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1.
Ter Arkh ; 95(1): 57-65, 2023 Feb 24.
Article in Russian | MEDLINE | ID: covidwho-20232701

ABSTRACT

BACKGROUND: Mortality and COVID-19 related factors are thoroughly analyzed. Given the large number of hospitalized patients, the potential short- and long-term COVID-19 related complications, further research is needed on the possible consequences of hospitalization, especially in higher-risk patients, after prolonged hospitalization and intensive care admission. AIM: To study the clinical course and outcomes of severe COVID-19 in elderly patients with asthma at the hospital and early post-hospital stages. MATERIALS AND METHODS: The study included 131 elderly patients (WHO, 2020) >60 years old, n=131 with asthma, hospitalized for severe COVID-19. Of these, 86 (65.6%) patients survived, 30 (22.9%) died in the hospital, and 15 (14.9%) patients died after discharge from the hospital (in the 90-day post-hospital period). COVID-19 was confirmed by laboratory tests (SARS-CoV-2 PCR RNA test) and/or clinically and radiologically. All patients had a documented history of asthma. Patients were followed up during the hospital stay and for 90 days after discharge. RESULTS: Comparison of outcomes showed that in the groups of patients with a fatal outcome (regardless of the stage), the Charlson comorbidity index, respiratory rate, extent of lung damage assessed by computed tomography, the absolute leukocyte and neutrophil number and the ratio of neutrophils to lymphocytes were statistically significantly higher. The absolute number of eosinophils was lower in these groups. In the group of patients who died during hospitalization, severe (IV-V) asthma (p=0.03), steroid use during the previous year (p=0.02), chronic heart failure with a reduced ejection fraction (p=0.009) were more common, and atopic asthma phenotype was less common (p=0.02). In those who died after discharge, more common were non-invasive ventilation and diabetes mellitus (p<0.001). The multivariate regression analysis model revealed the most significant predictors of mortality at the hospital and early post-hospital stages. CONCLUSION: Adverse outcomes of severe COVID-19 in elderly patients with asthma include hospital and post-hospital mortality. The most significant predictors of mortality are the comorbidity index and low eosinophil count. Hospital mortality is associated with a higher ratio of neutrophils to lymphocytes and lower total protein levels; early (90-day) post-hospital mortality is associated with extensive lung damage shown by computed tomography and diabetes mellitus.


Subject(s)
Asthma , COVID-19 , Diabetes Mellitus , Humans , COVID-19/complications , SARS-CoV-2 , Risk Factors , Hospitalization , Hospitals , Asthma/complications , Asthma/epidemiology
2.
PLoS One ; 18(6): e0286870, 2023.
Article in English | MEDLINE | ID: covidwho-20239895

ABSTRACT

BACKGROUND: Incorrect use of inhalers is a problem associated with poor patient outcomes. Despite improvement in the technique after verbal educations, this deteriorates over-time requiring re-enforcement through different educative strategies. This study aimed to assess the impact of a novel video-based teach-to-goal (TTG) educational intervention on: mastery of inhaler technique, disease control, medication adherence and disease-related quality of life (QoL) over-time among asthma and COPD patients. METHODS: This prospective, open-label, randomized controlled trial was registered in ClinicalTrials.gov: Identifier NCT05664347. After baseline assessment participants received either a verbal (control group) or a video-based (intervention group) TTG strategy. After 3-month the intervention was assessed for impact on the intended outcomes. Inhaler technique was assessed using standardized checklists, disease control using the Asthma control test and COPD assessment test respectively for asthma and COPD patients while adherence using the Morisky Green Levine scale. For QoL, the mini asthma quality of life questionnaire and the St. George respiratory questionnaire were used for asthmatic and COPD patients, respectively. Differences in outcomes between intervention-control groups were analyzed using either Chi-Square (X2)/Fisher Exact or Mann Whitney test. The impact of intervention on outcomes over-time was examined using either McNemar or Wilcoxon test. RESULTS: At baseline, intervention (n = 51) and control (n = 52) groups had comparable demographic/clinical characteristics. At follow-up, inhaler technique improved among intervention group compared to control group (93.4% vs 67%) and to baseline (93.4% to 49.5%), (P<0.05). Similarly, medication adherence ameliorated among the intervention group in comparison to control group (88.2% to 61.5%) and to baseline (88.2% to 66.7%), (P<0.05). In regards to disease control, results showed an amelioration among the intervention group compared to baseline (35.3% to 54.9%) (P<0.05). QoL scores improved significantly among asthma patients (intervention group) at follow-up vs baseline. Better scores were also observed for COPD patients compared to controls, (P<0.05). CONCLUSION: Video-based (TTG) was effective in enhancing inhaler technique over time as well as improving disease control, medication adherence, and QoL. TRIAL REGISTRATION: ClinicalTrials.gov: NCT05664347. https://clinicaltrials.gov/ct2/show/NCT05664347.


