Minerva Respiratory Medicine最新文献

英文中文

Clinical aspect of AATD AATD的临床特点

IF 2.4 Q4 RESPIRATORY SYSTEM

Minerva Respiratory Medicine

Pub Date : 2023-02-01 DOI: 10.23736/s2784-8477.22.02046-0

R. Stockley

引用次数: 0

Isolated post exertion desaturation: is it an early feature of severe COVID-19 pneumonia? 孤立性运动后失饱和:是重症COVID-19肺炎的早期特征吗?

IF 2.4 Q4 RESPIRATORY SYSTEM

Minerva Respiratory Medicine

Pub Date : 2023-02-01 DOI: 10.23736/s2784-8477.22.02015-0

M. Ekanayake, A. Wijewickrama, A. Kiritharan, B. Galabada, Sanjeewa Munasinghe, B. Samarasekera, K. Jayasekera, Gayan Ranasinghe, S. Jayasinghe

引用次数: 0

A new logistic regression derived combined index for early prediction of in-hospital mortality in COVID-19 patients 基于logistic回归的新型COVID-19住院死亡率早期预测联合指标

IF 2.4 Q4 RESPIRATORY SYSTEM

Minerva Respiratory Medicine

Pub Date : 2023-02-01 DOI: 10.23736/s2784-8477.22.02007-1

Stefania Bassu, Elena Masotto, Chiara Sanna, Verdiana Muscas, Dario Argiolas, C. Carru, P. Pirina, A. Mangoni, P. Paliogiannis, A. Fois, A. Zinellu

BACKGROUND: While the type and the number of treatments for Coronavirus Disease 2019 (COVID-19) have substantially evolved since the start of the pandemic a significant number of hospitalized patients continue to succumb. This requires ongoing research in the development and improvement of early risk stratification tools. METHOD(S): We developed a prognostic score using epidemiological, clinical, laboratory, and treatment variables collected on admission in 130 adult COVID-19 patients followed until in-hospital death (N.=38) or discharge (N.=92). Potential variables were selected via multivariable logistic regression modelling conducted using a logistic regression univariate analysis to create a combined index. RESULT(S): Age, Charlson Comorbidity Index, P/F ratio, prothrombin time, C-reactive protein and troponin were the selected variables. AUROC indicated that the model had an excellent AUC value (0.971, 95% CI 0.926 to 0.993) with 100% sensitivity and 83% specificity for in-hospital mortality. The Hosmer-Lemeshow calibration test yielded non-significant P values (chi2=1.79, P=0.99) indicates good calibration. CONCLUSION(S): This newly developed combined index could be useful to predict mortality of hospitalized COVID-19 patients on admission.Copyright © 2022 EDIZIONI MINERVA MEDICA.

背景:自大流行开始以来，尽管2019冠状病毒病(COVID-19)的治疗类型和数量发生了重大变化，但仍有大量住院患者死亡。这需要在开发和改进早期风险分层工具方面进行持续研究。方法:我们利用入院时收集的流行病学、临床、实验室和治疗变量，对130例成年COVID-19患者进行预后评分，直至院内死亡(38例)或出院(92例)。通过多变量logistic回归建模选择潜在变量，采用单变量logistic回归分析创建组合指数。结果(S):年龄、Charlson合并症指数、P/F比、凝血酶原时间、c反应蛋白和肌钙蛋白是选择的变量。AUROC结果表明，该模型对院内死亡率具有良好的AUC值(0.971,95% CI 0.926 ~ 0.993)，敏感性为100%，特异性为83%。Hosmer-Lemeshow校准检验P值不显著(ch2 =1.79, P=0.99)，表明校准良好。结论:该综合指标可用于预测COVID-19住院患者入院时的死亡率。版权所有©2022 EDIZIONI MINERVA MEDICA。

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引用次数: 0

Acute respiratory failure due to cutis laxa pulmonary emphysema treated with high-flow nasal cannula 高流量鼻插管治疗皮肤松弛性肺气肿急性呼吸衰竭

IF 2.4 Q4 RESPIRATORY SYSTEM

Minerva Respiratory Medicine

Pub Date : 2023-02-01 DOI: 10.23736/s2784-8477.22.01997-0

Tommaso Perazzo, A. Perazzo, Gianluca Ferraioli, Teresa Díaz de Terán, Monica V Gonzales, P. Banfi, A. Nicolini

引用次数: 0

Advances in molecular diagnostic tests for community-acquired pneumonia 社区获得性肺炎分子诊断试验研究进展

