Expressions of miR-21 TGF-beta/Smad signaling pathway in peripheral blood of bronchial asthma patients complicated with respiratory virus infection

OBJECTIVE: To investigate the expressions of peripheral blood microRNA-21(miR-21) and transforming growth factor-beta(TNF-beta)/Smad signaling transduction pathway in patients with bronchial asthma complicated with respiratory virus infection. METHODS: Totally 109 patients with asthma complicated with respiratory virus infection(study group) and 104 patients without virus infection(control group) in the Third People's Hospital of Gansu Province between Feb.2019 and Feb.2021 were selected for the cross-sectional study. The basic data of the two groups were collected, and parameters including vital signs, lung function, peripheral blood miR-21 and TGF-beta/Smad signaling pathway proteins were measured. According to the guidelines, the patients of the two groups were divided into acute exacerbation phase and stable phase. The examination results of each group were compared and the levels of peripheral blood miR-21 and TGF-beta/Smad signaling pathway proteins expression of patients with asthma complicated with respiratory virus infection were analyzed. RESULTS: In study group, the proportion of respiratory virus infection among 109 patients was 33.94% for influenza virus, 23.85% for human rhinovirus, 19.27% for respiratory syncytial virus, 10.09% for parainfluenza virus, 6.42% for adenovirus, 4.59% for human coronavirus and 1.83% for human metapneumovirus respectively. The proportion of patients with acute exacerbation phase in the study group was higher than that in the control group, and the levels of peripheral blood miR-21, TGF-beta1, Smad7, pSmad2 and pSmad3 were higher than those in control group(P<0.05). The levels of miR-21, TGF-beta1, Smad2, Smad3, Smad7, pSmad2 and pSmad3 in peripheral blood of patients with acute exacerbation phase of asthma were higher than those of patients with stable phase of asthma(P<0.05). There were no statistical differences in peripheral blood miR-21, TGF-beta1, Smad2, Smad3, Smad7, pSmad2 and pSmad3 levels in asthma patients with different virus infections. CONCLUSION: Early respiratory virus infections might lead to increased expression of peripheral blood miR-21 and increased activation of TGF-beta/Smad signaling pathway in patients with asthma, which played an important role in acute attack of asthma.

Pathology Detector System in the Bronchopulmonary System of Asthmatic patients visualized through a radiofrequency of the chest

The arrival of COVID-19 caused devastation to humanity by spreading rapidly around the world and seriously affecting the entire health system. To date, the peculiar symptoms of COVID-19 and the problems it generates in those asthmatic people are already known, which is complicated if they have not had an adequate treatment of their disease, since bronchial asthma is one of the complex bronchopulmonary diseases and for its diagnosis some methods are used that do not provide enough information about the patient's condition, being inefficient methods, therefore, it is necessary to use tools to diagnose pathologies to patients in a comfortable way for an efficient treatment by providing the greatest amount of information about the patient's condition for continuous treatment and in addition to facilitating constant access to several patients with asthma. In view of this problem, in this article a pathology detection system was made in the bronchopulmonary system of asthmatic patients visualized through a radiofrequency of the chest, in such a way that an early diagnosis is made, and some pathological change can be detected in the patient's bronchopulmonary system, with this, an efficient treatment of the patient can be carried out. Through the development of the system, it was possible to observe that the operation was done correctly in the tests conducted, the positioning equipment will move the radiant module on the patient's body for the detection of some pathology with an accuracy of 97.86% efficiency. © 2023 IEEE.

