Respiratory Medicine and Research最新文献

Introduction: Sarcoidosis is a multisystem granulomatous disorder that affects mediastinal and pulmonary structures in nearly 90% of cases. Given the high prevalence of respiratory involvement, pulmonologists are crucial in managing the disease, from diagnosis through to follow-up. In France, epidemiological data on sarcoidosis are limited, despite notable regional and international variations in the incidence and prevalence of the disease.

Materials and methods: The SARCOPIDEMIO study is a prospective, multicenter observational study designed to estimate the incidence and prevalence of pulmonary sarcoidosis in the Haute-Garonne department (France). A total of 55 pulmonologists, representing both hospital-based and private practices, were invited to participate.

Results: A total of 172 patients were included in the analysis. The minimal and estimated prevalence rates were determined to be 14.8 to 29.6 cases per 100,000 inhabitants, respectively. The incidence rate was 3.6 new cases per 100,000 inhabitants per year. Histological confirmation of granuloma was obtained in approximately 78% of the patients. Half of the patients received corticosteroid therapy, while one-quarter were treated with second-line immunosuppressive agents. The distribution of patients between public and private sectors was relatively balanced; however, multisystemic clinical presentations and the need for treatment were more frequently observed in hospital settings.

Conclusion: The epidemiological data on pulmonary sarcoidosis from the Haute-Garonne department are relatively with those previously reported in France. Although sarcoidosis is a rare disease, its management is shared by all pulmonologists in our region.

Background: The COVID-19 pandemic has presented considerable challenges for lung transplant (LTx) recipients, a population inherently at high risk for severe complications. Although early data from the pandemic indicated worrisome outcomes for these patients, understanding the current context of SARS-CoV-2 infections is essential to inform ongoing management strategies. The efficacy of anti-viral treatments, including Remdesivir (RDV), remains uncertain. This study aims to evaluate the effect of RDV on clinical outcomes in LTx recipients infected with SARS CoV-2, primarily those with a clinically significant disease course.

Methods: A single-center retrospective cohort study was conducted, including LTx recipients with confirmed SARS-CoV-2 infection diagnosed between January 2022 and December 2023. Patients were classified as treated with RDV if they received at least three consecutive days of therapy, typically initiated in the context of symptomatic infection with increased oxygen requirements (RDV group). The primary outcome was all-cause mortality. Secondary outcomes were ICU admission, longitudinal changes in lung function, at 3-, 6-, and 12-months post-infection, incidence of COVID-19-associated pulmonary aspergillosis (CAPA) and bacterial co-infections. A multivariable logistic regression model was used to control for cofounding factors.

Results: Among the 130 LTx infected with SARS CoV-2, 61% (80/130) received at least 3 days of RDV. All cause of mortality was lower in the RDV group (4% 2/50) compared to the non-RDV group (15%, 12/80) (p= 0.05). Non-RDV group experienced a significant decline in forced expiratory volume in 1 second (FEV1) at 3 months post-infection compared to those in the RDV group (6% vs 3%, p = 0.04). ICU admission rates, bacterial coinfection, and CAPA were similar between groups.

Conclusion: RDV treatment appears to improve survival and may mitigate the long-term deterioration of lung function in lung transplant recipients infected with SARS CoV-2. These findings underscore the potential of RDV as a beneficial therapy in this high-risk population and highlight the need for further investigation in larger studies.