Yedikule Hospital for Chest Disease and Thoracic Surgery

Objectives The burden of metastatic lymph node (LN) stations might reflect a distinct N subcategory with a more aggressive biology and behaviour than the traditional N classification. Methods Between 2008 and 2018, we analysed 1236 patients with pN1/2 lung cancer. When survival was analysed according to LN station metastasis, the number of metastatic LN stations that provided additional prognostic information was considered the optimal threshold. We performed the N prognostic subgrouping according to the thresholds for the number of metastatic LN stations with a maximum chi-square log-rank value. This was validated at each pT-stage. Results Survival showed stepwise statistical deterioration with an increase in the number of metastatic LN stations. According to survival analyses results, threshold values for the number of metastatic LN stations were determined and N prognostic subgrouping was created as sN-αlfa; one LN station metastases (n = 632), sN-βeta; two-three LN stations metastases (n = 505), and sN-Ɣamma; ≥4 LN stations metastasis (n = 99). The 5-year survival rate was 57.7% for sN-αlfa, 39.2% for sN-βeta, and 12.7% for sN-Ɣamma (chi-square log rank = 97.906, p < 0.001). We observed a clear tendency of deterioration of survival from sN-αlfa to sN-Ɣamma in the same pT stage, except for pT4 stage. Multivariate analysis showed that age (p < 0.001), sex (p = 0.002), tumour histology (p < 0.001), IASLC-proposed N subclassification (p < 0.001), and sN prognostic subgroups (p < 0.001) were independent risk factors for survival. Conclusion The burden of metastatic LN stations is an independent prognostic factor for survival in patients with lung cancer and could add different prognostic information to the N classification.

Objective We evaluated the association between the triglyceride–glucose (TG) index, a marker of insulin resistance, and obstructive sleep apnoea (OSA) severity in patients without diabetes mellitus, obesity, and metabolic syndrome. Methods This retrospective cohort study included 1,527 patients. We used univariate and multivariate analyses to identify the independent predictors associated with OSA. Results Most patients were males (81.5%) with a mean age of 43.9 ± 11.1 (15–90) years. Based on the apnoea–hypopnea index (AHI), 353 (23.1%) patients were included in the control group, whereas 32.4%, 23.5%, and 21% had mild, moderate, and severe OSA, respectively. The TG index values demonstrated significant associations with OSA patients compared with the control group ( p = 0.001). In addition, the mean values of the oxygen desaturation index (ODI), AHI, minimum oxygen saturation, and total sleep time percentage with saturation below 90% demonstrated statistically significant differences among the TG index groups (p: 0.001; p:0.001; p:0.001; p:0.003). The optimal TG index cutoff value to predict OSA was 8.615 (AUC = 0.638, 95% CI = 0.606–0.671, p = 0.001). In multivariate logistic regression analysis, after adjusting for age, sex, and body mass index, the TG index was independently associated with OSA patients. Conclusion The TG index is independently associated with increased risk for OSA. This indicates that this index, a marker for disease severity, can be used to identify severe OSA patients on waiting lists for PSG.

Background and Objectives: Pulmonary arterial hypertension (PAH) is a rare chronic disease of the small pulmonary arteries that causes right heart failure and death. Accurate management of PAH is necessary to decrease morbidity and mortality. Understanding current practices and perspectives on PAH is important. For this purpose, we intended to determine physicians' knowledge, attitudes, and practice patterns in adult pulmonary arterial hypertension (PAH) in Turkey. Materials and Methods: Between January and February 2022, an online questionnaire was sent via e-mail to all cardiologists and pulmonologists who were members of the Turkish Society of Cardiology (TSC) and the Turkish Thoracic Society (TTS). Results: A total of 200 physicians (122 pulmonologists and 78 cardiologists) responded to the questionnaire. Cardiologists were more frequently involved in the primary diagnosis and treatment of PAH than pulmonologists (37.2% vs. 23.8%, p = 0.042). More than half of the physicians had access to right heart catheterization. In mild/moderate PAH patients with a negative vasoreactivity test, the monotherapy option was most preferred (82.8%) and endo-thelin receptor antagonists (ERAs) were the most preferred group in these patients (73%). ERAs plus phosphodiesterase-5 inhibitors (PDE-5 INH) were the most preferred (69%) combination therapy , and prostacyclin analogues plus PDE-5 INH was preferred by only pulmonologists. Conclusions: Overall, clinical management of patients with PAH complied with guideline recommendations. Effective clinical management of PAH in specialized centers that having right heart catheter-ization achieve better outcomes.