SOME FEATURES OF THE CORONAVIRUS INFECTION COURSE IN BRONCHIAL ASTHMA PATIENTS

The outbreak of a new coronavirus infection was officially recognized by the World Health Organization as a global pandemic since March 11, 2020. The pandemic is currently gradually receding, the number of patients is also steadily decreasing. However, these circumstances are not grounds to believe that the virus has been definitively and irrevocably defeated. For this reason, the world medical community is still concerned about the coronavirus' impact on the course and outcome of various chronic bronchopulmonary diseases. Bronchial asthma has been recognized as one of the leading forms of human somatic pathology throughout the history of mankind and medicine. It is quite natural that the focus of the researchers' attention turned out to be questions about the SARS-CoV-2 virus' impact on patients suffering from bronchial asthma, starting with the peculiarities of the course of combined pathology and ending with the peculiarities of therapy and subsequent rehabilitation. The issues of coronavirus infection and bronchial asthma pathogenesis were considered. The research data on some features of the development and course of a new coronavirus infection in patients with this profile were analyzed and summarized. The low coronavirus infection prevalence among patients with an allergic bronchial asthma form compared with other phenotypes is shown among such features, data on the effect of eosinophilia on the course of infection are presented, and the basic therapy's positive effect using inhaled glucocorticosteroids and/or monoclonal antibodies (biological therapy) in severe asthma, is shown in the form of a protective effect that provides a lighter coronavirus infection course. The main features of patient management suffering from bronchial asthma in the conditions of a pandemic are the organization of stable medical control in online telemedicine once monthly, regular examinations in accordance with the severity of the course of the disease and the correction of basic therapy to achieve complete control over the course of asthma. The article can be used under the CC BY-NC-ND 4.0 license © Authors, 2022.

Respiratory Disorders: Contemporary Issues in 2020

Respiratory system bears the major brunt of environmental insults. Respiratory infections such as pneumonias continue to threaten human health. The corona virus pandemic (COVID-19) is the most recent example of a respiratory infection threatening the human kind. Tuberculosis is one of the most ancient diseases which continue to pose as a clinical problem. Besides infections, there is a huge burden of chronic respiratory disorders in terms of morbidity and mortality. Chronic respiratory disease (CRD) is among the most common non-communicable diseases (NCDs) identified by the World Health Organization. Chronic obstructive pulmonary disease (COPD) is the third most common cause of death the world over. Respiratory allergies such as bronchial asthma, environmental, occupational and other interstitial lung diseases are other common chronic lung diseases which are increasing in incidence. Several new diagnostic and treatment modalities have been added in our armamentarium to fight against these disorders. Besides the medical and surgical treatments, some of these interventions are non-pharmacological in nature such as the pulmonary rehabilitation and patient education programmes. Newer strategies and governmental programmes constitute other important steps to control the disease-burden. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022.

Organization of immunobiological therapy for severe bronchial asthma in the Sverdlovsk region

BACKGROUND: Biologicals use in severe asthma (SA) is associated with targeted therapy (TT) availability problem. Ensuring the availability of biologicals can be resolved within the territorial compulsory medical insurance program (TCMIP) in day-stay or round-the-clock hospital. AIMS: This study aimed to develop and implement a program for immunobiological therapy (IBT) introduction for SA in Sverdlovsk Region (SR). MATERIALS AND METHODS: Program for introduction of IBT for SA was developed in SR in 2018 to provide patients with expensive biologicals within the TCMIP. Program includes the following: SA prevalence study in SR;practitioners training in differential diagnosis of SA;organization of affordable therapy for patients with SA;registration of patients with SA creation and maintenance;and selection and management of patients with SA in accordance with federal clinical guidelines. RESULT(S): Atopic phenotype in SA was detected in 5%, eosinophilic - in 2.3% of all analyzed cases of asthma (n=216). Practitioners of SR were trained in differential diagnosis of SA. Orders of the Ministry of Health of SR were issued as follows: regulating the procedure for referring patients with SA to IBT, with a list of municipal medical organizations providing IBT in a day-stay or round-the-clock hospital;approving regional registration form of patients with SA requiring biologicals use;ungrouping of clinical and statistical groups of day-stay hospital was depending on INN and dosage of biologicals;and selecting patients with SA for TT and including them in the regional register. Initiating of TT in round-the-clock hospital and continuation therapy in day-stay hospital provides a significant savings in compulsory medical insurance funds. CONCLUSION(S): IBT introduction for SA in SR is carried out within the framework of the developed program. Principle of decentralization brings highly specialized types of medical care closer to patients making it possible to provide routine medical care in "allergology-immunology" profile in the context of restrictions caused by coronavirus disease 2019 pandemic.Copyright © 2020 Pharmarus Print Media All rights reserved.

