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Mert Oztas

Bio: Mert Oztas is an academic researcher from Istanbul University. The author has contributed to research in topics: Medicine & Internal medicine. The author has an hindex of 4, co-authored 11 publications receiving 62 citations.

Papers
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Journal ArticleDOI
TL;DR: In this paper, the authors conducted a web-based questionnaire survey in a cross-sectional design in three groups of participants just before the mass vaccination program in Istanbul, Turkey, and evaluated the willingness to get vaccination and its probable predictors among patients with rheumatic diseases compared to healthcare workers and a sample from the general population.
Abstract: Vaccination against COVID-19 emerges as an effective strategy for combating the pandemic. While many of our patients with rheumatic diseases (RD) wonder whether it is safe to get the vaccine, vaccine hesitancy is rising among the general population. We assessed the willingness to get vaccination and its probable predictors among patients with RD compared to healthcare workers and a sample from the general population. We conducted a web-based questionnaire survey in a cross-sectional design in 3 groups of participants just before the mass vaccination program in Istanbul, Turkey. The questionnaire sought socio-demographic variables, COVID-19 related risk factors, willingness to get vaccination, and concerns and thoughts about vaccine. COVID-19 anxiety scale (CAS) was also evaluated. We studied in total 732 patients with RD (Group 1), 763 individuals representing general population (Group 2) and 320 hospital workers (Group 3). Dysfunctional anxiety related to COVID-19 was found in 4.9%, 3.8% and 4.1%, in Group 1, 2 and 3, respectively. Of the patients with RD, 29.2% were willing to be vaccinated, 19.0% were unwilling and 51.8% were undecided. These were somewhat similar among the general population (yes: 34.6%, no: 23.3% and unsure: 42.1%), with significantly less undecided individuals (p < 0.001). On the other hand, hospital workers were significantly more willing (yes: 52.5%, no: 20.9% and unsure: 26.6%) (p < 0.001). Main concerns were probable side effects, unknown scientific results and having no trust. Being male, older age, working in a hospital, not having contracted COVID-19 and high scores on CAS were found to be independently associated with willingness. The low rate of vaccine acceptance among patients with RD, as well as general population sampling is worrying. Healthcare policies should aim to implement communication, promote confidence and increase demand for COVID-19 vaccine.

77 citations

Journal ArticleDOI
TL;DR: In this paper, a cross-sectional study was conducted to assess antibody response to inactivated COVID-19 vaccine in patients with immune-mediated diseases (IMD) among hospital workers and people aged 65 and older.
Abstract: To assess antibody response to inactivated COVID-19 vaccine in patients with immune-mediated diseases (IMD) among hospital workers and people aged 65 and older. In this cross-sectional study, we studied 82 hospital workers with IMD (mean age: 42.2 ± 10.0 years) and 300 (mean age: 41.7 ± 9.9 years) controls. Among + 65 aged population, we studied 22 (mean age: 71.4 ± 4.5 years) patients and 47 controls (mean age: 70.9 ± 4.8 years). All study subjects had a negative history for COVID-19. Sera were obtained after at least 21 days following the second vaccination. Anti-spike IgG antibody titers were measured quantitatively using a commercially available immunoassay method. Patients with IMD were significantly less likely to have detectable antibodies than healthy controls both among the hospital workers (92.7% vs 99.7%, p < 0.001) and elderly population (77.3% vs 97.9%, p = 0.011). Among patients with IMD, those using immunosuppressive or immune-modulating drugs (64/75, 85.3%) were significantly less likely to have detectable antibodies compared to those off treatment (29/29, 100%) (p = 0.029). Additionally, a negative association between age and the antibody titer categories among patients (r = − 0.352; p < 0.001) and controls (r = − 0.258; p < 0.001) were demonstrated. Among hospital workers, the vast majority of patients with IMD and immunocompetent controls developed a significant humoral response following the administration of the second dose of inactivated COVID-19 vaccine. This was also true for the elderly population, albeit with lower antibody titers. Immunosuppressive use, particularly rituximab significantly reduced antibody titers. Antibody titers were significantly lower among those aged ≥ 60 years both in patient and control populations. Whether these individuals should get a booster dose warrants further studies.

