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    ACUTE AND LONG-TERM PATHOLOGICAL EFFECTS OF COVID-19 ON THE PLACENTA DURING SECOND TRIMESTER AND LABOR
    (Univ Quindio, 2023) Tast, Fatih; Erdemci, Fikri; Yilmaz, Mehmet; Asir, Firat; Ozudogru, Osman; Deveci, Engin
    Background: COVID-19 pandemic has affected all the world. The consequence of the COVID-19 infection causes many disorders in many organs, one of them is the placenta. COVID-19 disease has long-term effects on various tissues after recovery. The aim of this study was to investigate the placentas of pregnant women with healthy, COVID-19 positive during the second trimester and labor. Material and methods: A total of twenty-four pregnant women (8 patients per each group) were included in the study. Their placentas were processed for routine paraffin wax embedding protocol. The blood parameters of patients were recorded. Placental tissues were stained with hematoxylin-eosin dye and immune stained with TNF-a and ADAMTS-8. Statistical analysis was performed on blood and histological parameters.Results: AST and CRP values of biochemical parameters were higher in women with second trimester and labor groups than in the healthy group. Also, a significant increase in ALT values was observed in the labor group. Normal histology was observed in the placentas of healthy patients. More histopathology was recorded in the placentas of COVID-19 infected women compared to healthy placentas. The expression of TNF-a and ADAMTS-8 were found significantly higher in the COVID-19 placentas compared to the non-COVID-19 group.Conclusions: COVID-19 infection can cause pathological changes during pregnancy and labor. This study shows that COVID-19 not only acutely has adverse effects on placental pathologies but also has long-term effects. TNF-a and ADAMTS-8 primary antibodies can be a guide in demonstrating these effects.
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    Association of viral load with age, gender, disease severity, and death in severe acute respiratory syndrome coronavirus 2 variants
    (Wiley, 2022) Acer, Omer; Genc Bahce, Yasemin; Ozudogru, Osman
    In this study, the relationship between viral load, demographic characteristics, and disease information in 1007 (48.5%) patients with Delta variant (B.1.617.2), and 1070 (51.5%) patients with Alpha variant (B1.1.7) were investigated. We found that there was a significant difference in viral load between patients who died from the Alpha variant and those who were discharged (p < 0.05). Nevertheless, no significant difference was observed in patients with the Delta variant. The viral load in patients who died from the Alpha variant was significantly higher than those who were discharged (p < 0.05). The viral load was found to be higher in females in patients with the Delta variant, whereas it was very close in males and females in patients with the Alpha variant (p > 0.05). No significant difference was detected between the cycle threshold values (Ct) and disease severity. In terms of the mean Ct values, statistical differences were observed in patients with Delta and Alpha variants. The Alpha variant was found to have a higher viral load than the Delta variant. Furthermore, the Delta variant was found to be higher in the 40-year-old and under-age group than the Alpha variant, whereas the Alpha variant was higher in the groups over 40 years old. Although the rate of moderate and severe patients in the Alpha variant was found to be higher, the rate of mild survivors was found to be higher in the Delta variant. In conclusion, the increase in vaccination before the appearance of the Delta variant in our region may have influenced the viral load and clinical status of the patients.
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    Carbapenem-resistant Acinetobacter baumannii strains in the Covid-19 pandemic: 16 S rRNA analysis, carbapenem resistance genes, and antibiotic resistance profiles
    (Springer, 2024) Acer, Omer; Bahce, Yasemin Genc; Ozudogru, Osman
    Acinetobacter baumannii was reported as a frequent pathogen leading to outbreaks of multidrug-resistant organisms both in the intensive care unit (ICU) and in non-ICU units during the coronavirus disease in 2019 (COVID-19). In this study we aimed to examine the phenotypic and molecular characteristics of clinical isolates of carbapenem-resistant A. baumannii (CrAb) obtained from Siirt Training Hospital in Siirt, Turkiye, during the Covid-19 pandemic. In our study, 31.6% of the patients whose culture was taken were Covid-19 positive. Of the 57 CrAb strains tested for antibiotic resistance, 52 (91.2%) showed extensive-drug resistance (XDR), 4 (7%) multi-drug resistance (MDR), and 1 (1.8%) pan-drug resistance (PDR). According to 16 S rRNA analysis, the sequences of the CrAb strains used in our study were 99-100% similar to the 16 S rRNA genes of the A. baumannii strains registered in GenBank. The most frequently detected carbapenem resistance gene in the species in our study was the OXA51 gene (85.7%). It's interesting to note that the blaNDM gene, which has a direct connection to the Indian Subcontinent and has recently been observed in the Middle East but has been rarely detected in Turkiye, was discovered in our study at a high rate. We think that this situation is caused by migration from the Middle East due to war in recent years. Additionally, we believe that horizontal gene transfer between bacteria is the cause of the high frequency of the blaVIM gene, whose source is primarily Pseudomonas species, in A. baumannii species in our study.