Some features of the coronavirus infection course in bronchial asthma patients

The outbreak of a new coronavirus infection was officially recognized by the World Health Organization as a global pandemic since March 11, 2020. The pandemic is currently gradually receding, the number of patients is also steadily decreasing. However, these circumstances are not grounds to believe that the virus has been definitively and irrevocably defeated. For this reason, the world medical community is still concerned about the coronavirus' impact on the course and outcome of various chronic bronchopulmonary diseases. Bronchial asthma has been recognized as one of the leading forms of human somatic pathology throughout the history of mankind and medicine. It is quite natural that the focus of the researchers' attention turned out to be questions about the SARS-CoV-2 virus' impact on patients suffering from bronchial asthma, starting with the peculiarities of the course of combined pathology and ending with the peculiarities of therapy and subsequent rehabilitation. The issues of coronavirus infection and bronchial asthma pathogenesis were considered. The research data on some features of the development and course of a new coronavirus infection in patients with this profile were analyzed and summarized. The low coronavirus infection prevalence among patients with an allergic bronchial asthma form compared with other phenotypes is shown among such features, data on the effect of eosinophilia on the course of infection are presented, and the basic therapy's positive effect using inhaled glucocorticosteroids and/or monoclonal antibodies (biological therapy) in severe asthma, is shown in the form of a protective effect that provides a lighter coronavirus infection course. The main features of patient management suffering from bronchial asthma in the conditions of a pandemic are the organization of stable medical control in online telemedicine once monthly, regular examinations in accordance with the severity of the course of the disease and the correction of basic therapy to achieve complete control over the course of asthma.

Features of COVID-19 in patients with chronic obstructive pulmonary disease, bronchial asthma, and cardiovascular comorbidity

Aim. The aim of the study was to identify the features of a new coronavirus infection in patients with chronic obstructive pulmonary disease (COPD), bronchial asthma (BA), and cardiovascular disease (CVD). Materials and Methods. The retrospective study included 58 patients with novel coronavirus infection, which were divided into four groups: group 1 comprised 12 patients with COPD and CVD;group 2 comprised 15 patients with BA and CVD;and group 3 comprised 31 patients with CVD only. All patients underwent a clinical examination, complete blood count, biochemical blood examination, coagulation testing, serum ferritin test, and multi-slice computed tomography. Results. The severity of dyspnea was greater in patients with COPD/CVD compared with BA/CVD, and in patients without bronchopulmonary pathology. The frequency of desaturation was the lowest in BA/CVD group compared with COPD/CVD and COPD/BA/CVD. A lower level of saturation was observed in COPD/CVD group in comparison with BA/CVD. The extent of lung damage also prevailed in group with COPD/CVD compared with patients without bronchopulmonary pathology. Patients with CVD only demonstrated the lowest level of leukocytes in contrast with all other study groups. However, the platelet count prevailed in the CVD group compared with the COPD/CVD group. Serum ferritin in patients with COPD/CVD was higher than in the AD/CVD group. Conclusion. Patients with COPD had more severe coronavirus infection due to severity of dyspnea, low saturation indicators, high values of ferritin, and greater severity of lung damage according to computed tomography. Patients with asthma were prone to a less severe course of coronavirus infection due to less dyspnea, rare episodes of desaturation, high saturation rates, and low ferritin values. © 2022 Tomsk State University. All rights reserved.

[A CASE OF INDUCIBLE LARYNGEAL OBSTRUCTION UNSUCCESSFULLY TREATED AS SEVERE ASTHMA WAS WELL CONTROLLED AFTER APPROPRIATE DIAGNOSIS AND INSTRUCTION OF THERAPEUTIC BREATHING MANEUVERS].

BACKGROUND: Inducible laryngeal obstruction (ILO) refers to respiratory disorders caused by airflow limitation in the larynx, including vocal cord dysfunction, and may sometimes be misdiagnosed as bronchial asthma (BA). Here, we report the case of an 11-year-old boy diagnosed with BA in infancy. He was referred to our Allergy Center and was taking a high dose of inhaled corticosteroids (ICS) due to frequent coughing from the age of 10 years and persistent coughing following COVID-19 infection at the age of 11. However, the patient continued to experience frequent coughing attacks and repeated visits to the emergency department after inhalation of ß2-stimulants failed to improve his cough. We admitted him to the allergy center for examinations to assess the BA severity. In the airway hypersensitiveness test, saline inhalation performed prior to methacholine inhalation caused expiratory stridor and respiratory distress in the larynx, which worsened with ß2-stimulant inhalation. Based on these results, we ruled out BA and diagnosed ILO. We instructed him on breathing maneuvers, and he was able to respond appropriately when symptoms appeared. We then started reducing his ICS dose.

