Subject(s)
Aftercare , COVID-19/physiopathology , Hospitalization , Lung/physiopathology , Aged , Asthma/epidemiology , COVID-19/diagnostic imaging , COVID-19/epidemiology , COVID-19/therapy , Comorbidity , Critical Illness , Dyspnea/physiopathology , Female , Humans , Lung/diagnostic imaging , Male , Middle Aged , Pulmonary Diffusing Capacity , Pulmonary Disease, Chronic Obstructive/epidemiology , Respiratory Function Tests , SARS-CoV-2 , Severity of Illness Index , Tomography, X-Ray Computed , Total Lung Capacity , Walk TestABSTRACT
The clinical and social impacts of the COVID-19 epidemic on lung transplant (LTx) recipients remain poorly known. We aimed to evaluate its social, clinical, and behavioral consequences on the LTx patients followed in Strasbourg university hospital. A questionnaire was used to collect details concerning patients' lifestyles, their protection methods used to avoid COVID-19 contamination, and clinical infection-related information for March 2020. A specific score was created to quantify patients' contacts and the associated risk of infectious contagion. Data were collected from 322 patients (91.2%). A majority reported a higher application than usual of social distancing and barrier measures. 43.8% described infectious-related symptoms and 15.8% needed an anti-infective treatment. There was no difference in symptom onset according to age, native lung disease, diabetes, or obesity. Nineteen patients were tested for COVID-19, and four were diagnosed positive, all with a favorable outcome. The infection risk contact score was higher for symptomatic patients (p: 0.007), those needing extra-medical appointments (p < .001), and those receiving anti-infective treatments (p = .02). LTx patients reported a careful lifestyle and did not seem at higher risk for COVID-19. Our score showed encouraging preliminary results and could become a useful tool for the usual infection-related follow-up of the LTx patients.
Subject(s)
COVID-19/etiology , Health Behavior , Lung Transplantation , Postoperative Complications , Social Determinants of Health , Transplant Recipients/psychology , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , Contact Tracing , Epidemics , Female , France/epidemiology , Hospitals, University , Humans , Life Style , Male , Middle Aged , Patient Compliance/psychology , Patient Compliance/statistics & numerical data , Physical Distancing , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Postoperative Complications/prevention & control , Postoperative Complications/psychology , Retrospective Studies , Risk Assessment , Risk Factors , Young AdultABSTRACT
OBJECTIVES: To investigate the effects of 1-year lumacaftor-ivacaftor treatment on abnormalities in glucose tolerance (AGT) in Phe508del homozygous cystic fibrosis (CF) patients. METHODS: Untreated CF patients with glucose intolerance or newly diagnosed diabetes were included in a prospective, observational study. After 1-year lumacaftor-ivacaftor treatment, AGT were evaluated by using oral glucose tolerance test. RESULTS: Forty patients participated. 78% of patients had glucose intolerance and 22% diabetes at baseline. After one-year treatment, 50% of patients had normal glucose tolerance, 40% glucose intolerance, and 10% diabetes (p <0.001). The two-hour OGTT glycemia decreased from 171 (153-197) to 139 (117-162) mg/dL (p <0.001). 57.5% (n = 23) of patients improved their glucose tolerance with a significant decrease in both 1-hour (p<0.01) and 2-hour (p<0.001) OGTT glycemia. CONCLUSION: Improvements in AGT were observed following 1-year lumacaftor-ivacaftor treatment. Larger studies are needed to comprehensively assess CF transmembrane conductance regulator (CFTR) modulators.
Subject(s)
Aminophenols/therapeutic use , Aminopyridines/therapeutic use , Benzodioxoles/therapeutic use , Cystic Fibrosis/drug therapy , Cystic Fibrosis/metabolism , Diabetes Mellitus/metabolism , Glucose Intolerance/metabolism , Quinolones/therapeutic use , Adolescent , Adult , Blood Glucose , Child , Cystic Fibrosis/complications , Diabetes Mellitus/diagnosis , Diabetes Mellitus/etiology , Drug Administration Schedule , Drug Combinations , Female , Glucose Intolerance/diagnosis , Glucose Intolerance/etiology , Glucose Tolerance Test , Humans , Male , Middle Aged , Prospective Studies , Young AdultABSTRACT
BACKGROUND: The aim of our study was to describe the lung cancer characteristics in lung transplant recipients at our institution. METHODS: Between January 1, 1992, and August 15, 2017, 463 patients underwent lung transplantation. RESULTS: We found a total of 19 lung cancers (4.10%). Eight patients had lung cancer in the explanted lung, 8 in the native remaining lung, and 3 in the transplanted lung. Histopathological findings were: adenocarcinoma in 10, SCC in 8 patients, and 1 was undetermined. Among lung cancers in the explanted lungs, there were 6 stage I, 1 stage III, 1 stage IV. Among patients with a lung cancer in the remaining native lung, 3 had early stage disease and 5 had stage IV disease. Among lung cancers in the transplanted lung, there were: 1 stage I, 1 stage II and 1 stage IV. Overall median survival in lung transplant recipients without lung cancer was 8.77 ± 0.74 years compared to 6.19 ± 1.4 years in recipients with lung cancer. CONCLUSION: Lung cancer following lung transplantation was uncommon. Early stage lung cancer discovered in the explanted lungs had no impact on survival. Lung cancer occurring in the transplanted or in the native remaining lung had a poor prognosis.