Significant changes have occurred in the epidemiology and prevention of lung cancer in the past decade due to changes in smoking patterns, lung cancer genetics, the role of the immune system in lung cancer control, and breakthrough developments in lung cancer treatment options [1]. However, it still continues to be the most common cancer type that causes death [2]. In 2018, 2.09 million new cases (11.6% of total cancer cases) and 1.76 million deaths (18.4% of total cancer deaths) were identified globally in lung cancer patients, with a higher rate of new cases and deaths compared to 2012 [3–5]. Due to the global increase in the number of smokers in recent years, the lung cancer burden is expected to continue to increase in the coming years.

Background Bleomycin causes increased production of reactive oxygen species, leads to pulmonary toxicity, fibroblast activation, and fibrosis. Objectives This study aimed to evaluate the protective effect of pirfenidone on bleomycin-induced lung toxicity in rats. Methods Twenty-eight adult rats were randomly divided into 3 groups; Bleomycin (B group, n=10), Bleomycin and Pirfenidone (B-PND group, n=13), and the control group (n=5). The bleomycin regimen was administered for 9 weeks. Pirfenidone was administered at 100 mg/kg daily. Total antioxidant level (TAS), total oxidant level (TOS), tumor necrosis factor (TNF-α), transforming growth factor (TGF-β1), matrix metalloproteinase-2 (MMP-2), plasminogen activator inhibitor (PAI) levels were studied. Histopathologically, sections were stained with Hematoxylin-eosin and Masson-trichrome for grading-scoring according to the Ashcroft score. Results Stage 3 fibrosis was observed in 50% of the B group rats, stage 3 and higher fibrosis was never detected in the B-PND group and the difference was statistically significant (p=0.003). When evaluating tissue inflammation, the inflammation was higher in the B-PND group than in the other groups (p<0.001). Pleuritis was detected in all rats in group B, while was not observed in B-PND and control group (p<0.001). The TAS level was found to be significantly higher in group B than in group B-PND (p=0.034), while no difference was found between TOS, TNF-α, MMP-2, PAI, TGF-β1. Conclusions Pirfenidone had a statistically significant protective effect in bleomycin-induced lung fibrosis and pleuritis in rats. Despite the presence of inflammation in the tissue, no significant changes were observed in inflammation markers in the peripheral blood. Novel serum biomarkers are needed to indicate the presence of inflammation and fibrosis in the lung.

Introduction Whether changes should be made to the TNM classification of non-small cell lung cancer (NSCLC) according to the newly proposed nodal classification is unclear. We aim to compare the survival between stage-IIB subsets using a modelling study performed using the newly proposed nodal classification. Patients and methods A total of 682 patients with stage-IIB NSCLC based on the 8th TNM classification were analysed. Hazard ratio (HR) values calculated from survival comparisons between stage-IIB subgroups were used to create a model for patients with stage-IIB NSCLC, and modelling was performed according to the HR values that were close to each other. Results Patients with T1N1a cancer had the best survival rate (58.2%), whereas the worst prognosis was observed in those with T2bN1b cancer (39.2%). The models were created using the following HR results: Model A (T1N1a, n = 85; 12.4%), Model B (T2a/T2bN1a and T3N0, n = 438; 64.2%), and Model C (T1/T2a/T2bN1b, n = 159; 23.4%). There was a significant difference between the models in terms of overall survival (p = 0.03). The median survival time was 69 months in Model A, 56 months in Model B, and 47 months in Model C (Model A vs. Model B, p = 0.224; Model A vs. Model C, p = 0.01; and Model B vs. Model C, p = 0.04). Multivariate analysis showed that age (p < 0.001), pleural invasion (p < 0.001), and the developed modelling system (p = 0.02) were independently negative prognostic factors. Conclusion There was a prognostic difference between stage-IIB subsets in NSCLC patients. The model created for stage-IIB lung cancer showed a high discriminatory power for prognosis.