COVID-19 lockdown, personal protective equipment, hyper-hygiene and allergy.

SUMMARY: At the beginning of Sars-Cov 2 pandemic, in the absence of "targeted" therapies, the national health authorities have introduced some measures aimed at reducing the spread of infection in the community (lockdown, social distancing, personal protective equipment (PPE), personal hygiene and disinfection of living environments). All the containment measures have led to both positive and negative effects in patients with allergic diseases. We believe that further studies should be undertaken to investigate the possible correlations between SARS-CoV-2 infection and allergy, from a broader perspective. In particular, the risk factors for the development of undesirable effects should be investigated, especially in healthcare professionals forced to use PPE and sanitizing agents for a long time. However, since the COVID-19 pandemic probably will not be short-lived, the use of such protective aids will necessarily be widespread even in the general population. Therefore, further studies on the materials used for the production of PPE and sanitizing agents would be necessary to reduce their sensitizing and, in some cases, toxic potential.

Relationship between meteorological and environmental factors and acute exacerbation for pediatric bronchial asthma: Comparative study before and after COVID-19 in Suzhou.

Objective: Climate and environmental change is a well-known factor causing bronchial asthma in children. After the outbreak of coronavirus disease (COVID-19), climate and environmental changes have occurred. The present study investigated the relationship between climate changes (meteorological and environmental factors) and the number of hospitalizations for pediatric bronchial asthma in Suzhou before and after the COVID-19 pandemic. Methods: From 2017 to 2021, data on daily inpatients diagnosed with bronchial asthma at Children's Hospital of Soochow University were collected. Suzhou Meteorological and Environmental Protection Bureau provided daily meteorological and environmental data. To assess the relationship between bronchial asthma-related hospitalizations and meteorological and environmental factors, partial correlation and multiple stepwise regression analyses were used. To estimate the effects of meteorological and environmental variables on the development of bronchial asthma in children, the autoregressive integrated moving average (ARIMA) model was used. Results: After the COVID-19 outbreak, both the rate of acute exacerbation of bronchial asthma and the infection rate of pathogenic respiratory syncytial virus decreased, whereas the proportion of school-aged children and the infection rate of human rhinovirus increased. After the pandemic, the incidence of an acute asthma attack was negatively correlated with monthly mean temperature and positively correlated with PM2.5. Stepwise regression analysis showed that monthly mean temperature and O3 were independent covariates (risk factors) for the rate of acute asthma exacerbations. The ARIMA (1, 0, 0) (0, 0, 0) 12 model can be used to predict temperature changes associated with bronchial asthma. Conclusion: Meteorological and environmental factors are related to bronchial asthma development in children. The influence of meteorological and environmental factors on bronchial asthma may be helpful in predicting the incidence and attack rates.

Cross-sectional study: COVID-19 infection in patients with severe bronchial asthma receiving monoclonal antibody treatments

BACKGROUND AND AIM: The aim of this study was to expose the course of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in patients with severe bronchial asthma receiving monoclonal antibody (MAb) treatments and in patients not receiving MAb treatment. METHODS: In this retrospective study, 211 adult patients with severe bronchial asthma (155 females and 56 males), who were being followed up in a tertiary allergy clinic between June 2020 and December 31, 2020, were evaluated. RESULTS: A total of 211 patients with severe bronchial asthma were included in the study (155 females and 56 males). The mean age was 42 years (18-79 years). Thirty-six patients (17.1%) were on mepolizumab treatment and 58 patients (27.5%) were on omalizumab treatment. Fiftyseven patients (27%) became infected with the SARS-CoV-2 during the study. The rate of SARSCoV-2-related pneumonia was 7.6%. There was a significant difference between the patients on omalizumab treatment, patients on mepolizumab treatment, and the nonreceivers in terms of the rate of SARS-CoV-2-related pneumonia (p=0.023). No difference was found between the patients with severe bronchial asthma on omalizumab treatment and those on mepolizumab treatment in terms of the rate of pneumonia (p=0.752). No significant difference was found between the patients receiving omalizumab and/or mepolizumab treatments and nonreceivers in terms of SARSCoV-2-related hospitalization (p=0.191). CONCLUSIONS: The frequency of SARS-CoV-2 infection and the rate of SARS-CoV-2-related hospitalizations did not increase in patients with severe bronchial asthma on MAb treatment compared with patients who did not receive treatment.

