Pub Date : 2023-07-01DOI: 10.4103/ecdt.ecdt_108_22
Aida M. Yousef, M. Abdelsalam, Mohamed El Dosky Aboshehata, Heba El Dosky, S. Arafa
Purpose The aim of this study is to detect the prevalence of obstructive sleep apnea syndrome (OSAS) in patients having lone atrial fibrillation (AF). Patients and methods Fifty patients with lone AF were referred to our sleep unit from the Department of Cardiology at the University Hospital. Lone AF was defined as AF in patients without cardiac structural abnormality and less than 60 years of age. All patients were subjected to a detailed history with stress on the number and date of documented episodes of AF and how it was terminated, OSA symptoms (excessive daytime sleepiness, witnessed apnea, loud habitual snoring, and nocturnal choking), and OSA screening questionnaires. ENT and cardiac examination by a specialist was done. Full-night attended polysomnography was performed on full night. Results The median apnea–hypopnea index in the studied group was 10.8 (range, 0.4–69.4). There were 21 (42.0%) non-OSA patients, while there were 29 (58%) OSA patients. There were eight (27.6%) mild OSA patients. Moderate OSA patients were 10 (34.5%). Severe OSA patients were 11 (37.9%). Median of the frequency of AF episodes in the last 1 year was significantly higher in the OSA group than in the normal group (P=0.01). No significant difference was present between both groups as regards the number of nocturnal arrhythmias not related to respiratory events. The frequency of paroxysmal AF episodes during the last year shows a significant positive correlation with severity of OSA, desaturation index, and total arousal index. Conclusion The results of our study support our hypothesis that OSA is a risk factor for AF. We should investigate patients with lone AF for the possibility of OSA.
{"title":"Prevalence of obstructive sleep apnea in patients with lone atrial fibrillation","authors":"Aida M. Yousef, M. Abdelsalam, Mohamed El Dosky Aboshehata, Heba El Dosky, S. Arafa","doi":"10.4103/ecdt.ecdt_108_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_108_22","url":null,"abstract":"Purpose The aim of this study is to detect the prevalence of obstructive sleep apnea syndrome (OSAS) in patients having lone atrial fibrillation (AF). Patients and methods Fifty patients with lone AF were referred to our sleep unit from the Department of Cardiology at the University Hospital. Lone AF was defined as AF in patients without cardiac structural abnormality and less than 60 years of age. All patients were subjected to a detailed history with stress on the number and date of documented episodes of AF and how it was terminated, OSA symptoms (excessive daytime sleepiness, witnessed apnea, loud habitual snoring, and nocturnal choking), and OSA screening questionnaires. ENT and cardiac examination by a specialist was done. Full-night attended polysomnography was performed on full night. Results The median apnea–hypopnea index in the studied group was 10.8 (range, 0.4–69.4). There were 21 (42.0%) non-OSA patients, while there were 29 (58%) OSA patients. There were eight (27.6%) mild OSA patients. Moderate OSA patients were 10 (34.5%). Severe OSA patients were 11 (37.9%). Median of the frequency of AF episodes in the last 1 year was significantly higher in the OSA group than in the normal group (P=0.01). No significant difference was present between both groups as regards the number of nocturnal arrhythmias not related to respiratory events. The frequency of paroxysmal AF episodes during the last year shows a significant positive correlation with severity of OSA, desaturation index, and total arousal index. Conclusion The results of our study support our hypothesis that OSA is a risk factor for AF. We should investigate patients with lone AF for the possibility of OSA.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"21 1","pages":"407 - 411"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84495036","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 : 2023-07-01DOI: 10.4103/ecdt.ecdt_104_22
H. Said, A. Almansoury, S. Fekry, Wael Abdelfattah
Background The inflammatory process involved in severe acute respiratory syndrome coronavirus 2 infection is one of great interest in understanding the pathophysiology and severity of coronavirus disease 2019 (COVID-19). This study aimed to evaluate the association of inflammatory markers with severe COVID-19. Patients and methods The data were collected from patient files admitted to two tertiary hospitals in UAE during the COVID-19 pandemic from April to July 2020. During first COVID-19 wave that hits UAE, general symptoms as well as radiographic, blood, and immunological findings were also recorded. Results The study included 320 patients. Men (84.1%) outnumbered women (15.9%). Most (73.8%) patients had no comorbidities. The patients were from several nationalities, with Indians being the majority (51.9%). Most patients (65.6%) had mild, whereas 26.6% had severe manifestations. Only 25 patients were asymptomatic. C-reactive protein level had a significant relation to COVID-19 severity. Some parameters such as lactate dehydrogenase, ferritin, D-dimer, neutrophil/lymphocyte ratio, ICU admission, and death rates as well as radiological findings in the severe group had significant differences compared with the mild and asymptomatic groups. Conclusions These data are valuable contributions to the monitoring, severity assessment, and prognosis of patients with COVID-19.