Introduction: Whether changes should be made to the TNM classification of non-small cell lung cancer (NSCLC) according to the newly proposed nodal classification is unclear. We aim to compare the survival between stage-IIB subsets using a modelling study performed using the newly proposed nodal classification. Patients and methods: A total of 682 patients with stage-IIB NSCLC based on the 8th TNM classification were analysed. Hazard ratio (HR) values calculated from survival comparisons between stage-IIB subgroups were used to create a model for patients with stage-IIB NSCLC, and modelling was performed according to the HR values that were close to each other. Results: Patients with T1N1a cancer had the best survival rate (58.2%), whereas the worst prognosis was observed in those with T2bN1b cancer (39.2%). The models were created using the following HR results: Model A (T1N1a, n = 85; 12.4%), Model B (T2a/T2bN1a and T3N0, n = 438; 64.2%), and Model C (T1/T2a/T2bN1b, n = 159; 23.4%). There was a significant difference between the models in terms of overall survival (P = 0.03). The median survival time was 69 months in Model A, 56 months in Model B, and 47 months in Model C (Model A vs. Model B, P = 0.224; Model A vs. Model C, P = 0.01; and Model B vs. Model C, P = 0.04). Multivariate analysis showed that age (P < 0.001), pleural invasion (P < 0.001), and the developed modelling system (P = 0.02) were independently negative prognostic factors. Conclusion: There was a prognostic difference between stage-IIB subsets in NSCLC patients. The model created for stage-IIB lung cancer showed a high discriminatory power for prognosis.

Non-small cell lung cancer (NSCLC) is characterized by diagnosis at an advanced stage, low rate of operability and poor survival. Therefore, there is a need for a biomarker in NSCLC patients to predict the likely outcome and to accurately stratify the patients in terms of the most appropriate treatment modality. To evaluate prognostic value of pretreatment neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in NSCLC. A total of 124 NSCLC patients (mean ± standard deviation age: 60.7 ± 9.3 years, 94.4% were males) were included in this retrospective study. Data were retrieved from the hospital records. The association of NLR and PLR with clinicopathological factors and overall survival was analyzed. One-year, 2-year and 5-year survival rates were 59.2%, 32.0%, and 16.2%, respectively. Median duration of survival was shorter in patient groups with elevated NLR and PLR. Five-year survival rate was quite lower in patient groups with elevated NLR and PLR. Hazard rate (HR) for mortality was 1.76 (95% confidence interval [CI]: 1.19-2.61, P = .005) for NLR ≥ 3 over NLR < 3. HR was 1.64 (95%CI: 1.11-2.42, P = .013) for PLR ≥ 150 over PLR < 150. Cox-regression analysis revealed that, when adjusted for other independent predictors of survival, NLR and PLR still remain significant predictors of poorer survival. Our findings indicate that elevated pretreatment NLR and PLR are associated with advanced disease and poor survival in NSCLC patients, NLR and PLR values are correlated with each other.

Background/aim: MicroRNAs (miRNA) are a class of small non-coding RNAs of 18-25 nucleotides, which regulate gene expression at the post-transcriptional level by disrupting or blocking translation of messenger RNA targets. Non-small cell lung cancer (NSCLC) represents approximately 85% of all lung cancers. Early and accurate diagnosis of the disease affects the probability of success of treatment. The purpose of this study was to investigate the expression levels of serum specific miRNA221 and miRNA222 as a biomarker in NSCLC. Materials and methods: Thirty-two NSCLC cases and 30 healthy control cases that were diagnosed at Istanbul Yedikule Chest Diseases and Thoracic Surgery Training Hospital were included in this study. miRNAs were detected using miRNA-specific quantitative real-time-PCR. The relative expression of miRNAs was calculated using the 2-ΔΔCt method. Results: miR221 and miR222 showed 1.46 and 1.63-fold higher expression in the samples from patients with NSCLC compared to controls, and the difference of expression was statistically significant for miR221 (p=0.000095) but not for miR222 (p=0.084470). In the presence of metastasis in NSCLC patients, miR221 levels were 2.33-fold higher compared to non-metastatic cases (p=0.014), and those of miR221 and miR222 were expressed 1.44 and 1.52-fold higher, respectively, in advanced stage compared to early stage (p=0.000387, p=0.000302). Conclusion: The levels of miR221 and miR222 in the serum of patients could be used as biomarkers for the diagnosis, treatment, and prognosis of NSCLC.

