scholarly journals Effect of asthma and asthma medication on the prognosis of patients with COVID-19

2020 ◽  
Vol 57 (3) ◽  
pp. 2002226 ◽  
Author(s):  
Yong Jun Choi ◽  
Ju-Young Park ◽  
Hye Sun Lee ◽  
Jin Suh ◽  
Jeung Yoon Song ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Medical Cost ◽  
Asthma Severity ◽  
Asthma Medication ◽  
Diagnostic Code ◽  
Total Medical Cost ◽  
Global Initiative For Asthma ◽  
Prolonged Duration ◽  
Global Initiative ◽  
Poor Outcomes

BackgroundCoronavirus disease 2019 (COVID-19) has spread worldwide rapidly. However, the effects of asthma, asthma medication and asthma severity on the clinical outcomes of COVID-19 have not yet been established.MethodsThe study included 7590 de-identified patients, who were confirmed to have COVID-19 using the severe acute respiratory syndrome coronavirus 2 RNA-PCR tests conducted up to May 15, 2020; we used the linked-medical claims data provided by the Health Insurance Review and Assessment Service. Asthma and asthma severity (steps suggested by the Global Initiative for Asthma) were defined using the diagnostic code and history of asthma medication usage.ResultsAmong 7590 COVID-19 patients, 218 (2.9%) had underlying asthma. The total medical cost associated with COVID-19 patients with underlying asthma was significantly higher than that of other patients. Mortality rate for COVID-19 patients with underlying asthma (7.8%) was significantly higher than that of other patients (2.8%; p<0.001). However, asthma was not an independent risk factor for the clinical outcomes of COVID-19 after adjustment, nor did asthma medication use and asthma severity affect the clinical outcomes of COVID-19. However, use of oral short-acting β2-agonists was an independent factor to increase the total medical cost burden. Patients with step 5 asthma showed significant prolonged duration of admission compared to those with step 1 asthma in both univariate and multivariate analysis.ConclusionsAsthma led to poor outcomes of COVID-19; however, underlying asthma, use of asthma medication and asthma severity were not independent factors for poor clinical outcomes of COVID-19, generally.

scholarly journals Using Global Initiative for Asthma guidelines to assess asthma severity in populations

2000 ◽  
Vol 16 (4) ◽  
pp. 615 ◽  
Author(s):  
R. Liard ◽  
B. Leynaert ◽  
M. Zureik ◽  
F-X Beguin ◽  
F Neukirch
Keyword(s):  
Asthma Severity ◽  
Global Initiative For Asthma ◽  
Global Initiative

Asthma Severity According to Global Initiative for Asthma and Its Determinants: An International Study

2010 ◽  
Vol 151 (1) ◽  
pp. 70-79 ◽  
Author(s):  
Lucia Cazzoletti ◽  
Alessandro Marcon ◽  
Angelo Corsico ◽  
Christer Janson ◽  
Deborah Jarvis ◽  
...  
Keyword(s):  
International Study ◽  
Asthma Severity ◽  
Global Initiative For Asthma ◽  
Global Initiative

scholarly journals Evaluation of quality of life according to asthma control and asthma severity in children and adolescents

2015 ◽  
Vol 41 (6) ◽  
pp. 502-508 ◽  
Author(s):  
Natasha Yumi Matsunaga ◽  
Maria Angela Gonçalves de Oliveira Ribeiro ◽  
Ivete Alonso Bredda Saad ◽  
André Moreno Morcillo ◽  
José Dirceu Ribeiro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Children And Adolescents ◽  
Asthma Control ◽  
Asthma Severity ◽  
Life Questionnaire ◽  
Asthma Control Test ◽  
Global Initiative For Asthma ◽  
Pediatric Pulmonology ◽  
Global Initiative

ABSTRACT OBJECTIVE: To evaluate quality of life according to the level of asthma control and degree of asthma severity in children and adolescents. METHODS: We selected children and adolescents with asthma (7-17 years of age) from the Pediatric Pulmonology Outpatient Clinic of the State University of Campinas Hospital de Clínicas, located in the city of Campinas, Brazil. Asthma control and asthma severity were assessed by the Asthma Control Test and by the questionnaire based on the Global Initiative for Asthma, respectively. The patients also completed the Paediatric Asthma Quality of Life Questionnaire (PAQLQ), validated for use in Brazil, in order to evaluate their quality of life. RESULTS: The mean age of the patients was 11.22 ± 2.91 years, with a median of 11.20 (7.00-17.60) years. We selected 100 patients, of whom 27, 33, and 40 were classified as having controlled asthma (CA), partially controlled asthma (PCA), and uncontrolled asthma (UA), respectively. As for asthma severity, 34, 19, and 47 were classified as having mild asthma (MiA), moderate asthma (MoA), and severe asthma (SA), respectively. The CA and the PCA groups, when compared with the NCA group, showed higher values for the overall PAQLQ score and all PAQLQ domains (activity limitation, symptoms, and emotional function; p < 0.001 for all). The MiA group showed higher scores for all of the PAQLQ components than did the MoA and SA groups. CONCLUSIONS: Quality of life appears to be directly related to asthma control and asthma severity in children and adolescents, being better when asthma is well controlled and asthma severity is lower.

scholarly journals Effective Asthma Management: Is It Time to Let the AIR out of SABA?

