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Özgür Kılıç

and 7 more

Background: COVID 19 affects pregnant women more severe than the nonpregnant women of reproductive age. However, the rate of critical illness and fatality reported from the other studies varied in a wide range in both group. The study aims to investigate the clinical outcomes of pregnant and nonpregnant patients hospitalised with COVID 19 infection. Method: Clinical, radiologoic and laboratory data of pregnant and nonpregnant patients of reproductive age (18-45 years) infected with COVID 19 were analysed retrospectively. Results: Of 153 patients, 123 were nonpregnant and 30 were pregnant. 15 of the 30 pregnant patients delivered during the hopital stay and 6 of them received an urgent cesarean section. Of the six urgent delivery, five were due to respiratory insufficiency related to COVID 19 and one was unrelated to COVID 19. Four preterm birth, one perinatal death but no stillbirth or miscarriage was recorded. The most common symptom and comorbidity were cough and asthma in both group respectively. Semiquantative CT severity score was significantly higher in pregnants than in nonpregnants (9 points vs 2 points, p=0.022). Prognostic laboratory markers including lymphocytopenia, C-reactive protein and D-dimer were markedly worse in the pregnant group. Severe or critical patients were proportionally higher in the pregnants than in the nonpregnants (26% vs 15%, p=0.004). Hospital length of stay (HLOS) was median 4 vs 5 day; p=0.68, mortality rate was 1/123(0.8%) vs 0/30(0%), p=0.62; intensive care unit (ICU) admission rate was 3/123 (2.4%) vs 7/30 (23.3), p<0.001; need for invasive mechanical ventilation (IMV) was 2/123 (1.6%) vs 5/30 (17%), p=0.003 in nonpregnant and pregnant patients respectively. Conclusion: COVID 19 has a more severe course in pregnant women versus nonpregnant control group, but no difference was noted in terms of hospital length of stay and mortality.

Dursun Ali Kaba

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Background: Obesity is an important, worldwide public health problem. Obesity affects all body systems, but mainly cardiovascular and respiratory systems. Aim: We aimed to investigate the change in respiratory functions due to both the decrease in body-mass index (BMI) and laparoscopic obesity surgery that is used in obesity treatment. Methods: Patients were selected who applied to Ondokuz Mayıs University General Surgery Clinics and were referred to pulmonary medicine clinics for preoperative evaluation. The mean age of patients was 35.3±9.3. 32 patients who applied for laparoscopic obesity surgery with BMI>40 kg/m2 were monitored. Pulmonary symptoms of patients were evaluated pre-operatively and post-operatively; their BMIs were calculated and pulmonary function tests, lung diffusion testing and 6 minutes walking test (6 MWT) were applied. The data obtained at the end of the study were assessed under computer setting by SPSS 15.0 program. Chi-Square, Mann Whitney U, Wilcoxon Signed Ranks, Paired T and Student T tests were used in statistical analysis of data. Results: Average age of patients was 35.3±9.3 and 28.1% of the patients (n=9) were men, 71.9% (n=23) of them were women. The fact that majority of patients who participated the study were women was related with more frequent morbid obesity in women in general; we also saw that women patients applied to the hospital for obesity surgery at a higher ratio. When data of preoperative and post-operative were compared, BMI of patients decreased by 28%; FEV₁ value, FEV₁ percentage, FVC value and FVC percentages increased by 11.9%, 14.8%, 14.8% and 17.3% respectively, and these results were accepted as statistically significant. Conclusion: Recovery in respiratory functions due to decrease in BMI was observed after laparoscopic sleeve gastrectomy in obesity. More effective routes must be followed in fighting against obesity which affect all the body systems mainly including cardiovascular and respiratory systems.