Subject(s)
Asthma , Pulmonary Disease, Chronic Obstructive , Humans , Adult , Pulmonary Disease, Chronic Obstructive/drug therapy , Quality of Life , Prospective Studies , Goals , Administration, Inhalation , Asthma/drug therapy , Nebulizers and Vaporizers
3.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 37(2): 81-86, 2023 Feb.
Article in Chinese | MEDLINE | ID: covidwho-20236516

ABSTRACT

Respiratory tract viruses are the second leading cause of olfactory dysfunction. Between 2019 to 2022, the world has been plagued by the problem of olfaction caused by the COVID-19. As we learn more about the impact of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2), with the recognition that olfactory dysfunction is a key symptom of this disease process, there is a greater need than ever for evidence-based management of postinfectious olfactory dysfunction(PIOD). The Clinical Olfactory Working Group has proposed theconsensus on the roles of PIOD. This paper is the detailed interpretation of the consensus.


Subject(s)
Asthma , COVID-19 , Hypersensitivity , Olfaction Disorders , Humans , United States , Smell , COVID-19/complications , SARS-CoV-2 , Olfaction Disorders/etiology , Olfaction Disorders/therapy , Consensus , Hypersensitivity/complications , Asthma/complications
4.
Sensors (Basel) ; 23(10)2023 May 13.
Article in English | MEDLINE | ID: covidwho-20245327

ABSTRACT

Dyspnea is one of the most common symptoms of many respiratory diseases, including COVID-19. Clinical assessment of dyspnea relies mainly on self-reporting, which contains subjective biases and is problematic for frequent inquiries. This study aims to determine if a respiratory score in COVID-19 patients can be assessed using a wearable sensor and if this score can be deduced from a learning model based on physiologically induced dyspnea in healthy subjects. Noninvasive wearable respiratory sensors were employed to retrieve continuous respiratory characteristics with user comfort and convenience. Overnight respiratory waveforms were collected on 12 COVID-19 patients, and a benchmark on 13 healthy subjects with exertion-induced dyspnea was also performed for blind comparison. The learning model was built from the self-reported respiratory features of 32 healthy subjects under exertion and airway blockage. A high similarity between respiratory features in COVID-19 patients and physiologically induced dyspnea in healthy subjects was observed. Learning from our previous dyspnea model of healthy subjects, we deduced that COVID-19 patients have consistently highly correlated respiratory scores in comparison with normal breathing of healthy subjects. We also performed a continuous assessment of the patient's respiratory scores for 12-16 h. This study offers a useful system for the symptomatic evaluation of patients with active or chronic respiratory disorders, especially the patient population that refuses to cooperate or cannot communicate due to deterioration or loss of cognitive functions. The proposed system can help identify dyspneic exacerbation, leading to early intervention and possible outcome improvement. Our approach can be potentially applied to other pulmonary disorders, such as asthma, emphysema, and other types of pneumonia.


Subject(s)
Asthma , COVID-19 , Humans , COVID-19/diagnosis , Physical Exertion , Dyspnea , Benchmarking
5.
East Mediterr Health J ; 29(4): 285-294, 2023 Apr 27.
Article in English | MEDLINE | ID: covidwho-20245109

ABSTRACT

Background: Asthma is a common chronic noncommunicable disease which can impair the health-related quality-of-life (HRQOL) of patients. Aims: To investigate treatment-related experiences and HRQOL of asthma patients in Egypt during the COVID-19 pandemic. Methods: A multicentre cross-sectional study was conducted from 21 July to 17 December 2020 in 3 teaching hospitals in Egypt among a convenience sample of asthma patients. We used socioeconomic and clinical variables, perceived threat level of COVID-19, experiences before and during COVID-19, the Asthma Control Questionnaire (ACQ), and the mini Asthma Quality of Life Questionnaire (mini-AQLQ) to collect data. Results: Among the 200 respondents (66.0% male; mean age 40.2 years), 80.0% had uncontrolled asthma. The greatest impairment to HRQOL was due to limitation of activity. Females reported a higher level of perceived threat from COVID-19 (Chi squared = -2.33, P = 0.02). Before the pandemic, more patients visited the clinician when they had symptoms but did so more regularly during the pandemic. Over 75% could not differentiate between asthma and COVID-19 symptoms. Perceived uncontrolled asthma and poor compliance with treatment were significantly associated with impairment of HRQOL (P < 0.05) before COVID-19. Conclusion: The COVID-19 pandemic improved some asthma-related health behaviours, but limitations in HRQOL were still evident. Uncontrolled asthma is a key factor for HRQOL and should remain a focus for all patients.


