Publications by authors named "Celal Satıcı"

10 Publications

  • Page 1 of 1

Cytokine storm in severe COVID-19 pneumonia.

J Med Virol 2021 May 8. Epub 2021 May 8.

Department of Dermatology, Gaziosmanpasa Research and Training Hospital, University of Health Sciences, Istanbul, Turkey.

In this study, laboratorial parameters of hospitalized novel coronavirus (COVID-19) patients, who were complicated with severe pneumonia, were compared with the findings of cytokine storm developing in macrophage activation syndrome (MAS)/secondary hemophagocytic lymphohistiocytosis (sHLH). Severe pneumonia occurred as a result of cytokine storm in some patients who needed intensive care unit (ICU), and it is aimed to determine the precursive parameters in this situation. Also in this study, the aim is to identify laboratory criteria that predict worsening disease and ICU intensification, as well as the development of cytokine storm. This article comprises a retrospective cohort study of patients admitted to a single institution with COVID-19 pneumonia. This study includes 150 confirmed COVID-19 patients with severe pneumonia. When they were considered as severe pneumonia patients, the clinic and laboratory parameters of this group are compared with H-score criteria. Patients are divided into two subgroups; patients with worsened symptoms who were transferred into tertiary ICU, and patients with stable symptoms followed in the clinic. For the patients with confirmed COVID-19 infection, after they become complicated with severe pneumonia, lymphocytopenia (55.3%), anemia (12.0%), thrombocytopenia (19.3%), hyperferritinemia (72.5%), hyperfibrinogenemia (63.7%) and elevated lactate dehydrogenase (LDH) (90.8%), aspartate aminotransaminase (AST) (31.3%), alanine aminotransaminase (ALT) (20.7%) are detected. There were no significant changes in other parameters. Blood parameters between the pre-ICU period and the ICU period (in which their situation had been worsened and acute respiratory distress syndrome [ARDS] was developed) were also compared. In the latter group lymphocyte levels were found significantly reduced (p = 0.01), and LDH, highly sensitive troponin (hs-troponin), procalcitonin, and triglyceride levels were significantly increased (p < 0.05). In addition, there was no change in hemoglobin, leukocyte, platelet, ferritin, and liver function test levels, including patients who developed ARDS, similar to the cytokine storm developed in MAS/sHLH. COVID-19 pneumonia has similar findings as hyperinflammatory syndromes but does not seem to have typical features as in cytokine storm developed in MAS/sHLH. In the severe patient group who has started to develop ARDS signs, a decrease in lymphocyte level in addition to the elevated LDH, hs-troponin, procalcitonin, and triglyceride levels can be a predictor in progression to ICU admission and could help in the planning of anti-cytokine therapy.
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May 2021

Mediastinal lymphadenopathy may predict 30-day mortality in patients with COVID-19.

Clin Imaging 2021 Jul 2;75:119-124. Epub 2021 Feb 2.

Department of Rheumatology, Gaziosmanpasa Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.

Purpose: There is scarce data on the impact of the presence of mediastinal lymphadenopathy on the prognosis of coronavirus-disease 2019 (COVID-19). We aimed to investigate whether its presence is associated with increased risk for 30-day mortality in a large group of patients with COVID-19.

Method: In this retrospective cross-sectional study, 650 adult laboratory-confirmed hospitalized COVID-19 patients were included. Patients with comorbidities that may cause enlarged mediastinal lymphadenopathy were excluded. Demographics, clinical characteristics, vital and laboratory findings, and outcome were obtained from electronic medical records. Computed tomography scans were evaluated by two blinded radiologists. Univariate and multivariate logistic regression analyses were performed to determine independent predictive factors of 30-day mortality.