IF 2.4 Q4 RESPIRATORY SYSTEM

Minerva Respiratory Medicine

Pub Date : 2023-02-01 DOI: 10.23736/s2784-8477.22.02044-7

C. Cillóniz, Yuliya Poliakova, J. Hurtado

The use of a timely and appropriate antibiotic therapy, which requires early and accurate microorganisms' detection in pneumonia. Currently, the identification of microorganisms in pneumonia is limited by the low sensitivity and long response time of standard culture-based diagnostic tools. For this reason, treatment in pneumonia is empirical. An inadequate empirical treatment is related to poor outcomes in patients with pneumonia. The microbiological diagnosis is key to improve the outcomes in patient with pneumonia. Over the past years there was a significant advance in the molecular diagnosis of infectious diseases including pneumonia. Also the impact of the COVID-19 pandemic has impacted the development and application of these new molecular techniques. This review summarizes the advances in molecular diagnosis of community-acquired pneumonia.Copyright © 2022 EDIZIONI MINERVA MEDICA.

使用及时和适当的抗生素治疗，这需要在肺炎中早期和准确地发现微生物。目前，肺炎微生物的鉴定受到基于培养的标准诊断工具的低灵敏度和长响应时间的限制。因此，肺炎的治疗是经验性的。不充分的经验性治疗与肺炎患者预后不良有关。微生物学诊断是改善肺炎患者预后的关键。在过去几年中，包括肺炎在内的传染病的分子诊断取得了重大进展。此外，COVID-19大流行的影响也影响了这些新分子技术的开发和应用。本文就社区获得性肺炎分子诊断的研究进展作一综述。版权所有©2022 EDIZIONI MINERVA MEDICA。

引用次数: 0

Pulmonary function and functional capacity at 3, 6 and 12 months in COVID-19 patients and effect of physical activity on recovery COVID-19患者3、6和12个月的肺功能和功能能力以及体育活动对康复的影响

IF 2.4 Q4 RESPIRATORY SYSTEM

Minerva Respiratory Medicine

Pub Date : 2023-02-01 DOI: 10.23736/s2784-8477.22.02001-0

F. Anastasio, G. Pucci, E. Scarnecchia, Alessandro Gonella, Sarah Barbuto, Manuel Caccone, G. Rossi, P. Parravicini

BACKGROUND: Long-term sequelae due to Coronavirus disease 2019 (COVID-19) are now under investigation. Aim of this study was to evaluate the one-year clinical impact of COVID-19 on respiratory function and relation with physical activity. METHOD(S): One hundred four patients were evaluated 3, 6 and 12 months after SARS-CoV-2 diagnosis. Clinical conditions, symptomatology, 6-minute walking test (6MWT), pulmonary function test with spirometry and diffusing capacity of carbon monoxide (DLCO) were analyzed. RESULT(S): Eighty-six (82.7%) patients referred at least one symptom at 3 months, 46 (44.2%) at 6 months and 24 (23.1%) at 12 months. At the 3-months visit, patients with moderate COVID showed a slight decrease of distance at the 6MWT, with an improvement at 12 months (P=0.04). Patients with severe COVID-19 showed a recovery of SpO2 at rest (P<0.001), DLCO (P=0.001), DLCO/VA (P=0.002), forced vital capacity (P=0.01) and 6MWT distance (P=0.002) at 6 and 12 months. Patients with critical COVID-19 showed a remarkable reduction of DLCO at 3 months (65+/-21%). Then a subsequent gradual improvement of DLCO was recorded (78+/-18% at 6 months, 85+/-16% at 12 months, P=0.01). Patients with DLCO<80% of predicted at 12 months were older (P=0.02), with higher prevalence of cardio-vascular disease (P=0.006), diabetes (P=0.01) and critical COVID-19 (P=0.003). The improvement of 6MWT distance and DLCO during the three visits did not correlate with physical activity. CONCLUSION(S): Patients with COVID-19 lung involvement showed a progressive improvement in respiratory function and physical performance at 6 and 12 months after acute disease.Copyright © 2022 EDIZIONI MINERVA MEDICA.

背景:2019冠状病毒病(COVID-19)的长期后遗症目前正在调查中。本研究的目的是评估COVID-19对呼吸功能的一年临床影响及其与身体活动的关系。方法:在SARS-CoV-2诊断后3、6和12个月对104例患者进行评估。分析两组患者的临床情况、症状、6分钟步行试验(6MWT)、肺功能试验(肺活量测定)和一氧化碳弥散量(DLCO)。结果:86例(82.7%)患者在3个月时出现至少一种症状，46例(44.2%)患者在6个月时出现，24例(23.1%)患者在12个月时出现至少一种症状。在3个月的随访中，中度COVID患者在6MWT处距离略有下降，在12个月时有所改善(P=0.04)。重症COVID-19患者静息时SpO2 (P<0.001)、DLCO (P=0.001)、DLCO/VA (P=0.002)、用力肺活量(P=0.01)和6MWT距离(P=0.002)在6个月和12个月恢复。重症COVID-19患者在3个月时DLCO显著降低(65% +/-21%)。随后记录DLCO逐渐改善(6个月时78+/-18%，12个月时85+/-16%，P=0.01)。12个月时DLCO<预测值80%的患者年龄较大(P=0.02)，心血管疾病(P=0.006)、糖尿病(P=0.01)和危重型COVID-19 (P=0.003)的患病率较高。在三次访问中，6MWT距离和DLCO的改善与身体活动无关。结论(S): COVID-19肺部受累患者在急性疾病后6个月和12个月的呼吸功能和身体机能渐进式改善。版权所有©2022 EDIZIONI MINERVA MEDICA。

