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da Silva Alves C, Baptista Pestana R, Morais-Almeida M. Recent insights into the impacts of COVID-19 on pediatric asthma. Expert Rev Clin Immunol 2024:1-20. [PMID: 39136081 DOI: 10.1080/1744666x.2024.2390641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 07/31/2024] [Accepted: 08/06/2024] [Indexed: 08/28/2024]
Abstract
INTRODUCTION The emergence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and the subsequent coronavirus disease 2019 (COVID-19) pandemic has raised questions about its impact on pediatric asthma. This review analyzes the latest research to offer a comprehensive understanding of the dynamics between COVID-19 and pediatric asthma. AREAS COVERED This narrative review examines the effects of COVID-19 on pediatric asthma, exploring clinical outcomes, immune responses, recommended treatments, the impact of SARS-CoV-2 strains, and COVID-19 vaccination. Data were sourced from databases (PubMed, Embase, and BioRxiv/MedRxiv) from January 2020 to November 2023. EXPERT OPINION In response to the COVID-19 pandemic, the international scientific community rapidly developed extensive knowledge, demonstrating unprecedented cooperation. Despite these advances, questions remain about SARS-CoV-2 infection and pediatric asthma. Most research consists of epidemiological studies with varying methods, sometimes yielding contradictory results. While asthma generally did not increase the risk of severe COVID-19 in children, uncontrolled asthma was a risk factor, highlighting the importance of maintaining asthma management. Telemedicine has proven effective for asthma control and will continue to grow, despite its limitations. Notably, allergic asthma may have a protective role against severe COVID-19. We recommend COVID-19 vaccination in the pediatric age group, including those with asthma.
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Affiliation(s)
- Carolina da Silva Alves
- Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal
- Pulmonology Department, Doutor Fernando da Fonseca Hospital, Amadora, Portugal
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Moniz M, Pereira S, Soares P, Aguiar P, Donato H, Leite A. Individual risk factors associated with SARS-CoV-2 infection during Alpha variant in high-income countries: a systematic review and meta-analysis. Front Public Health 2024; 12:1367480. [PMID: 39139667 PMCID: PMC11319152 DOI: 10.3389/fpubh.2024.1367480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 07/18/2024] [Indexed: 08/15/2024] Open
Abstract
Objectives This study aimed to systematically appraise risk factors associated with SARS-CoV-2 infection in high-income countries during the period of predominance of the Alpha variant (January 2020 to April 2021). Methods Four electronic databases were used to search observational studies. Literature search, study screening, data extraction and quality assessment were conducted by two authors independently. Meta-analyses were conducted for each risk factor, when appropriate. Results From 12,094 studies, 27 were included. The larger sample size was 17,288,532 participants, more women were included, and the age range was 18-117 years old. Meta-analyses identified men [Odds Ratio (OR): 1.23, 95% Confidence Interval (CI): 1.97-1.42], non-white ethnicity (OR: 1.63, 95% CI: 1.39-1.91), household number (OR: 1.08, 95% CI: 1.06-1.10), diabetes (OR: 1.22, 95% CI: 1.08-1.37), cancer (OR: 0.82, 95% CI: 0.68-0.98), cardiovascular diseases (OR: 0.92, 95% CI: 0.84-1.00), asthma (OR: 0.83, 95% CI: 0.75-0.92) and ischemic heart disease (OR: 0.82, 95% CI: 0.74-0.91) as associated with SARS-CoV-2 infection. Conclusion This study indicated several risk factors for SARS-CoV-2 infection. Due to the heterogeneity of the studies included, more studies are needed to understand the factors that increase the risk for SARS-CoV-2 infection. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021244148, PROSPERO registration number, CRD42021244148.
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Affiliation(s)
- Marta Moniz
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, REAL, CCAL, NOVA University Lisbon, Lisbon, Portugal
| | - Sofia Pereira
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, REAL, CCAL, NOVA University Lisbon, Lisbon, Portugal
- Public Health Unit, Amadora Primary Healthcare Cluster, Lisbon, Portugal
| | - Patricia Soares
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, REAL, CCAL, NOVA University Lisbon, Lisbon, Portugal
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Pedro Aguiar
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, REAL, CCAL, NOVA University Lisbon, Lisbon, Portugal
| | - Helena Donato
- Documentation and Scientific Information Service, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Andreia Leite
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, REAL, CCAL, NOVA University Lisbon, Lisbon, Portugal
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA), Lisbon, Portugal
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Finnerty JP, Hussain ABMA, Ponnuswamy A, Kamil HG, Abdelaziz A. Asthma and COPD as co-morbidities in patients hospitalised with Covid-19 disease: a global systematic review and meta-analysis. BMC Pulm Med 2023; 23:462. [PMID: 37993829 PMCID: PMC10664669 DOI: 10.1186/s12890-023-02761-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 11/13/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Factors predisposing to increased mortality with COVID-19 infection have been identified as male sex, hypertension, obesity, and increasing age. Early studies looking at airway diseases gave some contradictory results. The purpose of our study was to determine global variation in studies in patients hospitalized with COVID-19 in the prevalence of COPD and asthma; and to determine whether the presence of asthma or COPD affected mortality in the same hospital population. METHODS A systematic review and meta-analysis of the published literature of COPD and asthma as co-morbidities in patients hospitalized with COVID-19 was performed, looking firstly at the prevalence of these diseases in patients hospitalized with COVID-19, and secondly at the relative risk of death from any cause for patients with asthma or COPD. RESULTS Prevalence of both airway diseases varied markedly by region, making meaningful pooled global estimates of prevalence invalid and not of clinical utility. For individual studies, the interquartile range for asthma prevalence was 4.21 to 12.39%, and for COPD, 3.82 to 11.85%. The relative risk of death with COPD for patients hospitalized with COVID-19 was 1.863 (95% CI 1.640-2.115), while the risk with asthma was 0.918 (95% CI 0.767 to 1.098) with no evidence of increased mortality. CONCLUSIONS For asthma and COPD, prevalence in patients hospitalized with COVID-19 varies markedly by region. We found no evidence that asthma predisposed to increased mortality in COVID-19 disease. For COPD, there was clear evidence of an association with increased mortality. TRIAL REGISTRATION The trial was registered with PROSPERO: registration number CRD42021289886.