Background: Endobronchial ultrasonography (EBUS) is a minimally invasive diagnostic tool in the diagnosis of mediastinal lymph nodes (LNs) and has sonographic features. We aimed to investigate the diagnostic accuracy of EBUS elastography, which evaluates tissue compressibility integrated into EBUS, on malignant vs. benign mediastinal-hilar LNs. Methods: A single-center, prospective study was conducted at the University of Health Sciences Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital between 01/10/2019 and 15/11/2019. The features of 219 LNs evaluated by thoracic computed tomography (CT), positron emission tomography (PET)/CT, EBUS sonography and EBUS elastography were recorded. The LNs sampled by EBUS-guided fine needle aspiration were classified according to EBUS elastography color distribution findings as follows: type 1, predominantly nonblue (green, yellow, and red); type 2, part blue, part nonblue; type 3, predominantly blue. The strain ratio (SR) was calculated based on normal tissue with the relevant region. Results: The average age of 131 patients included in the study was 55.86 ± 13 years, 76 (58%) were male. Two hundred and nineteen lymph nodes were sampled from different stations. Pathological diagnosis of 75 (34.2%) LNs was malignant, the rest was benign. When EBUS B-mode findings and pathological results were compared, sensitivity was 65.33%, specificity 63.19%, positive predictive value (PPV) 48%, negative predictive value (NPV) 77.8%, and diagnostic yield (DY) 64%. When the pathological diagnoses and EBUS elastography findings were compared, while type 1 LNs were considered to be benign and type 3 LNs malignant, sensitivity 94.12%, specificity 86.54%, PPV 82.1%, NPV 95.7%, and DY 89.5%. SR of malignant LNs was significantly higher than benign LNs (p < 0.001). When the classification according to color scale and SR were compared, no difference was found in DY (p = 0.155). Discussion: The diagnostic accuracy of EBUS elastography is high enough to distinguish malignant LN from benign ones with the SR option. When compared with EBUS-B mode sonographic findings, it was found to have a higher diagnostic yield.

Objective: It is known that inpatient hospital costs are much higher than outpatient services. It was aimed to investigate the effect of pneumococcal vaccination on hospitalizations. Material and methods: The direct hospitalization costs, length of stay, and factors of the vaccinated and unvaccinated patients in the same hospital during the 12-month follow-up of the patients who received pneumococcal vaccine between November 15, 2018, and November 15, 2020, in 3 chest diseases and thoracic surgery training and research hospitals were analyzed by obtaining Hospital Information Management System records. Data were collected with Statistical Package for the Social Sciences version 23 program (IBM Corp.; Armonk, NY, USA) , and statistical evaluation was made. Results: The mean age of 800 hospitalized patients, of whom 400 were unvaccinated and 400 were vaccinated, was 68.48 ± 11.97. There was no significant difference in the mean age of vaccinated and unvaccinated patients (P > .05). Five hundred sixty-six patients (70.8%) were aged 65 and over. Two hundred eighty (51.2%) of men were vaccinated and 120 (47.2%) of women were vaccinated, and there was no significant difference (P > .05). The mean hospital stay of these patients was 11.01 days, and those in the vaccinated group had an average mean hospital stay of 9.11 days and those in the unvaccinated group had a mean hospital stay less than 12.91 days (P < .001). Total 1-year hospitalization costs were $501.653.53 and the cost per person was calculated as $627.07. The cost per capita for the vaccinated group was $550.52, which was lower than the average cost of the unvaccinated group ($703.62) (P < .05). When comparing the status of being vaccinated, comorbidity, mortality, mean length of stay, chronic obstructive pulmonary disease, and heart disease were found to be statistically significant (P < .05). Conclusion: In our study, it was revealed that vaccination of patients hospitalized in chest disease hospitals with the pneumococcal vaccine reduced the average length of hospital stay by 41.7% and the cost of hospitalization by 27.8%.

