ABSTRACT
Background: A typical patient complaint in patients with a history of Covid-19 infection is dyspnoea with or without exercise. One of the causes of shortness of breath could be bronchial obstruction due to bronchial hyperreactivity (BHR), a characteristic asthma prerequisite. Therefore, we tried to find out if one of the consequences of Covid-19 could be the development of BHR. The objective: of the study was to find out whether Covid-19 infection causes bronchial hyperreactivity. Materials: The study was conducted between 25.01.2021 and 07.10.2021, when the Covid-19 delta variant predominated. During this period, 447 bronchial challenge tests with methacholine (BCT) were performed in patients who complained of dyspnoea. The 96 patients studied had a history of Covid-19 infection. We also identified factors (gender, pneumonia, BMI, smoking, allergy, lung function parameters) that may be associated with positive BPT in patients with a history of Covid-19 infection. Result(s): The study revealed that 43% of patients with a history of Covid-19 had a positive BCT, but uninfected patients had a significantly higher number (56%) of positive BCT (p = 0.02). Factors associated with a positive BCT in patients with a history of Covid-19 infection included allergy (n = 78, p = 0.002) and FEV1/FVC ratio below 0.7 (n = 55, p = 0.04). Other factors were not associated with a positive BCT in patients with a history of Covid-19. Conclusion(s): The cause of dyspnoea in patients with a history of Covid-19 is not associated with bronchial hyperreactivity. Bronchial hyperresponsiveness in infected people is likely to be caused by an underlying allergy, which may be exacerbated by the disease.
ABSTRACT
Background: There is a need for a unified pathway & structure for the respiratory follow-up of patients with COVID-19 pneumonia. Introduction: The long- term complications of COVID-19 pneumonia-Pulmonary Fibrosis, Pulmonary vascular disease, Bronchial Hyper-reactivity, Pleural effusion are real. Aims and Objectives: 1. To estimate the prevalence of post covid-19 pulmonary complications 2. To study the risk factors& long-term outcome of post covid pulmonary fibrosis. Methods: Prospective study;Study Period: November 2020-January 2021;All patients with history of COVID-19 attending post covid clinic of MES Medical College during the study period. RESULTS • Out of the 300 patients studied,most common outcome was post covid pulmonary fibrosis- 10.7%;followed by death 9%, Pleural effusion (2%), Bronchial hyperreactivity (1.3%), Pulmonary embolism (.3%), Anosmia (.3%), Pneumothorax (.3%) and Organizing Pneumonia (.3%) • Follow up study of patients with post covid pulmonary fibrosis, showed clearance in serial chest-xray. Conclusion: Most of the complications were seen among Cat-C patients, the most common being post covid pulmonary fibrosis which showed a serial decrement in the chest-xray scores suggesting favourable outcome.
ABSTRACT
BACKGROUND: Though physical activity (PA) is beneficial for healthy individuals and for those with chronic disease, its impact on sickle cell disease (SCD) children remains poorly studied. Moreover, patients may refrain from PA given a perceived fear of SCD complications. OBJECTIVES: 1) Evaluate whether SCD children engage differently in PA compared to their peers. 2) Evaluate the cardiopulmonary impact of PA in a group of SCD patients. DESIGN/METHODS: Prior to the COVID-19 pandemic, SCD patients aged 8-17 years old consented to answer a PA questionnaire (PAQ) and have their school peers answer the same PAQ. PAQ, a well-described surrogate marker of PA, is a standardized questionnaire evaluating PA during the last 7 days. Patients and their peers were approached only during the school year. A set of HbSS patients were invited to participate in a supervised exercise test including pre-and post-effort PFT, echocardiography, EKG, measurement of troponins and NT-proBNP and a methacholine challenge to evaluate exercise-induced bronchial hyperreactivity. T-test was used as statistical analysis, using SPSS V24. The study received IRB approval. RESULTS: Questionnaires from 25 SCD children (13 SS and 12 SC) were compared with 36 matched-school peers. SCD patients were overall less active (p=0.04). While their level of activity was similar at school, SCD patients were overall less active after school (p=0.028), in the evening (p=0.008) and weekends (p=0.049). While the difference was significant for both SS and SC patients, SS were less active than SC, although this difference was statistically not significant. Five HbSS patients on HU were subjected to an exercise test. There were no statistical differences in the preand post-PA evaluations including measurements of troponin, NT-proBNP and functional testing. None of them had exercise-induced hyperreactivity. CONCLUSION: Overall, SCD patients are less active than their peers, mostly outside of school. The absence of cardiopulmonary modifications during PA is reassuring, although our study was limited to 5 HbSS patients on HU. Whether HU has a protective role cannot be excluded. Our results encourage us to further evaluate PA interventions outside of school in SCD patients. Interventional studies evaluating the risk-benefit ratio of PA in SCD children are further needed.