Multimorbidity clusters in patients with chronic obstructive airway diseases in the EpiChron Cohort

AbstractChronic obstructive airway diseases such as chronic obstructive pulmonary disease (COPD), asthma, rhinitis, and obstructive sleep apnea (OSA) are amongst the most common treatable and preventable chronic conditions with high morbidity burden and mortality risk. We aimed to explore the existence of multimorbidity clusters in patients with such diseases and to estimate their prevalence and impact on mortality. We conducted an observational retrospective study in the EpiChron Cohort (Aragon, Spain), selecting all patients with a diagnosis of allergic rhinitis, asthma, COPD, and/or OSA. The study population was stratified by age (i.e., 15–44, 45–64, and ≥ 65 years) and gender. We performed cluster analysis, including all chronic conditions recorded in primary care electronic health records and hospital discharge reports. More than 75% of the patients had multimorbidity (co-existence of two or more chronic conditions). We identified associations of dermatologic diseases with musculoskeletal disorders and anxiety, cardiometabolic diseases with mental health problems, and substance use disorders with neurologic diseases and neoplasms, amongst others. The number and complexity of the multimorbidity clusters increased with age in both genders. The cluster with the highest likelihood of mortality was identified in men aged 45 to 64 years and included associations between substance use disorder, neurologic conditions, and cancer. Large-scale epidemiological studies like ours could be useful when planning healthcare interventions targeting patients with chronic obstructive airway diseases and multimorbidity.

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Summary of Utah Project on Exfoliation Syndrome (UPEXS): using a large database to identify systemic comorbidities

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2021-000803 ◽

2021 ◽

Vol 6 (1) ◽

pp. e000803

Author(s):

Christian James Pompoco ◽

Karen Curtin ◽

Samuel Taylor ◽

Chase Paulson ◽

Caleb Shumway ◽

...

Keyword(s):

Extracellular Matrix ◽

Lysyl Oxidase ◽

Genetic Disorders ◽

Epidemiological Studies ◽

Pelvic Organ ◽

Chronic Obstructive ◽

Exfoliation Syndrome ◽

Population Database ◽

Obstructive Sleep ◽

Increased Risk

The purpose of the Utah Project on Exfoliation Syndrome (UPEXS) is to identify associations between exfoliation syndrome (XFS) and other diseases that share the commonality of abnormalities in elastin and Lysyl Oxidase-Like 1 gene regulation. The UPEXS is unique because it uses the Utah Population Database, which is linked to the Utah genealogy, that contains a compilation of large pedigrees of most families in the state of Utah that go back multiple generations (3 to ≥11). The health and medical records of these family members are linked to vital records and can be used effectively in studies focused on genetic disorders like XFS, where familial clustering of a disorder is a trend. There is increasing evidence that patients with XFS have a higher risk of certain systemic disorders that reflect the systemic tissue abnormalities of XFS. Epidemiological studies focused on patients with XFS have shown that there is an increased risk of these individuals developing other pathologies that have abnormalities in extracellular matrix metabolism and repair. UPEXS has focused on suspected comorbidities that involve abnormalities in elastin maintenance, a protein that plays a role in the makeup of the extracellular matrix. In this paper, the results from the analysis of chronic obstructive pulmonary disease, inguinal hernias, pelvic organ prolapse, obstructive sleep apnoea and atrial fibrillation are summarised along with the utility of using such a large dataset.

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Hepcidin and MELD-XI score as markers of multiple organ failure in patients with heart failure with preserved and reduced ejection fraction

CARDIOVASCULAR THERAPY AND PREVENTION ◽

10.15829/1728-8800-2020-2529 ◽

2020 ◽

Vol 19 (3) ◽

pp. 2529

Author(s):

V. I. Podzolkov ◽

N. A. Dragomiretskaya ◽

S. K. Stolbova ◽

A. V. Tolmacheva

Keyword(s):

