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    Are surgical and non-operating room intervention safe in the COVID-19 pandemic? A retrospective study
    (CAMBRIDGE UNIV PRESS, 2021-01-01) Yildirim, Serap Aktas; Sarikaya, Zeynep Tugce; Ulugol, Halim; Ozata, Sanem; Aksu, Ugur; Toraman, Fevzi; Grp, C. O. V. I. D.-19 Study
    Little is known about the impact of COVID-19 on the outcomes of patients undergoing surgery and intervention. This study was conducted between 20 March and 20 May 2020 in six hospitals in Istanbul, and aimed to investigate the effects of surgery and intervention on COVID-19 disease progression, intensive care (ICU) need, mortality and virus transmission to patients and healthcare workers. Patients were examined in three groups: group I underwent emergency surgery, group II had an emergency non-operating room intervention, and group III received inpatient COVID-19 treatment but did not have surgery or undergo intervention. Mortality rates, mechanical ventilation needs and rates of admission to the ICU were compared between the three groups. During this period, patient and healthcare worker transmissions were recorded. In total, 1273 surgical, 476 non-operating room intervention patients and 1884 COVID-19 inpatients were examined. The rate of ICU requirement among patients who had surgery was nearly twice that for inpatients and intervention patients, but there was no difference in mortality between the groups. The overall mortality rates were 2.3\% in surgical patients, 3.3\% in intervention patients and 3\% in inpatients. COVID-19 polymerase chain reaction positivity among hospital workers was 2.4\%. Only 3.3\% of infected frontline healthcare workers were anaesthesiologists. No deaths occurred among infected healthcare workers. We conclude that emergency surgery and non-operating room interventions during the pandemic period do not increase postoperative mortality and can be performed with low transmission rates.
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    Assessment of clinical outcomes in renal transplant recipients with COVID-19
    (WILEY, 2021-01-01) Yilmaz, Gulay; Ebru, Ozdemir; Ibrahim, Berber; Ulkem, Cakir
    The coronavirus disease 2019 (COVID-19) has affected more than a hundred million individuals and caused more than three million deaths worldwide. Specific risk groups were defined for increased risk of mortality and morbidity in COVID-19, and renal transplant recipients are at a significantly increased risk regarding outcomes due to their immunosuppressed conditions. This study evaluated the general characteristics of kidney transplant recipients with COVID-19 infection. Among 1257 transplant cases, 56 had COVID-19 infection, and 23 (41\%) were hospitalized during the 9-month study period. Among all COVID-19 cases, 58\% were male with a mean age of 45.5 (+/- 13.2, 19-71) years, and the most frequent comorbidities were hypertension (70.9\%) and diabetes (23.6\%). Hospitalized patients were older (p = 0.03) and had higher rates of hypertension (p = 0.008), diabetes (p = 0.002), and ischemic heart disease (p = 0.03). Therapeutic management included antimetabolite withdrawal and prednisolone increase in 71\%, calcineurin inhibitor withdrawal in 8\% and decrease in 58\%, hydroxychloroquine in 17\%, tocilizumab in 3\%, and antivirals in 67\% of patients. Acute kidney injury and respiratory failure developed in 34\% and 85\%, respectively. The mortality rate was 23\%. These results emphasized that the COVID-19 infection in renal transplant recipients significantly increases the risk of morbidity and mortality. Therefore, these patients should be intervened earlier and monitored closely to prevent poor outcomes.
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    Did blood transfusion increase mortality in patients with diabetes undergoing isolated coronary artery bypass graft surgery? A propensity score-matched analysis of 816 patients
    (BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2020-01-01) Kocyigit, Muharrem; Ulugol, Halim; Kiran, Seher Irem; Alhan, Cem; Toraman, Fevzi
    Background: The aim of this study was to compare clinical outcomes of blood transfusion in patients with diabetes mellitus undergoing isolated on-pump coronary artery bypass grafting. Methods: The medical records of a total of 1,912 patients (1,300 males, 612 females