Pub Date : 2023-07-06DOI: 10.2174/1573398x19666230706121915
Akshata J S, Vijayalakshmi., Anushree Chakraborthy, S. Karanth, S. R, Nagaraja C
Tuberculosis continues to be a major public health disease to date. The mortality of this disease, which was reducing till 2019, was reversed in 2020 and 2021, as per the global tuberculosis report 2022. The novel coronavirus disease 2019(COVID-19) pandemic has affected tuberculosis management in various aspects. The transient immunosuppression associated with the disease and the treatment modality has been speculated to activate latent tuberculosis infection as well as increase the infection risk with Mycobacterium Tuberculosis. The aim of this study was to analyze the clinical characteristics of post-COVID-19 pulmonary tuberculosis patients. We conducted a retrospective descriptive analysis of post-COVID-19 patients admitted from January 2021 to May 2022 with persistent or new-onset respiratory symptoms. The occurrence of pulmonary tuberculosis in these patients and their clinico- demographic details are summarized. About 31(19.4%) of 160 post-COVID-19 patients with respiratory symptoms were diagnosed to have pulmonary tuberculosis. About 21(67.7%) had comorbidities, of which the predominant was diabetes mellitus in 14(45%) patients, and the majority(85%) had poorly controlled blood sugar levels. None of the patients had a history of contact with a pulmonary tuberculosis patient in the previous 2 years, but 4(13%) patients had a previous history of tuberculosis. Moreover,.66% of cases had a history of moderate and severe COVID-19 disease, and 70% had received systemic corticosteroids and other immunosuppressive drugs like tocilizumab during the COVID-19 illness treatment. More than 50% of the patients had negative smears for acid-fast bacilli and were diagnosed using rapid molecular methods like CBNAAT and LPA. Drug-resistant tuberculosis was seen in 6(19%) patients. 4(13%) patients died during the hospitalized course of treatment, and the remaining 27(87%) were discharged with antituberculous treatment, but their final outcome is unknown. A high index of suspicion and use of rapid molecular diagnostic methods is indicated in post-COVID-19 patients with respiratory symptoms for early diagnosis of tuberculosis and prevention of community transmission. Identification of post-COVID-19 patients with latent tuberculosis infection and the feasibility of advocation of tuberculosis preventive therapy in such patients, especially those with other risk factors like diabetes mellitus, need to be considered.
{"title":"“Pulmonary Tuberculosis in Post Covid-19 Patients: Occurrence and Clinical Profile”","authors":"Akshata J S, Vijayalakshmi., Anushree Chakraborthy, S. Karanth, S. R, Nagaraja C","doi":"10.2174/1573398x19666230706121915","DOIUrl":"https://doi.org/10.2174/1573398x19666230706121915","url":null,"abstract":"\u0000\u0000Tuberculosis continues to be a major public health disease to date. The mortality of this disease, which was reducing till 2019, was reversed in 2020 and 2021, as per the global tuberculosis report 2022. The novel coronavirus disease 2019(COVID-19) pandemic has affected tuberculosis management in various aspects. The transient immunosuppression associated with the disease and the treatment modality has been speculated to activate latent tuberculosis infection as well as increase the infection risk with Mycobacterium Tuberculosis.\u0000\u0000\u0000\u0000The aim of this study was to analyze the clinical characteristics of post-COVID-19 pulmonary tuberculosis patients.\u0000\u0000\u0000\u0000We conducted a retrospective descriptive analysis of post-COVID-19 patients admitted from January 2021 to May 2022 with persistent or new-onset respiratory symptoms. The occurrence of pulmonary tuberculosis in these patients and their clinico- demographic details are summarized.\u0000\u0000\u0000\u0000About 31(19.4%) of 160 post-COVID-19 patients with respiratory symptoms were diagnosed to have pulmonary tuberculosis. About 21(67.7%) had comorbidities, of which the predominant was diabetes mellitus in 14(45%) patients, and the majority(85%) had poorly controlled blood sugar levels. None of the patients had a history of contact with a pulmonary tuberculosis patient in the previous 2 years, but 4(13%) patients had a previous history of tuberculosis. Moreover,.66% of cases had a history of moderate and severe COVID-19 disease, and 70% had received systemic corticosteroids and other immunosuppressive drugs like tocilizumab during the COVID-19 illness treatment. More than 50% of the patients had negative smears for acid-fast bacilli and were diagnosed using rapid molecular methods like CBNAAT and LPA. Drug-resistant tuberculosis was seen in 6(19%) patients. 