Heart Failure ◽

Body Mass Index ◽

Ejection Fraction ◽

Cardiac Arrhythmias ◽

Multiple Organ ◽

Left Ventricular ◽

Chronic Obstructive ◽

Hepcidin Level ◽

Airway Diseases ◽

Obstructive Airway Diseases

Data on the changes in hepcidin levels in heart failure (HF) patients are contradictory and do not give an answer about its effect on the progression of multiple organ failure. Since the model of end-stage liver disease excluding INR (MELD-XI) reflects the severity of liver and kidney dysfunction, these markers have been suggested to be associated with decompensated HF.Aim. To assess the MELD-XI score and serum hepcidin levels in patients with decompensated HF with different values of left ventricular ejection fraction (EF).Material and methods. The study included 68 patients (29 women, 39 men; mean age 72,3±11,7 years) hospitalized due to decompensated HF. Patients were divided into three groups: reduced (HFrEF) (n=20), mid-range (HFmrEF) (n=23), and preserved EF (HFpEF) (n=24)). Upon admission, along with standard diagnostic tests, all patients were examined for hepcidin-25 levels by enzyme-linked immunosorbent assay. MELD-XI score was calculated. Statistical processing was carried out using the software package Statistica 8.0.Results. Hepcidin levels in the HFrEF group (31,63 ng/ml [22,0; 71,6]) were significantly higher than in the HFmrEF (23,89 ng/ml [21,1; 27,9]) (p<0,05) and HFpEF (26,91 ng/ml [18,6; 31,1]) (p<0,05) groups. In HFpEF, there was a correlation of hepcidin level with body mass index (r=0,47, p<0,05) and chronic obstructive airway diseases (r=0,44, p<0,05). A correlation of hepcidin level with significant cardiac arrhythmias (r=0,61, p<0,05) was revealed in HFmrEF patients. MELD-XI score were significantly increased from 9,44±3,96 for HFpEF and 11,53±3,82 for HFmrEF to 14,3±4,3 for HFrEF (p<0,005). We also revealed correlation of MELD-XI score with hepcidin levels (r=0,3, p<0,05) and EF (r=-0,43, p<0,0003). Patients with a MELD-XI score of >10,4 were more likely to have NYHA class III-IV HF, HFrEF and significantly higher levels of hepcidin (p<0,05 for all) These patients were also more likely to have chronic kidney disease (p<0,05).Conclusion. Hepcidin level and MELD-XI score in patients with decompensated HF are inversely related to left ventricular EF. There is a direct relationship between hepcidin levels and other clinical parameters: body mass index, the presence of chronic obstructive airway diseases and cardiac arrhythmias.

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Prevalence of Asthma and COPD and Blood Eosinophil Count in a Middle-Aged Belgian Population

Journal of Clinical Medicine ◽

10.3390/jcm8081122 ◽

2019 ◽

Vol 8 (8) ◽

pp. 1122 ◽

Cited By ~ 4

Author(s):

Sara R. A. Wijnant ◽

Lies Lahousse ◽

Marc L. De Buyzere ◽

Guy G. Brusselle ◽

Ernst R. Rietzschel

Keyword(s):

Eosinophil Count ◽

Respiratory Health ◽

Disease Status ◽

Chronic Obstructive ◽

Blood Eosinophil ◽

Middle Aged ◽

Blood Eosinophil Count ◽

Current Asthma ◽

Airway Diseases ◽

Obstructive Airway Diseases

Various phenotypes exist in asthma and Chronic Obstructive Pulmonary Disease (COPD). These are important to identify in order to guide treatment decisions. We aim to investigate the prevalence and clinical characteristics of obstructive airway diseases in the middle-aged population. We estimated the prevalence of COPD and/or asthma in the Asklepios cohort study (Belgium), using information from the third European Community Respiratory Health Survey (ECRHS3), medical records, and spirometry. Respiratory symptoms, respiratory medication, and current disease status distinguished clinical from sub-clinical cases. In addition, we compared the blood eosinophil count/µL (median [IQR]) between cases and controls. Of the 2221 participants (mean age 56.1 ± 5.9 years; 48.7% males), 138 (6.2%) participants had clinical current asthma, 22 (1.0%) participants had sub-clinical ever asthma, 102 (4.6%) had sub-clinical spirometry-defined COPD, 104 (4.6%) participants had clinical spirometry-confirmed COPD, and 11 (0.5%) had asthma and COPD overlap (ACO). Clinical current asthma (160.0 [110.0–250.0]), sub-clinical ever asthma (170.0 [110.0–230.0]), and clinical COPD (160.0 [110.0–220.0])—but less sub-clinical COPD (140.0 [90.0–210.0])—had higher eosinophil counts, compared to controls (130.0 [80.0–200.0]). We conclude that obstructive airway diseases are prevalent in the middle-aged Asklepios cohort. Moreover, the systemic eosinophil count is increased in clinical COPD cases, and in asthma cases regardless of clinical remission.