Subject(s)
Asthma , COVID-19 , Quality of Life , Adult , Female , Humans , Male , Asthma/epidemiology , Asthma/therapy , COVID-19/epidemiology , Cross-Sectional Studies , Egypt/epidemiology , Pandemics , Surveys and Questionnaires
6.
Zhongguo Zhong Yao Za Zhi ; 48(10): 2606-2612, 2023 May.
Article in Chinese | MEDLINE | ID: covidwho-20244902

ABSTRACT

Xiao Chaihu Decoction combined with Maxing Shigan Decoction is a classic herbal formula. All of them are derived from Treatise on Cold Damage(Shang Han Lun) by ZHANG Zhong-jing. This combination has the effects of harmonizing lesser yang, relieving exterior syndrome, clearing lung heat, and relieving panting. It is mainly used for treating the disease involving the triple-Yang combination of diseases and accumulation of pathogenic heat in the lung. Xiao Chaihu Decoction combined with Maxing Shigan Decoction is a classic combination for the treatment of exogenous diseases involving the triple-Yang combination. They are commonly used in exogenous diseases, especially in the north of China. This combination is also the main treatment strategy for coronavirus disease 2019(COVID-19) accompanied by fever and cough. Maxing Shigan Decoction is a classical herbal formula for treating the syndrome of phlegm-heat obstructing the lung. "Dyspnea after sweating" suggests the accumulation of pathogenic heat in the lung. Patients with mild symptoms may develop cough and asthma along with forehead sweating, and those in critical severe may develop whole-body sweating, especially the front chest. Modern medicine believes that the above situation is related to lung infection. "Mild fever" refers to syndromes rather than pathogenesis. It does not mean that the heat syndrome is not heavy, instead, it suggests that severe heat and inflammation have occurred. The indications of Xiao Chaihu Decoction combined with Maxing Shigan Decoction are as follows.(1) In terms of diseases, it is suitable for the treatment of viral pneumonia, bronchopneumonia, lobar pneumonia, mycoplasma pneumonia, COVID-19 infection, measles with pneumonia, severe acute respiratory syndrome(SARS), avian influenza, H1N1 influenza, chronic obstructive pulmonary disease with acute exacerbation, pertussis, and other influenza and pneumonia.(2) In terms of syndromes, it can be used for the syndromes of bitter mouth, dry pharynx, vertigo, loss of appetite, vexation, vomiting, and fullness and discomfort in the chest and hypochondrium. It can also be used to treat alternate attacks of chill and fever and different degrees of fever, as well as chest tightness, cough, asthma, expectoration, dry mouth, wanting cold drinks, feeling agitated, sweating, yellow urine, dry stool, red tongue, yellow or white fur, and floating, smooth, and powerful pulse, especially the right wrist pulse.


Subject(s)
Asthma , COVID-19 , Drugs, Chinese Herbal , Influenza A Virus, H1N1 Subtype , Influenza, Human , Pulmonary Disease, Chronic Obstructive , Animals , Humans , Cough , Syndrome , Drugs, Chinese Herbal/therapeutic use , Drugs, Chinese Herbal/pharmacology , Lung , Pulmonary Disease, Chronic Obstructive/drug therapy , Critical Care , Medicine, Chinese Traditional
7.
Sci Data ; 10(1): 370, 2023 Jun 08.
Article in English | MEDLINE | ID: covidwho-20243971

ABSTRACT

Monitoring asthma is essential for self-management. However, traditional monitoring methods require high levels of active engagement, and some patients may find this tedious. Passive monitoring with mobile-health devices, especially when combined with machine-learning, provides an avenue to reduce management burden. Data for developing machine-learning algorithms are scarce, and gathering new data is expensive. A few datasets, such as the Asthma Mobile Health Study, are publicly available, but they only consist of self-reported diaries and lack any objective and passively collected data. To fill this gap, we carried out a 2-phase, 7-month AAMOS-00 observational study to monitor asthma using three smart-monitoring devices (smart-peak-flow-meter/smart-inhaler/smartwatch), and daily symptom questionnaires. Combined with localised weather, pollen, and air-quality reports, we collected a rich longitudinal dataset to explore the feasibility of passive monitoring and asthma attack prediction. This valuable anonymised dataset for phase-2 of the study (device monitoring) has been made publicly available. Between June-2021 and June-2022, in the midst of UK's COVID-19 lockdowns, 22 participants across the UK provided 2,054 unique patient-days of data.


