scholarly journals Chronic respiratory diseases are predictors of severe outcome in COVID-19 hospitalised patients: a nationwide study

2021 ◽  
pp. 2004474
Author(s):  
Guillaume Beltramo ◽  
Jonathan Cottenet ◽  
Anne-Sophie Mariet ◽  
Marjolaine Georges ◽  
Lionel Piroth ◽  
...  
Keyword(s):  
Intensive Care ◽  
Mortality Rate ◽  
Respiratory Diseases ◽  
Respiratory Illness ◽  
Pulmonary Complications ◽  
Chronic Obstructive ◽  
Suitable Model ◽  
Chronic Respiratory Diseases ◽  
Influenza Outbreak ◽  
Hospitalised Patients

BackgroundInfluenza epidemics were initially considered to be a suitable model for the COVID-19 epidemic, but there is a lack of data concerning patients with chronic respiratory diseases (CRD), who were supposed to be at risk of severe forms of COVID-19.MethodsThis nationwide retrospective cohort study describes patients with prior lung disease hospitalised for COVID-19 (March-April 2020) or influenza (2018–2019 influenza outbreak). We compare the resulting pulmonary complications, need for intensive care and in-hospital mortality depending on respiratory history and virus.ResultsIn the 89 530 COVID-19 cases, 16.03% had at least one CRD, which was significantly less frequently than in the 45 819 seasonal influenza patients. Patients suffering from chronic respiratory failure, chronic obstructive pulmonary disease, asthma, cystic fibrosis and pulmonary hypertension were underrepresented, contrary to those with lung cancer, sleep apnea, emphysema, and interstitial pulmonary diseases (ILD). COVID-19 patients with CRD developed significantly more ventilator-associated pneumonia and pulmonary embolism than influenza patients. They needed intensive care significantly more often and had a higher mortality rate (except for asthma) when compared to patients with COVID-19 but without CRD, or patients with influenza.ConclusionPatients with prior respiratory diseases were globally less likely to be hospitalised for COVID-19 than for influenza but were at higher risk of developing severe COVID-19 and had a higher mortality rate compared to influenza patients and patients without a history of respiratory illness.Our data suggest that these patients should have priority access to SARS-CoV2 vaccination.

scholarly journals The COVID-19 pandemic

2020 ◽  
Vol 68 (1) ◽  
pp. 7-8
Author(s):  
José Ricardo Navarrro-Vargas
Keyword(s):  
Infectious Disease ◽  
Intensive Care ◽  
Mortality Rate ◽  
Older People ◽  
Health Systems ◽  
Hospital Care ◽  
Respiratory Diseases ◽  
Respiratory Illness ◽  
Chronic Respiratory Diseases ◽  
Underlying Diseases

I open this note with some alarming figures: as of May 26, 2020, over 5 635 000 people have become infected and nearly 350 000 have died from the new coronavirus (COVID-19) worldwide.1 Meanwhile, in Colombia, there are already 21 981 people infected and 750 deaths from this disease, that is, a 3.4% mortality rate.2COVID-19 is an infectious disease caused by a new coronavirus strain. Most people infected with COVID-19 will develop a mild to moderate respiratory illness and recover without the need for hospital care. However, the disease can significantly affect older people and those with underlying diseases such as diabetes, chronic respiratory diseases, cancer, obesity, and cardiovasculardisease,3 and it could even lead to death, which undoubtedly places a burden on health systems, particularly on intensive care units (ICUs).

CRISPR/Cas9 Genome Editing Tool: A Promising Tool for Therapeutic Applications on Respiratory Diseases

2020 ◽  
Vol 20 (5) ◽  
pp. 333-346
Author(s):  
Sadiya Bi Shaikh ◽  
Yashodhar Prabhakar Bhandary
Keyword(s):  
Respiratory Diseases ◽  
Gene Editing ◽  
Epithelial Mesenchymal Transition ◽  
Respiratory Health ◽  
Chronic Obstructive ◽  
Therapeutic Tool ◽  
Obstructive Pulmonary Disease ◽  
Mesenchymal Transition ◽  
Chronic Respiratory Diseases ◽  
Promising Tool