Results: Patients with enlarged mediastinal lymphadenopathy (n = 60, 9.2%) were older and more likely to have at least one comorbidity than patients without enlarged mediastinal lymphadenopathy (p = 0.03, p = 0.003). There were more deaths in patients with enlarged mediastinal lymphadenopathy than in those without (11/60 vs 45/590, p = 0.01). Older age (OR:3.74, 95% CI: 2.06-6.79; p < 0.001), presence of consolidation pattern (OR:1.93, 95% CI: 1.09-3.40; p = 0.02) and enlarged mediastinal lymphadenopathy (OR:2.38, 95% CI:1.13-4.98; p = 0.02) were independently associated with 30-day mortality.

Conclusion: In this large group of hospitalized patients with COVID-19, we found that in addition to older age and consolidation pattern on CT scan, enlarged mediastinal lymphadenopathy were independently associated with increased mortality. Mediastinal evaluation should be performed in all patients with COVID-19.
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July 2021

Clinical characteristics of adult patients hospitalized with laboratory-confirmed COVID-19 pneumonia.

J Infect Chemother 2021 Feb 23;27(2):306-311. Epub 2020 Oct 23.

Anesthesia and Reanimation, Istanbul Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey.

Background: The clinical spectrum of COVID-19 has a great variation from asymptomatic infection to acute respiratory distress syndrome and eventually death. The mortality rates vary across the countries probably due to the heterogeneity in study characteristics and patient cohorts as well as treatment strategies. Therefore, we aimed to summarize the clinical characteristics and outcomes of adult patients hospitalized with laboratory-confirmed COVID-19 pneumonia in Istanbul, Turkey.

Methods: A total of 722 adult patients with laboratory-confirmed COVID-19 pneumonia were analyzed in this single-center retrospective study between March 15 and May 1, 2020.

Results: A total of 722 laboratory-confirmed patients with COVID-19 pneumonia were included in the study. There were 235 (32.5%) elderly patients and 487 (67.5%) non-elderly patients. The most common comorbidities were hypertension (251 [34.8%]), diabetes mellitus (198 [27.4%]), and ischemic heart disease (66 [9.1%]). The most common symptoms were cough (512 [70.9%]), followed by fever (226 [31.3%]), and shortness of breath (201 [27.8%]). Lymphocytopenia was present in 29.7% of the patients, leukopenia in 12.2%, and elevated CRP in 48.8%. By the end of May 20, 648 (89.7%) patients had been discharged and 60 (8.5%) patients had died. According to our study, while our overall mortality rate was 8.5%, this rate was 14.5% in elderly patients, and the difference was significant.

Conclusions: This case series provides characteristics and outcomes of sequentially adult patients hospitalized with laboratory-confirmed COVID-19 pneumonia in Turkey.
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February 2021

Falsely low values of oxygen saturation measured by pulse oximetry in patients with coronavirus disease 2019.

Lung India 2020 Nov-Dec;37(6):553-554

Department of Rheumatology, University of Health Sciences, Istanbul Gaziosmanpasa Research and Training Hospital, Istanbul, Turkey.

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November 2020

Adenosine deaminase cutoff value when diagnosing tuberculous pleurisy in patients aged 40 years and older.

Clin Respir J 2021 Jan 6;15(1):109-115. Epub 2020 Oct 6.

Chest Disease Department, Yedikule Chest Disease and Chest Surgery Research and Training Hospital, Istanbul, Turkey.

Introduction: Tuberculous pleurisy (TBP) is one of the most common manifestations of extra-pulmonary tuberculosis. In patients aged ≥40 years, a closed needle pleural biopsy is recommended with an adenosine deaminase (ADA) level of 40-70 U/L. We aim to investigate whether the cutoff value of ADA and the cancer ratio in patients with TBP aged ≥40 years is different and determine the effects of both compounded biomarkers on diagnosing TBP.

Materials And Methods: Between 2009 and 2016, the ADA levels were measured in pleural effusions from patients who were admitted to the Chest disease clinic.