66 citations

Journal ArticleDOI
TL;DR: A case series of Behçet’s syndrome patients diagnosed with COVID-19 is presented and their presentation, disease course, management and outcomes are described.
Abstract: Coronavirus disease 2019 (COVID-19), caused by SARSCoV-2, is the cause of the global pandemic that originated in China in December 2019 [1]. It had spread all over Turkey in March 2020, Istanbul being hit the hardest. As of 28 May 2020, the total number of confirmed cases in the country is over 161,000 of which 124,400 have recovered and 4500 have died [2]. The most common symptoms of COVID-19 are fever and cough, which can progress to pneumonia and acute respiratory distress syndrome (ARDS) or multi-organ failure [3]. Additionally, it may predispose to thrombotic disease, both in the venous and arterial circulations [4–7]. Being older, smoking and having comorbid medical conditions are associated with severe outcome among patients with COVID-19 [3]. It is yet not known whether patients with rheumatic diseases (RD) receiving immunosuppressive therapy are more susceptible to SARS-CoV-2 or not. Recently two European centers reported that the prevalence of SARS-CoV-2 infection among patients with systemic autoimmune diseases was comparable to that observed in the general population [8, 9]. Both studies were done during a short period of time and had been completed while the outbreak was still going on. While more information about COVID-19 in this patient population is needed, close monitoring of such patients is warranted. Behçet’s syndrome (BS) is a complex disorder of unknown etiology, characterized by recurrent skin mucosa lesions and uveitis [10]. The usual onset is in the third decade. There is relapsing remitting course while the severity abates as the years pass [10]. Vascular involvement affecting both venous and arterial system is almost always associated with intensive thrombosis of inflammatory nature and can occur in up to 40% of cases [11]. Lower extremity veins are frequently affected followed by iliac veins and vena cava. Central nervous system (CNS) and joints may also be involved. Immunosuppressive agents along with colchicine are the mainstay of treatment [12]. In this article, we present a case series of BS with COVID-19 and describe their presentation, disease course, management and outcomes. This study was approved by the Ministry of Health COVID-19-related scientific research consortium. We identified 10 BS patients (5 M/5 F) diagnosed with COVID-19, between April 1 and 21 May 2020. Five patients were retrieved from the Cerrahpasa Medical Faculty COVID-19 inpatient database (n = 767). The remaining contacted us to ask whether they should continue their medication after having been diagnosed elsewhere. Data regarding initial signs and symptoms, laboratory analyses and detailed medical treatment related to COVID-19 were retrieved via the “Ministry of Health Public Health Data * Emire Seyahi eseyahi@yahoo.com

20 citations

Journal ArticleDOI
TL;DR: A 49-year-old man with no previous history of musculoskeletal or cutaneous problems who had a myocardial infarction who was treated with atorvastatin, prasugrel, enoxaparine, and diltiazem following percutaneous coronary intervention was referred to rheumatology outpatient clinic for rash and papules on the knuckles, face, and neck.
Abstract: A 49-year-old man with no previous history of musculoskeletal or cutaneous problems who had a myocardial infarction (MI) was treated with atorvastatin, prasugrel, enoxaparine, and diltiazem following percutaneous coronary intervention. He was referred to our rheumatology outpatient clinic for rash and papules on the knuckles, face, and neck, as well as proximal muscle weakness. In the physical examination, a reddish rash on the face and Gottron’s papules on the knuckles were detected. The skin biopsy performed indicated interface dermatitis with hydropic degeneration of basal keratinocytes, supporting the clinical impression of dermatomyositis. He was started on prednisolone 1 mg/kg/day. After 30 days of prednisolone therapy, all symptoms disappeared.