Subject(s)
Asthma , Machine Learning , Humans , Communicable Disease Control , Computers, Handheld , Surveys and Questionnaires , Datasets as Topic
8.
Respir Med ; 216: 107308, 2023 09.
Article in English | MEDLINE | ID: covidwho-20231107

ABSTRACT

OBJECTIVE: Asthma control is of importance when assessing the risk of severe outcomes of COVID-19. The aim of this study was to explore associations of clinical characteristics and the effect of multiple manifestations of uncontrolled asthma with severe COVID-19. METHODS: In 2014-2020, adult patients with uncontrolled asthma, defined as Asthma Control Test (ACT) ≤19 were identified in the Swedish National Airway Register (SNAR) (n = 24533). The SNAR database, including clinical data, was linked with national registers to identify patients with severe COVID-19 (n = 221). The effect of multiple manifestations of uncontrolled asthma was based on: 1) ACT ≤15, 2) frequent exacerbations and 3) previous asthma inpatient/secondary care and evaluated stepwise. Poisson regression analyses were conducted with severe COVID-19 as the dependent variable. RESULTS: In this cohort with uncontrolled asthma, obesity was the strongest independent risk factor for severe COVID-19 in both sexes, but even greater in men. Multiple manifestations of uncontrolled asthma were more common among those with severe COVID-19 vs. without: one, 45.7 vs. 42.3%, two, 18.1 vs. 9.1% and three, 5.0 vs. 2.1%. The risk ratio (RR) of severe COVID-19 increased with an increasing number of manifestations of uncontrolled asthma: one, RR 1.49 (95% CI 1.09-2.02), two, RR 2.42 (95% CI 1.64-3.57) and three, RR 2.96 (95% CI 1.57-5.60), when adjusted for sex, age, and BMI. CONCLUSIONS: It is important to consider the effect of multiple manifestations of uncontrolled asthma and obesity when assessing patients with COVID-19, as this increases the risk of severe outcomes substantially.


Subject(s)
Anti-Asthmatic Agents , Asthma , COVID-19 , Adult , Male , Female , Humans , Anti-Asthmatic Agents/therapeutic use , COVID-19/complications , COVID-19/epidemiology , Asthma/epidemiology , Asthma/drug therapy , Obesity/complications , Obesity/epidemiology , Risk Factors
9.
East. Mediterr. health j ; 29(4): 229-303, 2023-04.
Article in English | WHOIRIS | ID: gwh-368528

ABSTRACT

Eastern Mediterranean Health Journal is the official health journal published by the Eastern Mediterranean Regional Office of the World Health Organization. It is a forum for the presentation and promotion of new policies and initiatives in health services; and for the exchange of ideas concepts epidemiological data research findings and other information with special reference to the Eastern Mediterranean Region. It addresses all members of the health profession medical and other health educational institutes interested NGOs WHO Collaborating Centres and individuals within and outside the Region


المجلة الصحية لشرق المتوسط هى المجلة الرسمية التى تصدرعن المكتب الاقليمى لشرق المتوسط بمنظمة الصحة العالمية. وهى منبر لتقديم السياسات والمبادرات الجديدة فى الصحة العامة والخدمات الصحية والترويج لها، و لتبادل الاراء و المفاهيم والمعطيات الوبائية ونتائج الابحاث وغير ذلك من المعلومات، و خاصة ما يتعلق منها باقليم شرق المتوسط. وهى موجهة الى كل اعضاء المهن الصحية، والكليات الطبية وسائر المعاهد التعليمية، و كذا المنظمات غير الحكومية المعنية، والمراكز المتعاونة مع منظمة الصحة العالمية والافراد المهتمين بالصحة فى الاقليم و خارجه


La Revue de Santé de la Méditerranée Orientale est une revue de santé officielle publiée par le Bureau régional de l’Organisation mondiale de la Santé pour la Méditerranée orientale. Elle offre une tribune pour la présentation et la promotion de nouvelles politiques et initiatives dans le domaine de la santé publique et des services de santé ainsi qu’à l’échange d’idées de concepts de données épidémiologiques de résultats de recherches et d’autres informations se rapportant plus particulièrement à la Région de la Méditerranée orientale. Elle s’adresse à tous les professionnels de la santé aux membres des instituts médicaux et autres instituts de formation médico-sanitaire aux ONG Centres collaborateurs de l’OMS et personnes concernés au sein et hors de la Région


Subject(s)
Hospitals , Mental Health , Personal Protective Equipment , Health Personnel , SARS-CoV-2 , COVID-19 , Disease Outbreaks , Betacoronavirus , Pediatrics , Emergency Service, Hospital , Vaccination , Asthma , Health Knowledge, Attitudes, Practice , Dementia , Vaccines , Mediterranean Region
10.
East. Mediterr. health j ; 29(4): 285-294, 2023-04.
Article in English | WHOIRIS | ID: gwh-368523

