Post-COVID-19 Symptoms in Adults with Asthma-Systematic Review.

BACKGROUND: Research on the longer-term sequelae of COVID-19 in patients with asthma is limited. OBJECTIVE: To assess the frequency and severity of long-term symptoms of COVID-19 in the population of asthma patients. METHODS: A systematic review of the published literature was conducted in accordance with the recommendations of the PRISMA statement. EMBASE, MEDLINE/PubMed, Web of Science, CINAHL, and Scopus Scholar were searched for terms related to asthma and post or long COVID-19, and for systematic reviews related to specific questions within our review, up to June 2022. RESULTS: Data from 9 references publications included in the review were extracted. A total of 1466 adult asthmatic patients with COVID-19 infection were described in all the publications mentioned above. Of the long-term symptoms reported after COVID-19, patients indicated: lower respiratory symptoms, fatigue, cognitive symptoms, psychological problems, and other such as skin rashes, gastrointestinal disorders, tachycardia, palpitations, ocular disorders, ageusia/hypogeusia, anosmia/hyposmia, and poor sleep quality. These symptoms in similar intensity were observed in the comparison groups without a diagnosis of asthma. CONCLUSIONS: The published data neither confirm nor deny that long-term COVID-19 symptoms in patients with asthma diagnosis are different in strength and frequency from patients without asthma diagnosis. To indicate associations between asthma and COVID-19 infection and severity, as well as the frequency of long-term symptoms of COVID-19, more longitudinal research is needed in chronic asthma patients with different phenotypes, intensity of treatment, and degree of asthma control.

The impact of clinical and psychological factors on asthma control: the experience of a single asthma center in Poland.

OBJECTIVE: The asthma control test (ACT) is commonly used to identify patients with uncontrolled asthma. The goal of this study was to determine whether clinical parameters such as asthma history and medications, exacerbation rate, comorbidities, lung function, and socioeconomic status are risk factors for uncontrolled asthma assessed with the ACT, and to evaluate the psychological status of controlled and uncontrolled asthmatics. METHODS: Adult asthmatics (n = 104) were recruited from a single asthma center, Poland. Asthma control was assessed with the ACT, using <20 as the cutoff point for uncontrolled asthma. Data on clinical factors were collected and spirometry was performed. Patients completed the Asthma Quality of Life Questionnaire, General Health Questionnaire, Acceptance of Illness Scale, Life Orientation Test-Revised, and Eysenck's Personality Inventory. RESULTS: Asthma was uncontrolled in 42.3% of patients. Asthma exacerbations in the preceding 12 months and high inhaled corticosteroid (ICS) doses were identified as independent risk factors for uncontrolled asthma. Uncontrolled asthmatics had a significantly worse psychological status than controlled asthmatics. The groups did not differ in terms of personality traits, but in the controlled asthma group numerous significant correlations between psychological factors and personality traits were observed. In the uncontrolled asthma group, however, the occurrence of correlations between personality traits and other psychological variables was rarer. CONCLUSIONS: The study identified independent risk factors for uncontrolled asthma, namely, exacerbations in the recent 12 months and treatment with high-dose ICS. Uncontrolled asthmatics have a significantly worse psychological status than controlled asthmatics, irrespective of personality traits.

The influence of the trunk muscle activation on occlusion pressure and respiratory muscle strength in healthy participants: Randomized controlled trial.