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    Changes in Vitamin D Levels According to Age, Gender and Season in the Siirt Province
    (Galenos Yayincilik, 2020) Alayunt, Naci Omer; Ozudogru, Osman
    Objective: This study aims to determine the 25-hydroxyvitamin D [25(OH)DI profile of the region based on season, age and gender by examining the vitamin D levels of patients who applied to the Siirt Training and Research Hospital from Siirt and neighbouring provinces. Materials and Methods: (25(OH)DJ levels were analysed retrospectively in patients who applied to Siirt Training and Research Hospital. The study included 31,151 patients who were admitted to the hospital. Were included in the study. (25(OH)DJ levels were determined according to the age and gender of patients and the seasons of the year. A serum [25(OH)D] level <12 ng/mL was considered as serious deficiency, 12-20 ng/mL mild-to-moderate deficiency, 21-30 ng/mL insufficiency, >30 ng/mL sufficiency. Results: The average (25(OH)DJ level in patients aged 0-15 years (n=6,166) was 20.59 +/- 0.14 ng/mL, in patients aged 16-30 years (n=10,791) it was 15.65 +/- 0.10 ng/mL, in patients aged 31-45 years (n=6,649) it was 16.28 +/- 0.14 ng/mL, in patients aged 46-60 years (n=4,120) it was 16.83 +/- 0.23 ng/mL and in patients ages 61-75 years (n=2,597) it was 16.03 +/- 0.15 ng/mL. Conclusion: It has been observed that [25(OH)D] level, which is low in winter and spring, is high in summer and autumn when it is exposed to the intense rays of the sun. However, this level is lower than the desired levels in all four seasons. This low level of vitamin D may be related to the absence of almost any vitamin D synthesis in winter and inadequate vitamin D intake associated with foods.
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    Effectiveness of Inactivated and mRNA COVID-19 Vaccines Against SARS-CoV-2 Infection, Severe Disease and Mortality in the Geriatric Population
    (Springer, 2023) Genc Bahce, Yasemin; Acer, Omer; Ozudogru, Osman
    Older age (>60 years) has been identified as the main risk factor for COVID-19. In this study, we aimed to evaluate the efficacy of Pfizer-BioNTech and CoronaVac vaccines against COVID-19 infection, serious illness, and mortality in the geriatric population. We found that 2 doses of CoronaVac vaccine were ineffective in protecting against COVID-19 infection in people over 65 years of age, while the vaccine efficacy (VE) of the mRNA vaccine against COVID-19 was 80% (95% CI 70-87). The VE of full vaccination with BioNTech was 89% (95% CI 53-97) against hospitalization, 79% (95% CI 0-97) against death, and 79% (95% CI 0-97) against intensive care unit (ICU) admission. However, the VE of full vaccination with CoronaVac was 50% (95% CI 33-63) against hospitalization, 53% (95% CI 26-70) against ICU admission, and 56% (95% CI 30-73) against death. In conclusion, we found that the mRNA vaccine has higher efficacy against severe COVID-19 infection and mortality in the geriatric population than the inactivated vaccine. Booster doses of vaccines should be considered in increasing the effectiveness of inactivated vaccines. Given the potential of SARS-CoV-2 mutations evading vaccination protection and the risk of reduced immunity over time, regular monitoring of vaccine effectiveness in the real world is critical.
