scholarly journals Risk factors of SARS-CoV-2 infection

2021 ◽  
Vol 64 (3) ◽  
pp. 54-61
Author(s):  
Eugeniu Calenici ◽  
Keyword(s):  
Risk Factors ◽  
Severe Infection ◽  
Diabetes Patient ◽  
Small Population ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Diseases ◽  
Pregnancy Hypertension ◽  
Living Space ◽  
Number Of Patients

Background: Review is based on the biggest observational population study of all the risk factors of COVID-19 infection. The study was carried out in Royal College of General Practitioners, Oxford, and covering over 4 million of people. Were studied and analyzed risk factors as: age, sex and ethnicity, socioeconomic level, living space dimensions, rural-urban population, body mass index, smoker status, pregnancy, hypertension, chronic kidney disease, ischemic heart disease, chronic respiratory diseases including asthma, and chronic obstructive pulmonary disease, and type 1 and 2 diabetes. Patient variable with malignancy and immunocompromised status was separated due to the small number of patients in each group. Conclusions: By September 2020 more than 28.000 articles had been published related to COVID-19 in less than 9 months, 211 new papers every day. Most of them had small population of the studies. In the investigated sample, it was found that increasing age, male sex, economic deprivation, urban location and black ethnicity were associated with higher chances of testing positive for SARS-CoV-2. Active smoking decreased the chance of a positive test. The review covers the most important subjects influencing the development of severe infection outcomes.

scholarly journals The problems and limitations of cohort studies

Breathe ◽  
2014 ◽  
Vol 10 (4) ◽  
pp. 306-311 ◽  
Author(s):  
Warren Lenney ◽  
Francis J. Gilchrist ◽  
Aphrodite Kouzouna ◽  
Anand D. Pandyan ◽  
Val Ball
Keyword(s):  
Risk Factors ◽  
Lung Function ◽  
Cohort Studies ◽  
Chronic Obstructive ◽  
European Respiratory Society ◽  
Raw Data ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Diseases ◽  
Using Data ◽  
The Impact

SummaryChronic obstructive pulmonary disease (COPD) is the third most common cause of mortality worldwide and it is important to discover whether risk factors can be identified from studies undertaken in childhood.Numerous longitudinal cohort studies have been developed in many parts of the world to better understand the long-term outcomes of chronic respiratory diseases. Using data they have generated, it should be possible to identify specific risk factors in children and develop a model to prioritise their importance when found, in order to consider ways to reduce the prevalence and/or severity of disease in adults. However, this does require the sharing of data within the field, as is happening in other related fields, such as the Virtual International Stroke Trial Archive (www.vista.gla.ac.uk). Pooling of the raw data could be very informative and an organisation such as the European Respiratory Society could play an important role in ensuring this happens.Unfortunately, cohort studies vary widely in their inclusion criteria, their methodology and the format in which lung function data are presented. The raw data required to develop a model to assess the impact of childhood risk factors on future lung function have not been made available from many of the published articles.Our initial belief that recognised risk factors are independent variables was naïve and a different approach is required to better understand their interdependence.

scholarly journals Prognostic Impact and Risk Factors of Infections in Patients with Chronic Lymphocytic Leukemia Treated with Ibrutinib

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3240
Author(s):  
Francesca Romana Mauro ◽  
Diana Giannarelli ◽  
Andrea Visentin ◽  
Gianluigi Reda ◽  
Paolo Sportoletti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Lymphocytic Leukemia ◽  
Opportunistic Infections ◽  
Severe Infection ◽  
Lymphocytic Leukemia ◽  
Chronic Obstructive ◽  
Prognostic Impact ◽  
Obstructive Pulmonary Disease ◽  
Incidence Risk ◽  
Grade 3