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A study on asthma and chronic obstructive pulmonary disease overlaps among patients with obstructive airway diseases

IP Indian Journal of Immunology and Respiratory Medicine ◽

10.18231/j.ijirm.2021.016 ◽

2021 ◽

Vol 6 (2) ◽

pp. 71-74

Author(s):

Venkatesh B.C ◽

Raju C.H

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Smoking History ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Airway Diseases ◽

History Of ◽

Sputum Eosinophils ◽

Obstructive Airway Diseases ◽

Asthma Group

There is a need to re-evaluate the concept of asthma and chronic obstructive pulmonary disease (COPD) as separate conditions, and to consider situations when they may coexist, or when one condition may evolve into the other. This is prospective, observational and descriptive study conducted at MNR Medical College and Hospital, Sangareddy, India from June 2020 to December 2020 among chronic airway diseases who were classified into three groups (COPD, Asthma, and Asthma and COPD overlap (ACO)). Patients with COPD and ACO were diagnosed according to GOLD guidelines 2020 and patients with asthma were diagnosed according to Global Initiative for Asthma (GINA) guidelines 2020. : Regarding the age difference between groups, it was found that patients who were diagnosed as having COPD and ACO were with mean age of 57.23±8.54 and 56.26±7.73 years, respectively. The men age of patients of Asthma was 57.51±8.43. In our study, 28 (30%) patients as having COPD, 39 (45.5%) patients were diagnosed as having ACO, 23 (24.4%) patients were diagnosed as having asthma. In our study comparison of groups regarding history of atopy. We found that 71.7% of ACO group, 78.2% of asthma group and 25% of COPD group had a positive history of atopy. Comparison of study groups regarding sputum eosinophils revealed that 30.7 % of ACO group, 73.9% of asthma group and 32.1% of COPD group had positive sputum eosinophils. ACO represents a large percentage among patients with obstructive airway diseases. It shares some features of asthma such as atopy and positive sputum eosinophilia, and some features of COPD like old age of presentation and positive smoking history.

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Abstract 17471: Outcome of Acute Myocardial Injury in COVID-19 Patients

Circulation ◽

10.1161/circ.142.suppl_3.17471 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Magdi Zordok ◽

Muhammad Etiwy ◽

Shruti Hegde ◽

Michael Maysky

Keyword(s):

Myocardial Injury ◽

Average Length ◽

Invasive Mechanical Ventilation ◽

Morbidity And Mortality ◽

Hospital Death ◽

Chronic Obstructive ◽

High Morbidity ◽

Elevated Troponin ◽

Obstructive Sleep ◽

Acute Myocardial Injury

Background: Acute myocardial injury has been reported in approximately 20% of patients with Coronavirus disease 2019 (COVID-19). Little is known about the outcome of this subset of patients. We are testing the hypothesis of higher morbidity and mortality in patients with COVID-19 who have acute myocardial injury. Methods: In this retrospective study, we analyzed data from patients admitted to Steward Healthcare hospitals in Massachusetts between March 22 and April 24, who tested positive for COVID-19 confirmed by serology and found to have elevated troponin levels (>0.01). The sociodemographic information, clinical data, and outcomes of these critically ill patients were retrospectively extracted from the medical records. The primary outcome was in-hospital death. Data were analyzed using JMP statistical analysis software. Results: Two hundred eighty-three COVID-19 positive patients were found to have troponin levels >0.01 on admission. Of these 183 patients (64.6%) were males, 49.1% were Caucasian and 32.1% were African Americans. The mean age of the patients was 70.7 ± 13.8. The prevalence of comorbid conditions was as follows: hypertension, 69.7%; hyperlipidemia, 46.9%; diabetes mellitus, 42.6%; chronic kidney disease, 28.3%; heart failure, 19.3%; atrial fibrillation, 22.1%; coronary artery disease, 17.1%; cerebrovascular accident, 10.2%; obesity, 38%; chronic obstructive pulmonary disease or asthma 20.8%, obstructive sleep apnea, 4.9%. One hundred thirty-seven patients (48.4%) noted to have acute kidney injury on presentation,128 (45.2%) required ICU level of care, 41% required invasive mechanical ventilation for a mean of 10.4 ± 7.9 days, and 38.8% required vasopressors. The average length of stay (LOS) in the medical intensive care unit and the hospital was 11.5 ± 8.3 days and 11.4 ± 9.5 days respectively. The overall in-hospital mortality rate was 45.6%. Conclusion: Patients with COVID-19 and elevated Troponin levels had high morbidity and mortality

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Low socioeconomic status is associated with chronic obstructive airway diseases

Respiratory Medicine ◽

10.1016/j.rmed.2011.03.008 ◽

2011 ◽

Vol 105 (8) ◽

pp. 1140-1146 ◽

Cited By ~ 55

Author(s):

Merja Kanervisto ◽

Tuula Vasankari ◽

Tarja Laitinen ◽

Markku Heliövaara ◽

Pekka Jousilahti ◽

...