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    Evaluation of bacterial agents isolated from endotracheal aspirate cultures of Covid-19 general intensive care patients and their antibiotic resistance profiles compared to pre-pandemic conditions
    (Academic Press Ltd- Elsevier Science Ltd, 2022) Acer, Omer; Ozudogru, Osman; Bahce, Yasemin Genc
    Background: Early reports have shown that critically ill patients infected with SARS-CoV-2 have a high prevalence of nosocomial pneumonia, particularly ventilator-associated pneumonia (VAP). Method: In the present study, we determined the bacterial agents isolated from endotracheal aspirate (ETA) cultures of Covid-19 general intensive care patients and evaluated the antibiotic resistance profiles of common bacterial agents compared to the pre-pandemic period.Results: While a total of 119 significant growths with polymicrobial growths were detected in the ETA cultures of 73 (7.5%) of 971 patients hospitalized in the intensive care unit before the pandemic, 87 significant growths were detected in the ETA cultures of 67 (11.1%) of 602 patients hospitalized in the Covid-19 intensive care unit (ICU) after the pandemic. While 61 (83.6%) of patients in the ICU died before the pandemic, 63 (94.0%) of patients in the Covid-19 ICU died after the pandemic. In terms of age, gender, and mortality, there was no significant difference between the two ICUs (p > 0.05). Before the pandemic, the mean length of stay in the ICU was 33.59 +/- 32.89 days, and after the pandemic, it was 13.49 +/- 8.03 days. This was a statistically significant difference (p < 0.05). Acinetobacter baumannii (28.5%), Klebsiella pneumoniae (22.6%), Pseudomonas aeruginosa (15.9%), Staphylococcus aureus (6.7%), Escherichia coli (7.5%), Candida spp. (5.0%) were the most prevalent causal microorganisms discovered in pre-pandemic ICU ETA samples, whereas A. baumannii (54.0%), K. pneumoniae (10.3%), P. aeruginosa (6.8%), E. faecium (8%), and Candida spp.(13.7%) were the most common causative microorganisms detected in Covid-19 ICU ETA samples. Except for tigecycline, antibiotic resistance rates in A. baumannii strains increased following the pandemic. Only tobramycin showed a significant difference in the increase of resistance among these antibiotics (p = 0.037). The rate of tigecycline resistance, on the other hand, was 17.6% before the pandemic and 2.2% afterward (p < 0.05). After the pandemic, increased resistance of K. pneumoniae strains to colistin, meropenem, ertapenem, amoxicillin-clavulanic acid, piperacillin-tazobactam, ciprofloxacin, tigecycline, and cefepime antibiotics was observed. However, these increases were not statistically significant. Except for imipenem, antibiotic resistance rates in P. aeruginosa strains increased following the pandemic. The increase in resistance of ceftazidime and levofloxacin was statistically significant (p < 0.05).Conclusion: As a result, the Covid-19 pandemic requires intensive care follow-ups at an earlier age and with a more mortal course. Although the length of stay in the intensive care unit has been shortened, it is observed that this situation is observed due to early mortality. In P. aeruginosa strains, a significant difference was detected in the resistance increase of the ceftazidime and levofloxacin (p < 0.05) and with the exception of tigecycline, antibiotic resistance rates in A. baumannii strains increased following the pandemic. Only tobramycin showed a significant difference in the increase of resistance among these antibiotics (p = 0.037). Secondary infections in patients create more difficult treatment processes due to both Covid-19 and increasing antibiotic resistance today.
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    Homologous and Heterologous Covid-19 Booster Vaccinations Against SARS-CoV-2 Infection in the Elderly
    (Springer, 2024) Acer, Omer; Bahce, Yasemin Genc; Ozudogru, Osman
    A third booster doses for the 2019 coronavirus disease (COVID-19) is widely used all over the world, especially in risky individuals, with the recommendation of WHO. The purpose of this study was to evaluate the effectiveness of mRNA (BNT162b2), and CoronaVac (Sinovac Biotech) vaccines as a reminder dose following two doses of CoronaVac against COVID-19 infection, serious illness, and mortality in the geriatric population aged 75 and older during the delta variant dominant period. Our study comprised 2730 individuals the age of 75 and older in total, of which 1082 (39.6%) were male and 1648 (60.4%) were female. The vaccine effectiveness (VE) of 2 doses of CoronaVac + 1 dose of BNT162b2 vaccine combination against COVID-19 was determined as 89.2% (95% Confidence interval (CI) 80.7-93.9%), while the VE of 3 doses of CoronaVac vaccine was determined as 80.4% (95% CI 60.5-90.2%). Geriatric patients who received three doses of CoronaVac vaccine did not need intensive care. No deaths were observed in the vaccinated groups. While the VE of vaccination with 2 doses of CoronaVac + 1 dose of BNT162b2 was 41.8% (95% CI 0-74.1%) against hospitalization, 64.4% (95% CI 0-94.7%) against intensive care unit admission, the VE of vaccination with three doses of the CoronaVac was 78.2% (95% CI 0-96.5%) against hospitalization. In conclusion, our research showed that, even with the emergence of viral variants, a third dose of the CoronaVac and BNT162b2 vaccines is highly effective against symptomatic SARS-CoV-2 infection. Third-dose vaccination regimens, including heterologous and homologous vaccines, can be an effective tool in controlling the COVID-19 pandemic and the emergence of new variants.