Respiratory diseases are one of the prime topics of concern in the current era due to improper diagnostics tools. Gene-editing therapy, like Clustered regularly interspaced palindromic repeats- associated nuclease 9 (CRISPR/Cas9), is gaining popularity in pulmonary research, opening up doors to invaluable insights on underlying mechanisms. CRISPR/Cas9 can be considered as a potential gene-editing tool with a scientific community that is helping in the advancement of knowledge in respiratory health and therapy. As an appealing therapeutic tool, we hereby explore the advanced research on the application of CRISPR/Cas9 tools in chronic respiratory diseases such as lung cancer, Acute respiratory distress syndrome (ARDS) and cystic fibrosis (CF). We also address the urgent need to establish this gene-editing tool in various other lung diseases such as asthma, Chronic obstructive pulmonary disease (COPD) and Idiopathic pulmonary fibrosis (IPF). The present review introduces CRISPR/Cas9 as a worthy application in targeting epithelial-mesenchymal transition and fibrinolytic system via editing specific genes. Thereby, based on the efficiency of CRISPR/Cas9, it can be considered as a promising therapeutic tool in respiratory health research.

Interleukin-17A: A Potential Therapeutic Target in Chronic Lung Diseases

2019 ◽  
Vol 19 (7) ◽  
pp. 921-928 ◽  
Author(s):  
Sadiya Bi Shaikh ◽  
Ashwini Prabhu ◽  
Yashodhar Prabhakar Bhandary
Keyword(s):  
Respiratory Diseases ◽  
Inflammatory Cytokine ◽  
Inflammatory Responses ◽  
Chronic Obstructive ◽  
Interleukin 17 ◽  
Potential Therapeutic Target ◽  
Chronic Respiratory Diseases ◽  
Chronic Lung Diseases ◽  
Interleukin 17A ◽  
Insight Into

Background: Interleukin-17A (IL-17A) is a pro-inflammatory cytokine that has gained a lot of attention because of its involvement in respiratory diseases. Interleukin-17 cytokine family includes six members, out of which, IL-17A participates towards the immune responses in allergy and inflammation. It also modulates the progression of respiratory disorders. Objective: The present review is an insight into the involvement and contributions of the proinflammatory cytokine IL-17A in chronic respiratory diseases like Idiopathic Pulmonary Fibrosis (IPF), Chronic Obstructive Pulmonary Distress (COPD), asthma, pneumonia, obliterative bronchiolitis, lung cancer and many others. Conclusion: IL-17A is a major regulator of inflammatory responses. In all the mentioned diseases, IL- 17A plays a prime role in inducing the diseases, whereas the lack of this pro-inflammatory cytokine reduces the severity of respective respiratory diseases. Thereby, this review suggests IL-17A as an instrumental target in chronic respiratory diseases.

scholarly journals Hospitalisation for COPD in Puglia: the role of hospital discharge database to estimate prevalence and incidence

2016 ◽  
Vol 70 (3) ◽  
Author(s):  
P. Trerotoli ◽  
N. Bartolomeo ◽  
A.M. Moretti
Keyword(s):  
Disease Management ◽  
Hospital Discharge ◽  
Respiratory Diseases ◽  
Hospital Admissions ◽  
Diagnostic Procedures ◽  
Chronic Respiratory Disease ◽  
Chronic Obstructive ◽  
Chronic Respiratory Diseases ◽  
Hospital Discharge Database ◽  
Discharge Database

Background and aim. Chronic Obstructive Pulmonary Disease (COPD), although largely preventable, is a great health burden in all the countries worldwide. Statistics of morbidity and mortality of COPD show the need for correct management of the disease. Chronic Obstructive Respiratory Diseases (DRG 88) are in 9th place for discharge in in-patient hospital admission. It is necessary to establish specific indicators which are efficacious and relevant for the patient, the doctor and the health manager. This study will analyse the information in respect of hospital admissions (Hospital discharge database) in Puglia for the period 2000-2005. Methods. The analysis was carried out utilising the Puglia Region hospital patient discharge database, selecting those patients with admission for chronic respiratory disease as principal or secondary diagnosis. Results. Chronic respiratory diseases are more frequent in males and in people over 45 years old with frequency increasing with age. Geographical distribution shows that there are greater rates of hospitalisation in big cities and in the neighbourhood of industrial areas. Although the trend over time is slight. A higher percentage of re-admission has been found for patients with COPD, and the interval between the two admissions occurs within one or two months; the diagnosis at the second admission is the same as for the first. 10.6% of discharge forms report one diagnosis, especially in patients older than 65 years of age. Little could be said about diagnostic procedures because these are not reported on the discharge form. Conclusion. Hospitalisation data confirms expectations regarding age and sex of patients. The high hospitalisation rates indicate that in-patients care still remains the only viable treatment for COPD and other chronic respiratory diseases. The high number of exacerbations reflect the absence of out-patients service or community care, and the same diagnosis in more than one episode shows the lack of efficiency of health services and disease management. This data is necessary to understand disease distribution and the modification of disease management in order to reduce health care costs, to increase efficacy in disease control and to limit repeated exacerbation and so to obtain the maximum benefit for the patients.