Keyword(s):

Socioeconomic Status ◽

Low Socioeconomic Status ◽

Chronic Obstructive ◽

Low Socioeconomic ◽

Airway Diseases ◽

Obstructive Airway Diseases

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Periostin and Thymic Stromal Lymphopoietin—Potential Crosstalk in Obstructive Airway Diseases

Journal of Clinical Medicine ◽

10.3390/jcm9113667 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3667

Author(s):

Patrycja Nejman-Gryz ◽

Katarzyna Górska ◽

Magdalena Paplińska-Goryca ◽

Małgorzata Proboszcz ◽

Rafał Krenke

Keyword(s):

Immune Response ◽

Mrna Level ◽

Thymic Stromal Lymphopoietin ◽

Atopic Asthma ◽

Chronic Obstructive ◽

Strong Positive Correlation ◽

Th2 Response ◽

Airway Diseases ◽

Th2 Immune Response ◽

Obstructive Airway Diseases

Periostin and thymic stromal lymphopoietin (TSLP) are newly described markers of obstructive airway diseases and the mechanism by which both markers participate in immune response remains poorly understood. The aim of our study was to determine periostin and TSLP concentration in serum and induced sputum (IS) in patients with atopic asthma, chronic obstructive pulmonary disease (COPD), and controls, as well as to evaluate the potential link between periostin, TSLP, and Th2 immune response. Serum and IS levels of periostin, TSLP, IL-4, and IL-13 were determined in 12 atopic asthmatics, 16 COPD sufferers, and 10 controls. We noticed a significantly higher IS periostin and TSLP concentration at protein and mRNA level in asthmatics compared to the two other groups; additionally, periostin and TSLP were correlated positively with IS eosinophil count. A strong positive correlation between IS periostin and TSLP protein levels (r = 0.96) as well as mRNA expression level (r = 0.95) was found in patients with asthma. The results of our study show that periostin and TSLP are associated with eosinophilic airway inflammation and seem to be important drivers of atopic asthma but not COPD pathobiology. Very strong correlations between local periostin, TSLP, eosinophils, and IL-4 in asthma point to the link between periostin–TSLP and Th2 response.

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Computational Phenotyping of Obstructive Airway Diseases: Protocol for A Systematic Review

10.21203/rs.3.rs-56360/v1 ◽

2020 ◽

Author(s):

Muwada Bashir ◽

Rani Basna ◽

Guo-Qiang Zhang ◽

Helena Beckman ◽

Anne Lindberg ◽

...

Keyword(s):

Systematic Review ◽

Assessment Tool ◽

Public Health Practice ◽

Chronic Obstructive ◽

Reference List ◽

Quality Appraisal ◽

Computational Approaches ◽

Airway Diseases ◽

Ethical Approval ◽

Obstructive Airway Diseases

Abstract Background: Over the last decade, computational sciences have contributed immensely to characterization of phenotypes of airway diseases, but it is difficult to compare derived phenotypes across studies, perhaps as a result of the different decisions that fed into these phenotyping exercises. We aim to perform a systematic review of studies using computational approaches to phenotype obstructive airway diseases in children and adults.Methods and analysis: We will search PubMed, EMBASE, Scopus, Web of Science, Google scholar for papers published between 2010 and 2020. Conferences proceedings, reference list of included papers, and experts will form additional sources of literature. Two reviewers will independently screen the retrieved studies for eligibility, extract relevant data, and perform quality appraisal of included studies. A third reviewer will arbitrate any disagreements in these processes. Quality appraisal of the studies will be undertaken using the Effective Public Health Practice Project quality assessment tool. We will use summary tables to describe the included studies. We will narratively synthesize the generated evidence, providing critical assessment of the populations, variables, and computational approaches used in deriving the phenotypes across studiesConclusion: As progress continues to be made in the area of computational phenotyping of chronic obstructive airway diseases, this systematic review, the first on this topic, will provide the state-of-the-art on the field and highlight important perspectives for future works.Ethics and dissemination: No ethical approval is needed for this work is based only on the published literature and does not involve collection of any primary or human data.Registration: The protocol of this the review process is registered in PROSPERO with the number: CRD42020164898.

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