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Affiliation(s)
- James Patrick Finnerty
- Countess of Chester Hospital NHS Trust, Chester, UK.
- Department of Respiratory Medicine, Countess of Chester Hospital, Liverpool Road, Chester, CH2 1UL, UK.
| | - A B M Arad Hussain
- Alexandra Hospital, Worcestershire Acute Hospital NHS Trust, Worcester, UK
| | - Aravind Ponnuswamy
- Countess of Chester Hospital NHS Trust, Chester, UK
- University of Chester, Chester, UK
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Bozzola E, Caffarelli C, Santamaria F, Corsello G. Year 2022: exploring COVID-19 pandemic in children. Ital J Pediatr 2023; 49:128. [PMID: 37770981 PMCID: PMC10540415 DOI: 10.1186/s13052-023-01536-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/20/2023] [Indexed: 09/30/2023] Open
Abstract
COVID-19 pandemics is rapidly changing. In this article, we review progresses published in the Italian Journal of Pediatrics in 2022. More data on clinical pictures, prevention strategies and active management in children have been provided. The continued evolution of knowledge has driven transformations in the clinical approach to the disease and allowed key advancements in the care of children with COVID-19.
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Affiliation(s)
- Elena Bozzola
- Pediatric Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Carlo Caffarelli
- Department of Medicine and Surgery, Clinica Pediatrica, Azienda Ospedaliera-Universitaria, University of Parma, Parma, Italy
| | - Francesca Santamaria
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
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Jugulete G, Luminos M, Pavelescu C, Merișescu MM. Remdesivir Efficacy and Tolerability in Children with COVID-19-Associated Allergic Comorbidities such as Asthma, Allergic Rhinitis, and Atopic Dermatitis. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050810. [PMID: 37238359 DOI: 10.3390/children10050810] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/24/2023] [Accepted: 04/17/2023] [Indexed: 05/28/2023]
Abstract
In children, coronavirus disease 2019 (COVID-19) starts as a minor illness compared to adults, but during the ongoing COVID-19 pandemic, distinct SARS-CoV-2 variants and subvariants have changed options for therapies in both adults and children, especially for those with comorbidities such as allergies. On 25 April 2022, Remdesivir (RDV), a viral RNA-dependent RNA polymerase inhibitor, was approved by the Food and Drug Administration (FDA) for the treatment of pediatric patients 28 days and older, weighing ≥3 kg, hospitalized or non-hospitalized, who are at high risk of progression to severe forms of COVID-19. While RDV has been shown to have favorable effects in numerous types of research conducted on adults, such as shortening hospital stays, and has shown it has antiviral effects on various RNA viruses, there is a lack of findings regarding safety, tolerability, and efficacy of RDV in allergic pediatric patients since its initial FDA approval. This study aims to assess RDV's efficacy and tolerability in treating pediatric patients with mild and severe forms of COVID-19-associated allergies such as asthma, allergic rhinitis, and atopic dermatitis and how RDV affects the duration of hospitalization, especially for these comorbidities. The most recent pandemic wave among children rose due to the high transmissibility of the Omicron variant, and this study analyzed changes between July 2020 and September 2022 at the National Institute of Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania. Our retrospective study included 250 children <18 years old, 42 (16.8%) had allergies, 132 were males (52.8%), age group 0-5 years old (80%), with a positive viral test for SARS-CoV-2. Severity was categorized as mild (43.6%), moderate (53.2%), and severe (1.6%) COVID-19, and treatment with RDV was administered in 50.4% (126/250) of children included in the study. The presence of comorbidities, asthma (7.2%), allergic rhinitis (4.4%), and atopic dermatitis (4.4%), was associated with an increased risk of developing severe COVID-19 infection in children, p < 0.05. We did not register deaths and severe complications; all cases evolved favorably under the instituted treatment. Laboratory abnormalities in transaminase levels 53.97% (ALT) and 61.9% (AST) were grades 1 or 2 and did not require discontinuation of the antiviral treatment, p < 0.05. RDV in children reduced the duration and evolution of COVID-19 and decreased the length of hospitalization in group-associated allergies; p < 0.05. This article summarizes RDV's efficacy among children with COVID-19 and allergies when the clinical result was improved and reports positive effects on tolerability and reduced duration of hospitalization, especially in children with asthma, atopic dermatitis, and allergic rhinitis. More studies are needed to confirm our findings.