COVID-19 in a group of children with asthma: presentation, severity, and outcome

Background: There are insufficient data concerning COVID-19 severity among asthmatic children. Aim(s): to evaluate the impact of asthma on COVID-19 severity and outcome. Patients and Methods: We carried out an observational study that comprised 2 matched groups of children with confirmed/probable COVID-19: 30 with and 32 without asthma aged 6-18 years, who were enrolled consecutively from Children's Hospital, Ain Shams University, Egypt. COVID-19 clinical presentations, laboratory and radiological abnormalities, severity and outcome were compared between the 2 groups. Asthma severity and control were assessed based on GINA 2020. Result(s): The asthmatic COVID-19 children were 9 boys and 21 girls, with median age 9 years, IQR: 8-12 years. The non-asthmatic COVID-19 group included 18 males and 14 females with median age 9.5 years, IQR: 7-12.5 years. Clinical manifestations of COVID-19 were comparable among the 2 groups, except for wheezes which were more frequently encountered as a COVID-19 manifestation among the asthmatics (p=0.001). Multisystem inflammatory syndrome (MIS-c) was diagnosed in one asthmatic and 3 non-asthmatic patients. The asthmatic group had higher frequency of serum ferritin, LDH and D-dimer elevations compared to the non-asthmatic peers (p values 0.014, 0.001, and 0.015 respectively). Based on CO-RAD classification, 70% of the asthmatic patients had CO-RAD score of 5 versus 6.3 % among the non-asthmatic group with significant differences between the 2 groups in their CO-RAD scores (P=0.002). COVID-19 severity was comparable among the studied groups (P=0.775), as well as COVID-19 outcome and duration of hospital stay (p values 0.999, and 0.655, respectively). Conclusion(s): From our limited sample sized study, childhood asthma did not pose a significant impact on COVID-19 severity and outcome. Further longitudinal studies are warranted to validate our conclusion and investigate the relation of COVID-19 severity and outcome to allergen immunotherapy and the use of biologicals for asthma treatment. Copyright © 2022, E-Century Publishing Corporation. All rights reserved.

Aerococcus viridans Bacteraemia in a COVID-19 Positive Patient: A Rare Case Report from Northern India

Aerococcus viridans is a rare Gram positive microorganism identified largely as environmental or skin contaminants. With the advent of an increase in the immunosuppressed population due to diabetes, the use of steroids and the Coronavirus Disease 2019 (COVID-19) pandemic, this bacteria caused a variety of infections like bacteraemia, urinary tract infections, and endocarditis. The use of Matrix-Assisted Laser Desorption Ionisation Time-of-Flight Mass-Spectrometry (MALDI-TOF MS), a unique technique of microorganism identification, has placed Aerococci among human pathogens, capable of causing infection among immunocompromised patients. The present case was of a 48-year-old female presented with dry cough, high-grade fever associated with chills and rigors, and generalised body ache and weakness for the past one week. She was a known case of bronchial asthma. She tested positive for COVID-19 and over the course of hospital stay, her BACTEC blood culture performed due to high fever which flagged positive indicated her as a case of Aerococcus viridans bacteraemia. Despite of all the efforts she developed respiratory distress followed by an episode of asystole following which she could not be revived. Copyright © 2022 Journal of Clinical and Diagnostic Research. All rights reserved.

Bronchial asthma - a risk factor or not for the frequency and severity of COVID-19, where are we? [Bulgarian]

Introduction: The pandemic of a new strain of corona virus - SARS-CoV-2, which occurred at the end of 2019, caused the appearance of a new disease (Covid-19) in over 500 million people worldwide, and over 6 million died. This infection is often clinically manifested as lung complications. Bronchial asthma is a chronic pulmonary disease, which was considered to be a serious risk factor for more frequent and more severe infection with this virus. The aim of this study was to define the role of bronchial asthma as a risk factor for frequency and severity of COVID-19 infection. Materials and methods: The study is retrospective, for the period from April 1, 2020, to December 31, 2021, and includes 356 patients with bronchial asthma, 256 of whom (72%) females and 100 (28%) males, middle age 58.5 (+or- 15.8) years. The infected, hospitalized and deceased patients with COVID-19 and bronchial asthma were included. Data is collected from an outpatient practice database in Pleven, Bulgaria, and is statistically processed with Statgraphics 19.

