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1.
J Med Internet Res ; 23(12): e28318, 2021 12 20.
Article in English | MEDLINE | ID: covidwho-1598280

ABSTRACT

BACKGROUND: Chronic obstructive pulmonary disease (COPD) has become one of the most critical public health problems worldwide. Because many COPD patients are using video-based social media to search for health information, there is an urgent need to assess the information quality of COPD videos on social media. Recently, the short-video app TikTok has demonstrated huge potential in disseminating health information and there are currently many COPD videos available on TikTok; however, the information quality of these videos remains unknown. OBJECTIVE: The aim of this study was to investigate the information quality of COPD videos on TikTok. METHODS: In December 2020, we retrieved and screened 300 videos from TikTok and collected a sample of 199 COPD-related videos in Chinese for data extraction. We extracted the basic video information, coded the content, and identified the video sources. Two independent raters assessed the information quality of each video using the DISCERN instrument. RESULTS: COPD videos on TikTok came mainly from two types of sources: individual users (n=168) and organizational users (n=31). The individual users included health professionals, individual science communicators, and general TikTok users, whereas the organizational users consisted of for-profit organizations, nonprofit organizations, and news agencies. For the 199 videos, the mean scores of the DISCERN items ranged from 3.42 to 4.46, with a total mean score of 3.75. Publication reliability (P=.04) and overall quality (P=.02) showed significant differences across the six types of sources, whereas the quality of treatment choices showed only a marginally significant difference (P=.053) across the different sources. CONCLUSIONS: The overall information quality of COPD videos on TikTok is satisfactory, although the quality varies across different sources and according to specific quality dimensions. Patients should be selective and cautious when watching COPD videos on TikTok.


Subject(s)
COVID-19 , Pulmonary Disease, Chronic Obstructive , Social Media , Humans , Information Dissemination , Public Health , Pulmonary Disease, Chronic Obstructive/therapy , Reproducibility of Results , Video Recording
2.
Sensors (Basel) ; 21(21)2021 Nov 06.
Article in English | MEDLINE | ID: covidwho-1512568

ABSTRACT

Epidemiological trends over the past decade show a significant worldwide increase in the burden of chronic diseases. At the same time, the human resources of health care are becoming increasingly scarce and expensive. One of the management concepts that can help in solving this problem is business process management (BPM). The results of research conducted in the healthcare sector thus far prove that BPM is an effective tool for optimizing clinical processes, as it allows for the ongoing automatic tracking of key health parameters of an individual patient without the need to involve medical personnel. The aim of this article is to present and evaluate the redesign of diagnostic and therapeutic processes enabling the patient-centric organization of therapy thanks to the use of new telemedicine techniques and elements of hyperautomation. By using an illustrative case study of one of the most common chronic diseases, Chronic Obstructive Pulmonary Disease (COPD), we discuss the use of clinical pathways (CPs) prepared on the basis of the current version of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) as a communication tool between healthcare professionals, the patient and his or her caregivers, as well as the method of identifying and verifying new knowledge generated on an ongoing basis in diagnostic and therapeutic processes. We also show how conducting comprehensive, patient-focused primary health care relieves the health care system, and at the same time, thanks to the use of patient engagement and elements of artificial intelligence (predictive analyses), reduces the significant clinical risk of therapy.


Subject(s)
Pulmonary Disease, Chronic Obstructive , Telemedicine , Artificial Intelligence , Chronic Disease , Critical Pathways , Female , Humans , Male , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/therapy
3.
PLoS One ; 16(10): e0258914, 2021.
Article in English | MEDLINE | ID: covidwho-1480460