{"title":"Association of inflammatory biomarkers with coronavirus disease 2019 severity: a retrospective study in the UAE","authors":"H. Said, A. Almansoury, S. Fekry, Wael Abdelfattah","doi":"10.4103/ecdt.ecdt_104_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_104_22","url":null,"abstract":"Background The inflammatory process involved in severe acute respiratory syndrome coronavirus 2 infection is one of great interest in understanding the pathophysiology and severity of coronavirus disease 2019 (COVID-19). This study aimed to evaluate the association of inflammatory markers with severe COVID-19. Patients and methods The data were collected from patient files admitted to two tertiary hospitals in UAE during the COVID-19 pandemic from April to July 2020. During first COVID-19 wave that hits UAE, general symptoms as well as radiographic, blood, and immunological findings were also recorded. Results The study included 320 patients. Men (84.1%) outnumbered women (15.9%). Most (73.8%) patients had no comorbidities. The patients were from several nationalities, with Indians being the majority (51.9%). Most patients (65.6%) had mild, whereas 26.6% had severe manifestations. Only 25 patients were asymptomatic. C-reactive protein level had a significant relation to COVID-19 severity. Some parameters such as lactate dehydrogenase, ferritin, D-dimer, neutrophil/lymphocyte ratio, ICU admission, and death rates as well as radiological findings in the severe group had significant differences compared with the mild and asymptomatic groups. Conclusions These data are valuable contributions to the monitoring, severity assessment, and prognosis of patients with COVID-19.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"67 1","pages":"367 - 373"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83854681","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}
Background Because of the outbreak of coronavirus disease 2019 (COVID-19), there has been an increase in the demand for intensive care services all over the world. Severe cases fulfill one of the following criteria: respiratory rate more than 30/min, oxygen saturation less than or equal to 93%, and PaO2/FiO2 less than or equal to 300 mmHg. ICU admission is required for seriously ill patients who require high-flow nasal cannula, intubation, or more oxygen to treat hypoxemia or multiple organ dysfunctions. However, it is unclear whether patients with COVID-19 who are admitted to the ICU will survive. Aim To estimate the proportion and prognosis of ICU-admitted COVID cases in relation to whole COVID cases admitted at Abbassia Chest Hospital and estimation of risk factors responsible for mortality. Patients and methods This retrospective observational study was conducted on all cases of COVID-19-infected patients admitted at respiratory ICU of Abbassia Chest Hospital in relation to all hospitalized cases during the period between January 2021 and June 2021. All of the cases were subjected to full history taking, laboratory investigations, and radiological assessment with chest radiograph and computed tomography. The reported outcomes included weaning from mechanical ventilation, discharge, mortality, and cause of death. Results The study included 76 patients with COVID-19. Overall, 43 (56.6%) were males and 33 (43.4%) were females, with a mean age of 57.17 ± 12.54 years. The incidence of mortality was 32.9%. The acute respiratory distress syndrome (ARDS) was the most common cause for ICU admission and encountered in 57.4% of the cases. All of the dead cases had severe ARDS. The use of invasive mechanical ventilation was reported in 76.5% of the included died cases, and this was statistically significantly higher as compared with the survived group. On the contrary, the length of ICU stay was statistically significantly higher in the survived group. Conclusion COVID-19 infection is associated with a high percentage of ICU admission with a high mortality rate. Many factors are associated with the high risk of mortality among the ICU admitted COVID-19-infected patients including severe ARDS, deterioration of the systemic organ functions, and the utilization of invasive mechanical ventilation.
