scholarly journals Effect modification by age of the association between obstructive lung diseases, smoking, and COVID-19 severity

2021 ◽  
Vol 8 (1) ◽  
pp. e001038
Author(s):  
Peter P Moschovis ◽  
Mengdi Lu ◽  
Douglas Hayden ◽  
Lael M Yonker ◽  
Jesiel Lombay ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Diseases ◽  
Massachusetts General Hospital ◽  
Effect Modification ◽  
Chronic Obstructive ◽  
Electronic Health Record Data ◽  
Current Smoking ◽  
Obstructive Lung Diseases ◽  
Hospitalised Patients ◽  
Increased Risk

IntroductionObstructive lung diseases (asthma and chronic obstructive pulmonary disease (COPD)) and smoking are associated with greater risk of respiratory infections and hospitalisations, but conflicting data exist regarding their association with severity of COVID-19, and few studies have evaluated whether these associations differ by age.ObjectivesTo examine the associations between asthma, COPD and smoking on the severity of COVID-19 among a cohort of hospitalised patients, and to test for effect modification by age.MethodsWe performed a retrospective analysis of electronic health record data of patients admitted to Massachusetts General Hospital, assigning the maximal WHO Clinical Progression Scale score for each patient during the first 28 days following hospital admission. Using ordered logistic regression, we measured the association between maximal severity score and asthma, COPD and smoking and their interaction with age.Measurements and main resultsAmong 1391 patients hospitalised with COVID-19, we found an increased risk of severe disease among patients with COPD and prior smoking, independent of age. We also found evidence of effect modification by age with asthma and current smoking; in particular, asthma was associated with decreased COVID-19 severity among older adults, and current smoking was associated with decreased severity among younger patients.ConclusionsThis cohort study identifies age as a modifying factor for the association between asthma and smoking on severity of COVID-19. Our findings highlight the complexities of determining risk factors for COVID-19 severity, and suggest that the effect of risk factors may vary across the age spectrum.

scholarly journals Mortality and high risk of major adverse events in patients with COVID-19 and history of cardiovascular disease

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001526
Author(s):  
Elena Tessitore ◽  
David Carballo ◽  
Antoine Poncet ◽  
Nils Perrin ◽  
Cedric Follonier ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Male Gender ◽  
Hospital Death ◽  
Chronic Obstructive ◽  
University Hospitals ◽  
Adverse Cardiovascular Event ◽  
Risk Of Death ◽  
Hospitalised Patients ◽  
Increased Risk ◽  
History Of

ObjectiveHistory of cardiovascular diseases (CVDs) may influence the prognosis of patients hospitalised for COVID-19. We investigated whether patients with previous CVD have increased risk of death and major adverse cardiovascular event (MACE) when hospitalised for COVID-19.MethodsWe included 839 patients with COVID-19 hospitalised at the University Hospitals of Geneva. Demographic characteristics, medical history, laboratory values, ECG at admission and medications at admission were collected based on electronic medical records. The primary outcome was a composite of in-hospital mortality or MACE.ResultsMedian age was 67 years, 453 (54%) were males and 277 (33%) had history of CVD. In total, 152 (18%) died and 687 (82%) were discharged, including 72 (9%) who survived a MACE. Patients with previous CVD were more at risk of composite outcomes 141/277 (51%) compared with those without CVD 83/562 (15%) (OR=6.0 (95% CI 4.3 to 8.4), p<0.001). Multivariate analyses showed that history of CVD remained an independent risk factor of in-hospital death or MACE (OR=2.4; (95% CI 1.6 to 3.5)), as did age (OR for a 10-year increase=2.2 (95% CI 1.9 to 2.6)), male gender (OR=1.6 (95% CI 1.1 to 2.3)), chronic obstructive pulmonary disease (OR=2.1 (95% CI 1.0 to 4.2)) and lung infiltration associated with COVID-19 at CT scan (OR=1.9 (95% CI 1.2 to 3.0)). History of CVD (OR=2.9 (95% CI 1.7 to 5)), age (OR=2.5 (95% CI 2.0 to 3.2)), male gender (OR=1.6 (95% CI 0.98 to 2.6)) and elevated C reactive protein (CRP) levels on admission (OR for a 10 mg/L increase=1.1 (95% CI 1.1 to 1.2)) were independent risk factors for mortality.ConclusionHistory of CVD is associated with higher in-hospital mortality and MACE in hospitalised patients with COVID-19. Other factors associated with higher in-hospital mortality are older age, male sex and elevated CRP on admission.

scholarly journals THE MICROBIOTA OF LOWER AIRWAYS IN PATIENTS WITH CHRONIC OBSTRUCTIVE LUNG DISEASES

2018 ◽  
pp. 53-60
Author(s):  
S. A. Mazurina ◽  
G. A. Danilina ◽  
M. Yu. Smirnova ◽  
G. L. Osipova ◽  
V. B. Gervazieva ◽  
...  
Keyword(s):  
Burkholderia Cepacia ◽  
Lung Diseases ◽  
Morphological Changes ◽  
Bacterial Species ◽  
Chronic Obstructive Lung Disease ◽  
Induced Sputum ◽  
Chronic Obstructive ◽  
Obstructive Lung Diseases ◽  
Chronic Lung Diseases ◽  
Detection Frequency

