Exploring the experiences of chronic respiratory patients during the COVID-19 pandemic using interpretative phenomenological analysis

Background: During a coronavirus pandemic, respiratory patients may be more vulnerable to mental health problems in addition to their physical vulnerability. Due to the specific nature of their illness, they are more likely to have pre-existing experience of crisis situations, serious existential issues and coping with them. Despite a growing body of literature based on quantitative research, there is still a lack of insight into the subjective experiences of those affected. Aim: Our aims were to explore and deepen our understanding of the experiences of chronic respiratory patients at risk of pandemic COVID-19. Our research questions were: 1. How do the interviewees relate to their underlying respiratory condition? 2. What does it mean to experience vulnerability? 3. How do the initial experiences of the underlying disease affect the experience of vulnerability to pandemic disease? Methods: We used interpretative phenomenological analysis. The study involved 8 participants: 7 women and one man, aged 29-60, with one of the following diagnoses: asthma, chronic obstructive pulmonary disease, cystic fibrosis. Results: Three main themes emerged from the analysis of the semi-structured interviews: 1. respiratory illness as a defining experience in everyday life, 2. the impact of the COVID-19 pandemic on the self and identity organisation, and 3. adaptation to experiencing vulnerability. Breathlessness is the most frightening feature of progressive lung disease, and can be linked to fear and anxiety in different ways. The potentially contagious nature of COVID-19 draws a sharp line between the endangered Self and the dangerous Other, and represents a critical life situation for the satisfaction of social needs and desires. In coping with them, we observe essentially self-defense mechanisms and emotion-focused strategies. Conclusions: The current pandemic is having a widespread and powerful impact on the lives of affected patients. Because of the nature of the coronavirus, which primarily affects the airways, those affected consider themselves to be at risk. Experiencing vulnerability fundamentally determines their lives: their decisions, their connection to the world, organization of identity, coping and their belief in the security of the world. Identifying their experiences and difficulties is of particular importance for the development of strategies to mitigate the psychosocial impact of the epidemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Hungarian) Elmeleti hatter: A koronavirus vilagjarvany idejen a kronikus legzoszervi betegek fizikai serulekenyseguk mellett a mentalis problemakra is fokozottan erzekenyek lehetnek. Betegseguk sajatossagaibol kifolyolag nagyobb valoszinuseggel rendelkeznek mar meglevo tapasztalattal krizishelyzetek, sulyos egzisztencialis kerdesek es az ezekkel valo megkuzdes teruleten. Ezeknek a korabbi tapasztalatoknak szerepe lehet a COVID-19-jarvannyal kapcsolatos veszelyeztetettseg megelese szempontjabol. Az egyre nagyobb szamu kvantitativ kutatason alapulo szakirodalom ellenere az erintettek szubjektiv tapasztalatainak megismerese tovabbra is hianyzik. Cel: Kutatasunk celja a kronikus legzoszervi betegek COVID-19-vilagjarvany altali veszelyeztetettsegelmenyenek, tapasztalatainak feltarasa es melyebb megertese volt kvalitativ, idiografias modszerrel. Az alabbi kutatasi kerdesekre kivantunk valaszt kapni: 1. Hogyan viszonyulnak az interjualanyok a legzoszervi alapbetegsegukhoz? 2. Mit jelent a szamukra a veszelyeztetettseg megelese? 3. Hogyan hatnak az alapbetegseggel kapcsolatos eredeti tapasztalatok a vilagjarvannyal jaro serulekenyseg megelesere? Modszerek: Vizsgalatunkhoz az interpretativ fenomenologiai analizis modszeret hasznaltuk. A kutatasban 8 fo vett reszt: 7 no es 1 ferfi, 29-60 evesek, a kovetkezo diagnozisok valamelyikevel: asztma, kronikus obstruktiv tudobetegseg, cisztas fibrozis. Eredmenyek: A felig strukturalt interjuk elemzese soran harom fotema bontakozott ki: 1. legzoszervi betegseg mint a mindennapokat meghatarozo tapasztalat, 2. a koronavirus vilagjarvany hatasa az enre es az identitasszervezodesre, illetve 3. a veszelyeztetettseg megelesehez valo alkalmazkodas. A levegotlenseg a progressziv tudobetegsegek legnehezebben toleralhato, leginkabb felelmetes velejaroja, amely elmeny kulonbozo modokon kapcsolodhat a felelemmel es a szorongassal. A COVID-19 potencialis fertozo volta eles hatarvonalat huz a veszelyeztetett En es a veszelyes Masik;vagyis az en es a vilag koze, tovabba kritikus elethelyzetet jelent a tarsas szuksegletek es vagyak kielegithetosege szempontjabol. Adaptaciojukban alapvetoen envedo mechanizmusok, illetve erzelem-fokuszu strategiak bontakoztak ki. Kovetkeztetesek: A jelenlegi vilagjarvany jelentos hatast gyakorol az erintett betegek eletere. A koronavirus elsosorban legutakat erinto termeszete miatt az erintettek veszelyeztetettkent tekintenek onmagukra, a veszelyeztetettseg megelese pedig alapvetoen meghatarozza eletuket;donteseiket, a vilaghoz valo kapcsolodasukat, identitasszervezodesuket, megkuzdesuket, s megkerdojelezi a vilag biztonsagossagaba vetett hituket. A kronikus legzoszervi betegek tapasztalatainak feltarasa kiemelt jelentoseggel bir a jarvany pszichoszocialis hatasait merseklo strategiak kidolgozasaban. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Diversity of respiratory viruses present in nasal swabs under influenza suspicion in respiratory disease cases of weaned pigs.