Ibrutinib represents extraordinary progress in the treatment of chronic lymphocytic leukemia (CLL). However, treatment-related adverse events limit the benefit of this agent. This observational, multicenter study focused on the incidence, risk factors, and prognostic impact of infections in 494 patients with CLL treated with an ibrutinib-based treatment. Ibrutinib was given to 89 (18%) previously untreated patients (combined with rituximab, 24) and 405 (82%) relapsed/refractory patients. Pneumonia (PN), grade ≥3 non-opportunistic infections (NOI), and opportunistic infections (OI) were recorded in 32% of patients with an overall incidence rate per 100 person-year of 15.3% (PN, 10%; NOI, 3.3%; OI, 2%). Infections were the reason for the permanent discontinuation of ibrutinib in 9% of patients. Patients who experienced pneumonia or a severe infection showed a significantly inferior survival than those who were infection-free (p < 0.0001). A scoring system based on the three factors associated with a significant and independent impact on infections—PN or severe infection in the year before starting ibrutinib, chronic obstructive pulmonary disease, ≥2 prior treatments—identified patients with a two- to threefold increase in the rate of infections. In conclusion, the results of this study highlight the adverse impact of infectious events on the outcomes of CLL patients treated with ibrutinib.

scholarly journals Trimethoprim–sulfamethoxazole prophylaxis prevents severe/life-threatening infections following rituximab in antineutrophil cytoplasm antibody-associated vasculitis

2018 ◽  
Vol 77 (10) ◽  
pp. 1440-1447 ◽  
Author(s):  
Andreas Kronbichler ◽  
Julia Kerschbaum ◽  
Seerapani Gopaluni ◽  
Joanna Tieu ◽  
Federico Alberici ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Infections ◽  
Severe Infection ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Life Threatening ◽  
Severe Infections ◽  
Prophylactic Use ◽  
Grade 3 ◽  
Tract Infections

ObjectiveWe aimed to assess risk factors for the development of severe infection in patients with antineutrophil cytoplasm antibody-associated vasculitis (AAV) receiving rituximab.Methods192 patients with AAV were identified. Univariate and multivariate analyses were performed to identify risk factors for severe infection following rituximab. Severe infections were classified as grade ≥3 as proposed by the Common Terminology Criteria for Adverse Events V.4.0.Results95 severe infections were recorded in 49 (25.52%) patients, corresponding to an event rate of 26.06 per 100 person-years. The prophylactic use of trimethoprim–sulfamethoxazole was associated with a lower frequency of severe infections (HR 0.30, 95% CI 0.13 to 0.69), while older age (HR 1.03, 95% CI 1.01 to 1.05), endobronchial involvement (HR 2.21, 95% CI 1.14 to 4.26), presence of chronic obstructive pulmonary disease (HR 6.30, 95% CI 1.08 to 36.75) and previous alemtuzumab use (HR 3.97, 95% CI 1.50 to 10.54) increased the risk. When analysis was restricted to respiratory tract infections (66.3% of all infections), endobronchial involvement (HR 4.27, 95% CI 1.81 to 10.06), severe bronchiectasis (HR 6.14, 95% CI 1.18 to 31.91), higher neutrophil count (HR 1.19, 95% CI 1.06 to 1.33) and major relapse (HR 3.07, 95% CI 1.30 to 7.23) as indication for rituximab use conferred a higher risk, while refractory disease (HR 0.25, 95% CI 0.07 to 0.90) as indication had a lower frequency of severe infections.ConclusionsWe found severe infections in one quarter of patients with AAV receiving rituximab. Trimethoprim–sulfamethoxazole prophylaxis reduced the risk, while especially bronchiectasis and endobronchial involvement are risk factors for severe respiratory infections.

scholarly journals Increased adherence to the treatment of comorbid patients with arterial hypertension and chronic obstructive pulmonary disease on the background of complex therapy

2021 ◽  
pp. 18-25
Author(s):  
I. G. Menshikova ◽  
E. V. Magalyas ◽  
I. V. Sklyar ◽  
N. V. Loskutova
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Antihypertensive Drugs ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Number Of Patients ◽  
Complex Therapy ◽  
Group 2 ◽  
Group 1