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Affiliation(s)
- Gheorghiță Jugulete
- Faculty of Medicine, University of Medicine and Pharmacy, "Carol Davila", No. 37, Dionisie Lupu Street, 2nd District, 020021 Bucharest, Romania
- "Matei Balş" National Institute for Infectious Diseases, No. 1, Calistrat Grozovici Street, 2nd District, 021105 Bucharest, Romania
| | - Monica Luminos
- Faculty of Medicine, University of Medicine and Pharmacy, "Carol Davila", No. 37, Dionisie Lupu Street, 2nd District, 020021 Bucharest, Romania
- "Matei Balş" National Institute for Infectious Diseases, No. 1, Calistrat Grozovici Street, 2nd District, 021105 Bucharest, Romania
| | - Carmen Pavelescu
- Faculty of Medicine, University of Medicine and Pharmacy, "Carol Davila", No. 37, Dionisie Lupu Street, 2nd District, 020021 Bucharest, Romania
| | - Mădălina Maria Merișescu
- Faculty of Medicine, University of Medicine and Pharmacy, "Carol Davila", No. 37, Dionisie Lupu Street, 2nd District, 020021 Bucharest, Romania
- "Matei Balş" National Institute for Infectious Diseases, No. 1, Calistrat Grozovici Street, 2nd District, 021105 Bucharest, Romania
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Muntean IA, Leru PM, Pintea I, Bocsan IC, Dobrican CT, Deleanu D. A retrospective study regarding the influence of COVID-19 disease on asthma. BMC Pulm Med 2023; 23:22. [PMID: 36650490 PMCID: PMC9844196 DOI: 10.1186/s12890-023-02309-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 01/03/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND During the Covid-19 pandemic patients suffering from asthma raised many concerns regarding the outcome ofthe impact of COVID-19 disease on their preexisting condition. The 2021 GINA report indicates that people with asthma do not appear to be at increased risk of a severe form of COVID-19. METHOD This study is a retrospective study of patients (n = 163) median age = 27.8 years, M:F = 1:1.26, with asthma evaluated using ACT (asthma control test) and VAS (visual analog scale) before and after COVID-19 disease. An ACT score over 20 points placed patients in the controlled asthma group. RESULTS The overall evaluation for COVID-19 in our asthma patients revealed that 22.7% of the studied group had the COVID-19 disease (21.5% in the controlled asthma group and 24.5% in uncontrolled asthma group). Asthma disease history was longer in the uncontroled asthma group (128 ± 96.8 months vs. 296 ± 59.7 months, p = 0.05). Asthma treatment was conducted according to the GINA guideline, and 18.4% (30 pts) of the patients were on allergen immunotherapy treatment. Significantly more uncontrolled patients were significantly more in Step 1 and 5 of treatment (p = 0.05 and p = 0.03). During the COVID-19 pandemic, patients in the GINA step 5 of treatment experienced a worsening of asthma, often twice as severe as compared to patients with asthma in GINA step 1-4. In these patients, even mild COVID-19 disease led to worsened asthma symptoms, while severe COVID-19 led to a severe asthma impairment measured by ACT score (p = 0.03) and VAS scale (p = 0.02), with increased oral corticosteroids consumption. CONCLUSION Maintaining optimal asthma control should be able to reduce risk of severe outcomes after COVID-19 disease. Communication via phone with the specialist involved in their asthma care was very comforting for patients, thus confirming the necessity to include phone calls, smart phone's application or online evaluations and counseling in long-term care of chronic diseases.