{"title":"Proportion and prognosis of ICU-admitted coronavirus disease 2019-infected patients in relation to all hospitalized cases in Abbasia Chest Hospital, Cairo","authors":"H. Mahmoud, M. Tageldin, Yehia R. Yousef","doi":"10.4103/ecdt.ecdt_89_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_89_22","url":null,"abstract":"Background Because of the outbreak of coronavirus disease 2019 (COVID-19), there has been an increase in the demand for intensive care services all over the world. Severe cases fulfill one of the following criteria: respiratory rate more than 30/min, oxygen saturation less than or equal to 93%, and PaO2/FiO2 less than or equal to 300 mmHg. ICU admission is required for seriously ill patients who require high-flow nasal cannula, intubation, or more oxygen to treat hypoxemia or multiple organ dysfunctions. However, it is unclear whether patients with COVID-19 who are admitted to the ICU will survive. Aim To estimate the proportion and prognosis of ICU-admitted COVID cases in relation to whole COVID cases admitted at Abbassia Chest Hospital and estimation of risk factors responsible for mortality. Patients and methods This retrospective observational study was conducted on all cases of COVID-19-infected patients admitted at respiratory ICU of Abbassia Chest Hospital in relation to all hospitalized cases during the period between January 2021 and June 2021. All of the cases were subjected to full history taking, laboratory investigations, and radiological assessment with chest radiograph and computed tomography. The reported outcomes included weaning from mechanical ventilation, discharge, mortality, and cause of death. Results The study included 76 patients with COVID-19. Overall, 43 (56.6%) were males and 33 (43.4%) were females, with a mean age of 57.17 ± 12.54 years. The incidence of mortality was 32.9%. The acute respiratory distress syndrome (ARDS) was the most common cause for ICU admission and encountered in 57.4% of the cases. All of the dead cases had severe ARDS. The use of invasive mechanical ventilation was reported in 76.5% of the included died cases, and this was statistically significantly higher as compared with the survived group. On the contrary, the length of ICU stay was statistically significantly higher in the survived group. Conclusion COVID-19 infection is associated with a high percentage of ICU admission with a high mortality rate. Many factors are associated with the high risk of mortality among the ICU admitted COVID-19-infected patients including severe ARDS, deterioration of the systemic organ functions, and the utilization of invasive mechanical ventilation.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"10 1","pages":"358 - 366"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79240921","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}
Background Cells obtained from bronchoalveolar space can give a definite diagnosis in malignancies. The present study aimed to assess the diagnostic yield of bronchoalveolar lavage (BAL) in lung cancer and to assess the relationship of its yield with radiology, endoscopy, and pathological subtypes. Patients and methods A retrospective study with re-revision of saved bronchoscopic video, computed tomography (CT) films, and pathology slides was conducted on 101 patients with definite bronchogenic carcinoma diagnosed over 4 years. Results BAL positive yield was found in 42.4% of cases, and its yield coincided with other bronchoscopic sampling methods in 43.6% of cases. Regarding CT findings, the BAL positive yield was significantly higher in peripheral lesions (79.1%), mass size more than or equal to 3 cm (62.8%), CT bronchus sign (46.5%), hilar and/or mediastinal adenopathy (86.0%), and consolidation (51.2%). The most common bronchoscopic abnormality in patients with BAL positive yield was submucosal lesions (83.3%). The adenocarcinoma (48.8%) and bronchoalveolar carcinoma (11.6%) were the histopathological types having significant BAL positive yield. The most significant predictive factors for BAL positive yield were mediastinal adenopathy, endobronchial lesions, nonvisible lesions, adenocarcinoma type, submucosal lesions, CT bronchus sign, mass size more than or equal to 3 cm, peripheral lesions, and concomitant use of bronchial brushing. BAL had 40.3% sensitivity, 51.7% specificity, 67.4% positive predictive value, 25.9% negative predictive value, and 43.6% diagnostic accuracy in bronchogenic carcinoma. Conclusion BAL increases the positive yield of bronchoscopy by 13.9% with fair diagnostic performance, especially in peripherally locating nonvisible lesions. Although tissue biopsy remains the gold standard sampling, clinicians might rely on BAL cytology for diagnosis of lung cancer in some patients.