4(13%) patients died during the hospitalized course of treatment, and the remaining 27(87%) were discharged with antituberculous treatment, but their final outcome is unknown.\u0000\u0000\u0000\u0000A high index of suspicion and use of rapid molecular diagnostic methods is indicated in post-COVID-19 patients with respiratory symptoms for early diagnosis of tuberculosis and prevention of community transmission. Identification of post-COVID-19 patients with latent tuberculosis infection and the feasibility of advocation of tuberculosis preventive therapy in such patients, especially those with other risk factors like diabetes mellitus, need to be considered.\u0000","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47935647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-03DOI: 10.2174/1573398x19666230703094330
S. Pezeshki, Najmeh Nameh Goshay Fard, Atena Vaghf, Ekhlas Torfi, S. Shahrabi
The novel SARS-CoV-2 has caused a global pandemic. COVID-19 infection is described by the adverse impact on the population’s health and economy. Coagulopathy is associated with various thrombotic complications and disease severity. Therefore, this review aims to elucidate the pathophysiology of this coagulopathy. Relevant English language literature was searched and retrieved from the Google Scholar search engine and PubMed database. We used “COVID-19”, “SARS-CoV-2”, “Coagulopathy,” “Thrombosis,” “Anticoagulation,” and “ARDS” as keywords. Several studies showed that the primary targets of SARS-CoV-2 are pneumocytes, immune cells, and vascular endothelial cells. Coagulopathy appears to induce more thrombotic complications than hemorrhagic events. The critically ill patients stimulate the coagulopathy state and thrombosis complication through cytokine storm, systemic inflammation, complement cascade, and platelets. Accordingly, thromboembolic complications cause mortality among COVID-19-infected patients and can negatively affect disease management outcomes and treatment. A pivotal clinical feature of acute COVID-19 infection is coagulopathy and prothrombotic events, which are associated with excessive arterial and venous thrombosis, microvascular thrombosis, and adverse clinical outcomes. Therefore, adopting an approach for preventing, treating, and reducing thrombotic and bleeding events in these patients is necessary.
{"title":"Hyper-coagulopathy state in COVID-19: a pivotal challenge","authors":"S. Pezeshki, Najmeh Nameh Goshay Fard, Atena Vaghf, Ekhlas Torfi, S. Shahrabi","doi":"10.2174/1573398x19666230703094330","DOIUrl":"https://doi.org/10.2174/1573398x19666230703094330","url":null,"abstract":"\u0000\u0000The novel SARS-CoV-2 has caused a global pandemic. COVID-19 infection is described by the adverse impact on the population’s health and economy. Coagulopathy is associated with various thrombotic complications and disease severity. Therefore, this review aims to elucidate the pathophysiology of this coagulopathy.\u0000\u0000\u0000\u0000Relevant English language literature was searched and retrieved from the Google Scholar search engine and PubMed database. We used “COVID-19”, “SARS-CoV-2”, “Coagulopathy,” “Thrombosis,” “Anticoagulation,” and “ARDS” as keywords.\u0000\u0000\u0000\u0000Several studies showed that the primary targets of SARS-CoV-2 are pneumocytes, immune cells, and vascular endothelial cells. Coagulopathy appears to induce more thrombotic complications than hemorrhagic events. The critically ill patients stimulate the coagulopathy state and thrombosis complication through cytokine storm, systemic inflammation, complement cascade, and platelets. Accordingly, thromboembolic complications cause mortality among COVID-19-infected patients and can negatively affect disease management outcomes and treatment.\u0000\u0000\u0000\u0000A pivotal clinical feature of acute COVID-19 infection is coagulopathy and prothrombotic events, which are associated with excessive arterial and venous thrombosis, microvascular thrombosis, and adverse clinical outcomes. Therefore, adopting an approach for preventing, treating, and reducing thrombotic and bleeding events in these patients is necessary.\u0000","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46200403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-19DOI: 10.2174/1573398x19666230619100036
Angela Klain, C. Indolfi, G. Dinardo, M. Contieri, F. Decimo, M. Miraglia Del Giudice
