Person: YILMAZ, EMEL
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YILMAZ
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EMEL
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Publication Orbital tuberculosis: Two patients(Türk Oftalmoloji Derneği, 2005-11-01) Yazıcı, Bülent; Aygül, Feray; Yılmaz, Emel; Yazıcı, Bülent; Aygül, Feray; YILMAZ, EMEL; Tıp Fakültesi; Göz Hastalıkları Ana Bilim Dalı; 0000-0001-8889-1933; AAA-5384-2020; HTL-9425-2023; JPZ-0738-2023Purpose: To report two patients with orbital tuberculosis.Methods: The records of two patients treated at our institution were reviewed.Results: Both patients were male; their ages were 18 and 29 years. The presenting symptoms were proptosis in one patient and swelling in the eyelid and brow regions in the other. The radiological investigation showed a mass lesion, located in the intraconal region in the first patient and located in the orbita-frontal region in the other. We performed surgical excision and biopsy in both patients. The diagnosis was made through the histopathological examination, demonstrating granulomatosis inflammation associated with caseificatin necrosis; the results of the bacteriological examination was negative. No other focus of tuberculosis was determined. The patients received a multi-drug anti-tuberculosis treatment for 11 and 8 months. No recurrence or systemic involvement developed in the patients who were followed-up 39 and 22 months after treatment.Discussion: Tuberculosis should be considered in the differential diagnosis of the space occupying lesions of the orbit.Publication The diagnostic utility of the "Thwaites' system" and "lancet consensus scoring system" in tuberculous vs. non-tuberculous subacute and chronic meningitis: multicenter analysis of 395 adult patients(Bmc, 2020-10-23) Sulaiman, Tarek; Medi, Sai; Erdem, Hakan; Şenbayrak, Seniha; Öztürk-Engin, Derya; İnan, Asuman; Civljak, Rok; Nechifor, Mihai; Akbulut, Ayhan; Crisan, Alexandru; Özgüler, Müge; Namiduru, Mustafa; Savic, Branislava; Dulovic, Olga; Pehlivanoğlu, Filiz; Şengöz, Gönül; Yaşar, Kadriye; İnal, Ayşe Seza; Parlak, Emine; Johansen, Işık Somuncu; Kurşun, Ebru; Parlak, Mehmet; Yılmaz, Emel; Yılmaz, Gülden; Gül, Hanefi Cem; Öncül, Oral; Simeon, Soline; Tattevin, Pierre; Ulu-Kılıç, Ayşegül; Alabay, Selma; Beovic, Bojana; Catroux, Melanie; Hansmann, Yves; Harxhi, Arjan; Şener, Alper; Özkaya, Hacer Deniz; Cağ, Yasemin; Agalar, Canan; Vahaboğlu, Haluk; Uğur, Berna Kaya; Hasbun, Rodrigo; YILMAZ, EMEL; Tıp Fakültesi; Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı; HJZ-6992-2023Background Tuberculous meningitis (TBM) represents a diagnostic and management challenge to clinicians. The "Thwaites' system" and "Lancet consensus scoring system" are utilized to differentiate TBM from bacterial meningitis but their utility in subacute and chronic meningitis where TBM is an important consideration is unknown. Methods A multicenter retrospective study of adults with subacute and chronic meningitis, defined by symptoms greater than 5 days and less than 30 days for subacute meningitis (SAM) and greater than 30 days for chronic meningitis (CM). The "Thwaites' system" and "Lancet consensus scoring system" scores and the diagnostic accuracy by sensitivity, specificity, and area under the curve of receiver operating curve (AUC-ROC) were calculated. The "Thwaites' system" and "Lancet consensus scoring system" suggest a high probability of TBM with scores <= 4, and with scores of >= 12, respectively. Results A total of 395 patients were identified; 313 (79.2%) had subacute and 82 (20.8%) with chronic meningitis. Patients with chronic meningitis were more likely caused by tuberculosis and had higher rates of HIV infection (P < 0.001). A total of 162 patients with TBM and 233 patients with non-TBM had unknown (140, 60.1%), fungal (41, 17.6%), viral (29, 12.4%), miscellaneous (16, 6.7%), and bacterial (7, 3.0%) etiologies. TMB patients were older and presented with lower Glasgow coma scores, lower CSF glucose and higher CSF protein (P < 0.001). Both criteria were able to distinguish TBM from bacterial meningitis; only the Lancet score was able to differentiate TBM from fungal, viral, and unknown etiologies even though significant overlap occurred between the etiologies (P < .001). Both criteria showed poor diagnostic accuracy to distinguish TBM from non-TBM etiologies (AUC-ROC was <. 