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Affiliation(s)
- Ioana Adriana Muntean
- grid.411040.00000 0004 0571 5814Allergology Department, Department of Allergology and Immunology and “Octavian Fodor” Institute of Gastroenterology and Hepatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Polliana Mihaela Leru
- grid.8194.40000 0000 9828 7548Clinical Department 5, “Carol Davila” University of Medicine and Pharmacy, Bulevardul Eroii Sanitari 8, 050474 Bucharest, Romania
| | - Irena Pintea
- grid.411040.00000 0004 0571 5814Allergology Department, Department of Allergology and Immunology and “Octavian Fodor” Institute of Gastroenterology and Hepatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Ioana Corina Bocsan
- grid.411040.00000 0004 0571 5814Department of Pharmacology, Toxicology and Clinical Pharmacology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Carmen Teodora Dobrican
- grid.411040.00000 0004 0571 5814Allergology Department, Department of Allergology and Immunology and “Octavian Fodor” Institute of Gastroenterology and Hepatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Diana Deleanu
- grid.411040.00000 0004 0571 5814Allergology Department, Department of Allergology and Immunology and “Octavian Fodor” Institute of Gastroenterology and Hepatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
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Takaoka Y, Baba Y, Toriumi S, Ishida S, Ebara T, Ohishi K, Miyabayashi K, Kojima M, Yamada H, Yoneyama T, Yamazaki S, Honjo A, Inage E, Shoji H, Ohtsuka Y, Shimizu T. A retrospective study of SARS-CoV-2 antibodies in children with allergies. Pediatr Int 2023; 65:e15635. [PMID: 37795867 DOI: 10.1111/ped.15635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/18/2023] [Accepted: 07/26/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND The dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children are continually changing. We conducted a survey of pediatric allergy patients attending our department to determine the prevalence of antibodies against SARS-CoV-2 in children. METHODS A retrospective study was performed among children aged <11 years, referred to a pediatric allergy department between February 2020 and January 2022 with a chief complaint of allergy. The data of children with blood examination findings were retrospectively studied. Qualitative testing for anti-SARS-CoV-2 IgG and IgM antibodies was performed using a SARS-CoV-2 rapid antibody test. Participants were retested 1 year later to evaluate changes in antibody levels. RESULTS In total, 310 patients with a median age of 26 months (interquartile range: 11.6-58.4 months) and male/female ratio of 1.31 were included. A total of 32 patients tested positive for anti-SARS-CoV-2 IgG or IgM antibodies. No differences were observed in the severity of allergic disease. The prevalence of antibodies was higher among children enrolled in preschool or school (odds ratio: 13.19, 95% confidence interval; 2.30-249.7). A total of 66.7% of patients underwent follow-up testing. The antibody positivity rate increased between the first and second testing, but this was not related to the number of medical visits or the severity of allergic disease. CONCLUSION Antibody prevalence in children was low but increased during the study period. The majority of children who tested positive for SARS-CoV-2 antibodies did not have a history of coronavirus disease 2019, suggesting that most infections were subclinical.
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Affiliation(s)
- Yuri Takaoka
- Department of Pediatrics, Juntendo University Shizuoka Hospital, Shizuoka, Japan
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yosuke Baba
- Department of Pediatrics, Juntendo University Shizuoka Hospital, Shizuoka, Japan
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Shun Toriumi
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Shoji Ishida
- Department of Pediatrics, Juntendo University Shizuoka Hospital, Shizuoka, Japan
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Takahiro Ebara
- Department of Pediatrics, Juntendo University Shizuoka Hospital, Shizuoka, Japan
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Kenji Ohishi
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Kazuki Miyabayashi
- Department of Pediatrics, Juntendo University Shizuoka Hospital, Shizuoka, Japan
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Mayuki Kojima
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Hiromichi Yamada
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Toshiyuki Yoneyama
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Susumu Yamazaki
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Asuka Honjo
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Eisuke Inage
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Hiromichi Shoji
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yoshikazu Ohtsuka
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Toshiaki Shimizu
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
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SARS due to COVID-19: Predictors of death and profile of adult patients in the state of Rio de Janeiro, 2020. PLoS One 2022; 17:e0277338. [DOI: 10.1371/journal.pone.0277338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 10/25/2022] [Indexed: 11/12/2022] Open
Abstract
Introduction
We aimed to describe the profile of adult patients and analyze the predictors of death from severe acute respiratory syndrome (SARS) due to coronavirus disease 2019 (COVID-19) in the state of Rio de Janeiro. Knowledge of the predictors of death by COVID-19 in Rio de Janeiro, a state with one of the highest mortality rates in Brazil, is essential to improve health care for these patients.
Methods
Data from the Information System for Epidemiological Surveillance of Influenza and the Mortality Information System were used. A binary logistic regression model evaluated the outcome of death, sociodemographic data, and clinical-epidemiological and health care covariates. Univariate, bivariate, and multivariate statistics were performed with the R program, version 4.0.0.
Results
Overall, 51,383 cases of SARS due to COVID-19 among adults were reported in the state between March 5 and December 2, 2020. Mortality was high (40.5%). The adjusted final model presented the following predictors of death in SARS patients due to COVID-19: male sex (odds ratio [OR] = 1.10, 95% confidence interval [CI], 1.04–1.17); age (OR = 5.35, 95%CI, 4.88–5.88; ≥75 years); oxygen saturation <95% (OR = 1.48, 95%CI, 1.37–1.59), respiratory distress (OR = 1.31, 95%CI, 1.21–1.41) and dyspnoea (OR = 1.25, 95%CI, 1.15–1.36), the presence of at least one risk factor/comorbidity (OR = 1.32, 95%CI, 1.23–1.42), chronic kidney disease (OR = 1.94, 95%CI, 1.69–2.23), immunosuppression (OR = 1.51, 95%CI, 1.26–1.81) or chronic neurological disease (OR = 1.36, 95%CI, 1.18–1.58), and ventilatory support, invasive (OR = 8.89, 95%CI, 8.08–9.79) or non-invasive (OR = 1.25, 95%CI, 1.15–1.35).
Conclusions
Factors associated with death were male sex, old age, oxygen saturation <95%, respiratory distress, dyspnoea, chronic kidney and neurological diseases, immunosuppression, and use of invasive or noninvasive ventilatory support. Identifying factors associated with disease progression can help the clinical management of patients with COVID-19 and improve outcomes.