Long COVID affects 8 to 10 % of children. Currently, the COVID-19 follow-up protocols in children include chest auscultation, collection of growth parameters, including weight, height and body mass index, execution of the six-minute walking test, basal spirometry, and afterwards, bronchodilation test and lung ultrasound. In this paper, the authors describe a case series of long COVID followed up for 9 months at the Department of Pediatrics of the University Luigi Vanvitelli. The review of the literature was performed on PubMed using the keywords COVID-19, follow-up, children, and lung ultrasound. The aim of this article was to highlight the need to create custom follow-up programs for long Covid in children through the description of a case followed up at our Pediatric Department and a review of the current literature The reversal of pathological lung ultrasound signs occurred in six or nine months despite the early improvement of respiratory symptoms and pulmonary function. There are limited studies on the ultrasonography follow-up of kids with COVID-19 in the literature, and there are still no follow-up COVID-19 guidelines for paediatric population. Pathological lung ultrasound in children recovered from COVID-19, may take time to resolve; therefore, evaluating patients with lung ultrasound in the following months could be a radiation-saving approach useful for children who have fully recovered and have no warning signs.
{"title":"Pathological Lung Ultrasound may Take Time to Resolve Despite Respiratory Symptoms Improvement: A Pediatric Case Series Followed for Long COVID","authors":"Angela Klain, C. Indolfi, G. Dinardo, M. Contieri, F. Decimo, M. Miraglia Del Giudice","doi":"10.2174/1573398x19666230619100036","DOIUrl":"https://doi.org/10.2174/1573398x19666230619100036","url":null,"abstract":"\u0000\u0000Long COVID affects 8 to 10 % of children. Currently, the COVID-19 follow-up protocols in children include chest auscultation, collection of growth parameters, including weight, height and body mass index, execution of the six-minute walking test, basal spirometry, and afterwards, bronchodilation test and lung ultrasound.\u0000\u0000\u0000\u0000In this paper, the authors describe a case series of long COVID followed up for 9 months at the Department of Pediatrics of the University Luigi Vanvitelli. The review of the literature was performed on PubMed using the keywords COVID-19, follow-up, children, and lung ultrasound. The aim of this article was to highlight the need to create custom follow-up programs for long Covid in children through the description of a case followed up at our Pediatric Department and a review of the current literature\u0000\u0000\u0000\u0000The reversal of pathological lung ultrasound signs occurred in six or nine months despite the early improvement of respiratory symptoms and pulmonary function. There are limited studies on the ultrasonography follow-up of kids with COVID-19 in the literature, and there are still no follow-up COVID-19 guidelines for paediatric population.\u0000\u0000\u0000\u0000Pathological lung ultrasound in children recovered from COVID-19, may take time to resolve; therefore, evaluating patients with lung ultrasound in the following months could be a radiation-saving approach useful for children who have fully recovered and have no warning signs.\u0000","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46606480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-07DOI: 10.2174/1573398x19666230607115316
E. Mekov, M. Miravitlles, M. Topalovic, A. Singanayagam, Rosen Petkov
There is increasing interest in the application of artificial intelligence (AI) and machine learning (ML) in all fields of medicine to facilitate greater personalisation of management. ML could be the next step of personalized medicine in chronic obstructive pulmonary disease (COPD) by giving the exact risk (risk for exacerbation, death, etc.) of every patient (based on his/her parameters like lung function, clinical data, demographics, previous exacerbations, etc.), thus providing a prognosis/risk for the specific patient based on individual characteristics (individual approach). ML algorithm might utilise some traditional risk factors along with some others that may be location-specific (e.g. the risk of exacerbation thatmay be related to ambient pollution but that could vary massively between different countries, or between different regions of a particular country). This is a step forward from the commonly used assignment of patients to a specific group for which prognosis/risk data are available (group approach).