scholarly journals Chronic respiratory diseases at primary health care level in Georgia: the results of the pilot study

2016 ◽  
Vol 71 (4) ◽  
Author(s):  
I. Chkhaidze ◽  
T. Maglakelidze ◽  
N. Khaltaev
Keyword(s):  
Allergic Rhinitis ◽  
Respiratory Diseases ◽  
Chronic Obstructive ◽  
Official Statistics ◽  
Global Alliance ◽  
Care Level ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Diseases ◽  
Chronic Morbidity ◽  
Official Data

Background and aim. Millions of people suffer from chronic respiratory diseases (CRD). To address this serious global health problem WHO formed the Global Alliance against Chronic Respiratory Diseases (GARD). Chronic obstructive pulmonary disease (COPD) is a major priority of GARD due to high chronic morbidity and mortality; however, there is still little prevalence data available. The prevalence of COPD in Georgia, as well as other CRD, is suspected to be high. Methods. GARD Pilot Survey (GAPS) in Georgia had been carried out by the Georgian Respiratory Association. The survey was conducted in the Sagarejo and Mtskheta districts with total population of about 70.000. All subjects provided information on asthma, bronchitis, respiratory symptoms, smoking, allergic conditions, CRD comorbidity and lifestyle via an interviewer-administered questionnaire. A total of 3,646 questionnaires were analysed. Results. It was discovered that official data concerning allergic rhinitis, TB and asthma are almost equal, but readings in relation to CRD are about five times lower according to official data of the Ministry of Health of Georgia. The data results: for allergic rhinitis - 218 in GAPS vs. 177 in the official statistics (for 100.000 population); for TB -105 in GAPS vs. 147 in the official statistics; for asthma -250 in GAPS vs. 374 in the official statistics; the data about CRD according to our survey is almost five times higher - 365 in GAPS vs. 84 in the official statistics (for 100.000 population). Conclusions. It is necessary to expand the survey to the entire country population. Country results are likely to be useful and interesting for local doctors and managers, as well as for officials.

scholarly journals The ABCs of Rhinoviruses, Wheezing, and Asthma

2010 ◽  
Vol 84 (15) ◽  
pp. 7418-7426 ◽  
Author(s):  
James E. Gern
Keyword(s):  
Respiratory Diseases ◽  
Chronic Obstructive Lung Disease ◽  
Allergic Diseases ◽  
Chronic Respiratory Disease ◽  
Chronic Obstructive ◽  
Respiratory Illnesses ◽  
Chronic Respiratory Diseases ◽  
Acute Exacerbations ◽  
Close Relationship ◽  
Viral Diagnostics

ABSTRACT Human rhinoviruses (HRVs) were discovered as common cold pathogens over 50 years ago. Recent advances in molecular viral diagnostics have led to an appreciation of their role in more-significant respiratory illnesses, including bronchiolitis in infancy, childhood pneumonia, and acute exacerbations of chronic respiratory diseases such as asthma, chronic obstructive lung disease, and cystic fibrosis. Until a few years ago, only two groups of HRVs (A and B) had been recognized. However, full and partial sequencing of HRVs led to the discovery of a third species of HRV (HRV-C) that has distinct structural and biologic features. Risk factors and pathogenic mechanisms for more-severe HRV infections are being defined, and yet fundamental questions persist about mechanisms relating this common pathogen to allergic diseases and asthma. The close relationship between HRV infections and asthma suggests that antiviral treatments could have a major impact on the morbidity associated with this chronic respiratory disease.