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Akelma Z, Başkaya N, Çetin S, Bostancı İ, Özmen S. Improvement in school-aged children with asthma during the Covid-19 pandemic. Pediatr Pulmonol 2022; 57:2518-2523. [PMID: 35794002 PMCID: PMC9350178 DOI: 10.1002/ppul.26068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 06/10/2022] [Accepted: 07/01/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The coronavirus 2019 disease (Covid-19) pandemic led to a number of measures being introduced in many countries worldwide. Lockdowns were imposed on individuals aged <18 years, education was delivered online, and mask-wearing was made compulsory in public places, resulting in an unprecedented period for children. Real-life data showing how children with asthma are affected by major changes are limited. This study investigated how asthmatic children are affected by pandemic conditions based on real-life data. METHODS Patients with asthma aged 6-18 years followed up from March to May 2019-before the Covid-19 pandemic-were included in the study. Data from March to May 2020 and 2019 were then compared to reveal the effects of pandemic-related lifestyle changes on symptoms, frequency of exacerbations, and drug use in asthmatic children. RESULTS Eighty-six children with asthma aged 6-18 years were included in this study. Time spent inside the home was significantly higher in 2020 than in 2019. Rescue medication requirements and emergency department visits were significantly lower in 2020 compared to 2019 (p < 0.001). The number of well-controlled patients with asthma was higher in 2020 than in 2019 (p < 0.0001). The number of patients using prophylactic drugs within the previous 3 months was lower in 2020 compared to 2019 (p = 0.007). CONCLUSION The present study yielded valuable insights, based on real-life data, into the condition of children over the age of 6 years during the Covid-19 pandemic. Numbers of asthmatic exacerbations, rescue drug use, and asthma control were positively affected in school-aged children with asthma during the pandemic.
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Affiliation(s)
- Zülfikar Akelma
- Pediatric Allergy and Immunology Clinic, Dr. Sami Ulus Maternity and Children's Research and Training Hospital, Ankara, Turkey.,Division of Pediatric Allergy and Immunology, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Nevzat Başkaya
- Pediatric Allergy and Immunology Clinic, Dr. Sami Ulus Maternity and Children's Research and Training Hospital, Ankara, Turkey
| | - Sema Çetin
- Pediatric Allergy and Immunology Clinic, Dr. Sami Ulus Maternity and Children's Research and Training Hospital, Ankara, Turkey
| | - İlknur Bostancı
- Pediatric Allergy and Immunology Clinic, Dr. Sami Ulus Maternity and Children's Research and Training Hospital, Ankara, Turkey.,Division of Pediatric Allergy and Immunology, University of Health Sciences, Ankara, Turkey
| | - Serap Özmen
- Pediatric Allergy and Immunology Clinic, Dr. Sami Ulus Maternity and Children's Research and Training Hospital, Ankara, Turkey.,Division of Pediatric Allergy and Immunology, University of Health Sciences, Ankara, Turkey
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Peng Z, Hu Z. A bibliometric analysis of linguistic research on COVID-19. Front Psychol 2022; 13:1005487. [PMID: 36176813 PMCID: PMC9513670 DOI: 10.3389/fpsyg.2022.1005487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/22/2022] [Indexed: 11/26/2022] Open
Abstract
Research on COVID-19 has drawn the attention of scholars around the world since the outbreak of the pandemic. Several literature reviews of research topics and themes based on scientometric indicators or bibliometric analyses have already been conducted. However, topics and themes in linguistic-specific research on COVID-19 remain under-studied. With the help of the CiteSpace software, the present study reviewed linguistic research published in SSCI and A&HCI journals to address the identified gap in the literature. The overall performance of the documents was described and document co-citations, keyword co-occurrence, and keyword clusters were visualized via CiteSpace. The main topic areas identified in the reviewed studies ranged from the influences of COVID-19 on language education, and speech-language pathology to crisis communication. The results of the study indicate not only that COVID-19-related linguistic research is topically limited but also that insufficient attention has been accorded by linguistic researchers to Conceptual Metaphor Theory, Critical Discourse Analysis, Pragmatics, and Corpus-based discourse analysis in exploring pandemic discourses and texts.
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Affiliation(s)
- Zhibin Peng
- Foreign Language Research Department, Beijing Foreign Studies University, Beijing, China
- *Correspondence: Zhibin Peng
| | - Zhiyong Hu
- Center for Linguistics, Literary and Cultural Studies, Sichuan International Studies University, Chongqing, China
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Sex Steroids Effects on Asthma: A Network Perspective of Immune and Airway Cells. Cells 2022; 11:cells11142238. [PMID: 35883681 PMCID: PMC9318292 DOI: 10.3390/cells11142238] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/13/2022] [Accepted: 07/17/2022] [Indexed: 11/17/2022] Open
Abstract
A multitude of evidence has suggested the differential incidence, prevalence and severity of asthma between males and females. A compilation of recent literature recognized sex differences as a significant non-modifiable risk factor in asthma pathogenesis. Understanding the cellular and mechanistic basis of sex differences remains complex and the pivotal point of this ever elusive quest, which remains to be clarified in the current scenario. Sex steroids are an integral part of human development and evolution while also playing a critical role in the conditioning of the immune system and thereby influencing the function of peripheral organs. Classical perspectives suggest a pre-defined effect of sex steroids, generalizing estrogens popularly under the “estrogen paradox” due to conflicting reports associating estrogen with a pro- and anti-inflammatory role. On the other hand, androgens are classified as “anti-inflammatory,” serving a protective role in mitigating inflammation. Although considered mainstream and simplistic, this observation remains valid for numerous reasons, as elaborated in the current review. Women appear immune-favored with stronger and more responsive immune elements than men. However, the remarkable female predominance of diverse autoimmune and allergic diseases contradicts this observation suggesting that hormonal differences between the sexes might modulate the normal and dysfunctional regulation of the immune system. This review illustrates the potential relationship between key elements of the immune cell system and their interplay with sex steroids, relevant to structural cells in the pathophysiology of asthma and many other lung diseases. Here, we discuss established and emerging paradigms in the clarification of observed sex differences in asthma in the context of the immune system, which will deepen our understanding of asthma etiopathology.