11 citations

Journal ArticleDOI
TL;DR: In this article, the authors describe the incidence, clinical characteristics, disease course, management, and outcome in a large cohort of Behcet's syndrome (BS) patients with laboratory-confirmed infection of SARS-CoV-2.
Abstract: Initial case series of small number of patients at the beginning of the pandemic reported a rather guarded prognosis for Behcet’s syndrome (BS) patients infected with SARS-CoV-2. In this prospective study, we describe the incidence, clinical characteristics, disease course, management, and outcome in a large cohort of BS patients with laboratory-confirmed infection of SARS-CoV-2. We defined a cohort of 1047 registered BS patients who were aged between 16 and 60 years and seen routinely before the pandemic at the multidisciplinary outpatient clinic. We followed prospectively this cohort from beginning of April 2020 until the end of April 2021. During 13 months of follow-up, of the 1047 (599 M/448 F) patients, 592 (56.5%) were tested for SARS-CoV-2 PCR at least once and 215 (20.5%; 95% CI 0.18–0.23) were tested positive. We observed 2 peaks which took place in December 2020 and April 2021. Of the 215 PCR positive patients, complete information was available in 214. Of these 214, 14 (6.5%) were asymptomatic for COVID-19. In the remaining, the most common symptoms were anosmia, fatigue, fever, arthralgia, and headache. A total of 40 (18.7%) had lung involvement, 25 (11.7%) were hospitalized, 1 was admitted to the intensive care unit while none died. Favipiravir was the most prescribed drug (74.3%), followed by colchicine (40.2%), and hydroxychloroquine (20.1%) in the treatment of COVID-19. After COVID-19, 5 patients (2.3%) were given supplemental O2 and 31 (14.5%) antiaggregant or anticoagulants. During COVID-19, of the 214 PCR positive patients, 116 (54.2%) decreased the dose of their immunosuppressives or stopped taking completely; 36 (16.8%) experienced a BS flare which was mostly oral ulcers (10.3%). None of the patients reported a thrombotic event. A total of 93 (43.5%) patients reported BS flares after a median 45 days of COVID-19 infection and this was found to be significantly associated with immunosuppressive drug discontinuation. Multiple regression analysis adjusted for age and gender indicated that smoking and using interferon-alpha decreased the likelihood of getting COVID-19. The incidence and severity of COVID-19 did not differ between those who were using colchicine or not. The cumulative incidence of COVID-19 in this prospectively followed cohort of BS patients was almost two folds of that estimated for the general population living in Istanbul, Turkey, however, the clinical outcome of COVID-19 was not severe and there was no mortality. The protective effect of smoking and interferon deserves further investigation. On the other hand, colchicine did not have any positive or negative effect against COVID-19. Significant number of patients flared after COVID-19, however, this was significantly associated with immunosuppressive discontinuation during the infection. Contrary to our previous observations, COVID-19 did not seem to exacerbate thrombotic events during or after the infection.

6 citations


Cited by
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Journal ArticleDOI
TL;DR: A systematic review of the current literature regarding attitudes and hesitancy to receiving COVID-19 vaccination worldwide was conducted by as discussed by the authors, where the authors identified the consistent socio-demographic groups that were associated with increased hesitance, including women, younger participants, and people who were less educated, had lower income, had no insurance, living in a rural area, and self-identified as a racial/ethnic minority.

191 citations

Journal ArticleDOI
02 Mar 2022-BMJ
TL;DR: In this article , the efficacy of covid-19 vaccines was compared between immunocompromised and non-immunocompensated patients. But, the results showed that a third dose of a covid19 mRNA vaccine was associated with seroconversion among vaccine nonresponders with solid cancers, haematological cancers, and immune mediated inflammatory disorders, although response was variable in transplant recipients.
Abstract: To compare the efficacy of covid-19 vaccines between immunocompromised and immunocompetent people.Systematic review and meta-analysis.PubMed, Embase, Central Register of Controlled Trials, COVID-19 Open Research Dataset Challenge (CORD-19), and WHO covid-19 databases for studies published between 1 December 2020 and 5 November 2021. ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform were searched in November 2021 to identify registered but as yet unpublished or ongoing studies.Prospective observational studies comparing the efficacy of covid-19 vaccination in immunocompromised and immunocompetent participants.A frequentist random effects meta-analysis was used to separately pool relative and absolute risks of seroconversion after the first and second doses of a covid-19 vaccine. Systematic review without meta-analysis of SARS-CoV-2 antibody titre levels was performed after first, second, and third vaccine doses and the seroconversion rate after a third dose. Risk of bias and certainty of evidence were assessed.82 studies were included in the meta-analysis. Of these studies, 77 (94%) used mRNA vaccines, 16 (20%) viral vector vaccines, and 4 (5%) inactivated whole virus vaccines. 63 studies were assessed to be at low risk of bias and 19 at moderate risk of bias. After one vaccine dose, seroconversion was about half as likely in patients with haematological cancers (risk ratio 0.40, 95% confidence interval 0.32 to 0.50, I2=80%; absolute risk 0.29, 95% confidence interval 0.20 to 0.40, I2=89%), immune mediated inflammatory disorders (0.53, 0.39 to 0.71, I2=89%; 0.29, 0.11 to 0.58, I2=97%), and solid cancers (0.55, 0.46 to 0.65, I2=78%; 0.44, 0.36 to 0.53, I2=84%) compared with immunocompetent controls, whereas organ transplant recipients were 16 times less likely to seroconvert (0.06, 0.04 to 0.09, I2=0%; 0.06, 0.04 to 0.08, I2=0%). After a second dose, seroconversion remained least likely in transplant recipients (0.39, 0.32 to 0.46, I2=92%; 0.35, 0.26 to 0.46), with only a third achieving seroconversion. Seroconversion was increasingly likely in patients with haematological cancers (0.63, 0.57 to 0.69, I2=88%; 0.62, 0.54 to 0.70, I2=90%), immune mediated inflammatory disorders (0.75, 0.69 to 0.82, I2=92%; 0.77, 0.66 to 0.85, I2=93%), and solid cancers (0.90, 0.88 to 0.93, I2=51%; 0.89, 0.86 to 0.91, I2=49%). Seroconversion was similar between people with HIV and immunocompetent controls (1.00, 0.98 to 1.01, I2=0%; 0.97, 0.83 to 1.00, I2=89%). Systematic review of 11 studies showed that a third dose of a covid-19 mRNA vaccine was associated with seroconversion among vaccine non-responders with solid cancers, haematological cancers, and immune mediated inflammatory disorders, although response was variable in transplant recipients and inadequately studied in people with HIV and those receiving non-mRNA vaccines.Seroconversion rates after covid-19 vaccination were significantly lower in immunocompromised patients, especially organ transplant recipients. A second dose was associated with consistently improved seroconversion across all patient groups, albeit at a lower magnitude for organ transplant recipients. Targeted interventions for immunocompromised patients, including a third (booster) dose, should be performed.PROSPERO CRD42021272088.