{"title":"Stepping Up the Personalized Approach in COPD with Machine Learning","authors":"E. Mekov, M. Miravitlles, M. Topalovic, A. Singanayagam, Rosen Petkov","doi":"10.2174/1573398x19666230607115316","DOIUrl":"https://doi.org/10.2174/1573398x19666230607115316","url":null,"abstract":"\u0000\u0000There is increasing interest in the application of artificial intelligence (AI) and machine learning (ML) in all fields of medicine to facilitate greater personalisation of management.\u0000\u0000\u0000\u0000ML could be the next step of personalized medicine in chronic obstructive pulmonary disease (COPD) by giving the exact risk (risk for exacerbation, death, etc.) of every patient (based on his/her parameters like lung function, clinical data, demographics, previous exacerbations, etc.), thus providing a prognosis/risk for the specific patient based on individual characteristics (individual approach).\u0000\u0000\u0000\u0000ML algorithm might utilise some traditional risk factors along with some others that may be location-specific (e.g. the risk of exacerbation thatmay be related to ambient pollution but that could vary massively between different countries, or between different regions of a particular country).\u0000\u0000\u0000\u0000This is a step forward from the commonly used assignment of patients to a specific group for which prognosis/risk data are available (group approach).\u0000","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44213591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-06DOI: 10.2174/1573398x19666230606120912
Mohsen Shafiepour, Behnam Dalfardi, Seyed Mehdi Hashemi Bajgani, M. Najafzadeh, Mohadeseh Shafiei
Acute respiratory distress syndrome (ARDS) following Covid-19 pneumo-nia is a common complication; using non-invasive ventilation (NIV) is one of the best options avai-lable. In the recent Covid-19 pandemic, we have seen a significant increase in barotrauma incidence following the use of NIV in patients with severe Covid-19 pneumonia. We aimed to identify the risk factors of barotrauma in patients with Covid-19 pneumonia under-going NIV. In this retrospective study, all adult patients with severe Covid-19 pneumonia who suffe-red from any form of barotrauma undergoing NIV from July to September 2021 in Afzalipour Hos-pital, Kerman, Iran were evaluated. Lab tests and NIV machine settings were collected from pa-tients' files. A chi-square test and an independent t-test were used for analytical statistics. Twenty patients with barotrauma secondary to severe Covid-19 pneumonia were enrolled. The most common manifestations of barotrauma were pneumomediastinum in 19 patients (95%). No significant relationship was seen between the occurrence of barotrauma and lab tests. The mean ± SD Inspiratory Positive Airway Pressure (IPAP) level in passed-away patients (17.8 ± 1.1) was significantly higher than in recovered patients (13.5 ± 0.5) (p = 0.04). According to the results of the study, using a low level of IPAP in the ventilator ma-chine settings of patients with barotrauma secondary to severe Covid-19 pneumonia will reduce the mortality rate, although its excessive reduction can cause pulmonary collapse and respiratory arrest as a result..