Respiratory diseases in weaned pigs are a common problem, with a complex etiology involving both viruses and bacteria. In the present study, we investigated the presence of eleven viruses in nasal swabs, collected from nurseries (55 cases) under the suspicion of swine influenza A virus (swIAV) and submitted by swine veterinarians for diagnosis. The other ten viruses included in the study were influenza B (IBV) and D (IDV), Porcine reproductive and respiratory syndrome virus (PRRSV), Porcine respiratory coronavirus (PRCV), Porcine cytomegalovirus (PCMV), Porcine circovirus 2 (PCV2), 3 (PCV3) and 4 (PCV), Porcine parainfluenza 1 (PPIV1) and Swine orthopneumovirus (SOV). Twenty-six swIAV-positive cases and twenty-nine cases of swIAV-negative respiratory disease were primarily established. While IBV, IDV, PCV4 and PPIV1 were not found in any of the cases, PRCV, SOV, and PCMV were more likely to be found in swIAV-positive nurseries with respiratory disease (p < 0.05). Overall, PCV3, PRRSV, and PCMV were the most frequently detected agents at herd level. Taken individually, virus prevalence was: swIAV, 48.6%; PRCV, 48.0%; PRRSV, 31.6%; SOV, 33.8%; PCMV, 48.3%, PCV2, 36.0%; and PCV3, 33.0%. Moreover, low Ct values (<30) were common for all agents, except PCV2 and PCV3. When the correlation between pathogens was individually examined, the presence of PRRSV was negatively correlated with swIAV and PRCV, while was positively associated to PCMV (p < 0.05). Also, PRCV and SOV were positively correlated between them and negatively with PCMV. Besides, the analysis of suckling pig samples, collected in subclinically infected farrowing units under an influenza monitoring program, showed that circulation of PRCV, PCMV, SOV, and PCV3 started during the early weeks of life. Interestingly, in those subclinically infected units, none of the pathogens was found to be correlated to any other. Overall, our data may contribute to a better understanding of the complex etiology and epidemiology of respiratory diseases in weaners. This is the first report of SOV in Spain and shows, for the first time, the dynamics of this pathogen in swine farms.

Mobile heath applications for self-management in chronic lung disease: a systematic review.