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    Impact of empagliflozin on left atrial mechanical and conduction functions in patients with type 2 diabetes mellitus
    (Wiley, 2023) Aslan, Muzaffer; Oksen, Dogac; Kaynak, Cagdas; Ozudogru, Osman
    Objective Empagliflozin, an oral anti-diabetic drug that inhibits the sodium-dependent glucose co-transporter 2 (SGLT2), has pleiotropic effects on the myocardium. The aim of the study is to investigate the effect of empagliflozin on atrial electromechanical delay (AEMD) and the left atrial (LA) mechanical functions in patients with type 2 diabetes mellitus (DM). Method In total 62 patients (40.3% female, mean age 50.5 +/- 8.6 years old) with type 2 DM were enrolled to the study. Participants were used a SGLT2 inhibitor (empagliflozin 10-25 mg/daily) for 6 months. Patients were examined initially and after 6 months with echocardiography. LA volume was recorded, atrial conduction times were measured using tissue Doppler imaging (TDI). Results No significant change was observed in LA volumes (maximal, minimal, and presystolic), total emptying and passive emptying volume at the end of 6 months; however, there was a significant decrease in active emptying volume (8.3 +/- 2.9 ml/m(2) vs. 7.9 +/- 2.9 ml/m(2), p = 0.04). The posteroanterior lateral, septal, and tricuspid conduction times significantly decreased after the empagliflozin treatment. The decrease in right inter-AEMD was statistically significant (13.25 +/- 10.21 ms vs. 10.85 +/- 9.14 ms, p = 0.011). The changes in inter-AEMD were found to be correlated with the changes in LA active emptying volume (r = 0.408). Conclusion Empagliflozin may enhance the structure and electrical conductions of the atrium and may prevent DM patients from DM-2-related functional disorder and arrhythmia.
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    Relationship between ABO Blood Group and COVID-19: The Case of Siirt
    (Galenos Publ House, 2020) Uyuklu, Mehmet; Ozudogru, Osman
    Objective: Epidemiological and clinical studies have shown that age and chronic diseases are important risk factors in the mortality of patients infected by Coronavirus disease 2019 (COVID-19). However, there is no biomarker identified yet for susceptibility to the disease. Some studies have reported that ABO blood groups are associated with a predisposition to Covid-19. In this study, it was aimed to investigate the relationship between ABO blood groups and COVID-19 susceptibility in Siirt province scale. Methods: In this study, the blood groups of 174 patients, all of whom were in Siirt, were confirmed retrospectively at the Siirt State Hospital, all confirmed by revers-transcriptase chain reaction. For comparison, data from 36394 patients whose blood group was detected in the Siirt State Hospital were used. Results: In Siirt provincial normal population; while blood groups A, B, AB and O were 40%, 19.5%, 8.5% and 32% respectively, the blood groups of COVID-19 positive patients were 42.5%, 19.5%, 8%, and 30%. No statistically significant difference was found in blood group distribution rates between healthy and COVID-19 patient groups (>0.05). The distribution of blood group rates of patients hospitalized in the intensive care unit was not different from healthy individuals (>0.05). No significant difference could be calculated between the duration of hospitalization in the intensive care unit and blood groups. Conclusion: As a result, unlike studies showing that the risk of COVID-19 infection was higher in the A blood group and lower in the O blood group, no relationship was found between the blood group and the risk of COVID-19 infection and intensive care therapy. Combining the results of this study with data from other regions, it is thought that only if the relationship between blood group COVID-19 can be confirmed, it may be a guide for diagnosis, follow-up and treatment.