{"title":"Evaluation of Frequency and Risk Factors of Barotrauma among Patients with Severe Covid-19 Pneumonia Underwent Non-Invasive Ventilation in Afzalipour Hospital Kerman","authors":"Mohsen Shafiepour, Behnam Dalfardi, Seyed Mehdi Hashemi Bajgani, M. Najafzadeh, Mohadeseh Shafiei","doi":"10.2174/1573398x19666230606120912","DOIUrl":"https://doi.org/10.2174/1573398x19666230606120912","url":null,"abstract":"\u0000\u0000Acute respiratory distress syndrome (ARDS) following Covid-19 pneumo-nia is a common complication; using non-invasive ventilation (NIV) is one of the best options avai-lable. In the recent Covid-19 pandemic, we have seen a significant increase in barotrauma incidence following the use of NIV in patients with severe Covid-19 pneumonia.\u0000We aimed to identify the risk factors of barotrauma in patients with Covid-19 pneumonia under-going NIV.\u0000\u0000\u0000\u0000In this retrospective study, all adult patients with severe Covid-19 pneumonia who suffe-red from any form of barotrauma undergoing NIV from July to September 2021 in Afzalipour Hos-pital, Kerman, Iran were evaluated. Lab tests and NIV machine settings were collected from pa-tients' files. A chi-square test and an independent t-test were used for analytical statistics.\u0000\u0000\u0000\u0000Twenty patients with barotrauma secondary to severe Covid-19 pneumonia were enrolled. The most common manifestations of barotrauma were pneumomediastinum in 19 patients (95%). No significant relationship was seen between the occurrence of barotrauma and lab tests. The mean ± SD Inspiratory Positive Airway Pressure (IPAP) level in passed-away patients (17.8 ± 1.1) was significantly higher than in recovered patients (13.5 ± 0.5) (p = 0.04).\u0000\u0000\u0000\u0000According to the results of the study, using a low level of IPAP in the ventilator ma-chine settings of patients with barotrauma secondary to severe Covid-19 pneumonia will reduce the mortality rate, although its excessive reduction can cause pulmonary collapse and respiratory arrest as a result..\u0000","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46452776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-02DOI: 10.2174/1573398x19666230602143458
B. Karikalan, S. Chakravarthi
One of the rapidly growing groups of diseases known as ciliopathies is primary ciliary dyskinesia (PCD), a rare hereditary illness of the motile cilia. Different clinical symptoms of primary ciliary dyskinesia include infertility, left-right lateralization abnormalities, and chronic upper and lower respiratory tract disorders. Our knowledge of the genetics underlying primary ciliary dyskinesia has significantly increased in recent years. Involved in the formation, shape, and operation of motile cilia are axonemal, cytoplasmic, and regulatory proteins that are encoded by a rising number of disease-associated genes and pathogenic mutations. We now have a better grasp of the clinical signs and symptoms of motile ciliopathies because of advances in our understanding of cilia genetics and the function of the proteins expressed. These developments have altered how we approach primary ciliary dyskinesia diagnostic testing. The clinical characteristics of primary ciliary dyskinesia, the evolution of diagnostics, and the discovery of previously unknown genotype-phenotype connections in primary ciliary dyskinesia will all be covered in this review paper.
{"title":"Primary ciliary dyskinesia - An update on the genetics of underlying pathological mechanisms","authors":"B. Karikalan, S. Chakravarthi","doi":"10.2174/1573398x19666230602143458","DOIUrl":"https://doi.org/10.2174/1573398x19666230602143458","url":null,"abstract":"\u0000\u0000One of the rapidly growing groups of diseases known as ciliopathies is primary ciliary\u0000dyskinesia (PCD), a rare hereditary illness of the motile cilia. Different clinical symptoms of primary ciliary dyskinesia include infertility, left-right lateralization abnormalities, and chronic upper and\u0000lower respiratory tract disorders. Our knowledge of the genetics underlying primary ciliary dyskinesia has significantly increased in recent years. Involved in the formation, shape, and operation of\u0000motile cilia are axonemal, cytoplasmic, and regulatory proteins that are encoded by a rising number\u0000of disease-associated genes and pathogenic mutations. We now have a better grasp of the clinical\u0000signs and symptoms of motile ciliopathies because of advances in our understanding of cilia genetics and the function of the proteins expressed. These developments have altered how we approach\u0000primary ciliary dyskinesia diagnostic testing. The clinical characteristics of primary ciliary dyskinesia, the evolution of diagnostics, and the discovery of previously unknown genotype-phenotype\u0000connections in primary ciliary dyskinesia will all be covered in this review paper.\u0000","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47908233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-10DOI: 10.2174/1573398x19666230510142030