OBJECTIVES: The purpose of the study was to check if the trunk muscle activation done in accordance with rules of the Bobath concept affects the occlusion pressure and respiratory muscle efficacy in forced breathing manoeuvres in healthy participants. DESIGN: Randomized controlled trial. Between-subjects design. PARTICIPANTS: Seventy-four healthy volunteers, aged 20-26 years, were recruited from medical students, randomly assigned to the experimental or control groups. INTERVENTION: The intervention in the experimental group was individual physiotherapy based on the Bobath concept. It was provided by qualified physiotherapist and lasted about 60 min. The Bobath concept is an inclusive, individualized therapeutic approach to optimize movement recovery, informed by contemporary movement and neuro-sciences. The control group participated in a 45-minute lecture on the importance of the stability of trunk muscle and the diaphragm position that is adequate for its respiratory work. The described interventions, in both groups, were performed once, between the initial and final measurement of the respiratory drive. OUTCOME MEASURES: The subjects underwent two assessments of the following variables: occlusion pressure (P0.1) and the respiratory muscle strength: maximal inspiratory pressure (PImax), maximal expiratory pressure (PEmax), maximal occlusion pressure (P0.1max) with the use of MasterScope Spirometer. In experimental group, the physiotherapy assessment was carried out before intervention. RESULTS: As a result of the applied intervention, P0.1 in the experimental group increased (p = 0.001; 82.45 vs 103.73), which was not observed in the control group (p = 0.629; 88.95 vs 85.83). The intervention did not change the results of all other outcomes including P0.1 max; PImax and PEmax. CONCLUSION: The activation of trunk muscles such as transversus abdominis, multifidius and muscles of the pelvic floor was found to improve the effectiveness of diaphragmatic work during tidal breathing as measured with P0.1 values. Established abdominal pressure, which stabilizes the trunk and prevents chest mobility, might be the reason why forced measurements (PImax, PEmax, P.01 max) remain unchanged.

The comparison between pulmonary rehabilitation with music therapy and pulmonary rehabilitation alone on respiratory drive, cortisol level and asthma control in patients hospitalized with asthma exacerbation.

INTRODUCTION: Much emphasis is being placed on the role of music therapy as an easy-to-use, noninvasive and relatively cheap method of asthma treatment. The objective of this interventional double-blinded randomized controlled trial was to assess whether music therapy, as a complementary modality to pulmonary rehabilitation, can help to improve respiratory drive, asthma control and quality of life in patients with asthma exacerbation. METHODS: Hospitalized patients with asthma exacerbation enrolled in the study were randomly assigned to experimental (music therapy) or control (popular science program) group. Both groups during hospitalization received standard pharmacotherapy accompanied by respiratory physiotherapy. Respiratory drive, asthma control, quality of life and serum cortisol in all participants were assessed at the beginning and at the end of their hospitalizations. RESULTS: The experimental group consisted of 39 asthmatics and 34 subjects with asthma were assigned to the control group. During the hospitalization, the levels of the inspiratory occlusion pressure for the first 0.1 s of inspiration (P0.1) decreased (p = 0.004) and the maximum P0.1 increased (p = 0.041) only in the experimental group. The serum cortisol level decreased in both groups (p = 0.001). The changes in asthma control and quality of life did not reach significant levels in either subject group. CONCLUSION: Passive music therapy and its effects on the mental state of patients seem to improve the efficiency of the respiratory system. The results of this experimental study demonstrate that a complementary music therapy has beneficial effects on the treatment of asthma exacerbations in adults.

The Comorbidity of Chronic Obstructive Pulmonary Disease and Peripheral Artery Disease - A Systematic Review.

The comorbidity of peripheral arterial disease (PAD) and chronic obstructive pulmonary disease (COPD) is obvious from a clinical point of view, especially as smoking is an important risk factor for both. Another factor connecting these two clinical conditions is chronic inflammation, which plays a crucial role in their pathophysiology. The aim of this study was to present the prevalence of COPD in patients with PAD, as well as the prevalence of PAD in COPD patients confirmed in all patients by two reliable methods: spirometry and ankle-brachial index (ABI), respectively. The MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews were searched to identify the potentially eligible publications from the previous 10 years. The published characteristics of different PAD and COPD populations were analyzed. A database search identified 894 records. Reliable criteria of both COPD and PAD diagnosis were used only in seven publications. The prevalence of PAD among patients with COPD ranged from 8.5 to 81.4%. The severity of the disease and the exclusion of nonsmokers or symptomatic patients from the analyses were important factors affecting this parameter. The prevalence of COPD in patients with PAD was measured reliably only in one study and assessed as 27.2%. The comorbidity of COPD and PAD is a relatively common occurrence. There are very few publications addressing this issue based on reliable diagnostic criteria, especially in the field of PAD. In the case of COPD and PAD patients, spirometry and ABI measurements are worth considering as noninvasive screening tests for COPD and PAD, respectively.