{"title":"Bronchoalveolar lavage in lung cancer: does it increase the positive yield of bronchoscopy?","authors":"K. Salama, Manal R. Hafez, A. Farag, Doaa Salim","doi":"10.4103/ecdt.ecdt_88_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_88_22","url":null,"abstract":"Background Cells obtained from bronchoalveolar space can give a definite diagnosis in malignancies. The present study aimed to assess the diagnostic yield of bronchoalveolar lavage (BAL) in lung cancer and to assess the relationship of its yield with radiology, endoscopy, and pathological subtypes. Patients and methods A retrospective study with re-revision of saved bronchoscopic video, computed tomography (CT) films, and pathology slides was conducted on 101 patients with definite bronchogenic carcinoma diagnosed over 4 years. Results BAL positive yield was found in 42.4% of cases, and its yield coincided with other bronchoscopic sampling methods in 43.6% of cases. Regarding CT findings, the BAL positive yield was significantly higher in peripheral lesions (79.1%), mass size more than or equal to 3 cm (62.8%), CT bronchus sign (46.5%), hilar and/or mediastinal adenopathy (86.0%), and consolidation (51.2%). The most common bronchoscopic abnormality in patients with BAL positive yield was submucosal lesions (83.3%). The adenocarcinoma (48.8%) and bronchoalveolar carcinoma (11.6%) were the histopathological types having significant BAL positive yield. The most significant predictive factors for BAL positive yield were mediastinal adenopathy, endobronchial lesions, nonvisible lesions, adenocarcinoma type, submucosal lesions, CT bronchus sign, mass size more than or equal to 3 cm, peripheral lesions, and concomitant use of bronchial brushing. BAL had 40.3% sensitivity, 51.7% specificity, 67.4% positive predictive value, 25.9% negative predictive value, and 43.6% diagnostic accuracy in bronchogenic carcinoma. Conclusion BAL increases the positive yield of bronchoscopy by 13.9% with fair diagnostic performance, especially in peripherally locating nonvisible lesions. Although tissue biopsy remains the gold standard sampling, clinicians might rely on BAL cytology for diagnosis of lung cancer in some patients.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"4 1","pages":"326 - 333"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89578758","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}
Hisham Abdel-Aaty, Mahmoud M. El-Habashy, I. Shedeed, A. Mahrous
Background Coronavirus disease 2019 (COVID-19), a global pandemic that has spread worldwide in a dramatic manner since its first emergence in December 2019 from Wuhan, China. To date, there is still lack of an appropriate protocol that predicts cases who are impending to develop severe COVID-19. Hence, this work was an attempt to determine the potential association of the clinical, laboratory, and radiological parameters with the severity of COVID-19 and the ability of these parameters to predict the severe cases. Patients and methods This is a retrospective study that was based on recruiting the data from the files of patients who attended the chest outpatient clinic, or admitted to the chest department or the ICU of our institution. The study included adult patients who were diagnosed with COVID-19. Patients were categorized into two groups: severe/critical cases and mild/moderate disease cases. Data concerning the patient history, clinical picture, and radiological data were obtained and analyzed. Results Eighty adult patients with COVID-19 were included in this study. They were classified into severe/critical (40 patients) or mild/moderate disease (40 patients). Patients with severe/critical COVID-19 disease were significantly older in age and had higher comorbidities, prevalence, higher incidence of cough, dyspnea, gastrointestinal tract symptoms and fatigue, elevated total leukocyte count, lower relative lymphocytes, lower absolute lymphocytes and higher neutrophils, higher blood glucose levels, higher alanine transaminase, higher aspartate aminotransferase and lower serum albumin, reduced Ca levels, elevated lactate dehydrogenase, serum ferritin, D-dimer, and C-reactive protein levels. They had significantly higher computed tomographic (CT) scores and CT chest with greater than 50% lesions or progressive lesions. The mortality rate was 10%, all of which were from the severe disease group. Conclusion The current study is confirming an overall substantial association between severe COVID-19 and older age, chronic diseases, CT imaging pattern, and severity score, leukocyte count, lymphopenia, blood glucose, serum albumin, alanine transaminase, aspartate aminotransferase, calcium levels, C-reactive protein, D-dimer, lactate dehydrogenase, and ferritin. These results highlighted the importance of using clinical, laboratory, and radiological features for monitoring of COVID-19 patients.
