[Exacerbation of obstructive pulmonary diseases by SARS-CoV-2 infection in patients treated in the Pulmonology Clinic of Târgu Mures]. / Obstruktív tüdobetegségek súlyosbodása SARS-CoV-2-fertozés hatására a marosvásárhelyi Pulmonológiai Klinika beteganyagában.

INTRODUCTION: Literature data show an increased severity of SARS-CoV-2 infection in patients with cardiovascular, renal comorbidities, chronic obstructive pulmonary disease (COPD), asthma, obesity, diabetes, tumors and immunosuppression. METHOD: This retrospective study includes 90 patients with SARS-CoV-2 infection associated with COPD or asthma exacerbations from 303 patients hospitalized during a 7-month period (29.7%). The clinical aspect of COPD/asthma exacerbations overlapped to the one by SARS-CoV-2 infection, therefore, we compared our group with 90 patients with SARS-CoV-2 without obstructive disease. We excluded from both groups the patients with known severe cardiac impairment, diabetes, or tumors in order to not having interference with other unfavorable prognostic factors. We assessed the cases severity on clinical basis, pulzoximetry, CT/chest x-ray, and inflammatory markers. RESULTS: 72.2% of our group (48/52 with COPD and 17/38 with asthma) had moderate/severe pneumonia (bilateral interstitial-alveolar infiltrates, increased inflammatory markers, respiratory dysfunction) compared with 56.6% from the nonobstructive group. 14 patients required intensive therapy (including mechanical ventilation). We recorded 4 deaths in COPD group, 1 in asthma group, compared to 2 in non-obstructive patients (fatality 7.6% in COPD compared to 2.2% in nonobstructive group). Treatment included maximized inhaled bronchodilators ± corticosteroids, oxygen, antivirals, anticoagulants, corticosteroids, symptomatic. All patients were referred for clinical-functional and CT scan reassessment 2 months after discharge. CONCLUSION: The association of SARS-CoV-2 infection in patients with COPD or asthma was common, leading to exacerbation with significant severity. Fatality increased in COPD. Outpatient follow-up aims to restage adjust the treatment and monitor post-COVID-19 possible sequels. Orv Hetil. 2023; 164(2): 43-50.

Lung function and comorbidities in patients with exacerbated chronic obstructive pulmonary disease hospitalized in Tirgu-Mureș Pulmonology Clinic / Súlyos krónikus obstruktív tüdobetegségben szenvedo betegek tüdofunkciója és társbetegségei a marosvásárhelyi Tüdogyógyászati Klinikán

two-thirds and partial remission in one-third of the lesions. At doses above 100 J/cm², severe erythema was observed 24 hours after the treatment. To avoid this, we calculated the time to be spent outdoor by dosimetry. Partial remission was achieved in 15%, complete remission in 85% of the actinic keratoses with good tolerability. Discussion: The stepwise modification of the treatment protocol resulted in an effective and well-tolerated treatment in actinic keratoses under the local climatic conditions. Conclusion: The method has been successfully adapted in our clinic and is used in daily practice to treat actinic keratoses.