Asian Pacific Journal of Tropical Medicine

479-484

Authors: Fusun Fakili, Pelin Duru Cetinkaya, Oya Baydar, Serap Argun Baris, Nurdan Kokturk, Seval Kul, Oguz Karcioglu, Pinar Aysert Yildiz, Ilim Irmak, Yonca Sekibag, Emel Azak, Sait Mulamahmutoglu, Caglar Cuhadaroglu, Bugra Kerget, Burcu Baran Ketencioglu, Hasan Selcuk Ozger, Gulcihan Ozkan, Zeynep Ture, Merve Ercelik, Tansu Ulukavak Ciftci, Ozlem Alici, Esra Nurlu Temel, Ozlem Ataoglu, Neslihan Kose, Muge Meltem Tor, Gulsah Gunluoglu, Sedat Altin, Onder Ozturk, Pinar Yildiz Gulhan, Ilknur Basyigit, Hasim Boyaci, I. Kivilcim Oguzulgen, Sermin Borekci, Bilun Gemicioglu, Ismail Hanta, Hacer Kuzu Okur, Gulseren Sagcan, Metin Akgun, Ali Fuat Kalyoncu, Oya Itil, Hasan Bayram

Objective: To determine post-discharge mortality and associated factors of the first-wave multicenter Turkish Thoracic Society (TTD)-TURCOVID study. Methods: In this retrospective cohort study, we analyzed the data of 18 of 26 centers included in the first TTD-TURCOVID study, and 1 112 cases diagnosed with COVID-19 between 11 March and 31 July 2020 participated in the study. All causes of death after COVID-19 discharge were recorded. Results: The mean age of the patients was (51.07±16.93) years, with 57.6% male patients. In the cohort group, 89.1% of COVID-19 treatment locations were hospital wards, 3.6% were intensive care units (ICUs), and 7.2% were community outpatients. In the long-term follow-up, the in-hospital mortality rate was 3.6% (95% CI 2.6- 4.8), the post-discharge mortality rate was 2.8% (95% CI 1.9-3.9), and the total mortality was 6.3% (95% CI 5.0-7.8). After discharge, 63.3% of mortality overall occurred during the first six months. Mortality rates in post-discharge follow-ups were 12.7% (95% CI 8.0-30.6) in cancer patients, 10.8% (95% CI 6.3-22.9) in chronic obstructive pulmonary disease patients, 11.1% (95% CI 4.4-22.7) in heart failure patients, 7.8 (95% CI 3.8-14.3) in atherosclerotic heart disease patients, and 2.3% (95% CI 0.8-5.6) in diabetes mellitus patients. In smokers/ex-smokers, the all-mortality rates were higher than in non-smokers. Conclusions: This multicenter study showed that patients over 65 years of age, males, former/active smoker, ICU stay, lung, heart disease, and malignancy should be followed up for at least the first six months after discharge due to COVID-19.

496-502

Authors: Ikram Waheed, Samreen Khalid, Zubia Jamil

Objective: To predict the factors associated with progression to severe dengue infection to prevent potentially fatal complications and to identify the determinants of severe complicated dengue. Methods: The study was conducted in a tertiary care hospital-dengue ward from September to November 2021 including confirmed dengue infected patients (positive NS1 antigen or anti-dengue-antibodies IgM). Secondary dengue infection was labelled by positive anti-dengue-antibodies IgG in active dengue infected patients. Detailed history, physical examination, laboratory and radiological parameters, hospital stay (days) and mortality percentages were noted. Patients were classified into three groups according to disease severity: dengue fever (DF), dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). The predictors of complicated dengue infection were determined by regression analysis. Results: The most common symptom was fever (96.9%). Among 129 patients, 62.8% had DF, 31.0% had DHF and only 6.2% developed DSS. History of previous symptomatic dengue and positive anti-dengue-antibodies IgG were present in 100% DSS patients and nearly 75.0% DHF patients (P<0.05). The moratlity rate in patients with DSS, DHF and DF was 50.0%, 2.5% and none respectively (P<0.05). Clinical parameters (body aches, bleeding, conjunctival hemorrhage, maculopapular rash, right hypochondrial tenderness, ascites, pleural effusion) and laboratory parameters (thrombocytopenia, raised alanine aminotransferase and secondary dengue infection) were determinants that complicate the dengue infection. Conclusions: Thrombocytopenia, raised alanine aminotransferase and secondary dengue infection are important laboratory parameters to complicate the disease process of dengue infection.

511-517

Authors: Ümmühan Çay, Derya Alabaz, Özlem Özgür Gündeşlioğlu, Aysun Hatice Uguz, Hande Yanar

Objective: To investigate granulomatous inflammation etiology based on clinical history and ancillary tests. Methods: Children aged <18 years with biopsy proven granulomatous lesions in any tissue specimens between January 2014 and January 2022 were included in the study. The diagnosis was based on the results of immunohistochemical staining, molecular tests, culture, serology, radiological and other auxiliary laboratory tests. Diagnoses were categorized into infectious and non-infectious causes. Results: In total, 174 patients with granulomatosis inflammation confirmed by histopathology were analyzed. Approximately 59.2% patients were males, and the median age was 4.48 (IQR 2.36-6.39) years (range: 16 months-18 years). The tissues/organs that were most commonly biopsied were lymph node, bone, skin, and lung (51.1%, 17.8%, 9.2%, and 5.7%, respectively). Infectious and non-infectious causes were identified in 73.0% and 12.6% patients, respectively, in terms of granulomatosis inflammation etiology; however, no cause was identified in 14.4% patients. The most common infectious cause was tuberculosis (in 51.7% patients), followed by toxoplasmosis, aspergillosis, mucormycosis, leishmaniasis, and cat-scratch disease (in 8.6%, 5.7%, 1.7%, 1.7%, and 1.1% patients, respectively). The common non-infectious cause was chronic granulomatous disease. Histopathological evaluation revealed granulomatosis inflammation in 33.3% patients, necrotizing granulomatosis inflammation in 30.5% patients, and caseating granulomatosis inflammation in 12.1% patients. When the pathology results of patients with and without tuberculosis were compared, the incidence of caseating granulomatosis inflammation (P=0.003) and necrotizing granulomatosis inflammation (P=0.005) was higher in patients with tuberculosis. Conclusions: Chronic granulomatous disease is the most common non-infectious cause in children. Moreover, primary or secondary immune deficiencies may cause granulomatosis inflammation, especially in pediatric patients.

522-524

Authors: Jessica Joyce R De Guia, Mary Jane C Flores, Derick Erl P Sumalapao, Eligio Santiago V Maghirang, Vicente Y Belizario Jr.

None.