2020 ◽  
Vol 9 (4) ◽  
pp. 921
Author(s):  
Alan Kaplan ◽  
Patrick D. Mitchell ◽  
Andrew J. Cave ◽  
Remi Gagnon ◽  
Vanessa Foran ◽  
...  
Keyword(s):  
Asthma Management ◽  
Beta Agonist ◽  
Inhaled Corticosteroid ◽  
Short Acting ◽  
Asthma Symptoms ◽  
Beta Agonists ◽  
Global Initiative For Asthma ◽  
Global Initiative ◽  
Poor Outcomes ◽  
Fast Acting

For years, standard asthma treatment has included short acting beta agonists (SABA), including as monotherapy in patients with mild asthma symptoms. In the Global Initiative for Asthma 2019 strategy for the management of asthma, the authors recommended a significant departure from the traditional treatments. Short acting beta agonists (SABAs) are no longer recommended as the preferred reliever for patients when they are symptomatic and should not be used at all as monotherapy because of significant safety concerns and poor outcomes. Instead, the more appropriate course is the use of a combined inhaled corticosteroid–fast acting beta agonist as a reliever. This paper discusses the issues associated with the use of SABA, the reasons that patients over-use SABA, difficulties that can be expected in overcoming SABA over-reliance in patients, and our evolving understanding of the use of “anti-inflammatory relievers” in our patients with asthma.

scholarly journals Epidemiological profile of asthmatic children in the wilaya of Sidi Bel Abbes: factors of asthma severity

2021 ◽  
Vol 8 (1) ◽  
pp. 24-29
Author(s):  
Abdelkrim Messafeur ◽  
◽  
Nafissa Belkessam ◽  
Keyword(s):  
Nous Avons ◽  
Santé Publique ◽  
Asthma Severity ◽  
Mots Clés ◽  
Mode De Vie ◽  
Asthmatic Children ◽  
Global Initiative For Asthma ◽  
Facteurs Environnementaux ◽  
Global Initiative ◽  
Epidemiological Profile

Introduction : L’asthme sévère est un réel problème de santé publique. Le but de notre travail est de mettre en évidence les facteurs influençant la sévérité de l’asthme chez la population jeune. Matériel et méthode : Il s’agit d’une enquête transversale concernant les enfants et adolescents asthmatiques scolarisés âgés de 6 à 19 ans et résidents dans la wilaya de Sidi-Bel-Abbès entre Janvier et Mars 2016. Le questionnaire utilisé reprend les critères d'évaluation du contrôle recommandés par le Global Initiative for Asthma (GINA) 2008. Résultats et discussion : Nous avons colligé 432 enfants et adolescents asthmatiques. La prévalence de l'asthme sévère est de 12,7% et est élevée par rapport à la prévalence de 4% retrouvée dans l’étude de Benallal en 2010 menée en milieu hospitalier. Une relation significative est notée entre la sévérité de l’asthme et le mode de vie urbain de notre population et presque les deux tiers des enfants et adolescents souffrant d’asthme sévère sont exposés au tabagisme passif. Une association très significative est remarquée entre la prévalence relative de l’asthme sévère et le rang dans la fratrie d’une part et la taille de fratrie d’autre part. Dans notre étude, la répartition en fonction du statut pondéral, montre que 22% de nos patients sont en surpoids ou obèses. L’obésité est associée à une inflammation systémique qui module l’inflammation des voies respiratoires et, par conséquent, l’expression de l’asthme chez les obèses. Conclusion : La sévérité de l’asthme peut être causée, déclenchée ou influencée par de nombreux facteurs environnementaux ou liés au patient lui-même. Mots clés : asthme sévère, facteurs influençant, tabagisme passif, obésité.

scholarly journals The Quality of Life on Asthmatic Adolescent and Its Correlation with the Severity and Control of Asthma

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Lisa Adhia Garina ◽  
Muhammad Ridho Grahadinta ◽  
Ferry Achmad Firdaus Mansoer ◽  
Intan Puspitasari
Keyword(s):  
Quality Of Life ◽  
Asthma Control ◽  
Asthma Severity ◽  
Control Test ◽  
Asthma Control Test ◽  
Cross Sectional ◽  
Spearman's Rho ◽  
Global Initiative For Asthma ◽  
Global Initiative