ABSTRACT

Background: Asthma is a common chronic noncommunicable disease which can impair the health-related quality-of-life (HRQOL) of patients. Aims: To investigate treatment-related experiences and HRQOL of asthma patients in Egypt during the COVID-19 pandemic. Methods: A multicentre cross-sectional study was conducted from 21 July to 17 December 2020 in 3 teaching hospitals in Egypt among a convenience sample of asthma patients. We used socioeconomic and clinical variables, perceived threat level of COVID-19, experiences before and during COVID-19, the Asthma Control Questionnaire (ACQ), and the mini Asthma Quality of Life Questionnaire (mini-AQLQ) to collect data. Results: Among the 200 respondents (66.0% male; mean age 40.2 years), 80.0% had uncontrolled asthma. The greatest impairment to HRQOL was due to limitation of activity. Females reported a higher level of perceived threat from COVID-19 (Chi squared = –2.33, P = 0.02). Before the pandemic, more patients visited the clinician when they had symptoms but did so more regularly during the pandemic. Over 75% could not differentiate between asthma and COVID-19 symptoms. Perceived uncontrolled asthma and poor compliance with treatment were significantly associated with impairment of HRQOL (P < 0.05) before COVID-19. Conclusion: The COVID-19 pandemic improved some asthma-related health behaviours, but limitations in HRQOL were still evident. Uncontrolled asthma is a key factor for HRQOL and should remain a focus for all patients.


Subject(s)
Asthma , COVID-19 , Disease Outbreaks , Betacoronavirus , Cross-Sectional Studies , Egypt , Pandemics , Quality of Life , Surveys and Questionnaires
11.
East. Mediterr. health j ; 29(4): 285-294, 2023-04.
Article in English | WHOLIS, WHOIRIS | ID: covidwho-2327270

ABSTRACT

Background: Asthma is a common chronic noncommunicable disease which can impair the health-related quality-of-life (HRQOL) of patients. Aims: To investigate treatment-related experiences and HRQOL of asthma patients in Egypt during the COVID-19 pandemic. Methods: A multicentre cross-sectional study was conducted from 21 July to 17 December 2020 in 3 teaching hospitals in Egypt among a convenience sample of asthma patients. We used socioeconomic and clinical variables, perceived threat level of COVID-19, experiences before and during COVID-19, the Asthma Control Questionnaire (ACQ), and the mini Asthma Quality of Life Questionnaire (mini-AQLQ) to collect data. Results: Among the 200 respondents (66.0% male; mean age 40.2 years), 80.0% had uncontrolled asthma. The greatest impairment to HRQOL was due to limitation of activity. Females reported a higher level of perceived threat from COVID-19 (Chi squared = –2.33, P = 0.02). Before the pandemic, more patients visited the clinician when they had symptoms but did so more regularly during the pandemic. Over 75% could not differentiate between asthma and COVID-19 symptoms. Perceived uncontrolled asthma and poor compliance with treatment were significantly associated with impairment of HRQOL (P < 0.05) before COVID-19. Conclusion: The COVID-19 pandemic improved some asthma-related health behaviours, but limitations in HRQOL were still evident. Uncontrolled asthma is a key factor for HRQOL and should remain a focus for all patients.


Subject(s)
Asthma , COVID-19 , Disease Outbreaks , Betacoronavirus , Cross-Sectional Studies , Egypt , Pandemics , Quality of Life , Surveys and Questionnaires
12.
Int Immunopharmacol ; 120: 110365, 2023 Jul.
Article in English | MEDLINE | ID: covidwho-2326273

ABSTRACT

The study aimed to investigate the influence of comorbid asthma on the risk for mortality among patients with coronavirus disease 2019 (COVID-19) in the United Kingdom (UK) by utilizing a quantitative meta-analysis. The pooled odds ratio (OR) with 95% confidence interval (CI) was estimated by conducting a random-effects model. Sensitivity analysis, I2 statistic, meta-regression, subgroup analysis, Begg's analysis and Egger's analysis were all implemented. Our results presented that comorbid asthma was significantly related to a decreased risk for COVID-19 mortality in the UK based on 24 eligible studies with 1,209,675 COVID-19 patients (pooled OR = 0.81, 95% CI: 0.71-0.93; I2 = 89.2%, P < 0.01). Coming through further meta-regression to seek the possible cause of heterogeneity, none of elements might be responsible for heterogeneity. A sensitivity analysis proved the stability and reliability of the overall results. Both Begg's analysis (P = 1.000) and Egger's analysis (P = 0.271) manifested that publication bias did not exist. In conclusion, our data demonstrated that COVID-19 patients with comorbid asthma might bear a lower risk for mortality in the UK. Furthermore, routine intervention and treatment of asthma patients with severe acute respiratory syndrome coronavirus 2 infection should be continued in the UK.