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12
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Merga BT, Ayana GM, Raru TB, Alemu A, Negash B, Bekana M, Birhanu A, Dessie Y. Association of Pre-Existing Comorbidities with Disease Severity Among COVID-19 Patients in Eastern Ethiopia. Infect Drug Resist 2022; 15:2825-2834. [PMID: 35673546 PMCID: PMC9167592 DOI: 10.2147/idr.s362140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/27/2022] [Indexed: 12/11/2022] Open
Abstract
Background Comorbidities and advanced age increase the risk of severe outcomes of COVID-19. In order to shift the possible unfavorable treatment outcome in patients with chronic illnesses, information related to the prevalence of chronic illness and its effect on severity of COVID-19 infection has paramount importance. Objective This study was aimed at assessing the prevalence of comorbidities and associated severity among COVID-19 patients admitted to COVID-19 treatment center, eastern Ethiopia. Methods An institution-based cross-sectional study design was employed among 422 COVID-19 patients admitted to COVID-19 treatment center, eastern Ethiopia from April 10, 2020, to August 10, 2021. Binary logistic regression was fitted to identify comorbidities and other factors associated with severe clinical outcome, associations were presented with adjusted odds ratios (AORs) and 95% confidence intervals (CIs). In all analyses statistical significance were declared at p-value <0.05. Results More than half (52.4%) of the COVID-19 patients were presented with comorbid conditions. One third (34.6%) of the admitted COVID-19 patients were in severe clinical stages. Marital status (AOR=4.56; 95% CI: 1.40, 14.76), hypertension (AOR=2.08; 95% CI: 1.09, 3.97), diabetes mellitus (AOR=3.31; 95%:1.84, 5.98), and cardiovascular diseases (AOR=4.22; 95% CI: 2.18, 8.15) were identified as factors associated with severe clinical stages. Conclusion The comorbid conditions such as diabetes, hypertension, and cardiovascular diseases, and marital status were identified as significant predictors of severe outcomes of COVID-19. Therefore, identifying the people with chronic comorbidities as a risk group would help to anticipate and prevent the serious outcomes of COVID-19 infection.
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Affiliation(s)
- Bedasa Taye Merga
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Galana Mamo Ayana
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Temam Beshir Raru
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Alemu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Belay Negash
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Miressa Bekana
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abdi Birhanu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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13
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Özdemir Ö. Asthma and Prognosis of Coronavirus Disease 2019. World Allergy Organ J 2022; 15:100656. [PMID: 35662874 PMCID: PMC9151523 DOI: 10.1016/j.waojou.2022.100656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 05/16/2022] [Indexed: 12/04/2022] Open
Abstract
It is well-known that asthma patients show compromised production of antiviral interferons and lower expression of ACE-2, most likely owing to ACE-2 expression is inversely correlated with type 2 (Th2: T helper 2) cytokine levels of asthmatics. However, COVID-19 patients with poor outcomes show early vigorous type I interferon expression. This does not match with the pathophysiology of worse COVID-19 disease development in asthma patients. Actually, why asthma might protect against poor outcomes in COVID-19 is explained in detail in recent reviews. Some new data even show decreased mortality in asthma patients. There were no flawless data that asthma patients are at a greater risk of becoming severely ill with SARS-CoV-2 infection, although current reports from the United States and the United Kingdom indicate that asthma is much more common in children and adults with COVID-19 than was formerly described from Asia as well as from central Europe.