Aim. To determine the adherence to treatment of patients with arterial hypertension (AH) and chronic obstructive pulmonary disease (COPD) against the background of complex therapy.Materials and methods. We examined 56 patients with stage II hypertension in combination with COPD. Men accounted for 70%, women – 30%. The average age of patients is 52.9±0.46 years. The patients were prescribed a fixed combination of antihypertensive drugs – telmisartan 40 mg with amlodipine 5 mg and COPD therapy according to GOLD. Patients of group 1 (n=30) studied at a health school against the background of drug treatment, patients in group 2 (n=26) did not attend a health school.Results. After 6 months of treatment, the number of patients in group 1 increased (p=0.001) regularly taking antihypertensive drugs, 96.7% of patients began to independently control blood pressure and keep a diary of a patient with hypertension. Patients of group 2 showed a statistically significant increase in the level of awareness of the presence of the disease and the awareness of patients about the risk factors for the development of the disease (p=0.01), although the number of patients controlling blood pressure remained low (p=0.1). In group 1, there was a positive trend in terms of the main risk factors, in group 2 the frequency of the prevalence of risk factors practically did not change. By the 6th month of therapy, all patients in group 1 achieved the target blood pressure, in group 2 – in 73.1% of patients. By the end of the observation, in patients of group 1, against the background of the chosen treatment tactics, there was a significantly more significant decrease in left ventricular mass index (LVMI) with its normalization in 33.3% of patients, indicating regression of LV hypertrophy (p=0.01), as well as a significant increase in the ratio of peak velocities on the mitral valve (E/A), (p=0.01), indicating an improvement in LV diastolic function. In group 2, antihypertensive therapy showed a moderate decrease in LVMI (p=0.1) with normalization of this indicator in only 2 (7.7%) of patients. By the 6th month of treatment, an improvement in the parameters of bronchial patency was revealed, however, in the 2nd group of patients, the changes in these parameters were statistically insignificant.Conclusion. The effectiveness of the treatment of hypertension and COPD depends not only on the choice of the optimal treatment tactics, but also on the patient's compliance with the prescribed therapy regimen. The results obtained indicate a positive effect of the chosen complex treatment regimen on the functional parameters of the left ventricle and bronchial patency. 

CRISPR/Cas9 Genome Editing Tool: A Promising Tool for Therapeutic Applications on Respiratory Diseases

2020 ◽  
Vol 20 (5) ◽  
pp. 333-346
Author(s):  
Sadiya Bi Shaikh ◽  
Yashodhar Prabhakar Bhandary
Keyword(s):  
Respiratory Diseases ◽  
Gene Editing ◽  
Epithelial Mesenchymal Transition ◽  
Respiratory Health ◽  
Chronic Obstructive ◽  
Therapeutic Tool ◽  
Obstructive Pulmonary Disease ◽  
Mesenchymal Transition ◽  
Chronic Respiratory Diseases ◽  
Promising Tool

Respiratory diseases are one of the prime topics of concern in the current era due to improper diagnostics tools. Gene-editing therapy, like Clustered regularly interspaced palindromic repeats- associated nuclease 9 (CRISPR/Cas9), is gaining popularity in pulmonary research, opening up doors to invaluable insights on underlying mechanisms. CRISPR/Cas9 can be considered as a potential gene-editing tool with a scientific community that is helping in the advancement of knowledge in respiratory health and therapy. As an appealing therapeutic tool, we hereby explore the advanced research on the application of CRISPR/Cas9 tools in chronic respiratory diseases such as lung cancer, Acute respiratory distress syndrome (ARDS) and cystic fibrosis (CF). We also address the urgent need to establish this gene-editing tool in various other lung diseases such as asthma, Chronic obstructive pulmonary disease (COPD) and Idiopathic pulmonary fibrosis (IPF). The present review introduces CRISPR/Cas9 as a worthy application in targeting epithelial-mesenchymal transition and fibrinolytic system via editing specific genes. Thereby, based on the efficiency of CRISPR/Cas9, it can be considered as a promising therapeutic tool in respiratory health research.

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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