scholarly journals Asthma and COVID-19: Аn overview of the guidelines for the management of asthma patients during the COVID-19 pandemic

2021 ◽  
Vol 31 (5) ◽  
pp. 663-670
Author(s):  
Veronika V. Osipova ◽  
Galina L. Osipova ◽  
Elena A. Zaryanova ◽  
Dmitry V. Terekhov
Keyword(s):  
Risk Factors ◽  
Specific Immunotherapy ◽  
Target Therapy ◽  
Severe Disease ◽  
Chronic Obstructive ◽  
Allergen Specific Immunotherapy ◽  
Obstructive Pulmonary Disease ◽  
Effector Cells ◽  
Asthma Patients ◽  
Controller Medications

The emergence of a new disease COVID-19 (coronavirus disease 2019), caused by the coronavirus named SARS-CoV-2, has significantly changed the usual interaction pattern between a doctor and a patient. Previous large studies have identified risk factors for a severe course of COVID-19, including old age, hypertension, diabetes, cardiovascular diseases, and chronic obstructive pulmonary disease. However, asthma and respiratory allergy have not been identified as risk factors for the severe disease. These factors give clues to the pathogenesis of COVID-19, approaches to the controller medications, target therapy, allergen-specific immunotherapy (ASIT) in patients with various phenotypes and endotypes of asthma during the pandemic.The purpose of this review is to summarize the currently available knowledge about SARS-CoV-2, T2-endotype of asthma, eosinophilic inflammation. The article provides an overview of the data from studies of COVID-19 patients with asthma, the main recommendations of the Global Initiative for Asthma (2021) and the Ministry of Health of the Russian Federation. It shows that targeting the endotypes and phenotypes of asthma can influence the management of COVID-19 patients with asthma. The influence of the imbalance of the immune system, pro-inflammatory cytokines, and effector cells in patients with asthma on the development and progression of COVID-19 is considered. Recommendations are given for the controller medications, targeted therapy, allergen-specific immunotherapy during the pandemic.Conclusion. The current recommendations for asthma treatment, based on the latest research of COVID-19, deepen our understanding of the course of COVID-19 in patients with different phenotypes and endotypes of asthma, approaches to traditional methods of treating asthma according to clinical guidelines during the pandemic.

Immunological basis of reversible and fixed airways disease

2011 ◽  
Vol 121 (7) ◽  
pp. 285-296 ◽  
Author(s):  
Carolyn Tubby ◽  
Tim Harrison ◽  
Ian Todd ◽  
Lucy Fairclough
Keyword(s):  
Severe Disease ◽  
Research Work ◽  
Airflow Obstruction ◽  
Response To Treatment ◽  
Chronic Obstructive ◽  
Small Subset ◽  
Obstructive Pulmonary Disease ◽  
Th2 Cell ◽  
Asthma Patients ◽  
Inflammatory Profile

Asthma is characterized by airflow obstruction that is usually completely reversible either spontaneously or in response to treatment. However, a small subset of patients with asthma display FAO (fixed airflow obstruction) despite optimal treatment, a feature more commonly associated with smoking-induced COPD (chronic obstructive pulmonary disease). Why some asthma patients develop FAO is not understood, and it is not clear whether (i) they represent a subset of patients with more severe disease, (ii) they share some characteristics of patients who develop COPD, or (iii) they represent a different disease entity altogether. The present review compares the pulmonary inflammatory profile of asthma patients with FAO with those without FAO, as well as COPD sufferers. The inflammation in asthma patients with FAO can vary from neutrophilic with CD8 T-cell involvement, similar to that of COPD, to eosinophilic with CD4 Th2 cell involvement, akin to that of asthma patients without FAO. Although studies of FAO in asthma sufferers would benefit hugely from consistent inclusion criteria, further research work is also required to shed more light on the immunological processes involved.

scholarly journals Asthma Patients Benefit More Than Chronic Obstructive Pulmonary Disease Patients in the Coronavirus Disease 2019 Pandemic

2021 ◽  
Vol 8 ◽  
Author(s):  
Ruoyan Xiong ◽  
Zhiqi Zhao ◽  
Huanhuan Lu ◽  
Yiming Ma ◽  
Huihui Zeng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Pulmonary Disease ◽  
Logistic Regression Analysis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Asthma Patients