Integration of mobile health (mHealth) applications (apps) into chronic lung disease management is becoming increasingly popular. MHealth apps may support adoption of self-management behaviors to assist people in symptoms control and quality of life enhancement. However, mHealth apps' designs, features, and content are inconsistently reported, making it difficult to determine which were the effective components. Therefore, this review aims to summarize the characteristics and features of published mHealth apps for chronic lung diseases. A structured search strategy across five databases (CINAHL, Medline, Embase, Scopus and Cochrane) was performed. Randomized controlled trials investigating interactive mHealth apps in adults with chronic lung disease were included. Screening and full-text reviews were completed by three reviewers using Research Screener and Covidence. Data extraction followed the mHealth Index and Navigation Database (MIND) Evaluation Framework (https://mindapps.org/), a tool designed to help clinicians determine the best mHealth apps to address patients' needs. Over 90,000 articles were screened, with 16 papers included. Fifteen distinct apps were identified, 8 for chronic obstructive pulmonary disease (53%) and 7 for asthma (46%) self-management. Different resources informed app design approaches, accompanied with varying qualities and features across studies. Common reported features included symptom tracking, medication reminders, education, and clinical support. There was insufficient information to answer MIND questions regarding security and privacy, and only five apps had additional publications to support their clinical foundation. Current studies reported designs and features of self-management apps differently. These app design variations create challenges in determining their effectiveness and suitability for chronic lung disease self-management. Registration: PROSPERO (CRD42021260205). Supplementary Information: The online version contains supplementary material available at 10.1007/s13721-023-00419-0.

A comprehensive analysis of systematically screened laboratory tests: based on a COVID-19 cohort.

INTRODUCTION: The study aimed at screening indicators with differential diagnosis values and investigating the characteristics of laboratory tests in COVID-19 patients. METHODOLOGY: All the laboratory tests from COVID-19 patients and non-COVID-19 patients in this cohort were included. Test values from the groups during the course, days 1-7, and days 8-14 were analyzed. Mann-Whitney U test, univariate logistic regression analysis, and multivariate regression analysis were performed. Regression models were established to verify the diagnostic performance of indicators. RESULTS: 302 laboratory tests were included in this cohort, and 115 indicators were analyzed; the values of 61 indicators had significant differences (p < 0.05) between groups, and 23 indicators were independent risk factors of COVID-19. During days 1-7, the values of 40 indicators had significant differences (p < 0.05) between groups, while 20 indicators were independent risk factors of COVID-19. During days 8-14, the values of 45 indicators had significant differences (p < 0.05) between groups, and 23 indicators were independent risk factors of COVID-19. About 10, 12, and 12 indicators showed significant differences (p < 0.05) in multivariate regression analysis in different courses respectively, and the diagnostic performance of the model from them was 74.9%, 80.3%, and 80.8% separately. CONCLUSIONS: The indicators obtained through systematic screening have preferable differential diagnosis values. Compared with non-COVID-19 patients, the screened indicators indicated that COVID-19 patients had more severe inflammatory responses, organ damage, electrolyte and metabolism disturbance, and coagulation disorders. This screening approach could find valuable indicators from a large number of laboratory test indicators.

Detection of Influenza D-Specific Antibodies in Bulk Tank Milk from Swedish Dairy Farms.

Influenza D virus (IDV) has been detected in bovine respiratory disease (BRD) outbreaks, and experimental studies demonstrated this virus's capacity to cause lesions in the respiratory tract. In addition, IDV-specific antibodies were detected in human sera, which indicated that this virus plays a potential zoonotic role. The present study aimed to extend our knowledge about the epidemiologic situation of IDV in Swedish dairy farms, using bulk tank milk (BTM) samples for the detection of IDV antibodies. A total of 461 and 338 BTM samples collected during 2019 and 2020, respectively, were analyzed with an in-house indirect ELISA. In total, 147 (32%) and 135 (40%) samples were IDV-antibody-positive in 2019 and 2020, respectively. Overall, 2/125 (2%), 11/157 (7%) and 269/517 (52%) of the samples were IDV-antibody-positive in the northern, middle and southern regions of Sweden. The highest proportion of positive samples was repeatedly detected in the south, in the county of Halland, which is one of the counties with the highest cattle density in the country. In order to understand the epidemiology of IDV, further research in different cattle populations and in humans is required.

