nine received pegylated interferon (the pegylated interferon group). HDV-RNA negativity was observed in 67% (6/9) of patients in the pegylated interferon group and 33% (5/15) of patients in the combined treatment group. HDV-RNA became spontaneously negative in one of the two patients in the no-treatment group, while no patient in the oral antiviral group became HDV-RNA negative. Seven patients were diagnosed with cirrhosis and one with HCC. Three patients had undergone liver transplants. There were no fatalities among patients., Conclusions: Pegylated interferon therapy has been demonstrated to have partial efficacy in the treatment of delta hepatitis, while oral antivirals have been shown to offer no additional benefit. Although negative HDV-RNA was achieved in some patients treated with pegylated interferon, pegylated interferon treatment could not eliminate the risk of cirrhosis and HCC., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2025 Muhammet Salih Tarhan, Habip Gedik, Kadriye Kart-Yasar.)

Introduction: We aimed to evaluate the prevalence and clinical outcomes of COVID-19 in healthcare workers (HCWs) in the pre-vaccination and post-vaccination periods. In addition, we determined factors associated with the development of COVID-19 after vaccination., Methodology: In this analytical cross-sectional epidemiological study, HCWs who were vaccinated between January 14, 2021, and March 21, 2021, were included. HCWs were followed up for 105 days after the 2 doses of CoronaVac. Pre-vaccination and post-vaccination periods were compared., Results: A total of 1,000 HCWs were included, 576 patients (57.6%) were male, and the mean age was 33.2 ± 9.6 years. In the last 3 months during the pre-vaccination period, 187 patients had COVID-19, and the cumulative incidence of COVID-19 was 18.7%. Six of these patients were hospitalized. Severe disease was observed in three patients. In the first 3 months post-vaccination period, COVID-19 was detected in 50 patients, and the cumulative incidence of the disease was determined to be 6.1%. Hospitalization and severe disease were not detected. Age (p = 0.29), sex (OR = 1.5, p = 0.16), smoking (OR = 1.29, p = 0.43), and underlying diseases (OR = 1.6, p = 0.26) were not associated with post-vaccination COVID-19. A history of COVID-19 significantly reduced the likelihood of the development of post-vaccination COVID-19 in multivariate analysis (p = 0.002, OR = 0.16, 95% CI = 0.05-0.51)., Conclusions: CoronaVac significantly reduces the risk of SARS-CoV-2 infection and alleviates the severity of COVID-19 in the early period. Additionally, HCWs who have been infected and vaccinated with CoronaVac are less likely to be reinfected with COVID-19., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2023 Yusuf Emre Ozdemir, Aysegul Inci Sezen, Serkan Surme, Sevtap Senoglu, Zuhal Yesilbag, Meryem Sahin Ozdemir, Osman Faruk Bayramlar, Emine Ilay Duman, Nomin Bold, Habip Gedik, Kadriye Kart Yasar.)

We aimed to compare vaccinated and unvaccinated patients hospitalized with COVID-19 in terms of disease severity, need for intensive care unit (ICU) admission, and death. In addition, we determined the factors affecting the COVID-19 severity in vaccinated patients. Patients aged 18-65 years who were hospitalized for COVID-19 between September and December 2021 were retrospectively analyzed in three groups: unvaccinated, partially vaccinated, and fully vaccinated.A total of 854 patients were included. Mean age was 47.9 ± 10.6 years, 474 patients (55.5%) were male. Of these, 230 patients (26.9%) were fully vaccinated, 97 (11.3%) were partially vaccinated, and 527 (61.7%) were unvaccinated. Of the fully vaccinated patients, 67% (n = 153) were vaccinated with CoronaVac and 33% (n = 77) were vaccinated with Pfizer-BioNTech. All patients (n = 97) with a single dose were vaccinated with Pfizer-BioNTech. One hundred thirteen (13.2%) patients were transferred to ICU. A hundred (11.7%) patients were intubated and 77 (9.0%) patients died. Advanced age (P = 0.028, 95% CI = 1.00-1.07, OR = 1.038) and higher Charlson Comorbidity Index (CCI) (P < 0.001, 95% CI = 1.20-1.69, OR = 1.425) were associated with increased mortality, while being fully vaccinated (P = 0.008, 95% CI = 0.23-0.80, OR = 0.435) was associated with survival in multivariate analysis. Full dose vaccination reduced the need for ICU admission by 49.7% (95% CI = 17-70) and mortality by 56.5% (95% CI = 20-77). When the fully vaccinated group was evaluated, we found that death was observed more frequent in patients with CCI>3 (19.1 vs 5.8%, P < 0.01, OR = 3.7). Therefore, the booster vaccine especially in individuals with comorbidities should not be delayed, since the survival expectation is low in patients with a high comorbidity index.