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    Reliability and validity of the Diabetic foot self-care questionnaire in Turkish patients
    (Elsevier Sci Ltd, 2023) Aksoy, Meyreme; Buyukbayram, Zeliha; Ozudogru, Osman
    Aim: This study was conducted to examine the psychometric, properties of the Turkish version of the Diabetic, Foot Self-Care, Questionnaire. Methods: This was a descriptive- methodological study conducted on 193 diabetes patients. Data were collected, using Descriptive, Information Form and Diabetic Foot Self-Care Questionnaire. Data were analyzed using exploratory factor analysis, item-total score correlation, Cronbach's alpha, and test-retest analysis. Results: The Diabetic, Foot Self-Care, Questionnaire consists of 16 items and three sub-dimensions. The three subdimensions recorded a variance of 58.137%. The total Cronbach's alpha coefficient of the Turkish version of the Diabetic, Foot Self-Care, Questionnaire was 0.87, and Cronbach's alpha values of its sub-dimensions were 0.71 and 0.88. The two-month test-retest credibility interpreted with intra-class correlation was 0.97. Conclusions: It has been shown that the questionnaire is a valid and reliable tool for assessing foot self-care behavior in diabetic patients.
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    Risks of catching COVID-19 according to vaccination status of healthcare workers during the SARS-CoV-2 Delta variant dominant period and their clinical characteristics
    (Wiley, 2022) Ozudogru, Osman; Acer, Omer; Bahce, Yasemin Genc
    The exposure of healthcare workers (HCWs) to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been a major concern since the beginning of the coronavirus disease 2019 (COVID-19) pandemic. The study aimed to investigate the relationship between vaccination status and the status of catching COVID-19 in HCWs working in a Training and Research Hospital in Turkey, and the clinical course of the disease in those who were caught. The vaccination status of 1279 HCWs working at Siirt Training and Research Hospital during the period when the SARS-CoV-2 Delta variant was dominant, their cases of catching COVID-19 during this period, and the clinical course of the disease in patients with COVID-19 were investigated retrospectively. We found that the rate of COVID-19 transmission was lowest in fully vaccinated HCWs (p < 0.05). The rate of COVID-19 transmission in HCWs who received two doses of BioNTech vaccine (4.4%) and two doses of CoronaVac+ one dose of BioNTech vaccines (2.7%) was considerably lower than those without vaccination (26.2%) (p < 0.05). The transmission rate was lowest among those vaccinated with two doses of CoronaVac+ one dose of BioNTech. Hospitalization was not required in fully vaccinated HCWs. The lymphocyte count was found to be significantly higher in fully vaccinated patients than incompletely vaccinated and unvaccinated patients. Although C-reactive protein (CRP), d-dimer, and ferritin values were higher in unvaccinated and partially vaccinated patients than in fully vaccinated patients, the differences were not statistically significant. As a result, the transmission rate of COVID-19 was lowest in fully vaccinated HCWs and in those vaccinated with two doses of CoronaVac+ one dose of BioNTech. In fully vaccinated HCWs, hospitalization was not needed.
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    SARS CoV-2 reinfection rate is higher in the Omicron variant than in the Alpha and Delta variants
    (Springer London Ltd, 2023) Ozudogru, Osman; Bahce, Yasemin Genc; Acer, Omer
    Background and objectives Many mutations in variants for instance Delta and Alpha are associated with immune evasion and higher infectious potential. There are uncertainties regarding Omicron. In this regard, we aimed to compare the frequency of reinfection of SARS CoV-2 variants in our hospital between April 22, 2021 and January 26, 2022. Method The reinfection rates and demographic characteristics of a total of 27,487 COVID-19 patients infected with different SARS CoV-2 variants were examined. Results Reinfection was found in 26 (0.46%) of 5554 Alpha, 209 (1.16%) of 17,941 Delta, and 520 (13.0%) of 3992 Omicron variants. A statistically significant difference was observed between the reinfection rates of the variants (p = 0.000). The mean reinfection days were calculated as 204.4 +/- 51.1 in the Alpha variant, 291.2 +/- 58.2 in the Delta variant, and 361.2 +/- 131.6 in the Omicron variant (p = 0.000). It was observed that 16.5% of reinfection cases caught COVID-19 for the second time 3-6 months after the first COVID-19 infection, 36.7% after 6-12 months, and 46.8% after more than 12 months. There was a significant difference between the times in reinfection cases. Most reinfections occurred more than 12 months apart. Among those with a reinfection time > 12 months, 0% had Alpha, 3.4% had Delta, and 96.6% had Omicron variants. Conclusion The highest reinfection rate was observed in the Omicron variant. Reinfection was approximately 30 times more frequent in the Omicron variant than in the Alpha variant and 10 times more frequent in the Delta variant.