Ultrasonic personal spirometer appears accurate and feasible for remote monitoring

Introduction/Aim: Home spirometry may improve respiratory disease monitoring and management and mitigate the decline in testing exacerbated by COVID-19. Smartphone-connected spirometers could allow patients to conduct spirometry independently without the need to travel to lung function clinics. This study assessed the accuracy of a personal spirometer and the feasibility of unsupervised home spirometry. Method(s): Subjects (19-88 years) with (n = 44) and without (n = 20) respiratory disease, were recruited and supervised to perform spirometry on a standard desktop spirometer (MGC Diagnostics) and a personal ultrasonic spirometer (SpiroHome) in the clinical laboratory. Unsupervised testing was subsequently conducted using the SpiroHome at the subjects' home (2 tests/week for 3 weeks). Subjects returned to the clinic to conduct an exit survey which assessed their willingness to adopt a personal spirometer into their long-term care plan. Comparisons between desktop and personal spirometry, as well as supervised and unsupervised spirometry, were compared by Bland-Altman analysis (%Bias +/- CI) and Pearson's correlation. Result(s): The proportion of tests meeting American Thoracic Society/European Respiratory Society criteria (80%) remained constant across clinic and home spirometry sessions for subjects who completed 3 weeks of home testing (p = 0.73, Fisher's exact test, n = 61). Supervised spirometry on the SpiroHome (n = 56) reliably measured FEV 1 (-3.12+/-27.01%;r=0.98, p < 0.0001) and FVC (-0.38+/-22.91%;r=0.99, p < 0.0001) producing a small underestimation compared to desktop spirometry. Unsupervised home spirometry (when performed <24 hrs from the clinic appointment) on the SpiroHome (n = 51) produced a small underestimation of FEV 1 (-2.41+/-35.57%;r=0.96, p < 0.0001) and a slight overestimation of FVC (0.08+/-24.70%;r=0.98, p < 0.0001) compared with supervised manoeuvres in the clinical laboratory. Conclusion(s): Findings indicate that lung function assessed by SpiroHome compares well with in-clinic standard desktop spirometry across a range of diseases and severities in both the clinic and home settings. A larger cohort of subjects are being recruited to confirm the accuracy and the overall utility of personal spirometry.

Vitamin D and acute and severe illness - a mechanistic and pharmacokinetic perspective.

The coronavirus disease 2019 (COVID-19) pandemic has generated high interest in factors modulating risk of infection, disease severity and recovery. Vitamin D has garnered interest since it is known to modulate immune function and vitamin D deficiency is associated with increased risk of respiratory infections and adverse health outcomes in severely ill patients. There are no population representative data on the direct relationship between vitamin D status and severe acute respiratory syndrome coronavirus 2 infection risk and severity of COVID-19. Data from intervention studies are limited to four studies. Here we summarise findings regarding vitamin D status and metabolism and their alterations during severe illness, relevant to COVID-19 patients. Further, we summarise vitamin D intervention studies with respiratory disease outcomes and in critically ill patients and provide an overview of relevant patient and population guidelines. Vitamin D deficiency is highly prevalent in hospitalised patients, particularly when critically ill, including those with COVID-19. Acute and critical illness leads to pronounced changes in vitamin D metabolism and status, suggestive of increased requirements. This needs to be considered in the interpretation of potential links between vitamin D status and disease risk and severity and for patient management. There is some evidence that vitamin D supplementation decreases the risk of respiratory tract infections, while supplementation of intensive care unit patients has shown little effect on disease severity or length of treatment. Considering the high prevalence of deficiency and low risks associated with supplementation, pro-actively applying current population and patient management guidelines to prevent, monitor and correct vitamin D deficiency is appropriate.

COVID-19: Correlation between HRCT findings and clinical prognosis and analysis of parenchymal pattern evolution.