Leonardo Arzayus-Patiño, Valeria Perez-Hortua, Jaime Aguilar-Zambrano, Helberg Asencio-Santofimio, E. Wilches-Luna
Respiratory incentive, an instrumental technique used to increase transpulmonary pressure, is indicated when patients present decreased volumes and capacities, a condition presented by patients with acute phase coronavirus infection and patients with pulmonary sequelae post-COVID-19. Some studies recommend including respiratory incentives in managing COVID-19 patients because of its benefits and limited risk. The objective of this exploratory review was to describe and present the current evidence of the effectiveness of IR in improving pulmonary function in adult patients with acute and post-COVID-19 An exploratory review was performed. An extensive search was made in databases such as BVS (MEDLINE-LILLACS-IBECS), PubMed, OVID, Scielo, PEDro, and EBSCO, the checklist recommended by PRISMA was used and was based on the Johanna Briggs method (JGB), initially conceived by Arksey and O "Malley. To assess the quality of the studies, we used the PEDro Scale, which evaluates the methodological quality of the clinical designs. In this exploratory review, 4 studies published between 2019 and 2022 were identified related to the use of the respiratory incentive in COVID-19 and post COVID-19. The evidence reviewed identified that the respiratory incentive was used in the acute phase of the disease and post COVID-19, improvements in lung function such as FVC and FEV1, clinical parameters such as oxygen saturation, dyspnea and anxiety were obtained. The studies identified in this review describe that IR favors the increase of FVC and FEV1, with occasional benefits in improving dyspnea and oxygen saturation.
{"title":"Effectiveness of Incentive Spirometry on Lung Function in Adult COVID19 in the Acute and Post-COVID-19 Phase: Exploratory Review","authors":"Leonardo Arzayus-Patiño, Valeria Perez-Hortua, Jaime Aguilar-Zambrano, Helberg Asencio-Santofimio, E. Wilches-Luna","doi":"10.2174/1573398x19666230510142030","DOIUrl":"https://doi.org/10.2174/1573398x19666230510142030","url":null,"abstract":"\u0000\u0000Respiratory incentive, an instrumental technique used to increase\u0000transpulmonary pressure, is indicated when patients present decreased volumes and capacities, a\u0000condition presented by patients with acute phase coronavirus infection and patients with pulmonary\u0000sequelae post-COVID-19. Some studies recommend including respiratory incentives in managing\u0000COVID-19 patients because of its benefits and limited risk. The objective of this exploratory review\u0000was to describe and present the current evidence of the effectiveness of IR in improving pulmonary\u0000function in adult patients with acute and post-COVID-19\u0000\u0000\u0000\u0000An exploratory review was performed. An extensive search was made in databases such\u0000as BVS (MEDLINE-LILLACS-IBECS), PubMed, OVID, Scielo, PEDro, and EBSCO, the checklist\u0000recommended by PRISMA was used and was based on the Johanna Briggs method (JGB), initially\u0000conceived by Arksey and O \"Malley. To assess the quality of the studies, we used the PEDro Scale,\u0000which evaluates the methodological quality of the clinical designs.\u0000\u0000\u0000\u0000In this exploratory review, 4 studies published between 2019 and 2022 were identified related to the use of the respiratory incentive in COVID-19 and post COVID-19. The evidence reviewed identified that the respiratory incentive was used in the acute phase of the disease and post\u0000COVID-19, improvements in lung function such as FVC and FEV1, clinical parameters such as oxygen saturation, dyspnea and anxiety were obtained.\u0000\u0000\u0000\u0000The studies identified in this review describe that IR favors the increase of FVC and\u0000FEV1, with occasional benefits in improving dyspnea and oxygen saturation.\u0000","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47957480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-01DOI: 10.2174/1573398x19666230320164227