Eosinopenie als Biomarker des Schweregrads einer COVID-19-Infektion

2021 ◽  
pp. 1-2
Author(s):  
Panagiota Xanthouli
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Disease Severity ◽  
Respiratory Diseases ◽  
Severe Disease ◽  
Public Hospitals ◽  
Chronic Respiratory Diseases ◽  
Lack Of Information ◽  
Obstructive Sleep ◽  
Increased Risk

<b>Background:</b> Studies on the role of eosinophils in coronavirus disease 2019 (COVID-19) are scarce, though available findings suggest a possible association with disease severity. Our study analyzes the relationship between eosinophils and COVID-19, with a focus on disease severity and patients with underlying chronic respiratory diseases. <b>Methods:</b> We performed a retrospective analysis of 3,018 subjects attended at two public hospitals in Madrid (Spain) with PCR-confirmed SARS-CoV-2 infection from January 31 to April 17, 2020. Patients with eosinophil counts less than 0.02 × 10<sup>9</sup>/L were considered to have eosinopenia. Individuals with chronic respiratory diseases (<i>n</i> = 384) were classified according to their particular underlying condition, i.e., asthma, chronic pulmonary obstructive disease, or obstructive sleep apnea. <b>Results:</b> Of the 3018 patients enrolled, 479 were excluded because of lack of information at the time of admission. Of 2539 subjects assessed, 1,396 patients presented an eosinophil count performed on admission, revealing eosinopenia in 376 cases (26.93%). Eosinopenia on admission was associated with a higher risk of intensive care unit (ICU) or respiratory intensive care unit (RICU) admission (OR:2.21; 95% CI:1.42–3.45; <i>p</i> &#x3c; 0.001) but no increased risk of mortality (<i>p</i> &#x3e; 0.05). <b>Conclusion:</b> Eosinopenia on admission conferred a higher risk of severe disease (requiring ICU/RICU care), but was not associated with increased mortality. In patients with chronic respiratory diseases who develop COVID-19, age seems to be the main risk factor for progression to severe disease or death.

scholarly journals Evidence for pulmonary rehabilitation in chronic respiratory diseases in sub-Saharan Africa: a systematic review

2020 ◽  
Vol 24 (10) ◽  
pp. 991-999
Author(s):  
F. M. Bickton ◽  
C. Fombe ◽  
E. Chisati ◽  
J. Rylance
Keyword(s):  
Pulmonary Rehabilitation ◽  
Respiratory Diseases ◽  
Sub Saharan Africa ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Diseases ◽  
Exercise Regimen ◽  
Home Based ◽  
Sub Saharan ◽  
Randomised Controlled

BACKGROUND: Pulmonary rehabilitation (PR) is a highly effective non-pharmacological treatment for patients with chronic respiratory diseases.OBJECTIVE: To synthesise the evidence for PR practice and efficacy in sub-Saharan Africa.METHODS: We searched in PubMed and Scopus for relevant studies and scanned reference lists of relevant studies from these databases for additional studies. Articles meeting the inclusion criteria were included. Pre-determined data were extracted independently by two reviewers. A narrative synthesis approach was used in the interpretation of findings.RESULTS: Six studies were included, totalling 275 participants. Indications for PR were chronic obstructive pulmonary disease, asthma, pulmonary tuberculosis and post-tuberculosis lung disease. Programmes ran for 6–12 weeks, universally incorporated exercise, and variously used home-based and hospital-based delivery models. All were interventional studies, of which two were randomised controlled trials, and primarily reported pulmonary function and exercise tolerance endpoints. Evidence for individualising the exercise regimen was available in three studies.CONCLUSIONS: There is limited evidence on PR design and efficacy in sub-Saharan Africa, but available data support its use in a variety of chronic respiratory conditions. Future studies should report core outcome sets and their individualised exercise and education regimens.

scholarly journals Trends and risk factors of mortality and disability adjusted life years for chronic respiratory diseases from 1990 to 2017: systematic analysis for the Global Burden of Disease Study 2017

BMJ ◽  
2020 ◽  
pp. m234 ◽  
Author(s):  
Xiaochen Li ◽  
Xiaopei Cao ◽  
Mingzhou Guo ◽  
Min Xie ◽  
Xiansheng Liu
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Burden Of Disease ◽  
Respiratory Diseases ◽  
High Body Mass Index ◽  
Global Burden Of Disease ◽  
Global Burden ◽  
Chronic Respiratory Diseases ◽  
Life Years ◽  
Disease Study