Objectives: Severe acute respiratory syndrome - coronavirus 2 (SARS-CoV-2) is a single-stranded positive ribonucleic acid virus of the coronaviridae family. The disease caused by this virus has been named by the World Health Organization coronavirus disease 19 (COVID-19), whose main manifestation is interstitial pneumonia. Aim of this study is to describe the radiological features of SARS-CoV-2 infection in its original form, to correlate the high-resolution computed tomography (HRCT) patterns with clinical findings, prognosis and mortality, and to establish the need for treatment and admission to the intensive care unit. Material and Methods: From March 2020 to May 2020, 193 patients (72 F and 121 M) who were swab positive for SARS-CoV-2 were retrospectively selected for our study. These patients underwent HRCT in the clinical suspicion of SARS-CoV-2 interstitial pneumonia. Results: Our results confirm the role of radiology and, in particular, of chest HRCT as a technique with high sensitivity in the recognition of the most peculiar features of COVID-19 pneumonia, in the evaluation of severity of the disease, in the correct interpretation of temporal changes of the radiological picture during the follow-up until the resolution, and in obtaining prognostic information, also to direct the treatment. Conclusion: Chest computed tomography cannot be considered as a substitute for real-time - polymerase chain reaction in the diagnosis of COVID-19, but rather supplementary to it in the diagnostic process as it can detect parenchymal changes at an early stage and even before the positive swab, at least for patients who have been symptomatic for more than 3 days.

Evaluating Listening Performance for COVID-19 Detection by Clinicians and Machine Learning: Comparative Study.

BACKGROUND: To date, performance comparisons between men and machines have been carried out in many health domains. Yet machine learning (ML) models and human performance comparisons in audio-based respiratory diagnosis remain largely unexplored. OBJECTIVE: The primary objective of this study was to compare human clinicians and an ML model in predicting COVID-19 from respiratory sound recordings. METHODS: In this study, we compared human clinicians and an ML model in predicting COVID-19 from respiratory sound recordings. Prediction performance on 24 audio samples (12 tested positive) made by 36 clinicians with experience in treating COVID-19 or other respiratory illnesses was compared with predictions made by an ML model trained on 1162 samples. Each sample consisted of voice, cough, and breathing sound recordings from 1 subject, and the length of each sample was around 20 seconds. We also investigated whether combining the predictions of the model and human experts could further enhance the performance in terms of both accuracy and confidence. RESULTS: The ML model outperformed the clinicians, yielding a sensitivity of 0.75 and a specificity of 0.83, whereas the best performance achieved by the clinicians was 0.67 in terms of sensitivity and 0.75 in terms of specificity. Integrating the clinicians' and the model's predictions, however, could enhance performance further, achieving a sensitivity of 0.83 and a specificity of 0.92. CONCLUSIONS: Our findings suggest that the clinicians and the ML model could make better clinical decisions via a cooperative approach and achieve higher confidence in audio-based respiratory diagnosis.

Impact of the COVID-19 pandemic on diagnosis of respiratory diseases in the Northern Metropolitan Area in Barcelona (Spain).

Objective: The COVID-19 pandemic has had a great effect on the management of chronic diseases, by limiting the access to primary care and to diagnostic procedures, causing a decline in the incidence of most diseases. Our aim was to analyze the impact of the pandemic on primary care new diagnoses of respiratory diseases. Methods: Observational retrospective study performed to describe the effect of COVID-19 pandemic on the incidence of respiratory diseases according to primary care codification. Incidence rate ratio between pre-pandemic and pandemic period was calculated. Results: We found a decrease in the incidence of respiratory conditions (IRR 0.65) during the pandemic period. When we compared the different groups of diseases according to ICD-10, we found a significant decrease in the number of new cases during the pandemic period, except in the case of pulmonary tuberculosis, abscesses or necrosis of the lungs and other respiratory complications (J95). Instead, we found increases in flu and pneumonia (IRR 2.17) and respiratory interstitial diseases (IRR 1.41). Conclusion: There has been a decrease in new diagnosis of most respiratory diseases during the COVID-19 pandemic.