5), but Lancet consensus scoring system was fair in diagnosing TBM (AUC-ROC was .738), sensitivity of 50%, and specificity of 89.3%. Conclusion Both criteria can be helpful in distinguishing TBM from bacterial meningitis, but only the Lancet consensus scoring system can help differentiate TBM from meningitis caused by fungal, viral and unknown etiologies even though significant overlap occurs and the overall diagnostic accuracy of both criteria were either poor or fair.Publication Evaluation of the roles of regulatory B (Breg) cells and B cell exhaustion in COVID-19(Wiley, 2021-08-01) Budak, Ferah; Çağan, Eren; Kızmaz, Muhammed Ali; Şimşek, Abdurrahman; Dombaz, Fatma; Tezcan, Gülçin; Asan, Ali; Bal, S. Haldun; Ermiş, Diğdem Yöyen; Demir, H. İbrahim; Ediger, Dane; Yılmaz, Emel; Oral, Haluk Barbaros; Akalın, E. Halis; BUDAK, FERAH; Kızmaz, Muhammed Ali; ŞİMŞEK, ABDURRAHMAN; Dombaz, Fatma; TEZCAN, GÜLÇİN; BAL, SALİH HALDUN; YÖYEN ERMİŞ, DİĞDEM; Demir, H. İbrahim; EDİGER, DANE; YILMAZ, EMEL; ORAL, HALUK BARBAROS; AKALIN, EMİN HALİS; Tıp Fakültesi; Temel Bilimler Bölümü; 0000-0001-7625-9148; 0000-0001-5334-7911; 0000-0001-8850-0269; 0000-0001-7288-3250; 0000-0002-5956-8755; 0000-0002-8856-7356; 0000-0001-7585-7971; 0000-0002-2954-4293; 0000-0003-1785-3539; 0000-0003-0463-6818; 0000-0001-7530-1279; AAG-7381-2021; AAH-3843-2020; K-7285-2012; F-4657-2014; IZP-9398-2023; AAU-8952-2020; HKN-2347-2023; DWR-5356-2022; KBR-5535-2024; GYL-2038-2022; GPN-1473-2022; AAE-9142-2019; GDP-0005-2022Publication Immune reconstitution inflammatory syndrome. A case of postpartum tuberculosis(Aves, 2006-08-01) KAZAK, ESRA; AKALIN, EMİN HALİS; HEPER, YASEMİN; Akalın, Halis; Gürcüoğlu, Emel; Yılmaz, Emel; YILMAZ, EMEL; HAKYEMEZ, BAHATTİN; Hakyemez, Bahattin; Coşkun, Funda; COŞKUN, NECMİYE FUNDA; Coşkun, Funda; Helvac, Safiye; Mistik, Reşit; Tıp Fakültesi; Radyoloji Ana Bilim Dalı; 0000-0001-7530-1279; 0000-0003-3604-8826; AAI-2318-2021; AAD-1271-2019; AAH-6506-2021; AAG-8459-2021; AAU-8952-2020Immunorestitution disease or immune reconstitution inflammatory syndrome was initially described in HIV/AIDS patients under antiretroviral therapy. Although there were a decrease in viral load, control of viral replication and an increase in CD4+ T lymphocyte counts, the appearance of different forms of opportunistic infections and deterioration in their clinical status were observed in these patients. This clinical deterioration is a result of an excessive inflammatory response against previously diagnosed or asymptomatic opportunistic pathogens or undefined antigens. Recently, this syndrome was defined in HIV- negative patients and in other cases such as development of paradoxical response during antituberculosis therapy. In this report we present a case with postpartum tuberculosis from the perspective of immunorestitution diseasePublication Conventional culture and molecular screening methods for detection of vancomycin-resistant enterococci activity(Carbone Editore, 2016-01-01) Karakecili, Faruk; Cilo, Burcu Dalyan; Akın, Hicran; Ağca, Harun; Sınırtaş, Melda; Özakın, Cüneyt; Yılmaz, Emel; Akalın, Halis; Cilo, Burcu Dalyan; Akın, Hicran; AĞCA, HARUN; Sınırtaş, Melda; ÖZAKIN, CÜNEYT; YILMAZ, EMEL; AKALIN, EMİN HALİS; Tıp Fakültesi; Microbiooji Bölümü; 0000-0002-7368-7187; 0000-0002-2651-2034; 