Fatma Yildirim, Meltem Simsek, Muhammed Apaydin, Irem Karaman, Halil Ibrahim Dural
Objective: In this study, we investigated the risk factors affecting mortality of critically ill COVID-19-related acute respiratory distress syndrome (ARDS) patients who were followed up in the intensive care unit (ICU) and received tocilizumab and favipiravir treatments together before vaccination. Materials and Methods: The data of patients who were followed up and treated between 1, July 2020 and 5, October 2020 were retrospectively analyzed. Demographic data of the patients (age, gender), acute physiology and chronic health evaluation score II (APACHE II), sequential organ failure assessment (SOFA) score, RT-PCR of oro-nasopharyngeal swabs, the severity of ARDS on the day of tocilizumab admission, time from RT-PCR positivity to tocilizumab administration, respiratory support treatments, all other medical treatments, and ICU outcomes were recorded. Risk factors affecting mortality were evaluated with multiple regression analysis. Results: A total of 60 patients with a median age of 69.8 (24-87) years, 25 females and 35 males were included in the study. The mean APACHE II score was 18.9 ± 8.0, and the SOFA score was 4.5 ± 2.0. Fifty-two (86.7%) patients had positive oro-nasopharyngeal swabs for SARS-CoV-2 by RT-PCR; (13,3%) patients had positive IgM/Ig G rapid antibody tests for SARS-CoV-2. Tocilizumab was given on an average of 2.5th days (± 2.0 days). On the day of tocilizumab administration, 1 (1.7%) patient had mild ARDS, 30 (50.0%) had moderate ARDS, and 29 (48.3%) had severe ARDS. The PaO2/FIO2 ratio of the study group on the day of tocilizumab administration was 96.7 ± 36.6 mmHg. Thirty-four (56.7%) patients were intubated during follow-up. Forty (66.7%) patients died, while 20 (33.3%) patients were transferred to the ward. The mean length of stay in the ICU was 11.4 ± 5.5 days. Advanced age (Hazard ratio (HR) 1.8; 95% confidence interval (CI) 0.88-0.93; p < 0.001), higher APACHE II score (HR 0.81, 95% CI 0.74-0.98; p = 0.001), higher SOFA score on the day of tocilizumab administration (HR 1.47, 95% CI 0.39-0.79; p = 0.001), and lower PaO2/FIO2 ratio (HR 2.54, 95% CI 2.33-3.79; p < 0.001) were determined as independent risk factors for mortality. Conclusion: Patients administered tocilizumab and favipiravir in our ICU were mostly patients with moderate-severe ARDS and had higher inflammatory markers. The reason for the high mortality in this study was attributed to the fact that all of the patients had moderate-severe COVID-19-related ARDS, rather than severe COVID-19.
{"title":"Mortality Predictors of Pre-variant SARS-CoV-2 Infected ARDS Patients Receiving Favipiravir and Tocilizumab","authors":"Fatma Yildirim, Meltem Simsek, Muhammed Apaydin, Irem Karaman, Halil Ibrahim Dural","doi":"10.2174/1573398x19666230320164227","DOIUrl":"https://doi.org/10.2174/1573398x19666230320164227","url":null,"abstract":"Objective: In this study, we investigated the risk factors affecting mortality of critically ill COVID-19-related acute respiratory distress syndrome (ARDS) patients who were followed up in the intensive care unit (ICU) and received tocilizumab and favipiravir treatments together before vaccination. Materials and Methods: The data of patients who were followed up and treated between 1, July 2020 and 5, October 2020 were retrospectively analyzed. Demographic data of the patients (age, gender), acute physiology and chronic health evaluation score II (APACHE II), sequential organ failure assessment (SOFA) score, RT-PCR of oro-nasopharyngeal swabs, the severity of ARDS on the day of tocilizumab admission, time from RT-PCR positivity to tocilizumab administration, respiratory support treatments, all other medical treatments, and ICU outcomes were recorded. Risk factors affecting mortality were evaluated with multiple regression analysis. Results: A total of 60 patients with a median age of 69.8 (24-87) years, 25 females and 35 males were included in the study. The mean APACHE II score was 18.9 ± 8.0, and the SOFA score was 4.5 ± 2.0. Fifty-two (86.7%) patients had positive oro-nasopharyngeal swabs for SARS-CoV-2 by RT-PCR; (13,3%) patients had positive IgM/Ig G rapid antibody tests for