Background: Fever is one of the critical symptoms of collagen vascular diseases, malignancies, and infectious diseases. Patients with a fever of unknown origin (FUO) were evaluated to determine the etiology., Methods: In this study, 110 cases with FUO who were admitted to two hospitals with a total of 800 beds, in which 5000 daily outpatient patients were admitted between 2006 and 2016 have been evaluated retrospectively. Anamnesis and the findings were obtained from hospital records. Patients with a temperature higher than 38.3°C and lasting three weeks or longer without diagnosis despite one week of investigation in the hospital were included as FUO cases in this study. Nosocomial and neutropenic cases were excluded from the present study., Results: Fifty-seven patients were male (52%), and the mean age was 40.2 ± 17.2. The distribution of the classic and HIV-associated cases was 85 (77.3%) and 18 (16.4%). Tuberculosis (TB) was the most frequent disease in both groups. The etiology was infectious in 68.2%, autoimmune in 14.5%, and neoplastic in 5.4%. There was no case of collagen vascular disease in the HIV-associated FUO group., Conclusion: As a result of our study, infectious diseases and TB were still the leading factors that caused FUO. TB has been notably found higher in the HIV-associated group than the classic group. FUO is usually either a rare cause or an unusual clinical presentation of a well-known infectious disease in Turkey. Therefore, it should be noted that various manifestations of extra-pulmonary tuberculosis may be considered a FUO case.

The epigenetic features contribute to variations in host susceptibility to SARS-CoV-2 infection and severity of symptoms. This study aimed to evaluate the relationship between the relative expression of microRNAs (miRNAs) and the severity of the disease in COVID-19 patients. The miRNA profiles were monitored during the different stages of the disease course using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The expression levels of the selected 11 miRNAs were measured in the blood samples collected from 73 patients (moderate, n = 37; severe, n = 25; critically ill, n = 11, a total of 219 longitudinal samples) on hospitalization day and days 7 and 21. Expression changes were expressed as "fold change" compared to healthy controls ( n = 10). Our study found that several miRNAs differed according to disease severity, with the miR-155-5p the most strongly upregulated ( p = 0.0001). A statistically significant negative correlation was observed between the expression of miR-155-5p and its target gene, the suppressor of cytokine signaling 1 ( SOCS1 ). The relative expression of miR-155-5p was significantly increased and SOCS1 was significantly decreased with the disease progression (r = -0.805 p = 0.0001, r = -0.940 p = 0.0001, r = -0.933 p = 0.0001 for admission, day 7, and day 21, respectively). The overexpression of miR-155-5p has significantly increased inflammatory cytokine production and promoted COVID-19 progression. We speculated that microRNA-155 facilitates immune inflammation via targeting SOCS1 , thus establishing its association with disease prognosis.

This is a retrospective and observational study on 1511 patients with SARS-CoV-2, who were diagnosed with COVID-19 by real-time PCR testing and hospitalized due to COVID-19 pneumonia. 1511 patients, 879 male (58.17%) and 632 female (41.83%) with a mean age of 60.1 ± 14.7 were included in the study. Survivors and non-survivors groups were statistically compared with respect to survival, discharge, ICU admission and in-hospital death. Although gender was not statistically significant different between two groups, 80 (60.15%) of the patients who died were male. Mean age was 72.8 ± 11.8 in non-survivors vs. 59.9 ± 14.7 in survivors (p < 0.001). Overall in-hospital mortality was found to be 8.8% (133/1511 cases), and overall ICU admission was 10.85% (164/1511 cases). The PSI/PORT score of the non-survivors group was higher than that of the survivors group (144.38 ± 28.64 versus 67.17 ± 25.63, p < 0.001). The PSI/PORT yielding the highest performance was the best predictor for in-hospital mortality, since it incorporates the factors as advanced age and comorbidity (AUROC 0.971; % 95 CI 0.961−0.981). The use of A-DROP may also be preferred as an easier alternative to PSI/PORT, which is a time-consuming evaluation although it is more comprehensive.