0000-0002-3894-1231; 0000-0001-7530-1279; IVV-5845-2023; AAH-4027-2021; AAU-8952-2020; AAG-8392-2021; ISU-9626-2023Introduction: Early identification of vancomycin-resistant enterococci (VRE) colonization by screening patients is necessary in tends of preventing spread and development of infection. The purpose of this study was to investigate the presence of VRE using and real time polymerase chain reaction (RT-PCR) and to compare the results and costs.Materials and methods: Patients in the risk group attending our hospital and planned for treatment with hospitalization were included. Two rectal swab specimens were taken. One swab specimen was inoculated into enterococci broth for CCSM. Resistant gene investigation was performed with the other specimen by using RT-PCR. The costs of the two methods were then compared.Results: VRE were detected in 75 (6.63%) of the 1130 patients screened using the two methods. Resistance gene was determined in 69 (6.1%) patients using RT-PCR and 32 (2.8%) with CCSM. RT-PCR results were negative in 6 patients with VRE growth determined using CCSM. VRE was detected with CCSM in all 26 patients in whom vanA genotype VRE were determined using RT-PCR, but no growth was determined with CCSM in any of the 43 patients in whom vanB genotype VRE were detected. Results obtained in 3 days using CCSM and within 4 hours using RT-PCR. Costs were 58 $ with CCSM and 46 $ with RT-PCR.Conclusion: VRE colonization being detected faster with RT-PCR than CCSM. When the costs in isolation of patients until VRE screening test results emerged were compared, VRE screening with RT-PCR was cost-effective. RT-PCR was markedly superior to CCSM in determining VanB type resistance. Due to the late results from CCSM and its failure to detect VanB type resistance, we think that RT-PCR can be an alternative to CCSM or that the two techniques can usefully be combined depending on the hospital conditions.Publication Insight into pain syndromes in acute phase of mild-to-moderate covid-19: Frequency, clinical characteristics, and associated factors(Wiley, 2021-10-26) Karli, Necdet; KARLI, HAMDİ NECDET; Gullu, Gizem; GÜLLÜ, GİZEM; Kilic, Erhan; KILIÇ, ERHAN; Dinc, Yasemin; DİNÇ, YASEMİN; Ursavas, Ahmet; URSAVAŞ, AHMET; Yilmaz, Emel; YILMAZ, EMEL; Zarifoglu, Mehmet; ZARİFOĞLU, MEHMET; Tıp Fakültesi; 0000-0002-3894-1231; IUQ-6999-2023; AAI-3169-2021; IZQ-0662-2023; AAD-1271-2019Background Pain has been frequently described as a clinical feature of COVID-19, and the main pain syndromes that have been associated with the acute phase of this disease so far are headache, myalgia, arthralgia, and neuropathic pain. Understanding the characteristics of pain symptoms is crucial for a better clinical approach. Methods Patients who were diagnosed as having COVID-19 using reverse transcription-polymerase chain reaction were included in the study. Patients were asked to complete a 51-item questionnaire via a phone interview, which included questions on demographics, acute COVID-19 symptoms, the presence of pain symptoms, and their characteristics in the acute phase of COVID-19. Results A total of 222 out of 266 patients with COVID-19 participated in the study, yielding a response rate of 83.5%. A total of 159 patients reported at least one kind of pain syndrome with a prevalence of 71.6%. Myalgia was reported in 110 (49.6%) patients, headache in 109 (49.1%), neuropathic pain symptoms in 55 (24.8%), and polyarthralgia in 30 (13.5%) patients. A total of 66 patients reported only one type of pain, 46 reported two types, 42 reported three types, and five patients reported all four types of pain. Logistic regression analysis showed that there were significant associations between these pain syndromes and a strong association was found between neuropathic pain and headache. Conclusion Pain is a frequently observed symptom