Intrinsic asthma after SARS-CoV-19-infection

We report the case of a 40-year-old previously lung-healthy male who became infected with SARS-CoV-2 from a named index person while working in charity care. He developed intrinsic bronchial asthma during its course. Discussed are bronchial hyperreactivity following viral infection, occupational accident and occupational disease (number 3101 – German register of occupational diseases). ©2022 Dustri-Verlag Dr. K. Feistle.

Innate Immune Responses by Respiratory Viruses, Including Rhinovirus, During Asthma Exacerbation.

Viral infection, especially with rhinovirus (RV), is a major cause of asthma exacerbation. The production of anti-viral cytokines such as interferon (IFN)-ß and IFN-α from epithelial cells or dendritic cells is lower in patients with asthma or those with high IgE, which can contribute to viral-induced exacerbated disease in these patients. As for virus-related factors, RV species C (RV-C) induces more exacerbated disease than other RVs, including RV-B. Neutrophils activated by viral infection can induce eosinophilic airway inflammation through different mechanisms. Furthermore, virus-induced or virus-related proteins can directly activate eosinophils. For example, CXCL10, which is upregulated during viral infection, activates eosinophils in vitro. The role of innate immune responses, especially type-2 innate lymphoid cells (ILC2) and epithelial cell-related cytokines including IL-33, IL-25, and thymic stromal lymphopoietin (TSLP), in the development of viral-induced airway inflammation has recently been established. For example, RV infection induces the expression of IL-33 or IL-25, or increases the ratio of ILC2 in the asthmatic airway, which is correlated with the severity of exacerbation. A mouse model has further demonstrated that virus-induced mucous metaplasia and ILC2 expansion are suppressed by antagonizing or deleting IL-33, IL-25, or TSLP. For treatment, IFNs including IFN-ß suppress not only viral replication but also ILC2 activation in vitro. Agonists of toll-like receptor (TLR) 3 or 7 can induce IFNs, which can then suppress viral replication and ILC2 activation. Therefore, if delivered in the airway, IFNs or TLR agonists could become innovative treatments for virus-induced asthma exacerbation.

Artesunate: A review of its therapeutic insights in respiratory diseases.

BACKGROUND: Artesunate, as a semi-synthetic artemisinin derivative of sesquiterpene lactone, is widely used in clinical antimalarial treatment due to its endoperoxide group. Recent studies have found that artesunate may have multiple pharmacological effects, indicating its significant therapeutic potential in multiple respiratory diseases. PURPOSE: This review aims to summarize proven and potential therapeutic effects of artesunate in common respiratory disorders. STUDY DESIGN: This review summarizes the pharmacological properties of artesunate and then interprets the function of artesunate in various respiratory diseases in detail, such as bronchial asthma, chronic obstructive pulmonary disease, lung injury, lung cancer, pulmonary fibrosis, coronavirus disease 2019, etc., on different target cells and receptors according to completed and ongoing in silico, in vitro, and in vivo studies (including clinical trials). METHODS: Literature was searched in electronic databases, including Pubmed, Web of Science and CNKI with the primary keywords of 'artesunate', 'pharmacology', 'pharmacokinetics', 'respiratory disorders', 'lung', 'pulmonary', and secondary search terms of 'Artemisia annua L.', 'artemisinin', 'asthma', 'chronic obstructive lung disease', 'lung injury', 'lung cancer', 'pulmonary fibrosis', 'COVID-19' and 'virus' in English and Chinese. All experiments were included. Reviews and irrelevant studies to the therapeutic effects of artesunate on respiratory diseases were excluded. Information was sort out according to study design, subject, intervention, and outcome. RESULTS: Artesunate is promising to treat multiple common respiratory disorders via various mechanisms, such as anti-inflammation, anti-oxidative stress, anti-hyperresponsiveness, anti-proliferation, airway remodeling reverse, induction of cell death, cell cycle arrest, etc. CONCLUSION: Artesunate has great potential to treat various respiratory diseases.

Clinical Features and Outcomes Associated with Bronchial Asthma Among COVID-19 Hospitalized Patients.

