ABSTRACT
Objective: To evaluate long-term effects of COVID-19, and to determine the risk factors in long-COVID in a cohort of the Turkish Thoracic Society (TTS)-TURCOVID multicenter registry. Methods: Thirteen centers participated with 831 patients; 504 patients were enrolled after exclusions. The study was designed in three-steps: (1) Phone questionnaire; (2) retrospective evaluation of the medical records; (3) face-to-face visit. Results: In the first step, 93.5% of the patients were hospitalized; 61.7% had a history of pneumonia at the time of diagnosis. A total of 27.1% reported clinical symptoms at the end of the first year. Dyspnea (17.00%), fatigue (6.30%), and weakness (5.00%) were the most prevalent long-term symptoms. The incidence of long-term symptoms was increased by 2.91 fold (95% CI 1.04-8.13, P=0.041) in the presence of chronic obstructive pulmonary disease and by 1.84 fold (95% CI 1.10-3.10, P=0.021) in the presence of pneumonia at initial diagnosis, 3.92 fold (95% Cl 2.29-6.72, P=0.001) of dyspnea and 1.69 fold (95% Cl 1.02-2.80, P=0.040) fatigue persists in the early-post-treatment period and 2.88 fold (95% Cl 1.52-5.46, P=0.001) in the presence of emergency service admission in the post COVID period. In step 2, retrospective analysis of 231 patients revealed that 1.4% of the chest X-rays had not significantly improved at the end of the first year, while computed tomography (CT) scan detected fibrosis in 3.4%. In step 3, 138 (27.4%) patients admitted to face-to-face visit at the end of first year; at least one symptom persisted in 49.27% patients. The most common symptoms were dyspnea (27.60%), psychiatric symptoms (18.10%), and fatigue (17.40%). Thorax CT revealed fibrosis in 2.4% patients. Conclusions: COVID-19 symptoms can last for extended lengths of time, and severity of the disease as well as the presence of comorbidities might contribute to increased risk. Long-term clinical issues should be regularly evaluated after COVID-19.
ABSTRACT
To determine factors affecting smoking cessation success in different age groups. This was an intervention study consisting of 761 patients attending the Balcova Municipality, Smoke Cessation Center, Izmir, Turkey, between November 2009 and December 2011. Variables were successful smoking cessation for one year, socio-demographic features, previous attempts at smoking cessation, a smoking spouse, nicotine dependency level, risk of depression, method of smoking cessation, presence of chronic disease, and decreasing smoking in the last year. Data was analyzed by logistic regression. Approximately 43.8% of the elderly, and 62.7% of the adults reduced the number of cigarettes smoked in the past year. Approximately 83.6% of the elderly and 90.6% of the adults reported previously smoking 11 or more cigarettes daily. Two-thirds of the participants in both groups had tried smoking cessation. Smoking cessation was 49% in the elderly group and 33.4% in the adult group. The logistic regression test showed that moderate and less nicotine dependency level increased the success of cessation in the elderly group [odds ratio [OR]=2.39, 95% confidence interval [95% CI] 1.11-5.17, p=0.026], while in the adult group: increasing age [OR=1.02, 95% CI: 1.01-1.04, p=0.044], male gender [OR=1.69, 95% CI: 1.07-2.68, p=0.025], moderate and less nicotine dependency level [OR=1.65, 95% CI: 1.09-2.49, p=0.018], and the use of medication [OR=1.70, 95% CI: 1.13-2.56, p=0.011] increased the success. Different variables in different age groups may affect successful smoking cessation. These should be taken into consideration in efforts at smoking cessation
ABSTRACT
Walking distance is generally accepted as a functional capacity determinant in chronic obstructive pulmonary disease [COPD]. However, the use of gait speed in COPD patients has not been directly investigated. Thus, the aim of our study was to assess the use of gait speed as a functional capacity indicator in COPD patients. A total 511 patients with mild-to-very severe COPD and 113 healthy controls were included. The lung functions [pulmonary function test], general health- and disease-related quality of life [Medical Outcomes Study 36-Item Short-Form of Health Survey, St George's Respiratory Questionnaire], and gait speed [6-minute walk test] were assessed. The mean gait speed values were slower in moderate [75.7 +/- 14.0 m/min], severe [64.3 +/- 16.5 m/min], and very severe [60.2 +/- 15.5 m/min] COPD patients than controls [81.3 +/- 14.3 m/min]. There were significant correlations between gait speed and age, dyspnea-leg fatigue severities, pulmonary function test results [FEV [1], FVC, FVC%, FEV[1] /FVC ratio, PEF, PEF%], and all subscores of Medical Outcomes Study 36-Item Short-Form of Health Survey and activity, impact and total subscores of St George's Respiratory Questionnaire in patients with moderate, severe, and very severe COPD. However, these correlations were higher especially in patients with severe and very severe COPD. As a conclusion, according to our results gait speed slows down with increasing COPD severity. Also, gait speed has correlations with age, clinical symptoms, pulmonary functions, and quality of life scores in COPD patients. Thus, we consider that gait speed might be used as a functional capacity indicator, especially for patients with severe and very severe COPD