of mild-to-moderate COVID-19. There are significant relationships between pain syndromes in COVID-19, which may be due to a sequence of common etiologic factors. Significance This study described the main pain syndromes associated acute phase of mild-to-moderate COVID-19 and its associated features. Headaches and pain of neuropathic characteristics were prevalent in this sample.Publication Tocilizumab treatment in covid-19: A prognostic study using propensity score matching(Wroclaw Medical Univ, 2022-08-11) Güçlü, Özge Aydın; Önal, Uğur; Akalın, Halis; Öztürk, Nilüfer Aylin Acet; Belik, Hazel Öztürk; Demirdoğen, Ezgi; Dilektaşlı, Aslı Görek; Kazak, Esra; Ocakoğlu, Gökhan; Sağlık, İmran; Coşkun, Funda; Ediger, Dane; Heper, Yasemin; Ursavaş, Ahmet; Yılmaz, Emel; Uzaslan, Esra; Karadağ, Mehmet; AYDIN GÜÇLÜ, ÖZGE; ÖNAL, UĞUR; AKALIN, EMİN HALİS; ACET ÖZTÜRK, NİLÜFER AYLİN; ÖZTÜRK BELİK, HAZEL; DEMİRDÖĞEN, EZGİ; GÖREK DİLEKTAŞLI, ASLI; KAZAK, ESRA; OCAKOĞLU, GÖKHAN; SAĞLIK, İMRAN; COŞKUN, NECMİYE FUNDA; EDİGER, DANE; HEPER, YASEMİN; URSAVAŞ, AHMET; YILMAZ, EMEL; UZASLAN, AYŞE ESRA; KARADAĞ, MEHMET; Tıp Fakültesi; 0000-0003-1005-3205; 0000-0001-6194-3254; 0000-0001-7530-1279; 0000-0002-6375-1472; 0000-0002-7400-9089; 0000-0001-7099-9647; 0000-0002-1114-6051; 0000-0003-0864-4989; 0000-0003-3604-8826; 0000-0002-2954-4293; 0000-0003-1785-3539; 0000-0002-9027-1132; AAG-8744-2021; AAD-1271-2019; JCO-3678-2023; AAH-5180-2021; JPK-7012-2023; ACQ-7832-2022; AAU-8952-2020; AAI-3169-2021; AAG-9930-2019; Z-1424-2019; GQC-6764-2022; DTT-7416-2022Background. The potential role of interleukin-6 (IL-6) in coronavirus disease 2019 (COVID-19) pneumonia provides the rationale for investigating IL-6 signaling inhibitors.Objectives. To evaluate and report treatment responses to tocilizumab (TCZ) in COVID-19 patients and compare mortality outcomes with those of standard care.Materials and methods. Patients hospitalized with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, diagnosed with reverse transcription polymerase chain reaction (RT-PCR) between March 2020 and April 2021, were enrolled in this single-center retrospective cohort study. Propensity score matching was performed in order to reduce confounding effects secondary to imbalances in receiving TCZ treatment.Results. A total of 364 patients were included in this study. Two hundred thirty-six patients received standard care, while 128 patients were treated with TCZ in addition to standard care (26 (20.3%) patients received a dose of 400 mg intravenously once, while 102 (79.7%) patients received a total dose of 800 mg intravenously). In the propensity score-matched population, less noninvasive mechanical ventilation (p = 0.041) and mechanical ventilation support (p = 0.015), and fewer deaths (p = 0.008) were observed among the TCZ-treated patients. The multivariate adjusted Cox regression model showed a significantly higher survival rate among TCZ patients compared to controls (hazard ratio (HR): 0.157, 95% confidence interval (95% CI): 0.026-0.951; p = 0.044). The hazard ratio for mortality in the TCZ group was 0.098 (95% CI: 0.030-0.318; p = 0.0001 using log-rank test).Conclusions. This study determined that TCZ treatment in COVID-19 patients was associated with better survival, reduced need for mechanical ventilation and reduced hospital-associated mortality.Publication An outbreak of Ralstonia insidiosa bloodstream infections caused by contaminated heparinized syringes(Elsevier, 2022-08-05) Tüzemen, Nazmiye Ulkü; Önal, Uğur; Kazak, Esra; Tezgeç, Nergiz; Eren, Hale; Şimşek, Hüsniye; Bakkaloğlu, Zekiye; Ünaldı, Özlem; Çelebi, Solmaz; Yılmaz, Emel; Hacımustafaoğlu, Mustafa; Akalın, Emin Halis; Özakın, Cüneyt; TÜZEMEN, NAZMİYE ÜLKÜ; ÖNAL, UĞUR; KAZAK, ESRA; Tezgeç, Nergiz; Eren, Hale; ÇELEBİ, SOLMAZ; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; YILMAZ, EMEL; AKALIN, EMİN