Subject(s)
Asthma , COVID-19 , Humans , COVID-19/epidemiology , Reproducibility of Results , Comorbidity , Asthma/epidemiology , United Kingdom/epidemiology
13.
Rev Alerg Mex ; 69(4): 164-170, 2023 Apr 19.
Article in Spanish | MEDLINE | ID: covidwho-2321933

ABSTRACT

OBJECTIVE: The purpose of this study was to analyze the geographic variation in the prevalence of asthma in children, according to their place of residence in Mexico. METHODS: A cross-sectional analysis of the epidemiological surveillance system dataset for respiratory diseases in Mexico carried on. From 27 February to 5 November 2020, a total of 1,048,576 subjects were screened for SARS-CoV2 infection, of which 35,899 were children under 18 years of age. The strength of the association was estimated by odds ratio (OR). RESULTS: Of 1,048,576 patients who attended for SARS-CoV2 infection detection, 35,899 corresponded to pediatric patients who met the study criteria. The estimated national prevalence of asthma was 3.9% (95% CI: 3.7-4.1%). The nationwide prevalence of asthma was 3.9% (95% CI: 3.7% - 4.1%); the minimum was 2.8% (Southeast region) and the maximum 6.8% (Southeast region). Compared to the South-West Region that presented the minimum prevalence at the national level, the Northwest (OR = 2.41) and Southeast (OR = 1.33) regions showed the highest risk of asthma in pediatric population. CONCLUSIONS: The prevalence of asthma in children differed markedly among the different regions of Mexico; two regions, Northwest and Southeast, stood out. This study puts into context the role of the environment on the prevalence of asthma in children.


OBJECTIVO: Estimar la prevalencia de asma en pacientes pediátricos, según su lugar de residencia en la República Mexicana, durante la pandemia por SARS-CoV-2. MÉTODOS: Estudio transversal, llevado a cabo a partir de la revisión de datos del Sistema de Vigilancia Epidemiológica para Enfermedades Respiratorias en México, analizados del 27 febrero al 5 de noviembre de 2020. Criterios de inclusión: pacientes que acudieron a la detección de infección por SARS-CoV2, menores de 18 años. La fuerza de asociación se estimó con la razón de momios. RESULTADOS: De 1,048,576 pacientes que acudieron a la detección de infección de SARS-CoV2, 35,899 correspondieron a pacientes pediátricos que cumplieron con los criterios del estudio. La prevalencia nacional de asma estimada fue de 3.9% (IC95%: 3.7-4.1%); la prevalencia mínima se observó en la región Suroeste (2.8%) y la máxima en el Sureste (6.8%); comparada con la región Suroeste, que registró la prevalencia mínima a nivel nacional, y la Noroeste (RM = 2.41) y Sureste (RM = 1.33) mostraron el mayor riesgo de asma en la población pediátrica. CONCLUSIONES: La prevalencia de asma en niños mexicanos difirió notoriamente en los diferentes estados de la República Mexicana; sobresalieron las regiones Noroeste y Sureste. Este estudio pone de manifiesto el papel del medio ambiente en la prevalencia del asma en pacientes pediátricos mexicanos.


Subject(s)
Asthma , COVID-19 , Child , Humans , Adolescent , Prevalence , Mexico/epidemiology , Cross-Sectional Studies , Pandemics , RNA, Viral , COVID-19/epidemiology , SARS-CoV-2 , Asthma/epidemiology , Asthma/diagnosis
14.
Allergol Immunopathol (Madr) ; 51(3): 99-107, 2023.
Article in English | MEDLINE | ID: covidwho-2325362

ABSTRACT

Bronchiolitis is the most common respiratory infection leading to hospitalization and constitutes a significant healthcare burden. The two main viral agents causing bronchiolitis, respiratory syncytial virus (RSV) and rhinovirus (RV), have distinct cytopathic, immune response, and clinical characteristics. Different approaches have been suggested for subtyping bronchiolitis based on viral etiology, atopic status, transcriptome profiles in blood, airway metabolome, lipidomic data, and airway microbiota. The highest risk of asthma at school age has been in a subgroup of bronchiolitis characterized by older age, high prevalence of RV infection, previous breathing problems, and/or eczema. Regarding solely viral etiology, RV-bronchiolitis in infancy has been linked to a nearly three times higher risk of developing asthma than RSV-bronchiolitis. Although treatment with betamimetics and systemic corticosteroids has been found ineffective in bronchiolitis overall, it can be beneficial for infants with severe RV bronchiolitis. Thus, there is a need to develop a more individualized therapeutic approach for bronchiolitis and follow-up strategies for infants at higher risk of asthma in the future perspective.


Subject(s)
Asthma , Bronchiolitis, Viral , Bronchiolitis , Respiratory Syncytial Virus Infections , Respiratory Syncytial Virus, Human , Infant , Humans , Bronchiolitis/epidemiology , Respiratory Syncytial Virus Infections/epidemiology , Asthma/epidemiology , Asthma/prevention & control , Asthma/etiology , Hospitalization , Respiratory Sounds/etiology
15.
Acta Paediatr ; 112(8): 1740-1746, 2023 08.
Article in English | MEDLINE | ID: covidwho-2325069