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引用次数: 0

A local outbreak as mirror-like scenario for COVID-19 worldwide progression. Clinical presentation to the Emergency Department during one of the first sub-regional outbreak in Italy. A lesson to learn 作为COVID-19全球进展的镜像场景的局部爆发。在意大利第一次分区域暴发期间向急诊科的临床表现。值得学习的一课

IF 2.4 Q4 RESPIRATORY SYSTEM

Minerva Respiratory Medicine

Pub Date : 2023-02-01 DOI: 10.23736/s2784-8477.22.02003-4

C. Pratico’, I. Ricci Iamino, P. Viale, F. Fogacci, A. L. Tinuper, F. Verardi, S. Tedeschi, C. Morselli, V. Palmonari, Simone Cavini, A. Tampieri, R. Ferrari

BACKGROUND: One of the most precocious Italian COVID-19 outbreaks began in February 2020 in Medicina, a small town in the province of Bologna. We compared the characteristics of different cohorts, to identify potential predictive factors for outcome: patients of Medicina outbreak versus those of the surrounding district (Imola), and before or after the local medical intervention. METHOD(S): Between March the 3rd and April the 9th, 2020 167 adults with COVID-19 were admitted to the Emergency Department (ED) (78 from Medicina cluster, 89 from Imola district). Data at ED presentation were collected;hospitalized patients were followed until death or discharge. RESULT(S): Medicina and Imola cohorts were similar in age, main comorbidities, clinical presentation, laboratory tests, arterial blood gas analysis (ABG), death and acute respiratory distress syndrome (ARDS) rates. Age, hypertension, diabetes, chronic obstructive pulmonary disease, dyspnea, body temperature, quickSOFA Score, elevated C-reactive protein (CRP), creatinine, urea, DELTA A-a O2, respiratory rate and FiO2 were associated with death and ARDS. Elevated Glasgow Coma Scale, diastolic blood pressure, oxygen peripheral saturation, P/F and pH were associated with patient survival and protective from ARDS. After the intervention in Medicina district, patients presenting at ED were younger and with long-lasting symptoms;CRP values were significantly lower, ABG and respiratory clinical parameters were less severely impaired. These differences did not affect the outcome. CONCLUSION(S): Since the results of our study are consistent with worldwide evidences, we suggest that the early insight of a small local SARS-CoV-2 outbreak can be representative and predictive of the subsequent course of the virus in wider areas. This must be kept in mind to manage next epidemic waves.Copyright © 2022 EDIZIONI MINERVA MEDICA.

背景:意大利最早熟的COVID-19疫情之一于2020年2月在博洛尼亚省的一个小镇梅迪奇纳爆发。我们比较了不同队列的特征，以确定结果的潜在预测因素:梅迪奇纳暴发患者与周边地区(伊莫拉)患者，以及在当地医疗干预之前或之后。方法:在2020年3月3日至4月9日期间，167名成人COVID-19患者被急诊科收治(78名来自梅迪奇纳区，89名来自伊莫拉区)。收集ED出现时的数据，随访住院患者直至死亡或出院。结果(S): Medicina组和Imola组在年龄、主要合并症、临床表现、实验室检查、动脉血气分析(ABG)、死亡和急性呼吸窘迫综合征(ARDS)发生率方面相似。年龄、高血压、糖尿病、慢性阻塞性肺疾病、呼吸困难、体温、quickSOFA评分、c -反应蛋白(CRP)、肌酐、尿素、DELTA -a - O2、呼吸速率和FiO2升高与死亡和ARDS相关。格拉斯哥昏迷评分、舒张压、外周氧饱和度、P/F和pH值升高与患者生存和ARDS保护相关。美第奇纳区干预后，出现ED的患者年龄更轻，症状持续时间更长，CRP值明显降低，ABG和呼吸临床参数受损程度较轻。这些差异并不影响结果。结论(S):由于我们的研究结果与世界范围内的证据一致，我们认为，对当地小规模SARS-CoV-2爆发的早期洞察可以代表和预测该病毒在更广泛地区的后续病程。为了管理下一波流行病，必须牢记这一点。版权所有©2022 EDIZIONI MINERVA MEDICA。