Asthma is considered a global health problem that, if not managed properly, can reduce the sufferers' quality of life. The purpose of the study was to evaluate the quality of life from the perspectives of asthma severity and the asthma control level. A cross-sectional study was conducted from February to June 2018 on asthmatic adolescents aged 12–14 years old in two public junior high schools in Bandung city, Indonesia. The diagnosis, history of asthma,  severity, and asthma control were established based on the National Asthma Guidelines from the Indonesian Pediatric Society, Global Initiative for Asthma (GINA), asthma control test (ACT), and ISAAC questionnaire. Statistical analysis performed using SPSS v.20 with Spearman's rho to determine the significance. The gender distribution of the 98 subjects was almost similar with slightly more girls (51%). The median age was 13±1 years with average ACT, FVC, and PAQLQ(S) total scores of 20±4, 78±16%, and 5.3±1.3, respectively. The domain scores for symptoms, activity limitations, and emotional function were 4.9±1.4, 5.0±1.3, and 5.7±1.1, respectively. There are correlations between the total  PAQLQ(S) score and asthma severity (p<0.001, r=−0.5) and the level of asthma control (p<0.001, r=0.6). In summary, the quality of life has a relationship with asthma severity and the level of asthma control. Asthma management should not only focus on medication but also ways to maintain a good quality of life. KUALITAS HIDUP REMAJA ASMA DAN HUBUNGANNYA DENGAN KEKERAPAN GEJALA DAN DERAJAT KENDALI ASMAAsma masih menjadi masalah kesehatan penting yang jika tidak ditangani baik, asma dapat menurunkan kualitas hidup anak. Tujuan penelitian ini menilai kualitas hidup dan hubungannya dengan kekerapan gejala dan derajat kendali asma. Penelitian cross-sectional ini dilaksanakan dari bulan Februari hingga Juni 2018 pada remaja asma berusia 12–14 tahun di dua SMPN di Kota Bandung, Indonesia. Diagnosis, riwayat asma, kekerapan gejala, dan derajat kendali asma berdasar atas Pedoman Nasional Asma Anak Ikatan Dokter Anak Indonesia, Global Initiative for Asthma (GINA), asthma control test (ACT), dan kuesioner dari ISAAC. Analisis statistik menggunakan SPSS v.20 dengan uji Spearman’s rho untuk menentukan signifikansi. Distribusi gender dari 98 subjek penelitian hampir sama dengan sedikit lebih banyak perempuan (51%). Usia rerata subjek 13±1 tahun dengan skor rerata ACT, FVC, PAQLQ(S) masing-masing 20±4, 78±16%, dan 5,3±1,3. Skor domain gejala, keterbatasan beraktivitas, dan fungsi emosi masing-masing 4,9±1,4; 5,0±1,3; dan 5,7±1,1. Terdapat hubungan skor total PAQLQ(S) dengan kekerapan gejala (p<0,001; r=−0,5) dan dengan derajat kendali asma (p<0,001; r=0,6). Simpulan, kualitas hidup berhubungan dengan kekerapan gejala dan derajat kendali asma. Pengelolaan asma sebaiknya tidak hanya memperhatikan pengobatan, tetapi juga menjaga kualitas hidup yang baik.

scholarly journals National Asthma Education and Prevention Program 2020 Guidelines: What’s Important for Primary Care

2021 ◽  
Vol 70 (6 Supplement) ◽  
Author(s):  
Murphy
Keyword(s):  
Primary Care ◽  
Prevention Program ◽  
Expert Panel ◽  
Asthma Management ◽  
Persistent Asthma ◽  
Asthma Severity ◽  
Asthma Education ◽  
Global Initiative For Asthma ◽  
Primary Care Clinicians ◽  
Global Initiative

KEY TAKEAWAYS • The 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group provides updated recommendations for 6 topics related to the management of individuals with asthma. • The classification of asthma severity and asthma control, as well as the concept of utilizing a stepwise approach to pharmacologic treatment, were not updated from the Expert Panel Report 3, released in 2007. • However, important updates in preferred therapies for intermittent and persistent asthma at treatment steps 1 through 5 were suggested. • Recommendations regarding biologic therapy were not included in the 2020 update, as only evidence and US Food and Drug Administration approvals through October 2018 were considered. • The most recent 2021 Global Initiative for Asthma guidelines are not included in this review but can be used in a complementary manner to assist primary care clinicians to optimize decisions regarding the care of patients with asthma.