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Affiliation(s)
- Öner Özdemir
- Division of Allergy and Immunology, Department of Pediatrics, Sakarya University Faculty of Medicine, Research and Training Hospital of Sakarya University, Sakarya, Türkiye
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14
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El‐Hayek E, Kahwagi G, Issy N, Tawil C, Younis N, Abou‐Khalil R, Matar M, Hallit S. Factors associated with coronavirus disease 2019 infection severity among a sample of Lebanese adults: Data from a cross‐sectional study. Health Sci Rep 2022; 5:e654. [PMID: 35620538 PMCID: PMC9125884 DOI: 10.1002/hsr2.654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/16/2022] [Accepted: 05/05/2022] [Indexed: 01/08/2023] Open
Abstract
Background and Aims Identification of factors responsible for severe illness related to coronavirus disease 2019 (COVID‐19) could help in the early management of patients with high risk, especially in developing countries with poor medical care systems. To date, no data have been published concerning the factors associated with COVID‐19 severity in Lebanon. In this study, we aimed at investigating the relation between sociodemographic variables, health status, and the clinical outcomes of COVID‐19 in a sample of Lebanese adults. Methods In our cross‐sectional study, 1052 patients (563 male and 489 female, with the median age of 42.83 ± 17.88 years), tested positive for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) between January and March 2021, were recruited from a hospital in Byblos, Lebanon. Basic demographic data, medical history, clinical data, and selfreported symptoms related to COVID‐19 were collected. Clinical classification of COVID‐19 severity was carried out according to the WHO interim guidance on May 27, 2020. Multi and bivariate regression analysis were performed. Results When comparing patients with moderate symptoms versus mild, the results showed that older age (aOR = 1.05; 95% CI: 1.03–1.06) and having dyslipidemia (aOR = 1.89; 95% CI: 1.01–3.49) were significantly associated with higher odds of having moderate symptoms. When comparing patients with severe symptoms versus mild, older age (aOR = 1.08; 95% CI: 1.06–1.10), higher body mass index (aOR = 1.09; 95% CI: 1.04–1.15) and having respiratory diseases (aOR = 2.57; 95% CI: 1.03–6.36) were significantly associated with higher odds of having severe symptoms, whereas female gender (aOR = 0.56; 95% CI: 0.32–0.98) was significantly associated with lower odds of having severe symptoms compared to males. Finally, when comparing patients with severe symptoms versus moderate, older age (aOR = 1.03; 95% CI: 1.01–1.05) was found to be significantly associated with higher odds of having severe symptoms. Conclusion Identification of risk factors may contribute to a better understanding of the COVID‐19 pathogenesis and provide clinical reference for early prognosis and management of patients.
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Affiliation(s)
- Elissar El‐Hayek
- Department of Biology, Faculty of Arts and Sciences Holy Spirit University of Kaslik‐Jounieh Jounieh Lebanon
| | - Georges‐Junior Kahwagi
- Department of Biology, Faculty of Arts and Sciences Holy Spirit University of Kaslik‐Jounieh Jounieh Lebanon
- Faculty of Medicine and Medical Sciences Holy Spirit University of Kaslik (USEK) Jounieh Lebanon
| | - Nour Issy
- Department of Biology, Faculty of Arts and Sciences Holy Spirit University of Kaslik‐Jounieh Jounieh Lebanon
| | - Christina Tawil
- Department of Biology, Faculty of Arts and Sciences Holy Spirit University of Kaslik‐Jounieh Jounieh Lebanon
| | - Nabil Younis
- Department of Biology, Faculty of Arts and Sciences Holy Spirit University of Kaslik‐Jounieh Jounieh Lebanon
| | - Rony Abou‐Khalil
- Department of Biology, Faculty of Arts and Sciences Holy Spirit University of Kaslik‐Jounieh Jounieh Lebanon
| | - Madonna Matar
- Faculty of Medicine and Medical Sciences Holy Spirit University of Kaslik (USEK) Jounieh Lebanon
- Internal Medicine Department, Division of Infectious Diseases Notre Dame Des Secours University Hospital Jbeil Lebanon
| | - Souheil Hallit
- Internal Medicine Department, Division of Infectious Diseases Notre Dame Des Secours University Hospital Jbeil Lebanon
- Research Department Psychiatric Hospital of the Cross Jal Eddib Lebanon
- Psychology Department, College of Humanities Effat University Jeddah Saudi Arabia
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15
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Bezzini D, Schiavetti I, Manacorda T, Franzone G, Battaglia MA. First Wave of COVID-19 Pandemic in Italy: Data and Evidence. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1353:91-113. [PMID: 35137370 DOI: 10.1007/978-3-030-85113-2_6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Unexpectedly, Italy was the first Western country to face COVID-19 outbreak, but promptly it was the first one to adopt stringent procedures to stem the spread of infection. The objective of this study was to describe the epidemiological situation and comorbidities in Italy, in addition to containment measures and health system and social protection strengthening ones applied in this country. METHODS Available population data were collected, managed, and analysed from the daily reports on COVID-19 published every day, from 1 February to 8 June 2020. RESULTS Lombardia, a northern region of Italy, is considered the epicentre for the wave of the infection with the first diagnosed case, but in a few weeks other regions were involved (with Piemonte, Emilia-Romagna, and Veneto covering more than 70% of the Italian total cases). In the European context, after 3 months of containing measures of the sanitary emergency, Italy is the fourth country for the number of total positive cases (with 235,278 total case as at 8 June 2020), after Russia, the United Kingdom, and Spain, whereas it is the second for the number of deaths (with 33,964 deaths as at 8 June 2020), only after the United Kingdom. Regarding incidence, the curve of daily new cases shows an increasing trend up to 22 March 2020 with 6557 new daily cases and then a decreasing trend up to 280 as at 8 June. This turnaround can be explained by the application of national lockdown starting from 9 March and by the following 14 days of incubation of infection. Profiles of subjects at major risk of poor prognosis and death for COVID-19 are elderly (mean age of 80 years) and with three or more comorbidities. These characteristics can partially explain the high lethality rate for coronavirus observed in Italy, which is the European country with the highest share of elderly. In addition, other possible explanations of this high lethality are differences in testing policies among countries that influence the number of asymptomatic or pauci-symptomatic patients diagnosed as coronavirus positive, together with differences in definition and in the way of recording deaths for coronavirus. In the absence of a vaccine, severe nonpharmaceutical interventions (NPIs), including national lockdown, quarantine, social distancing, and use of facial masks, have been applied with success to reduce the virus spread and the burden on the National Health System. In addition to these stringent containment measures to fight the pandemic, other policies have been adopted searching to ensure economic sustainability, social safety, and stability. CONCLUSION Italy was the first Western country with a wide spread of COVID-19, but it was the first one to introduce containment restrictions, tightening them week by week and subjecting the 60 million people living in the country to unprecedented limitations. Many measurements have been adopted by the government, such as lockdown during the early stages of infection and subsequent social distancing and wearing face masks in public areas. Italians were compliant with all the measures ordered by the government and their discipline reflected in the COVID numbers: the curve of daily new cases after a peak at the end of March now shows a consistent decreasing trend up. In this phase of current reduction of virus diffusion, it is crucial to accommodate the need to continue protecting citizens from the risk of infection with the undeferrable, although gradual, restart of the economic and social system. This new scenario requires an active collaboration among all the actors: statutory bodies, employers, civil society, and the third sector.