HALİS; ÖZAKIN, CÜNEYT; Tıp Fakültesi; Tıbbi Mikrobiyoloji Ana Bilim Dalı; 0000-0001-6953-8499 ; A-4290-2018; ACQ-7832-2022; AAG-8459-2021; GQV-3906-2022; GQT-6881-2022; ENK-4130-2022; HJZ-6992-2023; CTG-5805-2022; AAU-8952-2020; DXX-3499-2022Introduction: Ralstonia insidiosa , a gram-negative waterborne bacteria able to survive and grow in any type of water source, can cause nosocomial infections, and are considered emerging pathogens of infectious diseases in hospital settings. In this study, we report an outbreak of R. insidiosa at our center related to contaminated heparinized syringes.Material and methods: The present study was conducted in a tertiary care university hospital in Turkey. An outbreak analysis was performed between September 2021 and December 2021. Microbiological samples were obtained from environmental sources and from patient blood cultures. Species identification was performed using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). To inves-tigate the clonality of strains, all confirmed isolates were sent to the National Reference Laboratory and pulsed -field gel electrophoresis (PFGE) was used to perform molecular typing.Results: Seventeen R. insidiosa isolates were identified from the blood cultures of 13 patients from various wards and intensive care units. Isolates from seven patient blood cultures and two heparinized blood gas syringes were characterized by PFGE. All isolates were found to belong to the same clone of R. insidiosa.Conclusion: R. insidiosa was identified as the cause of a nosocomial infection outbreak in our hospital, which was then rapidly controlled by the infection-control team. When rare waterborne microorganisms grow in blood or other body fluid cultures, clinicians and the infection-control team should be made aware of a possible outbreak.Publication Prognostic factors for COVID-19 patients(J Infection Developing Countries, 2022-03-01) Önal, Uğur; Güçlü, Özge Aydın; Akalın, Halis; Öztürk, Nilüfer Aylin Acet; Semet, Cihan; Demirdoğen, Ezgi; Dilektaşlı, Aslı Görek; Sağlık, İmran; Kazak, Esra; Özkaya, Güven; Coşkun, Funda; Ediger, Dane; Heper, Yasemin; Ursavaş, Ahmet; Yılmaz, Emel; Uzaslan, Esra; Karadağ, Mehmet; ÖNAL, UĞUR; AYDIN GÜÇLÜ, ÖZGE; AKALIN, EMİN HALİS; ACET ÖZTÜRK, NİLÜFER AYLİN; SEMET, CİHAN; DEMİRDÖĞEN, EZGİ; GÖREK DİLEKTAŞLI, ASLI; SAĞLIK, İMRAN; KAZAK, ESRA; ÖZKAYA, GÜVEN; COŞKUN, NECMİYE FUNDA; EDİGER, DANE; HEPER, YASEMİN; URSAVAŞ, AHMET; YILMAZ, EMEL; UZASLAN, AYŞE ESRA; KARADAĞ, MEHMET; Tıp Fakültesi; Mikrobiyoloji Ana Bilim Dalı; 0000-0001-6194-3254; 0000-0003-1005-3205; 0000-0001-7530-1279; 0000-0002-6375-1472; 0000-0002-7400-9089; 0000-0001-7099-9647; 0000-0003-0864-4989; 0000-0003-0297-846X; 0000-0003-3604-8826; 0000-0002-2954-4293; 0000-0002-3894-1231; 0000-0002-9027-1132; A-4421-2016; AAG-8459-2021; GCM-3391-2022; DTT-7416-2022; AAH-9812-2021; AEA-4817-2022; Z-1424-2019; AAU-8952-2020; AAG-9930-2019; ACQ-7832-2022; AAD-1271-2019; AAE-9142-2019; CTY-9474-2022; AAI-3169-2021; HJZ-6992-2023; CDI-1977-2022; AAG-8744-2021Introduction: Determining prognostic factors in patients with coronavirus disease (COVID-19) can have great impact on treatment planning and follow-up strategies. Herein, we aimed to evaluate prognostic factors and clinical scores for confirmed COVID-19 patients in a tertiary care hospital in the Bursa region of Turkey. Methodology: Patients who had been diagnosed with COVID-19 microbiologically and/or radiologically between March and October 2020 in a tertiary-care university hospital were enrolled retrospectively. Adult patients (>= 18 years) with a clinical spectrum of moderate, severe, or critical illness were included. The dependent variable was 30-day mortality and logistic regression analysis was used to evaluate any variables with a significant p value (< 0.05) in univariate