scholarly journals SOME ASPECTS OF PREDICTING THE SEVERITY OF VIRUS-INDUCED BRONCHIAL ASTHMA EXACERBATION IN CHILDREN DUE TO COVID-19 PANDEMIC

2021 ◽  
Vol 127 (4) ◽  
pp. 99-106
Author(s):  
Dorin Huzun ◽  
Uliana Kostiv ◽  
Serhii Sazhyn ◽  
Alla Sazhyna ◽  
Koliesnik Dmytro Koliesnik
Keyword(s):  
Severe Asthma ◽  
Bronchial Asthma ◽  
Asthma Exacerbation ◽  
Late Onset ◽  
Antiviral Treatment ◽  
Temporary Increase ◽  
Severe Exacerbation ◽  
Physical Analysis ◽  
Asthma Attack ◽  
Β2 Agonists

bronchial asthma is an important medical and social issue directly affects the health of patients, their quality of life, and the direct and indirect economic costs associated with the disease are quite significant. Due to the pandemic caused by a new strain of coronavirus SARS-CoV-2, international and domestic regulations documents have updated the management of patients with asthma. In particular, there have been recommendations for remote visits to assess the patients’ complaints however physical analysis and objective examination are not available during such consultations. It can lead to errors in diagnostic of asthma exacerbation severity and treatment tactic for prescription the reliever therapy. So it is actuality to find out additional indicators to improve the diagnostic and prediction of the severity of the disease exacerbations. Given the urgency of the problem, the aim of the study is to evaluate the clinical and paraclinical parameters in children with virus-induced bronchial asthma exacerbation to predict the severity of the asthma attack and personify the management of patients. Have been examined 47 patients who were hospitalized for disease exacerbation. The severity of a asthma attack was considered a group-forming feature. Statistical analysis was performed using parametric and nonparametric calculation methods, methods of clinical epidemiology and biostatistics. The results of the study give grounds to predict a more severe asthma attack among urban residents who have a phenotype of late-onset asthma. An additional, anamnestic risk of more severe exacerbation of the disease is body weight at birth, which exceeds 3500 g. Among spirometric indicators the highest prognostic criterion for severe bronchial asthma exacerbation was the general index of bronchodilation, which was 15% and above, as well as the index of bronchodilation at the level of the distal airways with a cut-off point of 30% and above. In the presence of the above risk factors for severe asthma attack on the background of confirmed infection with the coronavirus strain SARS-CoV-2 the patient needs hospitalization, antiviral treatment, increasing the dose of inhaled steroids and additional β2-agonists. When predicting a mild or moderate asthma attack provoked by the coronavirus SARS-CoV-2, it is advisable to continue remote monitoring by an allergist and the management of exacerbation includes a temporary increase daily dose of inhaled glucocorticosteroids and additional using of β2-agonists. It is recommended to avoid taking nebulizers and use individual metered powder or aerosol inhalers in cases of inpatient treatment.

scholarly journals Typical Antipsychotics Increase Risk of Severe Exacerbation in Asthma Patients– A Nationwide Population-Based Cohort Study

2021 ◽  
Author(s):  
Chin-Wei Kuo ◽  
Szu-Chun Yang ◽  
Yu-Fen Shih ◽  
Xin-Min Liao ◽  
Sheng-Hsiang Lin
Keyword(s):  
Severe Asthma ◽  
Asthma Exacerbation ◽  
High Dose ◽  
Severe Exacerbation ◽  
Severe Asthma Exacerbation ◽  
Increased Risk ◽  
Asthma Patients ◽  
Ed Visits ◽  
Dose Dependent ◽  
Typical Antipsychotics