ABSTRACT

BACKGROUND: Risk factors of severe COVID-19 have mainly been investigated in the hospital setting. We investigated pre-defined risk factors for testing positive for SARS-CoV-2 infection and cardiovascular or pulmonary complications in the outpatient setting. METHODS: The present cohort study makes use of ambulatory claims data of statutory health insurance physicians in Bavaria, Germany, with polymerase chain reaction (PCR) test confirmed or excluded SARS-CoV-2 infection in first three quarters of 2020. Statistical modelling and machine learning were used for effect estimation and for hypothesis testing of risk factors, and for prognostic modelling of cardiovascular or pulmonary complications. RESULTS: A cohort of 99 811 participants with PCR test was identified. In a fully adjusted multivariable regression model, dementia (odds ratio (OR) = 1.36), type 2 diabetes (OR = 1.14) and obesity (OR = 1.08) were identified as significantly associated with a positive PCR test result. Significant risk factors for cardiovascular or pulmonary complications were coronary heart disease (CHD) (OR = 2.58), hypertension (OR = 1.65), tobacco consumption (OR = 1.56), chronic obstructive pulmonary disease (COPD) (OR = 1.53), previous pneumonia (OR = 1.53), chronic kidney disease (CKD) (OR = 1.25) and type 2 diabetes (OR = 1.23). Three simple decision rules derived from prognostic modelling based on age, hypertension, CKD, COPD and CHD were able to identify high risk patients with a sensitivity of 74.8% and a specificity of 80.0%. CONCLUSIONS: The decision rules achieved a high prognostic accuracy non-inferior to complex machine learning methods. They might help to identify patients at risk, who should receive special attention and intensified protection in ambulatory care.


Subject(s)
Ambulatory Care , COVID-19 , Coronary Disease , Hypertension , Renal Insufficiency, Chronic , SARS-CoV-2 , Adult , Aged , Aged, 80 and over , COVID-19/complications , COVID-19/epidemiology , COVID-19/therapy , Coronary Disease/epidemiology , Coronary Disease/therapy , Dementia/epidemiology , Dementia/therapy , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/therapy , Female , Germany , Humans , Hypertension/epidemiology , Hypertension/therapy , Male , Middle Aged , Obesity/epidemiology , Obesity/therapy , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/therapy , Renal Insufficiency, Chronic/epidemiology , Renal Insufficiency, Chronic/therapy , Risk Assessment , Risk Factors
4.
Am J Physiol Lung Cell Mol Physiol ; 321(5): L983-L987, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1455765

ABSTRACT

World COPD Day raises awareness about chronic obstructive pulmonary disease (COPD). COPD accounts for over 150,000 US deaths per year. A major challenge is that COPD receives only a fraction of the research funding provided to other major diseases. Control of COPD is dependent on developing new approaches to diagnose the disease earlier with a recognition of either pre-COPD or established COPD based on symptoms, lung structural change and/or loss of lung function that occurs before meeting long established criteria for a population-based definition of obstruction. Optimization of current therapies improves lung function, exercise capacity, quality of life, and survival. New pathways of disease progression are being identified creating new opportunities for development of therapies that could stop or cure this disease.


Subject(s)
Pneumonia , Premature Birth , Pulmonary Disease, Chronic Obstructive , Adult , Child , Female , Global Health , Humans , Infant, Newborn , Pregnancy , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/therapy , Quality of Life
5.
BMC Fam Pract ; 22(1): 104, 2021 05 26.
Article in English | MEDLINE | ID: covidwho-1440902

ABSTRACT

BACKGROUND: Mobile technologies have become capable of changing the paradigm of healthcare services. A clear example is that, nowadays, these technologies are an important instrument for data collection processes, epidemiologic surveillance, health promotion and disease prevention. Therefore, technological tools should be exploited to optimize the monitoring of patients with chronic diseases, including patients who require home oxygen therapy. PURPOSE: The purpose of this study is to determine the efficacy of a mobile application in the clinical monitoring of patients under home oxygen therapy. METHODS: This is a randomized controlled trial includes subjects of 18 years or older diagnosed with Chronic Obstructive Pulmonary Disease (COPD) who are under home oxygen therapy. Subjects will be divided into two arms: the intervention group will include patients who will be monitored with a mobile application, and the control group will include patients monitored by conventional follow-up methods (periodic visits of a respiratory therapist). The following outcome variables will be considered to measure the effect of the intervention: identification of dyspnea self-management, number of acute exacerbations associated with oxygen therapy, and the occurrence of oxygen supply underuse. DISCUSSION: This study is expected to assess the efficacy of a mobile application in the follow up of patients under home oxygen therapy. It will also determine whether the monitoring of a six-month intervention by a team comprising a physician, a nurse and respiratory therapists can decrease acute exacerbations, determine the most appropriate oxygen dose, and identify the underuse of oxygen systems and supplies. TRIAL REGISTRATION: The study has been registered at ClinicalTrials.gov ( NCT04820790 ; date of registration: March 29, 2021).