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引用次数: 0

Life-threatening pulmonary laceration following bronchoscopic lung volume reduction 支气管镜下肺体积缩小后危及生命的肺撕裂伤

IF 2.4 Q4 RESPIRATORY SYSTEM

Minerva Respiratory Medicine

Pub Date : 2023-02-01 DOI: 10.23736/s2784-8477.22.02014-9

F. Patrucco, Sara Parini, Matteo Daverio, Maddalena Sarcoli, R. Molinari, G. Vallese, O. Rena, P. Balbo

引用次数: 0

COVID-19, immunosuppression and alcohol consumption COVID-19、免疫抑制和饮酒

IF 2.4 Q4 RESPIRATORY SYSTEM

Minerva Respiratory Medicine

Pub Date : 2022-12-01 DOI: 10.23736/s2784-8477.22.02006-x

G. Testino, R. Pellicano

引用次数: 0

Comparison of clinical characteristics of second and third peaks of COVID-19 pandemic: effects of vaccination and preventive measures 2019冠状病毒病大流行第二、第三高峰临床特征比较:疫苗接种效果及预防措施

IF 2.4 Q4 RESPIRATORY SYSTEM

Minerva Respiratory Medicine

Pub Date : 2022-12-01 DOI: 10.23736/s2784-8477.22.02002-2

Özer Özdemir, Atakan Arslan, H. M. Bülbül, P. Özdemir

BACKGROUND: Understanding the differences in consequent peaks of covid-19 may guide us for better predicting future disease characteristics. in this study, we aimed to compare clinical and radiological characteristics as well as outcomes of hospitalized patients with the diagnosis of covid-19 in second and third peaks of disease. METHOD(S): We retrospectively included 303 hospitalized patients with covid-19. the study population was examined in two groups: patients hospitalized between october 2020 and January 2021 during second peak and patients hospitalized between March and June 2021 during third peak. RESULT(S): there were 171 patients in group 1 and 132 patients in group 2. the patients in group 2 were younger (64+/-13.27 vs. 56.02+/-15.39, respectively;P<0.001) and female proportion was higher (64.9% and 48.5% males;P=0.005). Smoking history and presence of comorbidities were less in group 2 (41.5% vs. 25.7%, P=0.008;and 78.5% vs. 59.1%, P<0.001) and symptom duration was shorter (median 7 days vs. 6 days, P=0.039). CT severity scores, LDH, CRP, D-dimer, Ferritin, and creatinine levels were lower in group 2 (P=0.003, P=0.008, P<0.001, P<0.001, P<0.001, respectively), and mortality ratio was lower (N.=39 [28%] vs. N.=15 [11.4%], P=0.01). Duration of hospital stay and need for intensive unit care were similar across groups (median 8 days vs. 7 days, P=0.673 and N.=39 [22.8%] vs. N.=33 [25.2%], P=0.683). CONCLUSION(S): although duration of hospital stay was lower in third peak, clinical severity scores and prognostic markers were lower compared with second peak. These may reflect the increased proportion of immunized people, and the effect of preventive measures. Copyright © 2022 EDIZIONI MINERVA MEDICA.

背景:了解covid-19随后高峰的差异可能指导我们更好地预测未来的疾病特征。在本研究中，我们旨在比较在疾病第二和第三高峰诊断为COVID-19的住院患者的临床和影像学特征以及结局。方法:我们回顾性纳入了303例covid-19住院患者。研究人群分为两组:2020年10月至2021年1月期间的第二高峰住院患者和2021年3月至6月期间的第三高峰住院患者。结果:1组171例，2组132例。2组患者年龄较轻(分别为64+/-13.27 vs. 56.02+/-15.39, P<0.001)，女性比例较高(男性64.9% vs. 48.5%， P=0.005)。2组吸烟史和合并症发生率较低(41.5%比25.7%，P=0.008; 78.5%比59.1%，P<0.001)，症状持续时间较短(中位7天比6天，P=0.039)。2组CT严重程度评分、LDH、CRP、d -二聚体、铁蛋白、肌酐水平均低于对照组(P=0.003、P=0.008、P<0.001、P<0.001、P<0.001)，死亡率低于对照组(n =39[28%]比n =15 [11.4%]， P=0.01)。住院时间和重症监护需求在两组间相似(中位8天vs. 7天，P=0.673, n =39 [22.8%] vs. n =33 [25.2%]， P=0.683)。结论(S):虽然第三高峰住院时间较短，但临床严重程度评分和预后指标较第二高峰低。这可能反映了免疫人群比例的增加，以及预防措施的效果。版权所有©2022 EDIZIONI MINERVA MEDICA。

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