{"title":"Laboratory markers and radiological signs of mild versus severe COVID-19 patients","authors":"Hisham Abdel-Aaty, Mahmoud M. El-Habashy, I. Shedeed, A. Mahrous","doi":"10.4103/ecdt.ecdt_84_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_84_22","url":null,"abstract":"Background Coronavirus disease 2019 (COVID-19), a global pandemic that has spread worldwide in a dramatic manner since its first emergence in December 2019 from Wuhan, China. To date, there is still lack of an appropriate protocol that predicts cases who are impending to develop severe COVID-19. Hence, this work was an attempt to determine the potential association of the clinical, laboratory, and radiological parameters with the severity of COVID-19 and the ability of these parameters to predict the severe cases. Patients and methods This is a retrospective study that was based on recruiting the data from the files of patients who attended the chest outpatient clinic, or admitted to the chest department or the ICU of our institution. The study included adult patients who were diagnosed with COVID-19. Patients were categorized into two groups: severe/critical cases and mild/moderate disease cases. Data concerning the patient history, clinical picture, and radiological data were obtained and analyzed. Results Eighty adult patients with COVID-19 were included in this study. They were classified into severe/critical (40 patients) or mild/moderate disease (40 patients). Patients with severe/critical COVID-19 disease were significantly older in age and had higher comorbidities, prevalence, higher incidence of cough, dyspnea, gastrointestinal tract symptoms and fatigue, elevated total leukocyte count, lower relative lymphocytes, lower absolute lymphocytes and higher neutrophils, higher blood glucose levels, higher alanine transaminase, higher aspartate aminotransferase and lower serum albumin, reduced Ca levels, elevated lactate dehydrogenase, serum ferritin, D-dimer, and C-reactive protein levels. They had significantly higher computed tomographic (CT) scores and CT chest with greater than 50% lesions or progressive lesions. The mortality rate was 10%, all of which were from the severe disease group. Conclusion The current study is confirming an overall substantial association between severe COVID-19 and older age, chronic diseases, CT imaging pattern, and severity score, leukocyte count, lymphopenia, blood glucose, serum albumin, alanine transaminase, aspartate aminotransferase, calcium levels, C-reactive protein, D-dimer, lactate dehydrogenase, and ferritin. These results highlighted the importance of using clinical, laboratory, and radiological features for monitoring of COVID-19 patients.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"31 1","pages":"194 - 201"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80674850","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}
H. Shalaby, Sahar Abd Elmaksoud, H. Ezzelregal, Dalia ElDine Salem
Background Elevated serum level of interleukin-6 (IL-6) in patients with coronavirus disease 2019 (COVID-19) may be a result of a cytokine storm and can be an indicator of severe and critical forms of the disease.Therefore, it is crucial to detect and control IL-6 level early in severe acute respiratory syndrome coronavirus-2-infected patients; in addition to that, IL-6 may be a target for drug development. Aim In this study, we aimed to evaluate IL-6 serum levels in severe acute respiratory syndrome coronavirus-2-infected patients with positive PCR result early after diagnosis to detect disease severity and mortality. Study design and methods This prospective study was done on 60 COVID-19-infected patients. Serum IL-6 levels were tested after diagnosis. Tocilizumab was given to 11 patients with severe COVID-19. Results High serum levels of IL-6 had been detected in 95% of patients and in all patients of the critical group. Its levels in the mild group were 1.87 times less than that in the moderate group, whereas 2.85 times less than that in the critical group. IL-6 median levels were 24, 44.85, and 68.4 ng/l for the mild, moderate, and critical groups, respectively. The IL-6 concentration was predictive of severity (with IL-6 cutoff value >56 ng/l) and was predictive of mortality (with a cutoff value >67 ng/l) for COVID-19-infected patients. Tocilizumab cure rate was 30% in critical cases. Conclusion Serum IL-6 is of paramount importance in detecting severity and mortality of COVID-19 disease, whereas therapeutic value of tocilizumab needs confirmation by detailed studies.