Subject(s)
COVID-19 , Mobile Applications , Pulmonary Disease, Chronic Obstructive , Humans , Oxygen , Pulmonary Disease, Chronic Obstructive/therapy , Randomized Controlled Trials as Topic , SARS-CoV-2
7.
Best Pract Res Clin Anaesthesiol ; 35(3): 269-292, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1401261

ABSTRACT

Coronaviruses belong to the family Coronaviridae order Nidovirales and are known causes of respiratory and intestinal disease in various mammalian and avian species. Species of coronaviruses known to infect humans are referred to as human coronaviruses (HCoVs). While traditionally, HCoVs have been a significant cause of the common cold, more recently, emergent viruses, including severe acute respiratory syndrome coronavirus (SARS-CoV-2) has caused a global pandemic. Here, we discuss coronavirus disease (COVID-19) biology, pathology, epidemiology, signs and symptoms, diagnosis, treatment, and recent clinical trials involving promising treatments.


Subject(s)
Antiviral Agents/administration & dosage , COVID-19/epidemiology , COVID-19/therapy , SARS-CoV-2 , Adenosine Monophosphate/administration & dosage , Adenosine Monophosphate/analogs & derivatives , Adrenal Cortex Hormones/administration & dosage , Alanine/administration & dosage , Alanine/analogs & derivatives , Animals , COVID-19/diagnosis , COVID-19/immunology , Coronavirus/drug effects , Coronavirus/immunology , Cough/epidemiology , Cough/therapy , Diabetes Mellitus/epidemiology , Diabetes Mellitus/therapy , Fatigue/epidemiology , Fatigue/therapy , Fever , Heart Diseases/epidemiology , Heart Diseases/therapy , Humans , Positive-Pressure Respiration/methods , Prognosis , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/therapy , SARS-CoV-2/drug effects , SARS-CoV-2/immunology , Treatment Outcome
8.
Respir Res ; 22(1): 50, 2021 Feb 12.
Article in English | MEDLINE | ID: covidwho-1388766

ABSTRACT

The importance of vaccinations for COPD patients has been previously described. However, there is still a gap between guideline recommendations and the implementation of preventive care delivery for these patients. Specially, the rise of SARS-CoV-2 pandemic has made the significance of vaccination adherence more critical to address. Our study showed that referral to pulmonary clinic is associated with increased odds of receiving influenza (OR = 1.97, [95% CI 1.07, 3.65]) and pneumococcal vaccinations (PCV13 OR = 3.55, [1.47, 8.54]; PPSV23 OR = 4.92, [1.51, 16.02]). These data suggest that partnerships between primary care physicians and pulmonologists can potentially improve the vaccination rates for patients with COPD.


Subject(s)
Practice Patterns, Physicians' , Primary Health Care , Pulmonary Disease, Chronic Obstructive/therapy , Pulmonary Medicine , Referral and Consultation , Vaccination , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Guideline Adherence , Humans , Influenza Vaccines/therapeutic use , Male , Middle Aged , Pneumococcal Vaccines/therapeutic use , Practice Guidelines as Topic , Pulmonary Disease, Chronic Obstructive/diagnosis , Retrospective Studies
9.
Internist (Berl) ; 62(9): 906-920, 2021 Sep.
Article in German | MEDLINE | ID: covidwho-1355997

ABSTRACT

The attributable proportion of occupation-related influences on airway and lung diseases is 10-30%. In patients with obstructive airway diseases it is extremely important to sufficiently document findings during the period of activities burdening the airway as compared to periods off work. Chronic obstructive pulmonary disease (COPD) can have a work-related (partial) cause even in smokers. Regarding occupational infectious diseases, the main cause up to 2019 was tuberculosis but the corona pandemic has led to coronavirus disease 2019 (COVID-19) being the most frequent occupational disease. For the occupational medical assessment of interstitial and malignant pulmonary diseases, checklists can be helpful to support the medical history.