Alanine Aminotransferase Predicts Outcomes in Elderly Patients with Aneurysmal Subarachnoid Hemorrhage

2019 ◽  
Vol 16 (1) ◽  
pp. 89-95
Author(s):  
Jianfeng Zheng ◽  
Rui Xu ◽  
Zongduo Guo ◽  
Xiaochuan Sun
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Elderly Patients ◽  
Clinical Outcomes ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Laboratory Data ◽  
Cardiac Complications ◽  
World Population ◽  
Systemic Complications ◽  
Poor Outcome ◽  
Poor Outcomes

Objective: With the aging of the world population, the number of elderly patients suffering from aneurysmal subarachnoid hemorrhage (aSAH) is gradually growing. We aim to investigate the potential association between plasma ALT level and clinical complications of elderly aSAH patients, and explore its predictive value for clinical outcomes of elderly aSAH patients. Methods: Between January 2013 and March 2018, 152 elderly aSAH patients were analyzed in this study. Clinical information, imaging findings and laboratory data were reviewed. According to the Glasgow Outcome Scale (GOS), clinical outcomes at 3 months were classified into favorable outcomes (GOS 4-5) and poor outcomes (GOS 1-3). Logistic regression analysis was used to assess the indicators associated with poor outcomes, and receiver curves (ROC) and corresponding area under the curve (AUC) were used to detect the accuracy of the indicator. Results: A total of 48 (31.6 %) elderly patients with aSAH had poor outcome at 3 months. In addition to ICH, IVH, Hunt-Hess 4 or 5 Grade and Modified Fisher 3 or 4 Grade, plasma ALT level was also strongly associated with poor outcome of elderly aSAH patients. After adjusting for other covariates, plasma ALT level remained independently associated with pulmonary infection (OR 1.05; 95% CI 1.00–1.09; P = 0.018), cardiac complications (OR 1.05; 95% CI 1.01–1.08; P = 0.014) and urinary infection (OR 1.04; 95% CI 1.00–1.08; P = 0.032). Besides, plasma ALT level had a predictive ability in the occurrence of systemic complications (AUC 0.676; 95% CI: 0.586– 0.766; P<0.001) and poor outcome (AUC 0.689; 95% CI: 0.605–0.773; P<0.001) in elderly aSAH patients. Conclusion: Plasma ALT level of elderly patients with aSAH was significantly associated with systemic complications, and had additional clinical value in predicting outcomes. Given that plasma ALT levels on admission could help to identify high-risk elderly patients with aSAH, these findings are of clinical relevance.

scholarly journals In-Hospital Outcomes in Patients Admitted to the Intensive Care Unit after a Return Visit to the Emergency Department

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 431
Author(s):  
Chun-Fu Lin ◽  
Yi-Syun Huang ◽  
Ming-Ta Tsai ◽  
Kuan-Han Wu ◽  
Chien-Fu Lin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Regression Analysis ◽  
Intensive Care ◽  
Medical Cost ◽  
Total Medical Cost ◽  
Hospital Outcomes ◽  
Return Visit ◽  
Icu Admission ◽  
Ed Visits

Background: Intensive care unit (ICU) admission following a short-term emergency department (ED) revisit has been considered a particularly undesirable outcome among return-visit patients, although their in-hospital prognosis has not been discussed. We aimed to compare clinical outcomes between adult patients admitted to the ICU after unscheduled ED revisits and those admitted during index ED visits. Method: This retrospective study was conducted at two tertiary medical centers in Taiwan from 1 January 2016 to 31 December 2017. All adult non-trauma patients admitted to the ICU directly via the ED during the study period were included and divided into two comparison groups: patients admitted to the ICU during index ED visits and those admitted to the ICU during return ED visits. The outcomes of interest included in-hospital mortality, mechanical ventilation (MV) support, profound shock, hospital length of stay (HLOS), and total medical cost. Results: Altogether, 12,075 patients with a mean (standard deviation) age of 64.6 (15.7) years were included. Among these, 5.3% were admitted to the ICU following a return ED visit within 14 days and 3.1% were admitted following a return ED visit within 7 days. After adjusting for confounding factors for multivariate regression analysis, ICU admission following an ED revisit within 14 days was not associated with an increased mortality rate (adjusted odds ratio (aOR): 1.08, 95% confidence interval (CI): 0.89 to 1.32), MV support (aOR: 1.06, 95% CI: 0.89 to 1.26), profound shock (aOR: 0.99, 95% CI: 0.84 to 1.18), prolonged HLOS (difference: 0.04 days, 95% CI: −1.02 to 1.09), and increased total medical cost (difference: USD 361, 95% CI: −303 to 1025). Similar results were observed after the regression analysis in patients that had a 7-day return visit. Conclusion: ICU admission following a return ED visit was not associated with major in-hospital outcomes including mortality, MV support, shock, increased HLOS, or medical cost. Although ICU admissions following ED revisits are considered serious adverse events, they may not indicate poor prognosis in ED practice.

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