Abstract Background:Severe asthma exacerbation reduces patients’ life quality, results in visits to the emergency department (ED) and hospitalization, and incurs additional medical costs. Antipsychotics block receptors with bronchodilation function; however, the effects of antipsychotics use on severe asthma exacerbation are unknown. This study aimed to investigate the effects of antipsychotics on asthma-related ED visits and hospitalizations.Methods:This study used a case-crossover design. Using the 2003-2017 Taiwan National Health Insurance Reimbursement Database, we established a cohort of 18,657 adults with severe asthma exacerbation leading to ED visits or hospitalization. Univariate and multivariate conditional logistic regressions were conducted to explore the association of antipsychotics use with severe asthma exacerbation. Subgroup analyses of different classes, doses, receptor functions of antipsychotics and schizophrenia were also performed.Results:Antipsychotics use was associated with a higher risk of severe asthma exacerbation (adjusted odds ratio (OR): 1.27; 95% confidence interval (CI): 1.05-1.54; P = 0.013) compared with no use of antipsychotics. Use of typical antipsychotics increased the risk of severe asthma exacerbation (adjusted OR: 1.40, 95% CI: 1.10-1.79, P = 0.007), whereas use of atypical antipsychotics did not. There was a dose-dependent effect of antipsychotics (test for trend: P =0.025). Antipsychotics that block the M2 muscarinic or D2 dopaminergic receptor were associated with an increased risk of severe asthma exacerbation (adjusted OR: 1.39, 95% CI: 1.10-1.76, P = 0.007 and adjusted OR: 1.33, 95% CI: 1.08-1.63, P = 0.008, respectively).Conclusions: Use of typical antipsychotics is associated with a dose-dependent increased risk of severe asthma exacerbation. Physicians should thus weight the risk and benefit of prescribing high-dose typical antipsychotics for asthma patients.

scholarly journals Does the occurrence of a severe asthma exacerbation change the rate of subsequent events?

2021 ◽  
Author(s):  
Tae Yoon Lee ◽  
John Petkau ◽  
Mohsen Sadatsafavi
Keyword(s):  
Severe Asthma ◽  
Asthma Exacerbation ◽  
Failure Time ◽  
Asthma Management ◽  
Frailty Model ◽  
Severe Exacerbation ◽  
Adult Group ◽  
Old Patients ◽  
Severe Asthma Exacerbation

Background: Severe exacerbations requiring hospitalization are an important component of the natural history of asthma and a major source of its burden. Whether the occurrence of a severe exacerbation affects the rate of subsequent events has far-reaching implications in asthma management. Methods: Using the centralized administrative health databases of British Columbia, Canada (1997/01/01-2016/03/31), we created an incidence cohort of patients with at least one severe asthma exacerbation, defined as an episode of hospitalization with asthma as the primary diagnosis. We used an accelerated failure time joint frailty model for the time intervals between severe asthma exacerbations. Analyses were conducted separately for pediatric (< 14 years old) and adult (≥14 years old) patients. Results: There were 3,039 patients (mean age at baseline 6.4, 35% female) in the pediatric group and 5,459 patients (mean age at baseline 50.8, 68% female) in the adult group, with 16% and 15%, respectively, experiencing at least one severe asthma exacerbation during follow-up. The first follow-up severe asthma exacerbation was associated with an increase of 79% (95% CI: 15% - 186%) in the rate of the subsequent events for the pediatric group. The corresponding value was 186% (95% CI: 85% - 355%) for the adult group. For both groups, the effects of subsequent severe exacerbations were not statistically significant. Conclusion: Our findings suggest that among patients who have experienced their first severe asthma exacerbation, preventing the next event can drastically change the course of the disease and reduce the burden of future exacerbations.

scholarly journals Pros and Cons of Nebulizer Treatment in Asthma Exacerbation During the COVID-19 Pandemic

2021 ◽  
Vol 19 (1) ◽  
pp. 1-5
Author(s):  
Ayşe Bilge ÖZTÜRK ◽  
Ayşe Baccıoğlu ◽  
Özge Uysal Soyer ◽  
Ersoy Civelek ◽  
Bülent Enis Şekerel ◽  
...  
Keyword(s):  
Infection Control ◽  
Severe Asthma ◽  
Asthma Exacerbation ◽  
Aerosol Therapy ◽  
Home Setting ◽  
Asthma Exacerbations ◽  
Asthma Attack ◽  
Viral Particles ◽  
Pros And Cons ◽  
Keywords Asthma