Subject(s)
COVID-19 , Occupational Diseases , Pulmonary Disease, Chronic Obstructive , Humans , Lung , Occupational Diseases/diagnosis , Occupational Diseases/therapy , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/therapy , SARS-CoV-2
10.
Int J Environ Res Public Health ; 18(16)2021 Aug 12.
Article in English | MEDLINE | ID: covidwho-1354959

ABSTRACT

Monitoring COVID-19 patients with COPD has become one of the major tasks in preventing transmission and delivering emergency healthcare services after vaccination in case of any issues. Most COVID-19-affected patients are suggested to self-quarantine at home or in institutionalized quarantine centers. In such cases, it is essential to provide remote healthcare services. For remote healthcare monitoring, two approaches are being considered in this study, which include mHealth and Telehealth. A mixed-methods approach is adopted, where survey questionnaires are used for collecting information from 108 patients and semi-structured interviews are used with seven physicians regarding mHealth and Telehealth approaches. Survey results indicated that mHealth is rated to be slightly more effective than Telehealth, and interview results indicated that Telehealth is identified to be slightly more effective than mHealth in relation to parameters including usefulness, ease of use and learnability, interface and interaction quality, reliability, and satisfaction. However, both physicians and patients opined that both mHealth and Telehealth have a promising future with increasing adoption. Based on the findings, it can be concluded that both mHealth and Telehealth are considered to be effective in delivering remote care for COPD patients infected with COVID-19 at home. Implications of the study findings are discussed.


Subject(s)
COVID-19 , Pulmonary Disease, Chronic Obstructive , Telemedicine , Cross-Sectional Studies , Humans , Pulmonary Disease, Chronic Obstructive/therapy , Reproducibility of Results , SARS-CoV-2
11.
Int J Chron Obstruct Pulmon Dis ; 16: 2181-2201, 2021.
Article in English | MEDLINE | ID: covidwho-1337591

ABSTRACT

Purpose: The COVID-19 pandemic has disrupted many lives, including those of people suffering from chronic obstructive pulmonary disease (COPD) and their caregivers. The main aim of this study was to use narrative medicine, a validated approach promoting quality of care to explore how the COVID-19 pandemic impacted the quality of care, quality of life, psychological factors and social factors of people affected by COPD and their caregivers and healthcare professionals (HCPs). A secondary aim was to explore the role of telemedicine in combating isolation and providing access to care. Methods: A cross-sectional observational narrative medicine study was conducted between July and November 2020 across Italy. An online semi-structured questionnaire with a narrative plot was completed by 146 participants (79 COPD patients, 24 caregivers, and 43 HCPs). Narrations were analyzed with descriptive statistics and evaluated using NVivo 11 software to break down the text and identify recurring themes and major semantic clusters. Results: During the first lockdown, 58.22% of responses from COPD patients indicated terror, fear and/or apprehension; at reopening, this figure was 35.44%. Among caregivers, these figures were 100% at first lockdown and 45.83% at reopening. The metaphors most commonly used by patients to describe COPD and COVID-19 were monster and murderer, respectively. Patients described their homes more often as clean and lonely than as offering no shelter. The narratives of 42 COPD patients (45.2%) described coping. Only 12.6% of COPD patients reported regular access to medical visits during lockdown, while 59.1% of general practitioners and pulmonologists reported using telemedicine, which was perceived as satisfactory by both patients and caregivers. Conclusion: It is relevant to aim for a multidisciplinary and multilevel system of care that empowers telemedicine and integrates specific psychological support programs for COPD patients and their caregivers.


Subject(s)
COVID-19 , Pulmonary Disease, Chronic Obstructive , Telemedicine , Caregivers , Communicable Disease Control , Cross-Sectional Studies , Humans , Italy/epidemiology , Pandemics , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/therapy , Quality of Life , SARS-CoV-2
12.
Front Biosci (Landmark Ed) ; 26(7): 246-252, 2021 07 30.
Article in English | MEDLINE | ID: covidwho-1332573