Objetivo: La pandemia de COVID-19 ha tenido efecto sobre el seguimiento de las enfermedades crónicas. Nuestro objetivo fue analizar el impacto de la pandemia por COVID-19 en los nuevos diagnósticos respiratorios en atención primaria. Metodología: Estudio observacional retrospectivo realizado para describir el impacto de la COVID-19 sobre la incidencia de diagnósticos respiratorios en atención primaria. Se ha calculado la tasa relativa de incidencia entre el periodo prepandémico y el pandémico. Resultados: Hallamos una reducción en la incidencia de patología respiratoria (IRR 0,65) durante la pandemia. Al comparar los distintos grupos de enfermedades (CIE-10), encontramos una reducción significativa en el número de nuevos casos durante la pandemia, excepto en el caso de tuberculosis pulmonar, abscesos o necrosis pulmonar y otras complicaciones respiratorias. Por otro lado, se detectaron incrementos en nuevos diagnósticos de gripe y neumonía (IRR 2,17) y enfermedades respiratorias intersticiales (IRR 1,41). Conclusión: Se ha producido un descenso en el número de nuevos diagnósticos de la mayoría de las enfermedades respiratorias durante la pandemia por COVID-19.

[Expert opinion on strategies to improve vaccination coverage against seasonal influenza]. / Documento de opinión de expertos para la mejora de la cobertura vacunal frente a la gripe estacional.

Seasonal flu continues to be a major public health concern, and the influenza vaccine remains the most effective preventive measure. In Spain, vaccination coverage data from previous seasons show vaccination rates well below official targets; however, these figures improved significantly after the COVID-19 pandemic. Given the importance of achieving and maintaining high vaccination rates in order to avoid the clinical and economic impact of influenza, our multidisciplinary group of experts on vaccines analyzed the impact of low vaccination rates in Spain and drafted a series of measures to boost influenza vaccination coverage, particularly among priority groups.

Do Preprocessing and Class Imbalance Matter to the Deep Image Classifiers for COVID-19 Detection? An Explainable Analysis

In a world withstanding the waves of a raging pandemic, respiratory disease detection from chest radiological images using machine-learning approaches has never been more important for a widely accessible and prompt initial diagnosis. A standard machine-learning disease detection workflow that takes an image as input and provides a diagnosis in return usually consists of four key components, namely input preprocessor, data irregularities (like class imbalance, missing and absent features, etc.) handler, classifier, and a decision explainer for better clarity. In this study, we investigate the impact of the three primary components of the disease-detection workflow leaving only the deep image classifier. We specifically aim to validate if the deep classifiers may significantly benefit from additional preprocessing and efficient handling of data irregularities in a disease-diagnosis workflow. To elaborate, we explore the applicability of seven traditional and deep preprocessing techniques along with four class imbalance handling approaches for a deep classifier, such as ResNet-50, in the task of respiratory disease detection from chest radiological images. While deep classifiers are more capable than their traditional counterparts, explaining their decision process is a significant challenge. Therefore, we also employ three gradient visualization algorithms to explain the decision of a deep classifier to understand how well each of them can highlight the key visual features of the different respiratory diseases. © 2020 IEEE.

Indian Traditional Medicine for COVID-19

Background: A novel coronavirus COVID-19 outbreak causing infectious respiratory disorders. COVID-19 disease has no specific treatment. In traditional medicinal system, different formulations are available for infectious diseases. Objective(s): This review discusses the significance and utilization of Siddha and Ayurvedic herbal formulations for COVID-19 treatment and provides scientific information regarding the phytochem-istry and pharmacological profiles of Indian medicinal plants used in the formulation. Method(s): The information on medicine and medicinal plants was collected from research papers, review papers, and books available in several electronic databases, including Google Scholar, SpringerLink, and PubMed was explored as information sources. Result(s): Traditional medicinal plants are potentially used in formulations due to their inevitable therapeutic properties. Phytochemistry and pharmacological properties of medicinal plants used in the formulations served as scientific proof for traditional medicine. Conclusion(s): The present study explored the great importance of Siddha and Ayurvedic formulations for COVID-19 treatment. Further scientific investigations are required to explore these formulations as widely acceptable.Copyright © 2023 Bentham Science Publishers.