Background: Coronavirus disease 2019 (COVID-19) has raised many questions about the role of underlying chronic diseases on disease outcomes. However, there is limited information about the effects of COVID-19 on chronic airway diseases. Therefore, we conducted the present study to investigate the impact of COVID-19 on patients with asthma or chronic obstructive pulmonary disease (COPD) and ascertain risk factors for acute exacerbations (AEs).Methods: This single-center observational study was conducted at the Second Xiangya Hospital of Central South University, involving asthma or COPD patients who had been treated with inhaled combination corticosteroids (ICSs), such as budesonide, and one long-acting beta-2-agonist (LABA), such as formoterol, for at least a year before the COVID-19 pandemic. We conducted telephone interviews to collect demographic information and clinical data between January 1, 2019, and December 31, 2020, focusing on respiratory and systemic symptoms, as well as times of exacerbations. Data for asthma and COPD were then compared, and the risk factors for AEs were identified using logistic regression analysis.Results: A total of 251 patients were enrolled, comprising 162 (64.5%) who had asthma and 89 who had COPD, with none having COPD/asthma overlap. Frequency of AEs among asthma patients was significantly lower in 2020 than in 2019 (0.82 ± 3.33 vs. 1.00 ± 3.16; P < 0.05). Moreover, these patients visited the clinic less (0.37 ± 0.93 vs. 0.49 ± 0.94; P < 0.05) and used emergency drugs less (0.01 ± 0.11 vs. 007 ± 0.38; P < 0.05) during the COVID-19 pandemic. In contrast, among COPD patients, there were no significant differences in AE frequency, clinic visits, or emergency drug use. Furthermore, asthma patients visited clinics less frequently during the pandemic than those with COPD. Logistic regression analysis also showed that a history of at least one AE within the last 12 months was associated with increased AE odds for both asthma and COPD during the COVID-19 pandemic (odds ratio: 13.73, 95% CI: 7.04–26.77; P < 0.01).Conclusion: During the COVID-19 pandemic, patients with asthma showed better disease control than before, whereas patients with COPD may not have benefited from the pandemic. For both diseases, at least one AE within the previous 12 months was a risk factor for AEs during the pandemic. Particularly, among asthma patients, the risk factors for AE during the COVID-19 pandemic were urban environment, smoking, and lower asthma control test scores.

scholarly journals A Retrospective Study on Amoxicillin Susceptibility in Severe Haemophilus influenzae Pneumonia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Pierre Danneels ◽  
Maria Concetta Postorino ◽  
Alessio Strazzulla ◽  
Nabil Belfeki ◽  
Aurelia Pitch ◽  
...  
Keyword(s):  
Risk Factors ◽  
Haemophilus Influenzae ◽  
Severe Pneumonia ◽  
Chronic Obstructive ◽  
Ventilator Associated Pneumonia ◽  
Obstructive Pulmonary Disease ◽  
Amoxicillin Clavulanic Acid ◽  
Evolution Of Resistance ◽  
Resistant Strains ◽  
Over Time

Introduction. Treatment of Haemophilus influenzae (Hi) pneumonia is on concern because resistance to amoxicillin is largely diffused. This study describes the evolution of resistance to amoxicillin and amoxicillin/clavulanic acid (AMC) in Hi isolates and characteristics of patients with Hi severe pneumonia. Methods. A monocentric retrospective observational study including patients from 2008 to 2017 with severe pneumonia hospitalized in ICU. Evolution of amoxicillin and AMC susceptibility was showed. Characteristics of patients with Hi pneumonia were compared to characteristics of patients with Streptococcus pneumoniae (Sp) pneumonia, as reference. Risk factors for amoxicillin resistance in Hi were investigated. Results. Overall, 113 patients with Hi and 132 with Sp pneumonia were included. The percentages of AMC resistance among Hi strains decreased over the years (from 10% in 2008-2009 to 0% in 2016-2017) while resistance to amoxicillin remained stable at 20%. Also, percentages of Sp resistant strains for amoxicillin decreased over years (from 25% to 3%). Patients with Hi pneumonia experienced higher prevalence of bronchitis (18% vs. 8%, p=0.02, chronic obstructive pulmonary disease (43% vs. 30% p=0.03), HAP (18% vs. 7%, p=0.01, ventilator-associated pneumonia (27% vs. 17%, p=0.04, and longer duration of mechanical ventilation (8 days vs. 6 days, p=0.04) than patients with Sp pneumonia. Patients with Sp pneumonia had more frequently local complications than patients with Hi pneumonia (17% vs. 7%, p=0.03). De-escalation of antibiotics was more frequent in patients with Sp than in patients with Hi (67% vs. 53%, p=0.03). No risk factors were associated with amoxicillin resistance among patients with Hi pneumonia. Conclusions. Amoxicillin resistance was stable over time, but no risk factors were detected. AMC resistance was extremely low, suggesting that AMC could be used for empiric treatment of Hi pneumonia, as well as other molecules, namely, cephalosporins. Patients with Hi pneumonia had more pulmonary comorbidities and severe diseases than patients with Sp pneumonia.

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