{"title":"Assessment of interleukin-6 role in detecting coronavirus disease 2019 severity, mortality, and its control: A cohort study","authors":"H. Shalaby, Sahar Abd Elmaksoud, H. Ezzelregal, Dalia ElDine Salem","doi":"10.4103/ecdt.ecdt_75_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_75_22","url":null,"abstract":"Background Elevated serum level of interleukin-6 (IL-6) in patients with coronavirus disease 2019 (COVID-19) may be a result of a cytokine storm and can be an indicator of severe and critical forms of the disease.Therefore, it is crucial to detect and control IL-6 level early in severe acute respiratory syndrome coronavirus-2-infected patients; in addition to that, IL-6 may be a target for drug development. Aim In this study, we aimed to evaluate IL-6 serum levels in severe acute respiratory syndrome coronavirus-2-infected patients with positive PCR result early after diagnosis to detect disease severity and mortality. Study design and methods This prospective study was done on 60 COVID-19-infected patients. Serum IL-6 levels were tested after diagnosis. Tocilizumab was given to 11 patients with severe COVID-19. Results High serum levels of IL-6 had been detected in 95% of patients and in all patients of the critical group. Its levels in the mild group were 1.87 times less than that in the moderate group, whereas 2.85 times less than that in the critical group. IL-6 median levels were 24, 44.85, and 68.4 ng/l for the mild, moderate, and critical groups, respectively. The IL-6 concentration was predictive of severity (with IL-6 cutoff value >56 ng/l) and was predictive of mortality (with a cutoff value >67 ng/l) for COVID-19-infected patients. Tocilizumab cure rate was 30% in critical cases. Conclusion Serum IL-6 is of paramount importance in detecting severity and mortality of COVID-19 disease, whereas therapeutic value of tocilizumab needs confirmation by detailed studies.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"1 1","pages":"183 - 190"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90395550","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}
Background Idiopathic pulmonary fibrosis (IPF) is a progressive irreversible lung disease, but early assessment by pulmonary function tests (PFTs) and quantitative volumetric computed tomography (CT) analysis aid in diagnosis, disease monitoring, and prognosis in patients with IPF. Objectives The study aimed to study the role of quantitative volumetric CT indices and PFTs in assessing disease severity in patients with IPF. Patients and methods The study included 40 patients with IPF diagnosed by usual interstitial pneumonia pattern in high-resolution CT and subdivided into two groups according to the GAP staging system (sex, age, and physiology): group I included patients with IPF stage I (five patients) and stage II (15 patients), whereas group II included patients with IPF stage III (20 patients). Clinical history taking, physical examination, plain chest radiography to exclude other diagnosis, PFTs, and quantitative volumetric high-resolution CT were done for all patients. Results There was a significant difference between group I [higher normal attenuating lung volume (NL%) and lower honeycombing area volume (HA%)] versus group II (lower NL% and higher HA%), with no significant difference in whole lung volume (WL) between the two groups. There was a significant correlation between radiological parameters (NL% and HA%) and modified Medical Research Council score of dyspnea and GAP staging system. Radiological parameters (NL% and HA%) had a significant correlation with functional parameters (forced vital capacity% and diffusing capacity for carbon monoxide%). Furthermore, NL% and HA% showed a negative significant correlation with each other. Conclusions PFTs and quantitative volumetric CT parameters showed a statistically significant difference among IPF cases of various severity, and both are highly correlated with each other and with clinical modified Medical Research Council score of dyspnea score of dyspnea and GAP staging system. So, both can play a major role not only in diagnosis but also in detecting severity and predicting mortality in IPF.