Aim. We aimed to estimate the composition and the detection frequency of bacterial species in induced sputum samples from patients with bronchial asthma (BA), chronic obstructive lung disease (COPD) and its combined phenotype (ACOS). Materials and methods. Bacteriological examination of samples of induced sputum in patients with chronic obstructive pulmonary diseases (BA, COPD) was carried out. Results. Patients with asthma-COPD overlap syndrome exhibit more diverse bacterial species composition as represented both by gram-positive Streptococcus sрp., Staphylococcus spр., gram-negative Klebsiella pneumoniaе, Escherichia coli, Serratia marcescens, Pseudomonas aeruginosa, Haemophilus influenzae, Burkholderia cepacia and rodlike bacterium Corynebacterium spр., Actinomyces spр. и Tsukamurella рaurometabola as compared to patients with only one diagnosis of COPD or asthma. In addition, we revealed the differences between microbiological diversity and predominance of Streptococcus spр, Neisseria subflava with decrease of Enterococcus sрр. in samples from patients with complicated forms of obstructive lung diseases as COPD and ACOS, with pulmonary emphysema and/or pneumosclerosis. Conclusion. The biodiversity of lung microbiome could be one of the pathology risk factors in patients with chronic lung diseases, on the other hand reflecting the structural morphological changes in the lung tissue as a result of sustainable inflammation.

scholarly journals Risk for Cardiovascular Disease and One-Year Mortality in Patients With Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea Syndrome Overlap Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
Manyun Tang ◽  
Yidan Wang ◽  
Mengjie Wang ◽  
Rui Tong ◽  
Tao Shi
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Cardiovascular Diseases ◽  
Overlap Syndrome ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Independent Risk Factors

Background: Patients with chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSAS) overlap syndrome (OS) are thought to be at increased risk for cardiovascular diseases.Objective: To evaluate the burden of cardiovascular diseases and long-term outcomes in patients with OS.Methods: This was a retrospective cohort study. The prevalence of cardiovascular diseases and 1-year mortality were compared among patients diagnosed with OS (OS group), COPD alone (COPD group) and OSAS alone (OSAS group), and Cox proportional hazards models were used to assess independent risk factors for all-cause mortality.Results: Overall, patients with OS were at higher risk for pulmonary hypertension (PH), heart failure and all-cause mortality than patients with COPD or OSAS (all p &lt; 0.05). In multivariate Cox regression analysis, the Charlson comorbidity index (CCI) score [adjusted hazard ratio (aHR): 1.273 (1.050–1.543); p = 0.014], hypertension [aHR: 2.006 (1.005–4.004); p = 0.048], pulmonary thromboembolism (PTE) [aHR: 4.774 (1.335–17.079); p = 0.016] and heart failure [aHR: 3.067 (1.521–6.185); p = 0.002] were found to be independent risk factors for 1-year all-cause mortality.Conclusion: Patients with OS had an increased risk for cardiovascular diseases and 1-year mortality. More efforts are needed to identify the causal relationship between OS and cardiovascular diseases, promoting risk stratification and the management of these patients.

Pulmonary Evaluation

2016 ◽  
pp. 747-766
Author(s):  
Vivek N. Iyer
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cystic Fibrosis ◽  
Lung Disease ◽  
Lung Diseases ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Airway Stenosis ◽  
Obstructive Lung Diseases ◽  
Diffuse Panbronchiolitis ◽  
Antitrypsin Deficiency

Obstructive lung diseases include chronic obstructive pulmonary disease (COPD) (eg, chronic bronchitis and emphysema), asthma, bronchiectasis, cystic fibrosis, obliterative bronchiolitis, and diffuse panbronchiolitis (eg, bullous lung disease, α‎1-antitrypsin deficiency, and airway stenosis). The 2 most prevalent obstructive lung diseases are COPD and asthma.

Control of Breathing in Patients with Chronic Obstructive Lung Diseases and Secondary Polycythemia after Venesection

Respiration ◽  
1986 ◽  
Vol 49 (4) ◽  
pp. 257-262 ◽  
Author(s):  
Demetrios A. Patakas ◽  
Pandora I. Christaki ◽  
George E. Louridas ◽  
Brian J. Sproule
Keyword(s):  
Lung Diseases ◽  
Control Of Breathing ◽  
Chronic Obstructive ◽  
Obstructive Lung Diseases ◽  
Chronic Obstructive Lung Diseases ◽  
Secondary Polycythemia

scholarly journals Risk Factors for Postural and Functional Balance Impairment in Patients with Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 9 (2) ◽  
pp. 609
Author(s):  
Jaekwan K. Park ◽  
Nicolaas E. P. Deutz ◽  
Clayton L. Cruthirds ◽  
Sarah K. Kirschner ◽  
Hangue Park ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Postural Balance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Balance Impairment ◽  
Functional Balance ◽  
Control Subjects ◽  
Increased Risk

Reduced balance function has been observed during balance challenging conditions in the chronic obstructive pulmonary disease (COPD) population and is associated with an increased risk of falls. This study aimed to examine postural balance during quiet standing with eyes open and functional balance in a heterogeneous group of COPD and non-COPD (control) subjects, and to identify risk factors underlying balance impairment using a large panel of methods. In COPD and control subjects, who were mostly overweight and sedentary, postural and functional balance were assessed using center-of-pressure displacement in anterior-posterior (AP) and medio-lateral (ML) directions, and the Berg Balance Scale (BBS), respectively. COPD showed 23% greater AP sway velocity (p = 0.049). The presence of oxygen therapy, fat mass, reduced neurocognitive function, and the presence of (pre)diabetes explained 71% of the variation in postural balance in COPD. Transcutaneous oxygen saturation, a history of exacerbation, and gait speed explained 83% of the variation in functional balance in COPD. Neurocognitive dysfunction was the main risk factor for postural balance impairment in the control group. This suggests that specific phenotypes of COPD patients can be identified based on their type of balance impairment.

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