ABSTRACT Nebulizers generate aerosols and may potentially transmit respiratory viral particles including SARS-CoV-2. There is a great concern about the use of a nebulizer in the treatment of asthma exacerbations in the hospital or home setting during the COVID-19 pandemic and its use is not recommended unless essential. However, aerosol therapy should not be avoided in obligatory indications. Therefore, indications of nebulizer use during the pandemic should be evaluated on an individual basis in case of a severe asthma attack, and infection control recommendations should be followed by clinicians while using nebulizers. In this article, we aimed to assess the safety in addition to the “pro” and “con” sides of nebulizer treatment in asthma exacerbation during the COVID-19 pandemic. Keywords: Asthma, coronavirus disease 2019, COVID-19, SARS-CoV-2, nebulizers

scholarly journals Severe eosinophilic bronchial asthma: new therapeutic options

2018 ◽  
pp. 44-52 ◽  
Author(s):  
N. M. Nenasheva
Keyword(s):  
Monoclonal Antibodies ◽  
Severe Asthma ◽  
Bronchial Asthma ◽  
Biological Agents ◽  
Therapeutic Options ◽  
Clinical Use ◽  
Eosinophilic Asthma ◽  
Interleukin 5 ◽  
Severe Eosinophilic Asthma

Eosinophilic asthma is a common phenotype of severe asthma, occurring in at least half of patients. In recent years, there have been significant changes in the approaches to the treatment of severe bronchial asthma and, above all, eosinophilic asthma. The article discusses the role of eosinophils in the pathogenesis of severe asthma, the detection of the phenotype of severe eosinophilic asthma, and modern approaches to targeting severe asthma with an eosinophilic phenotype using biological agents. A special emphasis is placed on preparations of monoclonal antibodies to interleukin-5, in particular, mepolizumab, recently approved for clinical use in our country.

scholarly journals Relieving treatment of bronchial asthma attack in schoolchildren suffer from severe disease phenotype

2017 ◽  
Vol 0 (6 (14)) ◽  
pp. 4-7
Author(s):  
Mykola Garas ◽  
Gennadіy Lekhkun ◽  
Vladislav Lysenko ◽  
Basiuk Natalia
Keyword(s):  
Bronchial Asthma ◽  
Severe Disease ◽  
Disease Phenotype ◽  
Asthma Attack

scholarly journals A Case of COVID-19 Vaccine Associated New Diagnosis Myasthenia Gravis

2021 ◽  
Vol 12 ◽  
pp. 215013272110519
Author(s):  
Augustine Chavez ◽  
Charlotte Pougnier
Keyword(s):  
Myasthenia Gravis ◽  
Late Onset ◽  
Severe Exacerbation ◽  
Presenting Symptoms ◽  
Immune Mediated ◽  
Peg Tube ◽  
New Diagnosis

An 82-year-old man presented with intermittent episodes of slurred speech during his evening meals after receiving the BNT162b2 COVID-19 vaccine. Thorough evaluation was conducted including lab work and EMG confirming a new diagnosis of late-onset myasthenia gravis. Despite treatment, the patient progressed rapidly to severe exacerbation requiring intubation and placement of a PEG tube. Infections provoking new diagnosis and exacerbations of myasthenia gravis have been reported. New diagnosis of myasthenia gravis associated with the COVID-19 vaccine is rarely reported. This case highlights the need for clinicians to be aware of the uncommon presenting symptoms in late-onset myasthenia gravis and the possibility of vaccine provoked diagnoses of immune mediated diseases.

scholarly journals Decrease in asthma exacerbation prevalence during the Covid-19 lockdown in a moderate-severe asthma cohort

2020 ◽  
Author(s):  
Geertje de Boer ◽  
Gert Jan Braunstahl ◽  
Rudi Hendriks ◽  
Gerdien Tramper
Keyword(s):  
Severe Asthma ◽  
Asthma Exacerbation
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