{"title":"Role of pulmonary function tests and computed tomography volumetric quantitative analysis in assessment of idiopathic pulmonary fibrosis","authors":"Omina Zaki, R. Sharshar, R. Younes, A. Abdella","doi":"10.4103/ecdt.ecdt_71_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_71_22","url":null,"abstract":"Background Idiopathic pulmonary fibrosis (IPF) is a progressive irreversible lung disease, but early assessment by pulmonary function tests (PFTs) and quantitative volumetric computed tomography (CT) analysis aid in diagnosis, disease monitoring, and prognosis in patients with IPF. Objectives The study aimed to study the role of quantitative volumetric CT indices and PFTs in assessing disease severity in patients with IPF. Patients and methods The study included 40 patients with IPF diagnosed by usual interstitial pneumonia pattern in high-resolution CT and subdivided into two groups according to the GAP staging system (sex, age, and physiology): group I included patients with IPF stage I (five patients) and stage II (15 patients), whereas group II included patients with IPF stage III (20 patients). Clinical history taking, physical examination, plain chest radiography to exclude other diagnosis, PFTs, and quantitative volumetric high-resolution CT were done for all patients. Results There was a significant difference between group I [higher normal attenuating lung volume (NL%) and lower honeycombing area volume (HA%)] versus group II (lower NL% and higher HA%), with no significant difference in whole lung volume (WL) between the two groups. There was a significant correlation between radiological parameters (NL% and HA%) and modified Medical Research Council score of dyspnea and GAP staging system. Radiological parameters (NL% and HA%) had a significant correlation with functional parameters (forced vital capacity% and diffusing capacity for carbon monoxide%). Furthermore, NL% and HA% showed a negative significant correlation with each other. Conclusions PFTs and quantitative volumetric CT parameters showed a statistically significant difference among IPF cases of various severity, and both are highly correlated with each other and with clinical modified Medical Research Council score of dyspnea score of dyspnea and GAP staging system. So, both can play a major role not only in diagnosis but also in detecting severity and predicting mortality in IPF.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"259 1","pages":"253 - 261"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77137625","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}
Amol G Andhale, S. Acharya, S. Shukla, Akhilesh Annadatha, Vidyashree Hulkoti
{"title":"Coexistence of tubercular constrictive pericarditis with tubercular pleural effusion","authors":"Amol G Andhale, S. Acharya, S. Shukla, Akhilesh Annadatha, Vidyashree Hulkoti","doi":"10.4103/ecdt.ecdt_51_20","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_51_20","url":null,"abstract":"","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"27 1","pages":"302 - 304"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73327563","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}
Context Anxiety is one of the mood changes that occur postcoronavirus disease-2019 (post-COVID-19) and interfere with patients’ daily activity. After supposed clinical and radiological improvement to COVID-19, some still experience somatic complaints such as sensation of dyspnea. Aims Evaluating the relation between COVID-19 survivors and anxiety and to what extent this could affect their functional status. Settings and design Ain Shams University Hospital, survey study. Patients and methods The survey included 120 patients post-COVID-19 one month or more and free symptoms attending Ain Shams University Hospitals Chest Outpatient Clinic for follow-up, 45% of them were in the age group 35–55 years, 56.7% were females, 78.3% had high education, and 27.5% were smokers. All included study participants were subjected to computed tomography of chest, oxygen saturation, State Trait Anxiety Inventory (STAI) Arabic version, and Modified Medical Research Council (MMRC) Dyspnea Scale. χ2-test (or Fisher’s exact test) was used to compare data between different groups. Logistic regression analysis was used to determine the correlation between the features of individuals and their degree of anxiety. Results The most annoying COVID-19 symptoms as reported by this study participants were body pains (32.5%). About 61.7% of participants had high-state anxiety and 51.7% had high-trait anxiety. The age group 20–34 years was significantly associated with higher frequency of moderate or high-state anxiety (P<0.05), male sex was significantly associated with lower frequency of moderate or high-state anxiety compared with females (P<0.05). Conclusions Age and sex were important association factors with the prevalence of anxiety in post-COVID-19 patients. Higher grades of dyspnea were associated with higher probability of development of moderate or severe post-COVID anxiety.