analysis. Results: A total of 257 patients were included in the study. The mortality rate (30-day) was 14.4%. In logistic regression analysis, higher scores on sequential organ failure assessment (SOFA) (p < 0.001, odds ratio (OR) = 1.86, 95% CI = 1.42-2.45) and CURB-65 pneumonia severity criteria (p = 0.001, OR = 2.60, 95% CI = 1.47-4.57) were found to be significant in predicting mortality at admission. In deceased patients, there were also significant differences between the baseline, day-3, day-7, and day-14 results of D-dimer (p = 0.01), ferritin (p = 0.042), leukocyte (p = 0.019), and neutrophil (p = 0.007) counts. Conclusions: In our study of COVID-19 patients, we found that high SOFA and CURB-65 scores on admission were associated with increased mortality. In addition, D-dimer, ferritin, leukocyte and neutrophil counts significantly increased after admission in patients who died.Publication Association of SARS-CoV-2 cycle threshold (Ct) values with clinical course and serum biomarkers in COVID-19 patients(J Infection Developing Countries, 2022-03-01) Sağlık, İmran; Ener, Beyza; Akalın, Halis; Özdemir, Buşra; Ocakoğlu, Gökhan; Yalçın, Barış; Onal, Uğur; Güçlü, Özge Aydın; Öztürk, Nilüfer Aylin Acet; Tüzemen, Ülku; Demirdoğen, Ezgi; Dilektaşlı, Asli Görek; Ağca, Harun; Kazak, Esra; Coşkun, Funda; Heper, Yasemin; Payaslıoğlu, Melda; Ediger, Dane; Ursavaş, Ahmet; Yılmaz, Emel; Özakin, Cüneyt; Uzaslan, Esra; Karadağ, Mehmet; SAĞLIK, İMRAN; ENER, BEYZA; AKALIN, EMİN HALİS; OCAKOĞLU, GÖKHAN; ÖNAL, UĞUR; AYDIN GÜÇLÜ, ÖZGE; ACET ÖZTÜRK, NİLÜFER AYLİN; TÜZEMEN, NAZMİYE ÜLKÜ; DEMİRDÖĞEN, EZGİ; GÖREK DİLEKTAŞLI, ASLI; AĞCA, HARUN; KAZAK, ESRA; COŞKUN, NECMİYE FUNDA; HEPER, YASEMİN; PAYASLIOĞLU, AYŞE MELDA; EDİGER, DANE; URSAVAŞ, AHMET; YILMAZ, EMEL; ÖZAKIN, CÜNEYT; KARADAĞ, MEHMET; Tıp Fakültesi; Göğüs Hastalıkları Ana Bilim Dalı; 0000-0003-0864-4989; 0000-0001-7530-1279; 0000-0002-1114-6051; 0000-0001-6194-3254; 0000-0003-1005-3205; 0000-0002-6375-1472; 0000-0002-7400-9089; 0000-0001-7099-9647; 0000-0002-2651-2034; 0000-0003-3604-8826; 0000-0002-2954-4293; 0000-0002-3894-1231; 0000-0001-5428-3630; 0000-0002-9027-1132; AAD-1271-2019; ISU-9626-2023; ACQ-7832-2022; JCO-3678-2023; AAI-3169-2021; AAU-8952-2020; AAH-5180-2021; AAG-8744-2021; JPK-7012-2023; A-4970-2019Introduction: Our knowledge has gaps regarding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication levels and its association to severity of Coronavirus disease 2019 (COVID-19). The aim of this study was to investigate the association of SARS-CoV-2 viral load with disease severity and serum biomarkers in COVID-19 patients. Methodology: Viral load was determined via cycle threshold (Ct) values of SARS-CoV-2 real-time reverse transcriptase-polymerase chain reaction (RT-PCR) in 214 adult patients. Ct values were compared with clinical severity, biochemical and hematological biomarkers. Results: Clinical course of the disease was mild (49.1%), moderate (40.2%), and severe (10.7%). Median Ct value was 28.2 (IQR: 22.2-33.8) during the first week of the disease. Ct values were lower within five days after symptom onset [lowest Ct value on the third day (median: 24, IQR: 20.6-32.3)], but they increased significantly during the second and third weeks. No association was detected between admission Ct values and disease severity. Gender, age, co-morbidity, and mortality did not differ significantly in patients with low (<= 25) and high (> 25) Ct values. White blood cell, neutrophil, platelet, and especially lymphocyte counts, were significantly lower in patients with low Ct values. Conclusions: No definitive/clear correlation between SARS-CoV-2 viral load and severity and mortality was found in the studied COVID-19 patients. However, neutrophil, platelet, and especially lymphocyte count were significantly lower in patients with a high viral load.