AbstractObjectiveTo describe the temporal and spatial trends of mortality and disability adjusted life years (DALYs) due to chronic respiratory diseases, by age and sex, across the world during 1990-2017 using data from the Global Burden of Disease Study 2017.DesignSystematic analysis.Data sourceThe Global Burden of Diseases, Injuries, and Risk Factors Study 2017.MethodsMortality and DALYs from chronic respiratory diseases were estimated from the Global Burden of Disease Study 2017 using DisMod-MR 2.1, a Bayesian meta-regression tool. The estimated annual percentage change of the age standardised mortality rate was calculated using a generalised linear model with a Gaussian distribution. Mortality and DALYs were stratified according to the Socio-demographic index. The strength and direction of the association between the Socio-demographic index and mortality rate were measured using the Spearman rank order correlation. Risk factors for chronic respiratory diseases were analysed from exposure data.ResultsBetween 1990 and 2017, the total number of deaths due to chronic respiratorydiseases increased by 18.0%, from 3.32 (95% uncertainty interval 3.01 to 3.43) million in 1990 to 3.91 (3.79 to 4.04) million in 2017. The age standardised mortality rate of chronic respiratory diseases decreased by an average of 2.41% (2.28% to 2.55%) annually. During the 27 years, the annual decline in mortality rates of chronic obstructive pulmonary disease (COPD; 2.36%, uncertainty interval 2.21% to 2.50%) and pneumoconiosis (2.56%, 2.44% to 2.68%) has been slow, whereas the mortality rate for interstitial lung disease and pulmonary sarcoidosis (0.97%, 0.92% to 1.03%) has increased. Reductions in DALYs for asthma and pneumoconiosis have been seen, but DALYs due to COPD, and interstitial lung disease and pulmonary sarcoidosis have increased. Mortality and the annual change in mortality rate due to chronic respiratory diseases varied considerably across 195 countries. Assessment of the factors responsible for regional variations in mortality and DALYs and the unequal distribution of improvements during the 27 years showed negative correlations between the Socio-demographic index and the mortality rates of COPD, pneumoconiosis, and asthma. Regions with a low Socio-demographic index had the highest mortality and DALYs. Smoking remained the major risk factor for mortality due to COPD and asthma. Pollution from particulate matter was the major contributor to deaths from COPD in regions with a low Socio-demographic index. Since 2013, a high body mass index has become the principal risk factor for asthma.ConclusionsRegions with a low Socio-demographic index had the greatest burden of disease. The estimated contribution of risk factors (such as smoking, environmental pollution, and a high body mass index) to mortality and DALYs supports the need for urgent efforts to reduce exposure to them.

scholarly journals The microbiome in respiratory medicine: current challenges and future perspectives

2017 ◽  
Vol 49 (4) ◽  
pp. 1602086 ◽  
Author(s):  
Rosa Faner ◽  
Oriol Sibila ◽  
Alvar Agustí ◽  
Eric Bernasconi ◽  
James D. Chalmers ◽  
...  
Keyword(s):  
Respiratory Diseases ◽  
Future Research ◽  
Chronic Obstructive ◽  
Gene Expressions ◽  
Obstructive Pulmonary Disease ◽  
Bacterial Gene ◽  
Chronic Respiratory Diseases ◽  
Culture Techniques ◽  
Negative Results ◽  
Cultivable Bacteria

The healthy lung has previously been considered to be a sterile organ because standard microbiological culture techniques consistently yield negative results. However, culture-independent techniques report that large numbers of microorganisms coexist in the lung. There are many unknown aspects in the field, but available reports show that the lower respiratory tract microbiota: 1) is similar in healthy subjects to the oropharyngeal microbiota and dominated by members of the Firmicutes, Bacteroidetes and Proteobacteria phyla; 2) shows changes in smokers and well-defined differences in chronic respiratory diseases, although the temporal and spatial kinetics of these changes are only partially known; and 3) shows relatively abundant non-cultivable bacteria in chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, cystic fibrosis and bronchiectasis, with specific patterns for each disease. In all of these diseases, a loss of diversity, paralleled by an over-representation of Proteobacteria (dysbiosis), has been related to disease severity and exacerbations. However, it is unknown whether dysbiosis is a cause or a consequence of the damage to bronchoalveolar surfaces.Finally, little is known about bacterial functionality and the interactions between viruses, fungi and bacteria. It is expected that future research in bacterial gene expressions, metagenomics longitudinal analysis and host–microbiome animal models will help to move towards targeted microbiome interventions in respiratory diseases.

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