Risk factors for the development of interstitial lung disease following severe COVID-19 pneumonia and outcomes of systemic corticosteroid therapy: 3-month follow-up.

BACKGROUND: We aimed to evaluate the pulmonary involvement status, its related factors, and pulmonary function test (PFT) results in the first month follow-up in patients who were discharged for severe Covid-19 pneumonia, and to assess the efficacy of corticosteroid treatment on these parameters in severe pulmonary involvement patients. METHODS: We retrospectively analyzed all consecutive patients who applied to our COVID-19 follow-up clinic at the end of the first month of hospital discharge. Functional and radiological differences were compared after 3 months of corticosteroid treatment in severe pulmonary involvement group. Results We analyzed 391 patients with "pulmonary parenchymal involvement" (PPIG) and 162 patients with "normal lung radiology" (NLRG). 122 patients in the PPIG (corticosteroid-required interstitial lung disease group (CRILD)) had severe pulmonary involvement with frequent symptoms and required corticosteroid prescription. Pulmonary involvement was more common in males and elder patients (P<0.001, for both). Being smoker and elderly were associated with a higher risk-ratio in predicting to be in PPIG (OR:2.250 and OR:1.057, respectively). Smokers, male and elderly patients, and HFNO2 support during hospitalization were risk factors for being a patient with CRILD (OR:2.737, OR:4.937, OR:4.756, and OR:2.872, respectively). After a three-months of methylprednisolone medication, a good response was achieved on radiological findings and PFT results in CRILD. CONCLUSIONS: In conclusion, after severe COVID-19 pneumonia, persistent clinical symptoms and pulmonary parenchymal involvement would be inevitable in elder and smoker patients. Moreover, corticosteroid treatment in patients with severe parenchymal involvement was found to be effective in the improvement of radiological and functional parameters.

Effect of chronic lung diseases on mortality of prevariant COVID-19 pneumonia patients.

Background: The aim of the study is to assess the effect of chronic lung disease on mortality in patients hospitalized with the diagnosis of prevariant COVID-19 Pneumonia compared to patients without chronic lung disease. Research design and methods: A cohort of 1,549 patients admitted to the pandemic clinic with a COVID-19 Pneumonia diagnosis was analyzed. Group 1 and Group 2 were compared in terms of the treatment they received, admission to intensive care, mortality and follow-up parameters. Results: The patient group with COVID-19 and lung disease consisted of 231 participants (14.91%) (Group 1). The patient group with COVID-19 but without lung disease had 1,318 participants (85.19%). Group 1 cases were found to receive more oxygen therapy and mechanical ventilation than Group 2 cases (p ≤ 0.001), Following univariate and multiple logistic regression analyses, it was determined that patients with chronic lung disease had a 25.76% higher mortality risk [OR: 25.763, 95% CI (Lower-Upper) (2.445-271.465), p = 0.007]. Conclusion: It was found that chronic lung disease contributed significantly to mortality in this study. Among chronic lung diseases, Chronic Obstructive Pulmonary Disease (COPD), lung cancer and interstitial lung diseases (ILDs) were shown to be more effective than other chronic lung diseases in patients with prevariant COVID-19 population.

Are all granulomatous lesions tuberculosis?

INTRODUCTION: Granulomatous reactions are seen in a wide variety of diseases. METHODS: We present 3 cases referred to our clinic with presumptive diagnosis of tuberculosis (TB) were diagnosed as nontuberculous granulomatous diseases. RESULTS: Three cases were diagnosed as Tularemia, Cat-Scratch Disease (CSD) and idiopathic granulomatous mastitis (IGM) respectively. CONCLUSION: In countries with high incidence of TB, TB is considered firstly in differential diagnosis of granulomatous diseases. Detailed anamnesis and physical examinations should be done in differential diagnosis of granulomatous diseases, and TB must be excluded.

The association of topoisomerase 2α expression with prognosis in surgically resected non-small cell lung cancer (NSCLC) patients.

BACKGROUND: Topoisomerase 2α (Topo 2α) is a nuclear enzyme that alters the topology of DNA. It's essential for normal chromosome segregation during cellular division. We aimed to investigate the association of Topo 2α expression with clinical, pathological parameters and prognosis in surgically resected non-small cell lung cancer (NSCLC) patients. METHODS: The study is comprised of 100 surgically resected NSCLC (squamous cell carcinoma in 50 patients, adenocarcinoma in 50 patients). The paraffin embedded tumor sections were retrieved for expression of Topo 2α. Nuclear and cytoplasmic expression of Topo 2α was determined by immunohistochemistry. Clinical, pathological data and survival of patients were determined from the hospital files. Median follow-up time was 35 (range, 4-120) months. RESULTS: Nuclear and cytoplasmic expression of Topo 2α was positive in 41 (41%) and 66 (66%) patients, respectively. There was no significant association between nuclear or cytoplasmic expression of Topo 2α and age, gender, smoking history. While nuclear expression was significantly increased in squamous cell carcinoma (P=0.008), OR (95% CI): 3.01 (1.31-6.92), cytoplasmic expression wasn't different. Both nuclear and cytoplasmic expression didn't show any association with tumor diameter, pathological stage, tumor differentiation and relapse. There was no significant association between nuclear or cytoplasmic expression of Topo 2α and survival. Tumor diameter (P=0.031) and metastasis to N2 lymph nodes (P=0.005) were independent prognostic factors. CONCLUSIONS: There was no association between Topo 2α expression and prognosis in surgically resected NSCLC patients. Nuclear expression of Topo 2α was significantly higher in patients with squamous cell carcinoma.