Results: Of the 196 patients included in the study, 104 were aged ≥40 years. A significant relationship was found between the serum LDH/pleural ADA (sLDH/pADA) ratio and ADA levels in patients aged >40 years (OR: 0.935 and OR: 1.085, respectively). The model using an ADA value ≥30 and an sLDH/pADA ratio <16 yielded a sensitivity of 94.25% (95% CI, 87.1-98.10) in all patients and 69.23% (95% CI, 54.9-81.28) in patients aged >40 years.

Conclusion: ADA and the sLDH/pADA ratio are simple, cost-efficient, and obtain fast results and, therefore, are the preferred methods in TBP diagnosis. The diagnosis rate in the present study was 91% using ADA levels in combination with the sLDH/pADA ratio, both of which can be obtained only through thoracentesis.
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January 2021

Performance of pneumonia severity index and CURB-65 in predicting 30-day mortality in patients with COVID-19.

Int J Infect Dis 2020 Sep 14;98:84-89. Epub 2020 Jun 14.

Department of Rheumatology, Gaziosmanpasa Research and Training Hospital, University of Health Sciences, Istanbul, Turkey. Electronic address:

Objective: The aim of the study was to analyze the usefulness of CURB-65 and the pneumonia severity index (PSI) in predicting 30-day mortality in patients with COVID-19, and to identify other factors associated with higher mortality.

Methods: A retrospective study was performed in a pandemic hospital in Istanbul, Turkey, which included 681 laboratory-confirmed patients with COVID-19. Data on characteristics, vital signs, and laboratory parameters were recorded from electronic medical records. Receiver operating characteristic analysis was used to quantify the discriminatory abilities of the prognostic scales. Univariate and multivariate logistic regression analyses were performed to identify other predictors of mortality.

Results: Higher CRP levels were associated with an increased risk for mortality (OR: 1.015, 95% CI: 1.008-1.021; p < 0.001). The PSI performed significantly better than CURB-65 (AUC: 0.91, 95% CI: 0.88-0.93 vs AUC: 0.88, 95% CI: 0.85-0.90; p = 0.01), and the addition of CRP levels to PSI did not improve the performance of PSI in predicting mortality (AUC: 0.91, 95% CI: 0.88-0.93 vs AUC: 0.92, 95% CI: 0.89-0.94; p = 0.29).

Conclusion: In a large group of hospitalized patients with COVID-19, we found that PSI performed better than CURB-65 in predicting mortality. Adding CRP levels to PSI did not improve the 30-day mortality prediction.
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September 2020

Determining emphysema in adult patients with COPD-bronchiectasis overlap using a novel spirometric parameter: area under the forced expiratory flow-volume loop.

Expert Rev Respir Med 2020 08 18;14(8):839-844. Epub 2020 May 18.

Chest Disease Department, Yedikule Research and Training Hospital for Chest Diseases and Chest Surgery , Istanbul, Turkey.

Background: Defining the optimal therapeutic approach in patients with chronic obstructive pulmonary disease (COPD) bronchiectasis overlap (CBO) is challenging. The presence of emphysema suggests that COPD is the primary problem and it impacts therapeutic decision making.

Research Design And Methods: We hypothesized that the AreaFE% performance will be reliable in diagnosing the presence of emphysema such that serial CT scanning may not be needed. In this retrospective chart review study, we included 113 CBO patients (52 having emphysema, 61 not having emphysema). We compared these two groups according to conventional spirometric parameters and AreaFE% values.

Results: 54% of all patients were female and mean age was 58 years.FEV1%, FEV1/FVC and AreaFE% were found to be significantly lower in patients with emphysema. 12% is the cutoff value for AreaFE% in determining emphysema with 73% sensitivity,75% specificity, and 72% diagnostic accuracy (AUC: 0.82) and it provides superior estimation than conventional parameters.

Conclusions: We found that AreaFE% is more suitable for determining the presence of emphysema than conventional spirometric parameters in CBO patients. This novel parameter may be helpful instead of scanning thorax CT to indicate the presence of emphysema and manage treatment in the follow-up of CBO patients.
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August 2020

ERS International Congress, Madrid, 2019: highlights from the Respiratory Intensive Care Assembly.

