Current Respiratory Medicine Reviews - Online First

An inflammatory lung condition that lasts a long time is called chronic obstructive pulmonary disease (COPD), it results from exposure to noxious substances, abnormalities in the bronchi, and obstruction of lung airflow owing to alveoli.

This study compares the safety and efficacy of LABA-LAMA combination therapy administered at varied frequencies to individuals with stable chronic obstructive pulmonary disease. The purpose of the study is to ascertain which of the two combinations performs better when considering both subjective and objective criteria.

Patients with Group B Stable COPD in the outpatient department were assigned into two random groups of 50 and given a different medication combination. Those in Group 1 received a single daily dose of Indacaterol + Glycopyrrolate, while those in Group 2 received two daily doses of Formoterol + Glycopyrrolate. Every four weeks, patients were checked on individually. Spirometric data (FEV1 (% Pred), Trough FEV1 (L), FEV1/FVC), and symptoms (cough, shortness of breath, sputum production, sleep disturbance) were recorded for each patient.

After the therapy, both groups showed a decrease in symptomatic indicators. There was a notable improvement in trough FEV1 (L) and spirometric measurements. Moreover, no noticeable differences in subjective and objective criteria were observed between groups 1 and 2.

This study's conclusions are limited to patient populations with comparable features. To further elucidate the risk factors and potential genetic foundation of the disease conditions, more multi-centric studies including diverse ethnic groups must be conducted.

Growing evidence suggests an increased risk of venous thromboembolism (VTE) in chronic respiratory disease (CRD) patients. Persistent lung inflammation, repeated hospitalization, and associated comorbidities render patients prone to VTE. Considering the limited data, we intended to determine the clinical profile and risk factors of VTE in CRD.

A retrospective case-control study was conducted at the Department of Pulmonary Medicine in a tertiary respiratory care center. The medical records of CRD patients from January 2020 to March 2023 were reviewed and data were collected. Confirmed cases with VTE (n = 50) using Doppler and computed tomography pulmonary angiogram (CTPA) and matched controls (n = 50) without VTE were included in the study. Clinical and radiological profiles of these patients, including age, sex, presence of comorbidities, duration of illness, severity of CRD, treatment details, chest radiograph, electrocardiogram, CBC, CRP, and D-dimer levels, were recorded. Predictors for VTE were assessed using univariate and multivariate analyses.

VTE was found more commonly in middle-aged patients and those with TOPD and COPD. Univariate analysis showed high pulse rate, low oxygen saturation (SpO2), higher diastolic blood pressure, higher mMRC grade of breathlessness, evidence of cor pulmonale on 2D echo, elevated WBC count, and CRP and D-dimer levels to be the predictors of VTE. In the multivariate analysis, low SpO2, higher mMRC grade of breathlessness, and elevated CRP and D-dimer levels were found to be independent predictors for VTE. We found 72% and 80% sensitivity and specificity for serum C-reactive protein at 58mg/dl and 84% and 100% sensitivity and specificity for D-dimer values at 560 ng/LFEU, respectively.

VTE was found to be more common in tuberculosis-associated obstructive pulmonary disease (TOPD) than COPD at our centre. Low SpO2, greater severity of breathlessness, and elevated serum CRP and D-dimer levels were considered independent predictors of VTE in CRD. In CRD patients presenting with clinical worsening, evaluation for VTE in the presence of these risk factors can be useful in reducing morbidity and mortality.

The world changed in December 2019 due to respiratory tract infection cases, initially of unknown etiology, later known as COVID-19.

This study aimed to determine the factors and comorbidities associated with mortality from COVID-19 in Mexico.

It was a cross-sectional and observational prospective study of patients treated at an IMSS (Mexican Institute of Social Security) Hospital in Morelos with a confirmed diagnosis of COVID-19. Logistic regression models and survival analyses were developed to identify factors associated with mortality risk.

3,965 patients were analyzed, with most deaths occurring in men. The mortality risks were higher in men who were older than 50 years. The most significant associations were: age older than 80 years (HR:3.17), endotracheal intubation (HR:1.54), dyspnea (HR: 13.55), and polypnea (HR:1.54).

The risk of death in this population was high, considering the absence of primary protective measures at the beginning of the pandemic and the lack of consistency in using personal protection elements.

Around 10-20% of hospitalized COVID-19 patients require readmission within 30-90 days, posing heightened risks of morbidity, mortality, and economic burden. Research on factors influencing post-COVID-19 readmission and hospital stay duration is limited.

This study describes clinical characteristics and identifies risk factors for prolonged hospital stays in readmitted post-COVID-19 patients.

A cross-sectional study included 52 patients readmitted between January and June 2022.

Patients had a mean age of 63.5 years. Severe and critical COVID-19 histories were reported in 27% and 11.5% of cases, respectively. Common symptoms leading to readmission included dyspnea, cough, fever, and chest pain. Respiratory support was required for 67.3% of patients (SpO2 < 90%), with 38.5% needing mechanical ventilation. Elevated D-Dimer (2029.07 ± 406.61) and CRP (50.97 ± 8.95) levels were common, and lung consolidation was the predominant chest image finding. The median hospital stay was 24.5 days, with 71.2% of patients staying longer than 14 days. Upon discharge, 96.1% were stable; 1 patient died, and 1 was transferred. Longer hospital stays were positively correlated with severe COVID-19 history, mechanical ventilation, CRP, Urea, and lung consolidation, while Hb and LDH were negatively correlated. Severe COVID-19 and lung consolidation were independent risk factors for extended stays.

Readmitted post-COVID-19 patients often experience respiratory complications requiring prolonged hospital stays. Key risk factors include a history of severe COVID-19 and lung consolidation at admission.

Tracheobronchopathia osteochondroplastica (TBOCP) is a rare, benign condition characterised by the presence of multiple bony and cartilaginous nodules in the tracheal and bronchial submucosa. Its etiology remains unknown, and clinical presentations and management vary.

We conducted a scoping review to evaluate clinical and radiological characteristics, diagnostic investigations and prognostic outcomes of TBOCP in adults by exploring Pubmed and SCOPUS databases.

From the search results of 675 studies, 98 were included in this scoping review. TBOCP has a myriad of presenting symptoms and clinical severity but is notably an asthma mimic, displaying an obstructive pattern on spirometry. Bronchoscopic tools were the most common interventional diagnostic or management tool.

While the etiology of TBOCP remains unknown, clinicians are alerted to its varied presentations and classical histopathological and gross morphological appearance.

Given the high prevalence of Long COVID, sleep problems have emerged as a significant issue for individuals after COVID-19 infection, potentially impacting their quality of life.

Our study aims to identify effective strategies for improving sleep quality and offers recommendations for future research.

The present systematic review study investigated ways to improve sleep quality in Long COVID patients. The study was conducted according to the updated PRISMA guidelines. The risk of bias was assessed using ROB 2.0.

Finally, six articles were included in the present study to identify strategies for improving and enhancing sleep quality in Long COVID. The results of the present study indicate that various interventions have been carried out to improve sleep quality, including psychological, cognitive, and physical factors related to long-term COVID-19 conditions.

Based on existing evidence, interventions such as mind meditation, yoga, and hyperbaric oxygen therapy have demonstrated efficacy in enhancing sleep quality among Long COVID patients.