Background: The impact of diagnosis treatment and bronchial asthma on coronavirus disease 2019 (COVID-19) associated outcomes remains unclear. Objective: To identify the prevalence and outcomes associated with asthma among hospitalized patients with COVID-19. Methods: Electronic health records of 130 patients with asthma among hospitalized patients with COVID-19 were reviewed. Two subgroups of asthmatic patients were compared according to clinical outcomes during hospitalization. Patients with death results, intubation, and/or need of intensive care unit (ICU) stay were grouped as asthmatic patients with severe COVID-19 outcomes, and the rest were grouped as asthmatic patients with non-severe COVID-19 outcomes. Multivariable analyses were conducted with logistic regression to identify independent risk factors for severe outcomes. Results: The prevalence of asthma in COVID-19 hospitalized patients was 5%. The mean age was 59.4 years and 54% were women. 17% received treatment in GINA step 4-5 asthma at the time of admission. An allergic asthma phenotype was determined in 38%. There was no significant difference in hospital length of stay or need for intubation between asthmatic patients and global COVID-19 admitted patients. 17% of asthmatic patients developed a severe outcome, and 5% had a death result. Elevated Lactate Dehydrogenase (LDH) level, low transcutaneous pulse oximetry (SpO2), the coexistence of atrial fibrillation (AF), and need for moderate or high ICS at admission were independent risk factors for a worse outcome in asthmatics COVID-19 hospitalized patients. Conclusion: The prevalence of asthma in COVID-19 hospitalized patients was 5%, consistent with the asthma prevalence in the general population. The asthmatic patients with the previous prescription of moderate or high doses of ICS and/or coexistence of atrial fibrillation at admission had a higher risk of the severe outcome.

Calcifediol for Use in Treatment of Respiratory Disease.

Calcifediol is the prohormone of the vitamin D endocrine system (VDES). It requires hydroxylation to move to 1,25(OH)2D3 or calcitriol, the active form that exerts its functions by activating the vitamin D receptor (VDR) that is expressed in many organs, including the lungs. Due to its rapid oral absorption and because it does not require first hepatic hydroxylation, it is a good option to replace the prevalent deficiency of vitamin D (25 hydroxyvitamin D; 25OHD), to which patients with respiratory pathologies are no strangers. Correcting 25OHD deficiency can decrease the risk of upper respiratory infections and thus improve asthma and COPD control. The same happens with other respiratory pathologies and, in particular, COVID-19. Calcifediol may be a good option for raising 25OHD serum levels quickly because the profile of inflammatory cytokines exhibited by patients with inflammatory respiratory diseases, such as asthma, COPD or COVID-19, can increase the degradation of the active metabolites of the VDES. The aim of this narrative revision is to report the current evidence on the role of calcifediol in main respiratory diseases. In conclusion, good 25OHD status may have beneficial effects on the clinical course of respiratory diseases, including COVID-19. This hypothesis should be confirmed in large, randomized trials. Otherwise, a rapid correction of 25(OH)D deficiency can be useful for patients with respiratory disease.

The Effects of Sex Hormones and some Respiratory Diseases on the Severity of Corona Virus Infection

Sex hormones and chronic respiratory diseases play a role in the pathogenesis and the management of Covid-19 infection. Present research tries to shed light on the role of sex hormones, bronchial asthma and lung cancer on the severity of Covid-19 infection and the resulting mortality rate. This study included a follow-up of the health status of 85 patients infected with Covid-19, and all the patients previously diagnosed had hereditary respiratory diseases (bronchial asthma (64) and lung cancer (21)). The serum level of progesterone and testosterone and the stages of lung cancer development were measured in the laboratories of Diwaniyah Teaching Hospital. After conducting medical examinations, computed tomography and x-rays, the severity of Covid-19 infection was classified according to the WHO to moderate, severe and critical infection. The current results showed that most of the hospitalized cases were males (65%) with a death rate (18%), so bronchial asthma was associated with the death rate in males (70% of dead males), followed by postmenopausal (POM) women (66.7% of the dead woman), while pre-menopausal (PRM) women had the highest cure rate (100%). The results of the study showed that the rise in the mean of progesterone in PRM (13.55 ng/ml) was associated with moderate symptoms of Covid-19, while the increased testosterone in males and POM (1018 ng/dL and 67.3 ng/dL, respectively) was associated with an increase in the severity of the infection. In conclusion, asthma and high testosterone directly affected the increase in the severity of Covid-19 and the high mortality rate among the Corona sufferers. While advanced lung cancer had a clear role in that, at the same time, progesterone appeared as a protective factor in young women. © 2022 by the authors.