ABSTRACT

Individuals with COPD are at higher risk of severe disease and mortality if they contract COVID-19. Shielding and social distancing have negatively impacted the delivery of routine care for COPD patients, which should be maintained to avoid further deterioration. We aimed to review the literature about the key toolkits of non-pharmacological treatments of COPD patients before and during the COVID-19 pandemic. In particular, we focused on smoking cessation, pulmonary rehabilitation, and telehealth delivery approaches during the COVID-19 crisis. Smoking cessation services are important to mitigate the spread of the virus, especially in people with chronic lung disease; the pandemic, in one way or another, has helped to enhance people's motivation to quit smoking. Also, tele-rehabilitation is considered as effective as conventional pulmonary rehabilitation in controlling symptoms of disease, promoting physical activity, and enhancing self-management of COPD. Tele-rehabilitation offers flexibility and it could be the dominant mode for providing a pulmonary rehabilitation programme. Finally, the use of telehealth (TH) modes has trended during the pandemic. Consensus about the effectiveness of TH in reducing exacerbation events is still inconclusive. In the context of COPD, further clinical research must concentrate on understanding attitudes, behaviours, and motivations towards smoking cessation. Further recommendations include gauging the feasibility of a long-term tele-rehabilitation programme in large COPD populations, designing more COPD-related mobile apps, and evaluating the feasibility of tele-rehabilitation in clinical practice.


Subject(s)
COVID-19/epidemiology , Pulmonary Disease, Chronic Obstructive/therapy , Attitude to Health , COVID-19/virology , Health Promotion , Humans , Pulmonary Disease, Chronic Obstructive/psychology , Pulmonary Disease, Chronic Obstructive/rehabilitation , Smoking Cessation , Telemedicine
14.
JMIR Mhealth Uhealth ; 9(6): e21728, 2021 06 11.
Article in English | MEDLINE | ID: covidwho-1290684

ABSTRACT

BACKGROUND: Hospital admissions due to the acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are costly for individuals and health services. Pulmonary rehabilitation (PR) is known to reduce hospital readmissions when delivered after hospitalization, but the uptake and completion of PR following hospitalization remains poor (<10% of those eligible in the UK audit data). A web-based platform of the SPACE (Self-management Program of Activity Coping and Education) for COPD (chronic obstructive pulmonary disease) has previously shown promising results in patients with stable COPD but has not been tested following an AECOPD. OBJECTIVE: This study aims to assess the feasibility and acceptability of a web-based self-management program. METHODS: A nonrandomized feasibility study for patients with confirmed AECOPD who were deemed web literate was conducted. All patients consented during their hospitalization and received access to the website following discharge in addition to usual care. The program aims to facilitate patients to better understand and manage their condition through education and home-based exercises. Participants were asked to complete the Bristol COPD Knowledge Questionnaire at baseline and after 6 months. A total of 14 participants were also interviewed (n=8 completers; n=6 noncompleters) regarding their experiences with the web-based program and trial. The interviews were analyzed using thematic analysis. RESULTS: In total, 2080 patients were screened for eligibility, of which 100 patients (age: mean 71.2 years, SD 9.3 years; male: 55/100, 55%; forced expiratory volume in 1 second/forced vital capacity ratio: mean 0.46, SD 0.14; pack-years: mean 50.2, SD 31.0; current smokers: 35/100, 35%) were recruited (4.8% of those screened). The main reason for ineligibility was a lack of web literacy (1366/1980, 68.98%). In total, 18% (18/100) of patients had completed the web program by 6 months, with others still registered in the program (27/100, 27%), and more than half did not register (55/100, 55%). There was a mean change in Bristol COPD Knowledge Questionnaire scores at 6 months of 7.8 (SD 10.2) points. Qualitative interviews identified three main themes: preparing for, engagement with, and benefits of the study and program. A total of 57% (57/100) accepted a referral to PR on discharge and 19% (19/100) had completed the program after 6 months. CONCLUSIONS: On the basis of the challenges of recruiting, retaining, and engaging participants in a web-based self-management program, it is not a feasible approach to roll out widely. This study acknowledges that this is a challenging time for patients with an AECOPD to engage in exercise and self-management education. However, for patients who were able to engage in such an intervention, the completion rate of PR was double the previous audit estimates from the United Kingdom, disease knowledge improved, and the intervention was of value to patients. TRIAL REGISTRATION: ISRCTN Registry 13081008; https://www.isrctn.com/ISRCTN13081008.