A Review on Covid-19

COVID-19 (Corona Virus Disease 2019) is a matter of concern since the end of the year 2019, when China informed WHO that there is some pneumonia-like disease with unknown causes in Wuhan.Corona disease is related to the SARS-CoV-2 i.e. Severe Acute Respiratory Syndrome Corona Virus 2. SARS CoV-2 is the strain of coronavirus that causes the disease. Coronaviruses are a group of single-stranded viral RNA genome.WHO has declared COVID-19 as pandemic. Among the various varieties of coronavirus, six are known to infect the human host and cause respiratory diseases. Belonging to the family "Coronaviridae", coronavirus causes a broad spectrum of human and animal diseases. In this review, we have worked to possibly cover all the information about coronavirus.Copyright © 2020 Ubiquity Press. All rights reserved.

SARS-CoV-2 Related Antibody-Dependent Enhancement Phenomena In Vitro and In Vivo.

Antibody-dependent enhancement (ADE) is a phenomenon in which antibodies produced in the body after infection or vaccination may enhance subsequent viral infections in vitro and in vivo. Although rare, symptoms of viral diseases are also enhanced by ADE following infection or vaccination in vivo. This is thought to be due to the production of antibodies with low neutralizing activity that bind to the virus and facilitate viral entry, or antigen-antibody complexes that cause airway inflammation, or a predominance of T-helper 2 cells among the immune system cells which leads to excessive eosinophilic tissue infiltration. Notably, ADE of infection and ADE of disease are different phenomena that overlap. In this article, we will describe the three types of ADE: (1) Fc receptor (FcR)-dependent ADE of infection in macrophages, (2) FcR-independent ADE of infection in other cells, and (3) FcR-dependent ADE of cytokine production in macrophages. We will describe their relationship to vaccination and natural infection, and discuss the possible involvement of ADE phenomena in COVID-19 pathogenesis.

A Decade of Clinical Advances in Chronic Rhinosinusitis: 2012-2022.

The field of chronic rhinosinusitis (CRS) is constantly evolving. In the past 10 years, key advancements in basic and translational research as well as clinical studies have improved our understanding and management of CRS. Notably, treatment options have expanded to include novel therapeutic drugs, devices, and surgical techniques. Assessments of patient symptoms and their impact on quality of life have become more standardized. Progress has also been made in both determining the true prevalence of CRS and recognizing comorbidities that can impact CRS severity. Practice guidelines have also shifted from expert opinion to more data-driven analyses. This review highlights major clinical advancements made in the field of CRS over the past 10 years as well as identifies current gaps in knowledge that can form the basis for new areas of study over the next decade.

[The impact of the COVID-19 epidemic on the course of the most common respiratory diseases]. / A COVID­19-járvány hatása a leggyakoribb légzoszervi megbetegedések lefolyására.

INTRODUCTION: SARS-CoV-2 has defined our everyday lives over the past three years and by constituting a serious risk factor for patients with pre-existing respiratory illnesses, it placed an unexpected burden on the health care systems worldwide. OBJECTIVE: The aim of this study was to explore the association between COVID-19 and pre-existing respiratory comorbidities such as chronic obstructive pulmonary disease (COPD) and asthma. METHOD: In our current study, we retrospectively processed the data of nearly 29 000 Hungarian patients. RESULTS: We found that COPD was directly associated with the severity of COVID-19 and slightly increased the risk of intensive care unit admission and the need for mechanical ventilation during the SARS-CoV-2 infection. On the other hand, the presence of asthma influenced neither the severity of COVID-19 nor the need for intensive care unit admission or mechanical ventilation significantly. DISCUSSION: International studies suggest that COPD does not significantly increase the risk of SARS-CoV-2 infection. However, the likelihood of hospitalization due to COVID-19 is much higher in COPD patients and the presence of COPD is associated with a more severe disease course. Given the structural alterations and abnormal regeneration processes of the airways that occur during lung injury in COPD patients, these individuals require increased attention and personalized rehabilitation protocols after the onset of the viral infection. CONCLUSION: Altogether, the assessment of clinical manifestations associated with different COPD phenotypes (as well as other chronic lung diseases) and SARS-CoV-2 infection is essential for the implementation of personalized therapeutic approach in the future. Orv Hetil. 2023; 164(2): 51-56.