187 citations

Journal ArticleDOI
TL;DR: CoronaVac, an inactivated SARS-CoV-2 vaccine, has been approved for emergency use in several countries as mentioned in this paper, but its immunogenicity in immunocompromised individuals has not been well established.
Abstract: CoronaVac, an inactivated SARS-CoV-2 vaccine, has been approved for emergency use in several countries. However, its immunogenicity in immunocompromised individuals has not been well established. We initiated a prospective phase 4 controlled trial (no. NCT04754698, CoronavRheum) in 910 adults with autoimmune rheumatic diseases (ARD) and 182 age- and sex-frequency-matched healthy adults (control group, CG), who received two doses of CoronaVac. The primary outcomes were reduction of ≥15% in both anti-SARS-CoV-2 IgG seroconversion (SC) and neutralizing antibody (NAb) positivity 6 weeks (day 69 (D69)) after the second dose in the ARD group compared with that in the CG. Secondary outcomes were IgG SC and NAb positivity at D28, IgG titers and neutralizing activity at D28 and D69 and vaccine safety. Prespecified endpoints were met, with lower anti-SARS-Cov-2 IgG SC (70.4 versus 95.5%, P < 0.001) and NAb positivity (56.3 versus 79.3%, P < 0.001) at D69 in the ARD group than in the CG. Moreover, IgG titers (12.1 versus 29.7, P < 0.001) and median neutralization activity (58.7 versus 64.5%, P = 0.013) were also lower at D69 in patients with ARD. At D28, patients with ARD presented with lower IgG frequency (18.7 versus 34.6%, P < 0.001) and NAb positivity (20.6 versus 36.3%, P < 0.001) than that of the CG. There were no moderate/severe adverse events. These data support the use of CoronaVac in patients with ARD, suggesting reduced but acceptable short-term immunogenicity. The trial is still ongoing to evaluate the long-term effectiveness/immunogenicity.

124 citations

Journal ArticleDOI
TL;DR: Clinical phenotypes including rhabdomyolysis, myalgia and/or mild hyperCKemia, self-limited toxin statin myopathy, and immune-mediated necrotizing myopathy are herein described.
Abstract: Introduction: Musculoskeletal manifestations are well-recognized side effects of treatment with statins. New advances in this field have appeared in recent years. This review focuses on the diagnos...

110 citations

Journal ArticleDOI
TL;DR: In this paper, a systematic review about seroconversion after SARS-CoV-2 vaccination in patients with IMIDs and impact of various drugs on seroconversation rates was performed.

102 citations