Introduction: The clinical and physiological effects of long-duration use of N95-type masks without ventilation valves, on health-care workers during the coronavirus disease-2019 (COVID-19) pandemic, were evaluated. Methods: All volunteering personnel working in operating theater or intensive care unit, using nonventilated N95 type respiratory masks, minimum for a 2-h noninterrupted duration were observed. The partial oxygen saturation (SpO2) and heart rate (HR) were recorded before wearing the N95 mask and at 1st and 2nd h. Volunteers were then questioned for any symptoms. Results: A total of 210 measurements were completed in 42 (24 males and 18 females) eligible volunteers, each having 5 measurements, on different days. The median age was 32.7. Premask, 1st h, and 2nd h median values for SpO2 were 99%, 97%, and 96%, respectively (P < 0.001). The median HR was 75 premask, 79 at 1st h, and 84/min at 2nd h (P < 0.001). A significant difference between all three consecutive measurements of HR was achieved. Statistical difference was only reached between premask and other SpO2 measurements (1st and 2nd h). Complaints seen in the group were head ache (36%), shortness of breath (27%), palpitation (18%), and nausea feeling (2%). Two individuals took off their masks to breathe, on 87th and 105th min, respectively. Conclusions: Long duration (>1 h) use of N95-type masks causes a significant reduction in SpO2 measurements and increase in HR. Despite being an essential personal protective equipment in COVID-19 pandemic, it should be used with short intermittent time periods in health-care providers with known heart disease, pulmonary insufficiency, or psychiatric disorders.

Background and aim: Median sternotomy is an unfavourable approach for performing lung resection and mediastinal lymphadenectomy. Some studies have speculated that concurrent pulmonary resections other than upper lobectomy, necessitate anterolateral thoracotomy in addition to sternotomy. In this study, we aimed to discuss the feasibility and advantages of concomitant video-thoracoscopy (VATS) assisted lower lobectomy after coronary artery bypass grafting (CABG). Methods: We analysed 21 patients who underwent a single combined procedure that includes CABG followed by anatomical pulmonary resection and divided them into two groups: patients who underwent upper lobectomy via median sternotomy incision (Group A, n = 12) and patients who underwent lower lobectomy with video-thoracoscopic assistance (VATS) next to sternotomy incision (Group B, n = 9). Results: There were no significant differences between the groups in age, sex, comorbidities, tumour side or size, tumour stage, tumour histopathology, number of dissected lymph node stations, N status, CABG type, number of grafts used, operative time, hospitalization and complication rates. Conclusion: The feasibility of upper lobectomies via median sternotomy is clear; however, performing lower lobectomies is challenging. In our study, we concluded that the operative feasibility of concurrent lower lobectomy by VATS assistance showed no essential difference to that of concurrent upper lobectomy by presenting that there was no statistically significant difference between the groups in terms of any studied parameters. We can speculate that median sternotomy with VATS assistance should be especially considered instead of anterolateral thoracotomy for lower lobectomies at centres where VATS lobectomies are performed.

Aim: We aimed to evaluate the awareness of pneumococcal vaccination (PCV13, PPSV23) in general cardiology outpatient clinics and impact of physicians' recommendations on vaccination rates. Methods: This was a multicenter, observational, prospective cohort study. Patients over the age of 18 from 40 hospitals in different regions of Turkey who applied to the cardiology outpatient clinic between September 2022 and August 2021 participated. The vaccination rates were calculated within three months of follow-up from the admitting of the patient to cardiology clinics. Results: The 403 (18.2%) patients with previous pneumococcal vaccination were excluded from the study. The mean age of study population (n = 1808) was 61.9 ± 12.1 years and 55.4% were male. The 58.7% had coronary artery disease, hypertension (74.1%) was the most common risk factor, and 32.7% of the patients had never been vaccinated although they had information about vaccination before. The main differences between vaccinated and unvaccinated patients were related to education level and ejection fraction. The physicians' recommendations were positively correlated with vaccination intention and behavior in our participants. Multivariate logistic regression analysis showed a significant correlation between vaccination and female sex [OR = 1.55 (95% CI = 1.25-1.92), p < 0.001], higher education level [OR = 1.49 (95% CI = 1.15-1.92), p = 0.002] patients' knowledge [OR = 1.93 (95% CI = 1.56-2.40), p < 0.001], and their physician's recommendation [OR = 5.12 (95% CI = 1.92-13.68), p = 0.001]. Conclusion: To increase adult immunization rates, especially among those with or at risk of cardiovascular disease (CVD), it is essential to understand each of these factors. Even if during COVID-19 pandemic, there is an increased awareness about vaccination, the vaccine acceptance level is not enough, still. Further studies and interventions are needed to improve public vaccination rates.

This study explores the relationship between spirituality and hope levels in lung cancer patients. Cancer patients often use their spirituality as a way of coping. Among a sample of 124 Turkish lung cancer patients, spirituality levels were assessed using the Spiritual Orientation Scale (SOS) and hope levels were measured using the Herth Hope Scale (HHS). Spirituality and hope levels in Turkish lung cancer patients were found to be above average. While no significant effect of demographic and disease-related variables was detected on spirituality and hope levels, spirituality and hope were found to be positively correlated in Turkish lung cancer patients.