Subject(s)
Pulmonary Disease, Chronic Obstructive , Self-Management , Aged , Feasibility Studies , Humans , Internet , Male , Pulmonary Disease, Chronic Obstructive/therapy , United Kingdom
15.
Pulm Med ; 2021: 5533123, 2021.
Article in English | MEDLINE | ID: covidwho-1288475

ABSTRACT

Method: Data was collected retrospectively from electronic hospital records during the periods 1st March until 10th May in 2019 and 2020. Results: There was a marked decrease in AECOPD admissions in 2020, with a 54.2% drop in admissions (n = 119 in 2020 vs. n = 259 in 2019). There was no significant difference in patient demographics or medical comorbidities. In 2020, there was a significantly lower number of patients with AECOPD who received nebulised medications during admission (60.4% in 2020 vs. 84.9% in 2019; p ≤ 0.001). There were also significantly lower numbers of AECOPD patients admitted in 2020 who received controlled oxygen via venturi masks (69.0% in 2020 vs. 84.5% in 2019; p = 0.006). There was a significant increase in inpatient mortality in 2020 (19.3% [n = 23] and 8.4% [n = 22] for 2020 and 2019, respectively, p = 0.003). Year was found to be the best predictor of mortality outcome (p = 0.001). The lack of use of SABA pre-admission treatment (p = 0.002), active malignancy (p = 0.003), and increased length of hospital stay (p = 0.046) were also found to be predictors of mortality for AECOPD patients; however, these parameters were unchanged between 2019 and 2020 and therefore could not account for the increase in mortality. Conclusions: There was a decrease in the number of admissions with AECOPD in 2020 during the COVID-19 pandemic, when compared to 2019. The year 2020 proved to be a significant predictor for inpatient mortality, with a significant increase in mortality in 2020. The decrease in nebuliser and controlled oxygen treatment noted in the study period did not prove to be a significant predictor of mortality when corrected for other variables. Therefore, the difference in mortality cannot be explained with certainty in this retrospective cohort study.


Subject(s)
COVID-19 , Hospitalization/statistics & numerical data , Pulmonary Disease, Chronic Obstructive/therapy , Aged , Cross-Sectional Studies , Disease Progression , Female , Humans , Male , Malta , Retrospective Studies
17.
Int J Chron Obstruct Pulmon Dis ; 16: 1549-1554, 2021.
Article in English | MEDLINE | ID: covidwho-1266602

ABSTRACT

Purpose: Exacerbations of COPD (ECOPD) are a frequent cause of hospitalization that seemed to ameliorate during the COVID outbreak. We aimed to evaluate the clinical characteristics of COPD-related hospital admissions and mortality in relation to the presence of COVID-19. Patients and Methods: We conducted a case-control study of patients admitted in four teaching hospitals throughout Spain between March 15 and April 30, 2020. Hospital admissions of respiratory cause with and without PCR-proven SARS-CoV-2 infection in patients with COPD were evaluated. Baseline and episode-related clinical characteristics were analyzed. Logistic regression analysis was performed to evaluate the risk for mortality. Results: During the study period, 2101 patients were admitted for respiratory worsening, 1200 (57.1%) with COVID-19. A total of 228 (10.8%) were admitted due to COPD worsening, of whom 52 (22.8%) tested positive for COVID-19. COPD patients with COVID-19, when compared to those without COVID-19, were more frequently males with better lung function (FEV1 postbronchodilator 71% vs 46% respectively, p<0.001) and had higher mortality (44.9% vs 13.6% respectively, p<0.001) despite similar age, comorbidities, total days of hospitalization and admission to intensive care unit. COVID-19 and eosinopenia were the strongest risk factors for mortality in the multivariate analysis in the overall COPD population. Inhaled corticosteroid use was not associated to mortality. Conclusion: Hospitalizations for ECOPD without COVID-19 were more frequent than COPD with COVID-19 during the first outbreak, but the latter were associated with higher mortality and low eosinophil counts that warrant further analysis.