ABSTRACT

AIM: Face masks have been used to prevent severe acute respiratory syndrome coronavirus-2 transmission. We investigated the impact of face mask use on paediatric patients with asthma. METHODS: Between February 2021 and January 2022, we surveyed adolescents aged 10-17 attending the paediatric outpatient clinic at the Lillebaelt Hospital, Kolding, Denmark with asthma, other breathing problems or no breathing problems. RESULTS: We recruited 408 participants (53.4% girls) with a median age of 14 years: 312 in the asthma group, 37 in the other breathing problems group and 59 in the no breathing problems group. Most participants experienced mask-related breathing impairment. The relative risk (RR) of experiencing severe breathing problems, compared to no problems, was more than four times as high for adolescents with asthma (RR 4.6, 95% CI 1.3-16.8, p = 0.02) than adolescents with no breathing problems. More than a third (35.9%) of the asthma group experienced mild asthma and 3.9% had severe asthma. Girls experienced more mild (RR 1.9, 95% CI 1.2-3.1, p < 0.01) and severe (RR 6.6, 95% CI 3.1-13.8, p < 0.01) symptoms than boys. Age had no effect. Adequate asthma control minimised negative effects. CONCLUSION: Face masks caused significant breathing impairment in most adolescents, particularly in those with asthma.


Subject(s)
Asthma , COVID-19 , Respiration Disorders , Male , Female , Humans , Adolescent , Child , COVID-19/epidemiology , Pandemics/prevention & control , Masks , Dyspnea , Asthma/epidemiology
16.
Immun Inflamm Dis ; 9(2): 561-568, 2021 06.
Article in English | MEDLINE | ID: covidwho-2320071

ABSTRACT

BACKGROUND: The lockdown imposed by the COVID-19 pandemic resulted in a completely different style of life with possible effects on the attitude toward their disease in patients with chronic lung disease, such as asthma. The aim of our study was to investigate in asthmatic children the level of asthma control and the maintenance therapy used during the lockdown. METHODS: Among asthmatic children attending our clinic, we identified those who had been prescribed the same therapy in March-April 2019 and March-April 2020. The level of asthma control (GINA-score) and the maintenance therapy used during the lockdown (March-April 2020) were compared with those of March-April 2019. We separately analyzed a small group of children with severe asthma treated with Omalizumab during the lockdown. RESULTS: We enrolled 92 asthmatic children (67 males). Compared to 2019, in 2020 a higher proportion of children modified their maintenance therapy (38% vs. 15.2%, p < .001), with a significant increase in both the proportion of children who increased (p = .033) and in that of children who decreased their therapy (p = .026). The level of control resulted as significantly higher in 2020 (March p = .023; April p = .007). Also, the 13 children treated with Omalizumab showed a good level of control in 2020. CONCLUSIONS: In asthmatic children, the COVID-19 pandemic lockdown had a significant impact on their asthma control and on their attitude toward maintenance therapy.


Subject(s)
Anti-Asthmatic Agents/therapeutic use , Asthma/drug therapy , COVID-19 , Omalizumab/therapeutic use , Pandemics , SARS-CoV-2 , Adolescent , Asthma/epidemiology , Asthma/psychology , Attitude to Health , COVID-19/epidemiology , COVID-19/prevention & control , Child , Communicable Disease Control/methods , Female , Humans , Italy/epidemiology , Maintenance Chemotherapy , Male , Retrospective Studies , Rhinitis, Allergic/epidemiology , Self Report , Severity of Illness Index , Social Isolation , Surveys and Questionnaires
17.
Am J Case Rep ; 24: e939170, 2023 May 01.
Article in English | MEDLINE | ID: covidwho-2320757

ABSTRACT

BACKGROUND Pneumomediastinum, or mediastinal emphysema, means air present inside the mediastinum. It usually presents with symptoms of chest pain and shortness of breath. Examination can be significant for crepitus along the neck area. There are many risk factors associated with pneumomediastinum, including asthma and COVID-19. Most cases of pneumomediastinum improve with conservative management, and surgery (mediastinotomy) is reserved for complicated cases with tension pneumomediastinum. CASE REPORT This is the case of a 23-year-old man who presented with chest tightness after 3.5 h of cycling. The patient did have a prior history of clinically stable asthma, with no recent exacerbation, and denied any other associative factors. Imaging was significant for pneumomediastinum. The patient was admitted for observation in the hospital and treated with supportive care, without any surgical intervention. The patient had appropriate improvement in his symptoms in 24 h. Repeat imaging showed improvement in the pneumomediastinum, and the patient was discharged to outpatient follow-up. CONCLUSIONS Our case presents a unique link between cycling and pneumomediastinum. Prolonged cycling may emerge as a risk factor for this complication. People with a previous history of pneumomediastinum should be careful to review other risk factors prior to planning long-distance bicycling. Physicians need to keep this differential diagnosis in mind when encountering a patient with similar symptoms so that a timely diagnosis is made.