Introduction: Cancer patients are more sensitive to infections, and, compared to other patients, may have more serious outcomes. Thus, cancer patients are a high-risk group in the COVID-19 pandemic. The aim of this study was to evaluate how cancer patients are affected by COVID-19 infection; the prevalence, and factors affecting mortality., Methodology: This single-centre, retrospective study included cancer patients under follow-up treatment at our hospital with a laboratory-confirmed diagnosis of COVID-19. Demographic and clinical data were obtained from electronic medical records. The effects of tumour subtype and patient demographic data on COVID-19 prevalence and mortality were analyzed using univariate and multivariate models., Results: Evaluation was made of 217 cancer patients, comprising140 (64.5%) males and 77 (35.5%) females with a mean age of 62.05 ± 12.95 years. Mortality was seen in 84 (38.7%) patients. Disease grade, chemotherapy within the last 3 months and CT findings were determined to be related to mortality. In logistic regression analysis, the most important factors affecting survival were determined to be severe lung involvement (p < 0.001) and hematological malignancy., Conclusions: It is clear that cancer patients are at greater risk from COVID-19 infection than individuals without a malignant disease. The results showed that cancer patients with different tumour types had different levels of sensitivity to COVID-19. It is clear that with ongoing viral mutations, the duration of the pandemic is unknown. Therefore, the continuation of cancer screening and cancer treatments should not be interrupted., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2022 Ramazan Korkusuz, Gulcin Sahingoz Erdal, Isil Kibar Akilli, Müge Bilge, Deniz Tural, Kadriye Kart Yasar.)

Background: To determine and compare nasopharyngeal microbiota (NM) composition, in vitro basal (Nil tube), provoked (Mitogen tube) production of cytokines at the early stage of COVID-19., Methods: This cross-sectional study included 4 age and sex-matched study groups; group 1 (recovered COVID-19) (n = 26), group 2 (mild COVID-19) (n = 24), group 3 (severe COVID-19) (n = 25), and group 4 (healthy controls) (n = 25). The study parameters obtained from the COVID-19 (group 2, and 3) at the early phase of hospital admission., Results: The results from the reaserch deoicted that the Mean ± SD age was 53.09 ± 14.51 years. Some of the in vitro cytokines production was significantly different between the study groups. Some of the findinggs on cytokines depicted a significant differences between study groups were interleukin (IL)-1β Nil, IL-1β Mitogen, and their subtraction (i.e Mitogen-Nil). Regarding IL-10, and IL-17a levels, Mitogen, and Mitogen-Nil tube production levels were significantly different between the groups. Surprisingly, most of these measures were lowest in the severe COVID-19 patients' group. Using discriminant analysis effect size (LEfSe), Taxa of NM with significant abundance was determined. About 20 taxa with an LDA score > 4 were identified as candidate biomarkers. Some of these taxa showed a significant correlation with IL-1β and IL-10 Mitogen and Mitogen- Nil levels (R > 0.3 or < -0.3, p < 0.05)., Conclusions: The findings of this perticular study regarting the early stage of COVID-19 showed that in vitro cytokines production, studies might be more useful than the ordinary cytokines' blood level measurement. Besides, the study identified some NM species that could be candidate biomarkers in managing this infection. However, further detailed studies are needed in these fields., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Introduction: The novel coronavirus disease (COVID-19) pandemic has had a profound global impact economically, socially, and in many other areas. As vaccines are developed and introduced, their effect on the disease on both, the global and individual scale is a subject of intense curiosity. This study aimed to evaluate the relationship between risk factors for hospitalization, disease severity, and vaccination status in COVID-19 inpatients in a pandemic hospital., Methodology: Patients hospitalized for COVID-19 between June and September 2021 were retrospectively analyzed in three groups: unvaccinated, incompletely vaccinated, and fully vaccinated. Disease severity was classified as moderate, severe, or critical according to World Health Organization criteria, and mortality risk factors and the prognostic effect of vaccination were analyzed., Results: The study included 486 patients, 228 women (46.9 %) and 258 men (53.1 %), with a mean age of 55.4 ± 16.5 years. Of these, 264 patients (54.3 %) were unvaccinated, 147 (30.2 %) were incompletely vaccinated, and 75 (15.4 %) were fully vaccinated. Older age, higher Charlson Comorbidity Index, greater disease severity, and being unvaccinated or incompletely vaccinated were associated with higher mortality., Conclusions: The results of our study indicate that age, disease severity, comorbidities, and vaccination status were factors affecting COVID-19 mortality. Our findings support that full vaccination reduces COVID-19 -related mortality rates, disease severity, and length of hospital stay. However, large-scale studies with larger patient populations are needed (Tab. 2, Ref. 22).