Subject(s)
COVID-19 , Pulmonary Disease, Chronic Obstructive , Case-Control Studies , Disease Outbreaks , Hospitalization , Humans , Male , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/therapy , SARS-CoV-2 , Spain/epidemiology
18.
Expert Rev Respir Med ; 15(8): 1025-1033, 2021 08.
Article in English | MEDLINE | ID: covidwho-1225578

ABSTRACT

Introduction: The role of COPD in COVID-19 is not yet well understood. However, there is increasing evidence showing that COPD patients with COVID-19 have a higher risk of presenting a serious infection, a greater likelihood of requiring ICU support, and a higher mortality than other groups.Areas covered: In this article, we address some critical questions on COVID-19 as they pertain to COPD. In particular, we discuss whether the usual algorithms of pharmacological and non-pharmacological management in COPD still apply.Expert opinion: Patients with COPD must continue their regular therapy, regardless of whether they are affected by COVID-19. Corticosteroids reduce mortality in COVID-19 patients in need of supportive oxygen therapy or invasive mechanical ventilation. It is essential that a COPD patient who has tested positive for SARS-CoV-2 is closely followed over time because any delay in diagnosis and initiation of appropriate therapy could negatively affect his/her prognosis. However, we still do not know if COVID-19 infection occurs and evolves differently in each of the recognized COPD phenotypes and, therefore, whether it needs a different management. There are other open questions concerning COVID-19 and COPD that need to be considered. Future studies are absolutely necessary to answer these questions.


Subject(s)
COVID-19 , Pulmonary Disease, Chronic Obstructive , Female , Humans , Male , Oxygen Inhalation Therapy , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/therapy , Respiration, Artificial , SARS-CoV-2
19.
Expert Rev Respir Med ; 15(8): 1069-1076, 2021 08.
Article in English | MEDLINE | ID: covidwho-1214360

ABSTRACT

BACKGROUND: Although COPD is not one of the most common comorbidities in COVID-19 patients, it can be more fatal in this group. This study aimed to investigate the characteristics and prognosis of COPD patients among the population with COVID-19. RESEARCH DESIGN AND METHODS: Patients diagnosed with positive PCR test were included in our multicentered, retrospective study. Patients with airway obstruction (previous spirometry) were included in 'COPD group'. RESULTS: The prevalence of COPD in COVID-19 patients was 4.96%(53/1069). There was a significant difference between COPD and non-COPD COVID-19 patients in terms of gender, mean age, presence of dyspnea, tachypnea, tachycardia, hypoxemia and presence of pneumonia. The mortality rate was 13.2% in COPD, 7% in non-COPD patients(p = 0.092). The significant predictors of mortality were higher age, lymphopenia (p < 0.001), hypoxemia (p = 0.028), high D-dimer level (p = 0.011), and presence of pneumonia (p = 0.043) in COVID-19 patients. CONCLUSIONS: Our research is one of the first studies investigating characteristics of COPD patients with COVID-19 in Turkey. Although COPD patients had some poor prognostic features, there was no statistical difference between overall survival rates of two groups. Age, status of oxygenization, serum D-dimer level, lymphocyte count and pneumonia were significantly associated parameters with mortality in COVID-19.


Subject(s)
COVID-19 , Pneumonia , Pulmonary Disease, Chronic Obstructive , Humans , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/therapy , Retrospective Studies , SARS-CoV-2
20.
Respir Investig ; 59(4): 385-388, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1203265

ABSTRACT

The Japanese Respiratory Society (JRS) has recommended spirometry for the diagnosis of respiratory diseases. It is indispensable for the confirmation of airflow obstruction by spirometry in chronic obstructive pulmonary disease (COPD) diagnosis. However, the coronavirus disease 2019 (COVID-19) pandemic has made it difficult for many clinics to perform spirometry as it may lead to possible aerosol infections. Thus, the diagnosis of COPD, especially in the early stage, has become difficult. To overcome this situation, JRS issued a "Flowchart of Working Diagnosis and Management of COPD during the COVID-19 Pandemic". This flowchart may help physicians provisionally diagnose COPD patients without performing spirometry, offering them appropriate intervention even in epidemic and pandemic situations.


Subject(s)
COVID-19 , Diagnostic Techniques, Respiratory System , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/therapy , Pulmonary Medicine/organization & administration , Societies, Medical/organization & administration , Adrenergic beta-2 Receptor Agonists/therapeutic use , Delayed-Action Preparations , Drug Therapy, Combination , Early Diagnosis , Humans , Japan , Muscarinic Antagonists/therapeutic use , Spirometry
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