Severity of SARS-CoV-2 pneumonia according to occupational exposure to asbestos

Introduction: Inflammation is a mechanism implicated in the pathogenesis of SARS-CoV-2 pneumonia. Lung retention of asbestos fibers is thought to promote chronic low-grade inflammation potentially leading to asbestosrelated diseases in exposed subjects. Our hypothesis is that occupational exposure to asbestos may be related to the severity of SARS-CoV-2 pneumonia. Method(s): Prospective observational study of patients discharged after a SARS-CoV-2 pneumonia (March 1st - August 8th 2020) and recruited at our postcovid outpatient clinic. Severity was defined as the need for respiratory support (oxygen therapy, HFNC, CPAP, NIMV or IMV). All patients completed a validated asbestos exposure questionnaire (QEAS-7) and were classified as exposed and non-exposed. Result(s): 293 patients were included, 53.9% men, with a mean age of 58.4 +/- 12.8 years. Table 1 shows the patients' characteristics according to the severity of SARS-CoV-2 pneumonia. Conclusion(s): Our data are consistent with previous studies showing greater severity of SARS-CoV-2 pneumonia in male, older age and higher BMI. Patients requiring oxygen therapy or respiratory support have a higher inflammatory profile, more complications during admission and more days of hospitalization. Occupational exposure to asbestos was related to greater severity of SARS-CoV-2 pneumonia.

Smell improvement by anti-IgE and anti-IL 5 biologics in patients with CRSwNP and severe asthma. A real life study.

BACKGROUND AND OBJECTIVE: Chronic rhinosinusitis with nasal polyps (CRSwNP), characterized by partial (hyposmia) or total (anosmia) loss of smell, is commonly associated with asthma and/or nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD), worsens disease severity and quality of life. Objectives. The objective of this study was to determine whether, in real-life conditions, biological treatments prescribed for severe asthma can improve olfaction in patients with CRSwNP. A further objective was to compare smell improvement in N-ERD and non-N-ERD subgroups. METHODS: A multicenter, non-interventional, retrospective, observational study was performed, including 206 patients with severe asthma undergoing biological treatment (omalizumab, mepolizumab, benralizumab, or reslizumab) with CRSwNP. RESULTS: Improved olfaction was found after treatment with all monoclonal antibodies: omalizumab (35.8%), mepolizumab (35.4%), reslizumab (35.7%), and benralizumab (39.1%), with no differences between groups. Patients with atopy, greater use of short course systemic corticosteroids, and larger polyp size were more likely to experience improvement in smell. The proportion of patients experiencing smell improvement was similar between the N-ERD (37%) and non-N-ERD (35.7%) groups. CONCLUSION: This is the first study to compare real-life improvement in sense of smell among patients undergoing long-term treatment with omalizumab, mepolizumab, reslizumab, or benralizumab for severe asthma and associated CRSwNP. Approximately 4 out of 10 patients reported a subjective improvement in sense of smell (with non-significant differences between biologic drugs). No differences were found in smell improvement between the N-ERD and non-N-ERD group.