Introduction: We evaluated several biological indicators based on inflammation and/or nutritional status, such as systemic immune-inflammation index (SII), early warning score (ANDC) and prognostic nutritional index (PNI) in hospitalized COVID-19 patients with and without malignancies for a prognostic significance., Methodology: This is a retrospective and observational study on 186 patients with SARS-CoV-2, who were diagnosed with COVID-19 by real-time PCR testing and hospitalized due to COVID-19 pneumonia. 75 patients had various malignancies, and the rest (111), having a similar age and comorbidity profile based on propensity score matching, had no malignancy., Results: None of the measures as neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, monocyte to lymphocyte ratio, SII, PNI or ANDC was found to be significantly different between two groups. Odds ratio for the mortality, OR 2.39 (%95 CI 1.80-3.16) was found to be significantly higher for the malignancy group, even though the duration of hospitalization was statistically similar for both groups. PNI was found to be significantly lower for deceased patients compared with survivors in the malignancy group. Contrarily, ANDC was found to be significantly higher for deceased patients in the malignancy group., Conclusions: PNI and ANDC have independent predictive power on determining the in-hospital death in COVID-19 malignancy cases. It is suggested that ANDC seems to be a more sensitive score than SII in COVID-19 cases with malignancies., (© 2021. The Author(s).)

Background: The aim of this study was to demonstrate the presence of the virus in tear and conjunctival secretions of clinically-confirmed COVID-19 pneumonia patients., Methods: This prospective study was conducted at Bakirkoy Dr. Sadi Konuk Training and Research Hospital (2020/190). Nasopharyngeal and ocular samples were obtained by swab technique and investigated by RT-PCR., Results: A total of 83 patients were included. The mean age was 61.88 ± 16.04 years. 28.92% of the patients had mild, 65.06% moderate and 6.02% severe pneumonia radiologically. RT-PCR was positive in 31 (37.35%) patients in the first nasopharyngeal swabs and in 19 (22.89%) in the second swabs. 17 of 19 patients had positive both first and second nasopharyngeal swabs; only the second swabs of two patients were positive. The first conjunctival swabs RT-PCR were positive in 5 out of 83 clinically-confirmed patients or 33 laboratory-confirmed patients (rates: 6.02% and 15.15%). There were no positives detected in the second conjunctival swabs., Conclusions: SARS-CoV-2 can be detected in the conjunctival swabs of patients with COVID-19 pneumonia., (© 2021. The Author(s).)

Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by a decreased number of platelets and mucocutaneous bleeding. Many viruses have been identified as triggers of the autoimmune process, including human immunodeficiency virus (HIV), hepatitis C virus (HCV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), parvovirus, rubella, and measles. Association with the new severe acute respiratory syndrome coronavirus, SARS-CoV-2 infection (Covid-19 infection) has been rarely reported. Here, we report the oldest case of ITP patient triggered by the novel coronavirus infection. He showed inadequate response to IVIG but responded to corticosteroids with no severe adverse events. Further studies are warranted to determine the optimal therapeutic strategies for ITP with the Covid-19 infection., (Copyright © 2020 Hindilerden, Yonal-Hindilerden, Sevtap and Kart-Yasar.)

Competing Interests: Competing interests: The authors declare no conflict of Interest.

The aim of this study is to evaluate the therapeutic effect of mesenchymal stem cells (MSCs) in a severe case of brain and multiple organ involvement in a patient with COVID-19. Here, a 51-year-old male patient with multi-organ involvement due to COVID-19 infection and developing cardiac arrest is presented. MSCs were transplanted to the patient four times systematically and once intrathecally. As a result, the application of MSCs has been found to have a healing effect on organs in this patient with severe COVID-19 infection. In addition, transplantation of MSCs both systematically and intrathecally is considered to be effective in the treatment of the central nervous system (Tab. 2, Fig. 2, Ref. 24). Keywords: mesenchymal stem cell, COVID-19, organ involvement.