ERJ Open Res 2020 Jan 9;6(1). Epub 2020 Mar 9.

Intensive Care, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands.

The Respiratory Intensive Care Assembly of the European Respiratory Society is delighted to present the highlights from the 2019 International Congress in Madrid, Spain. We have selected four sessions that discussed recent advances in a wide range of topics: from acute respiratory failure to cough augmentation in neuromuscular disorders and from extra-corporeal life support to difficult ventilator weaning. The subjects are summarised by early career members in close collaboration with the Assembly leadership. We aim to give the reader an update on the most important developments discussed at the conference. Each session is further summarised into a short list of take-home messages.
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January 2020

Does Adherence to Domiciliary NIMV Decrease the Subsequent Hospitalizations Rates and Cost for Patients Diagnosed with COPD?

COPD 2018 06 6;15(3):303-309. Epub 2018 Sep 6.

a Chest Disease Department , Yedikule Research and Training Hospital for Chest Diseases and Chest Surgery , Istanbul , Turkey.

Domiciliary noninvasive mechanical ventilation (NIMV) is used for treating patients with hypercapnic chronic obstructive pulmonary disease (COPD). We aimed to evaluate the association between adherence to the treatment and subsequent hospitalizations and costs. Data from 54 (27 adherent; 27 non-adherent) patients with COPD who were undergoing NIMV treatment at home for 6 months. We assessed adherence based on digitally recorded data and checked hospital records for clinical and laboratory data, rehospitalization rates, and costs during the following 6 months. Nocturnal NIMV usage, mean daily usage of the device, and time to first hospitalization were higher in the treatment-adherent group (p < .001, p < .001, and p=.006, respectively). The percentage of active smokers, device leaks above 30 L/min, length of hospital stay, rehospitalization rates, and costs were significantly higher in the treatment-non-adherent group (p = 05, p = 006, p = 004, p = 006, and p = 01, respectively). The most frequent reasons for not using NIMV in the treatment-non-adherent group were a decreased need, dry mouth, mask incompatibility, and gastrointestinal complaints. Adherence to NIMV treatment decreases the subsequent hospitalizations rates and noncompliance leads to complications. Findings of this study may help physicians in convincing patients diagnosed with COPD of the need for correct NIMV use to prevent hospitalizations and reduce the costs of COPD treatment.
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June 2018

Personality traits in cancer patients.

Asian Pac J Cancer Prev 2013 ;14(8):4515-8

Department of Internal Medicine, Division of Oncology, Marmara University Medical Faculty, Istanbul, Turkey E-mail :

Background: This study was planned to investigate the personality traits of cancer patients in different treatment settings, and to correlate the demographics with the personality features.

Materials And Methods: A total of 237 patients referred either to Marmara University School of Medicine (MUSM) Oncology Outpatient Unit or to the private office of the faculty between March 10th and April 22nd, 2010 were enrolled in the study. The Big Five Mini Test was used to evaluate the 40 personality traits of the patients.

Results: The study group consisted of 98 males (41.35%) and 139 females (58.65%) with a mean age of 51. Out of the 237, 73.9% had an educational level beyond the junior high school, and 47.3% of all patients reported a positive family history for cancer. A significant difference in terms of reconcilability, extraversion, and responsibility was observed between patients admitting to the university outpatient clinic and the private office (p<0.05). Reconcilability and extraversion were found to differ between genders significantly (p<0.05). The description of the patients by him/herself or by relatives displayed a significant difference in terms of openness (p<0.05). Parameters such as educational level, family history of cancer, age and marital status showed no relevance to their characters. No discordance was observed between the self-analysis of the patient and the patient's relatives.

Conclusions: Patients with cancer are typically highly reconcilable and responsible, moderately stable, open and extraverted.
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May 2014