SARS-CoV-2. Tocilizumab was given on an average of 2.5th days (± 2.0 days). On the day of tocilizumab administration, 1 (1.7%) patient had mild ARDS, 30 (50.0%) had moderate ARDS, and 29 (48.3%) had severe ARDS. The PaO2/FIO2 ratio of the study group on the day of tocilizumab administration was 96.7 ± 36.6 mmHg. Thirty-four (56.7%) patients were intubated during follow-up. Forty (66.7%) patients died, while 20 (33.3%) patients were transferred to the ward. The mean length of stay in the ICU was 11.4 ± 5.5 days. Advanced age (Hazard ratio (HR) 1.8; 95% confidence interval (CI) 0.88-0.93; p < 0.001), higher APACHE II score (HR 0.81, 95% CI 0.74-0.98; p = 0.001), higher SOFA score on the day of tocilizumab administration (HR 1.47, 95% CI 0.39-0.79; p = 0.001), and lower PaO2/FIO2 ratio (HR 2.54, 95% CI 2.33-3.79; p < 0.001) were determined as independent risk factors for mortality. Conclusion: Patients administered tocilizumab and favipiravir in our ICU were mostly patients with moderate-severe ARDS and had higher inflammatory markers. The reason for the high mortality in this study was attributed to the fact that all of the patients had moderate-severe COVID-19-related ARDS, rather than severe COVID-19.","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":"248 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135847769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-01DOI: 10.2174/1573398x1902230606164833
Moisés Rodríguez, J. Varon
{"title":"The Potential of Procalcitonin as a Biomarker in Exacerbations of COPD","authors":"Moisés Rodríguez, J. Varon","doi":"10.2174/1573398x1902230606164833","DOIUrl":"https://doi.org/10.2174/1573398x1902230606164833","url":null,"abstract":"<jats:sec>\u0000<jats:title />\u0000<jats:p />\u0000</jats:sec>","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43548613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-24DOI: 10.2174/1573398x19666230324102615
Chulkov V.S, Minina E.E, Medvedeva L.V.
Maternal diabetes during pregnancy, regardless of the type, is a risk factor for macrosomia or excessive fetal growth. Macrosomia and subsequent complications are the main short-term consequences of intrauterine exposure to gestational diabetes mellitus (GDM). Additionally, they have an increased risk of neonatal complications, such as congenital heart defects (CHDs) and central nervous system (CNS) congenital birth defects, hyperbilirubinemia, hypoglycemia, hypocalcemia, and polycythemia with their subsequent complications. More and more indisputable data are evidencing long-term consequences on offspring health in the case of diabetes. While most of this research has focused on metabolic and cardiovascular consequences, there is a growing body of evidence suggesting an impact of maternal diabetes on respiratory health, which is influenced by intrinsic and extrinsic environmental factors during fetal and postnatal development, with important implications for respiratory disorders in later life.
{"title":"Maternal diabetes, respiratory and other disorders in offspring: short-term and long-term outcomes","authors":"Chulkov V.S, Minina E.E, Medvedeva L.V.","doi":"10.2174/1573398x19666230324102615","DOIUrl":"https://doi.org/10.2174/1573398x19666230324102615","url":null,"abstract":"\u0000\u0000Maternal diabetes during pregnancy, regardless of the type, is a risk factor for macrosomia or excessive fetal growth. Macrosomia and subsequent complications are the main short-term consequences of intrauterine exposure to gestational diabetes mellitus (GDM). Additionally, they have an increased risk of neonatal complications, such as congenital heart defects (CHDs) and central nervous system (CNS) congenital birth defects, hyperbilirubinemia, hypoglycemia, hypocalcemia, and polycythemia with their subsequent complications. More and more indisputable data are evidencing long-term consequences on offspring health in the case of diabetes. While most of this research has focused on metabolic and cardiovascular consequences, there is a growing body of evidence suggesting an impact of maternal diabetes on respiratory health, which is influenced by intrinsic and extrinsic environmental factors during fetal and postnatal development, with important implications for respiratory disorders in later life.\u0000","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44762955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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