{"title":"Post-COVID anxiety and its associated factors in Egyptian patients","authors":"H. Ezzelregal, Azza Hassan, Rehab Serag, H. Eldin","doi":"10.4103/ecdt.ecdt_51_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_51_22","url":null,"abstract":"Context Anxiety is one of the mood changes that occur postcoronavirus disease-2019 (post-COVID-19) and interfere with patients’ daily activity. After supposed clinical and radiological improvement to COVID-19, some still experience somatic complaints such as sensation of dyspnea. Aims Evaluating the relation between COVID-19 survivors and anxiety and to what extent this could affect their functional status. Settings and design Ain Shams University Hospital, survey study. Patients and methods The survey included 120 patients post-COVID-19 one month or more and free symptoms attending Ain Shams University Hospitals Chest Outpatient Clinic for follow-up, 45% of them were in the age group 35–55 years, 56.7% were females, 78.3% had high education, and 27.5% were smokers. All included study participants were subjected to computed tomography of chest, oxygen saturation, State Trait Anxiety Inventory (STAI) Arabic version, and Modified Medical Research Council (MMRC) Dyspnea Scale. χ2-test (or Fisher’s exact test) was used to compare data between different groups. Logistic regression analysis was used to determine the correlation between the features of individuals and their degree of anxiety. Results The most annoying COVID-19 symptoms as reported by this study participants were body pains (32.5%). About 61.7% of participants had high-state anxiety and 51.7% had high-trait anxiety. The age group 20–34 years was significantly associated with higher frequency of moderate or high-state anxiety (P<0.05), male sex was significantly associated with lower frequency of moderate or high-state anxiety compared with females (P<0.05). Conclusions Age and sex were important association factors with the prevalence of anxiety in post-COVID-19 patients. Higher grades of dyspnea were associated with higher probability of development of moderate or severe post-COVID anxiety.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"115 1","pages":"262 - 267"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73296986","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}
Engy Soliman, Ashraf Madkour, Ibrahim A Dwedar, M. Abdelkader
Background Six-minute walk test (6MWT) is well-established in assessing functional capacity and exercise-induced oxygen desaturation. For some patients, 6MWT may be very exhausting and shorter-duration test would likely be less time-consuming and easier. Aim To investigate if 1-minute walk test (1MWT) predicts the results of 6MWT test as regards the exercise capacity, exercise-induced oxygen desaturation, and symptoms in patients with interstitial lung diseases (ILDs). Patients and methods Thirty patients with ILD were recruited from a university hospital between April 2019 and June 2019. Demographics data were collected. Spirometry, 6MWT, and 1MWT were performed. Total walking distance, oxygen saturation decline, heart rate recovery, dyspnea, and leg fatigue were evaluated. Results Out of 30 cases studied, 22 (73.3%) were females and eight (26.7%) were males. The mean age was 51.9 ± 13.86, mean BMI 28.32 ± 5.55, and mean forced vital capacity 47.27 ± 14.65 l/m. The mean walking distance of 1MWT and 6MWT were 46.43 ± 9.97 and 269 ± 76.94, respectively. There was a statistically significant positive correlation between 1MWT and 6MWT regarding walking distance, heart rate recovery, dyspnea at the end of the test (Borg scale), leg fatigue at the end of the test (Borg scale), and oxygen saturation decline. No adverse events related to both walking tests were recorded. Conclusion 1MWT can predict results of 6MWT in ILD patients as regards exercise capacity, exercise-induced oxygen desaturation, and symptoms. 1MWT might serve as a practical substitute for the more cumbersome 6MWT.
{"title":"Does 1-minute walk test predict results of 6-minute walk test in patients with interstitial lung diseases?","authors":"Engy Soliman, Ashraf Madkour, Ibrahim A Dwedar, M. Abdelkader","doi":"10.4103/ecdt.ecdt_5_21","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_5_21","url":null,"abstract":"Background Six-minute walk test (6MWT) is well-established in assessing functional capacity and exercise-induced oxygen desaturation. For some patients, 6MWT may be very exhausting and shorter-duration test would likely be less time-consuming and easier. Aim To investigate if 1-minute walk test (1MWT) predicts the results of 6MWT test as regards the exercise capacity, exercise-induced oxygen desaturation, and symptoms in patients with interstitial lung diseases (ILDs). Patients and methods Thirty patients with ILD were recruited from a university hospital between April 2019 and June 2019. Demographics data were collected. Spirometry, 6MWT, and 1MWT were performed. Total walking distance, oxygen saturation decline, heart rate recovery, dyspnea, and leg fatigue were evaluated. Results Out of 30 cases studied, 22 (73.3%) were females and eight (26.7%) were males. The mean age was 51.9 ± 13.86, mean BMI 28.32 ± 5.55, and mean forced vital capacity 47.27 ± 14.65 l/m. The mean walking distance of 1MWT and 6MWT were 46.43 ± 9.97 and 269 ± 76.94, respectively. There was a statistically significant positive correlation between 1MWT and 6MWT regarding walking distance, heart rate recovery, dyspnea at the end of the test (Borg scale), leg fatigue at the end of the test (Borg scale), and oxygen saturation decline. No adverse events related to both walking tests were recorded. Conclusion 1MWT can predict results of 6MWT in ILD patients as regards exercise capacity, exercise-induced oxygen desaturation, and symptoms. 1MWT might serve as a practical substitute for the more cumbersome 6MWT.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"29 1","pages":"247 - 252"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86557315","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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