Subject(s)
Asthma , COVID-19 , Mediastinal Emphysema , Male , Humans , Young Adult , Adult , Mediastinal Emphysema/diagnostic imaging , Mediastinal Emphysema/complications , Bicycling , COVID-19/complications , Tomography, X-Ray Computed , Asthma/complications , Chest Pain/diagnosis , Chest Pain/etiology
19.
Pediatr Pulmonol ; 58(8): 2189-2203, 2023 Aug.
Article in English | MEDLINE | ID: covidwho-2317693

ABSTRACT

BACKGROUND: The COVID-19 pandemic has led to a significant increase in cases of bronchiolitis among children. As a result, there has been a corresponding increase in the number of publications on this topic. It is essential to examine the main areas of focus within the scientific literature to understand the current trends in research on pediatric bronchiolitis. This research aims to analyze the types of scientific advances related to pediatric bronchiolitis, the research trends being pursued, and the countries and research institutions leading these efforts. By understanding these aspects of bronchiolitis research, we can better understand the current state of knowledge and identify areas where further research is needed. METHODS: To conduct a bibliometric analysis of the scientific literature on pediatric bronchiolitis, all relevant publications were retrieved from the Scopus database. The Scopus API and the SW VosViewer software with optimized modularity functions were used. This analysis was intended to provide a comprehensive overview of the current state of research on this topic, including the types of scientific advances being developed, the research trends being pursued, and the countries and research institutions leading these efforts. RESULTS: A total of 3810 publications were reviewed. We observed an increasing number of publications, particularly in recent years. Of these, 73.7% were articles, 95% were written in English, and 29.4% were from the United States. The main keywords used in these publications included: human, bronchiolitis, child, preschool, preschool child, major clinical study, controlled study, pneumonia, asthma, adolescent, hospitalization, infant, and newborn. These keywords were grouped into six clusters: outpatient management, long-term consequences, etiology, intensive care management, diagnostic methods, and the main cluster, which focused on hospital treatment and clinical studies. CONCLUSIONS: The bibliometric analysis of bronchiolitis research in pediatrics reveals that there has been a significant increase in the number of publications on this topic, particularly in recent years. Most of these publications are articles written in English and published in the United States. The main keywords used in these studies relate to various aspects of bronchiolitis, including diagnosis, treatment, and long-term consequences. The results of this analysis suggest that bronchiolitis is a topic of significant interest and concern for researchers and practitioners in the field of pediatrics and that further research is needed to improve our understanding and management of this condition.


Subject(s)
Asthma , Bronchiolitis , COVID-19 , Adolescent , Infant , Infant, Newborn , Child , Child, Preschool , Humans , Pandemics , Bronchiolitis/epidemiology , Bronchiolitis/therapy , Bibliometrics
20.
Allergol Immunopathol (Madr) ; 51(3): 68-79, 2023.
Article in English | MEDLINE | ID: covidwho-2315070

ABSTRACT

BACKGROUND: Pandemic period may affect aeroallergen sensitization. OBJECTIVE: The study aimed to investigate changes in allergen sensitivities of skin prick test (SPT) in patients with allergic rhinitis (AR) during pandemic and to evaluate relationship with disease severity. METHODS: In all, 164 AR patients with or without asthma, aged 6-17 years, who have undergone SPTs prior to the pandemic and after October 1, 2021 (18th month of the pandemic), were evaluated retrospectively. The wheal size of allergens in performed SPTs during and prior to the pandemic were compared. Detected changes in allergen sensitivities via SPT results were compared with changes in the disease severity parameters (AR severity, asthma severity, and the number of asthma exacerbations per year), frequency of upper respiratory tract infections and antibiotic use, laboratory parameters, demographic characteristics, and visual analogue scores (VAS). RESULTS: House dust mites (HDMs), cat, pollen, Artemisia, and Cupressus sensitization increased in AR patients during the Coronavirus disease 2019 (COVID-19) pandemic. HDM, mold, and pollen wheal diameters increased in SPTs. Proportion of polysensitization increased during the pandemic, compared to pre-pandemic period (9.1% vs 3%; P < 0.001), and number of non-sensitized patients decreased during the pandemic period compared to the pre-pandemic period (7.9% vs 22.6%; P < 0.001). An increase in HDM sensitivity in SPTs was correlated with VAS for nasal blockage, and an increase in cat sensitivity was correlated with VAS for all nasal symptoms. CONCLUSION: We believe that inhalant allergen sensitization might have been affected by the lifestyle changes of patients during the pandemic. Hence, it is important to evaluate patients for allergen sensitization, especially patients with moderate/severe AR, to revise disease control measurements.


Subject(s)
Asthma , COVID-19 , Rhinitis, Allergic , Child , Humans , Pandemics , Retrospective Studies , COVID-19/epidemiology , Allergens , Rhinitis, Allergic/epidemiology , Rhinitis, Allergic/diagnosis , Asthma/epidemiology , Skin Tests
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