Introduction: Many studies have shown that training in smoking cessation care (SCC) is important for increasing the number and quality of delivered interventions by health professionals, and various training methods are available. The study aimed to identify the relationship between receiving training on SCC and the frequency of providing outpatient-based SCC among pulmonologists who were members of the Turkish Thoracic Society (TTS). Methods: For this cross-sectional study, a self-administered online questionnaire-based survey was conducted on a group of active pulmonologists who were members of the TTS, between April and October 2019. The survey included questions about demographics, smoking status, participation in SCC training, and providing outpatient-based SCC. Results: A total of 199 (53%) pulmonologists were actively taking part in outpatient-based SCC. Compared to those that were not providing outpatient-based SCC, median age, median time since graduation, and the number of non-academics, non-current smokers and recipients of smoking cessation care training were significantly higher in the group providing outpatient-based SCC (p<0.001, p<0.001, p=0.002, p=0.001, respectively). It was observed that having SCC training increased more than 6-fold the likelihood of providing outpatient-based SCC (AOR=6.45; 95% CI: 3.96-10.49; p<0.001). Conclusions: The most crucial obstacle in providing smoking cessation is healthcare workers not providing smoking cessation to smokers. It is worthwhile to devote more tasks and resources to training physicians on smoking cessation care since this may increase their effective involvement in tobacco cessation.

Background: A successful planning methodology for patients with hemoptysis promises overall improvement in patient care. Conducted in a reference center for chest diseases, the present study aims to analyze characteristics and predictors of interventional methods in patients with recurrent hemoptysis. Methods: The present study is a single-center, retrospective observational study. Between 2015 and 2018, 5973 patients with follow-up data until 2021 requiring more than one hospitalization due to recurrent hemoptysis were investigated. Patient characteristics, the amount of hemoptysis, baseline admission parameters, interventional procedures of bronchial artery embolization (BAE), fiberoptic bronchoscopy, rigid bronchoscopy, and surgical resections applied were analyzed according to number of hospitalizations and outcome. Results: : Hospital admission numbers were higher in patients with sequela of tuberculosis, bronchiectasis and lung cancer. While lung cancer was the most frequent underlying reason in recurrent admissions, it was determined that as the amount of bleeding increased, the number of admissions also increased to the hospital, and BAE and rigid bronchoscopy were performed more frequently in the groups with less frequent admissions. There was no statistically significance between the amount of bleeding, and the interventional procedure alone or in combination with another procedure (p > 0.05). Discussion: In conclusion, patients with certain diseases may experience frequent hospital admissions due to hemoptysis. Recurrent admissions may get better results with BAE and rigid bronchoscopy. We think that these procedures should be preferred in the foreground of suitable patient selection in line with available facilities and experience.

Objective: To evaluate the persistence of symptoms and health-related quality of life of coronavirus disease-2019 patients. Methods: The cross-sectional study was conducted from April to September 2020 at Health Sciences University, Yedikule Chest Diseases Hospital, Istanbul, Turkey, and comprised patients of either gender who had to be hospitalised and treated for coronavirus disease-2019. Those who had spent <3 months (46-90 days) post-discharge formed Group 1, those having spent 3-6 were in Group 2, while those with >6 months post-discharge were in Group 3. Data was collected over the telephone Using the EuroQol's quality of life scale with 5 dimensions and 5 levels. The variables likely to affect the persistence of symptoms and the quality of life questionnaire scores were analysed using SPSS 16. Results: Of the 225 subjects, 135(60%) were male and 90(40%) were female. The overall mean age was 55.7±19.91 years. There were 85(37.8%) participants in Group 1, 83(36.9%) in Group 2, and 57(25.3%) in Group 3. The age (p=0.09) and gender (p=0.23) distribution across the groups had no significant difference. Patients were called on an average 131.72±58.9 days after discharge (range: 46-279 days). Only 52 (23.1%) patients continued to show symptoms. Anxiety was the domain in which most patients 64(28.4%) reported deterioration. Conclusions: Most patients who have had coronavirus disease-2019COVID-19 after a long follow-up period did not show any symptoms or had any significant deterioration in their quality of life.