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Affiliation(s)
- Daiana Bezzini
- Department of Life Sciences, University of Siena, Siena, Italy.
| | - Irene Schiavetti
- Department of Health Sciences, Biostatistics Unit, University of Genoa, Genoa, Italy
| | - Tommaso Manacorda
- Italian Multiple Sclerosis Foundation, Genoa, Italy.,Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Giorgia Franzone
- Welfare Observatory, Italian Multiple Sclerosis Society, Genoa, Italy
| | - Mario A Battaglia
- Department of Life Sciences, University of Siena, Siena, Italy.,Italian Multiple Sclerosis Foundation, Genoa, Italy
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16
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Zekri AR, Ahmed OS, Asem N, Musa S, Ibrahem M, Soliman HK, Hafez MM, Nessim MS, Aboelkasem H, Bahnassy AA. SARS-CoV-2 Reverse Transcription-Polymerase Chain Reaction Positivity and Seroprevalence among Health Care Workers in a Referral Cancer Institute: A Cross-sectional Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND: During the ongoing coronavirus disease 2019 pandemic, healthcare workers (HCWs) are presumed to be at increased risk of infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), transmitting the infection to vulnerable patients if they are not timeously isolated.
AIM: This study aimed to determine the point prevalence of SARS-CoV-2 infection in a cohort of HCWs providing oncology services.
METHODS AND RESULTS: HCWs in a large referral cancer hospital in Egypt were tested using real-time reverse transcription-polymerase chain reaction (RT-PCR) on nasopharyngeal swabs, and immunochromatography-based rapid serological test (RST). Clinical and epidemiological data were collected. In 2020, 999 HCWs were screened, of whom 86 tested positive for SARS-CoV-2 by RT-PCR (8.6%) and 127 subjects were seropositive for antibodies against SARS-CoV-2 by RST (12.8%). Immunoglobulin M seroprevalence demonstrated considerable concordance with RT-PCR positivity (sensitivity 82.14% and specificity 96.71%). Most HCWs (>95%) reported adherence to personal protective equipment. Patient transporters/cleaner were the group with the highest frequency of positive RT-PCR (19%) whereas laboratory and radiology technicians displayed the lowest frequency. Fever, dry cough, rhinorrhea, shortness of breath, fatigue and diarrhea were significantly associated with RT-PCR positivity, with increased likelihood of being positive with the presence of five or six simultaneous symptoms.
CONCLUSIONS: The point prevalence of SARS-CoV-2 infection in screened HCWs is 8.6% by RT-PCR and seroprevalence is 12.8% by RST. Strict measures should be implemented to minimize transmission within healthcare settings and to the community. Our data support the importance of HCWs screening for SARS-CoV-2, taking in account the significant proportion of asymptomatic carriers.
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17
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Prevalence of COVID-19 in children affected by allergic rhinoconjunctivitis and asthma: results from the second "SIAIP rhinosinusitis and conjunctivitis committee" survey. Ital J Pediatr 2022; 48:1. [PMID: 34991654 PMCID: PMC8733922 DOI: 10.1186/s13052-021-01198-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 12/13/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The role of allergic sensitization seems to be protective against SARS CoV2 infection. The aim of this study was to evaluate, using online surveys, the impact of COVID-19 on Italian allergic children, comparing the prevalence of AR and asthma symptoms between the first and second pandemic wave. METHODS Both surveys were emailed to Italian pediatricians in April 2020 (first survey) and in March 2021 (second survey). The first one was related to the impact of COVID-19 and the most frequently reported symptoms. The second one was superimposed on the previous one, taking into account some additional aspects in the management of disease. RESULTS A total of 99 pediatricians participated in the first survey and 267 in the second one. The first survey showed that, asthma and allergic rhinoconjunctivitis prevalence was mostly between 0 and 20% throughout the country. The second survey showed a lower prevalence of both diseases nationwide in comparison to the first one. Comparing the two surveys, statistically significant differences were reported only in the distribution of asthma prevalence in Southern Italy while no differences were highlighted in the North and in the Center. Finally regarding allergic rhinoconjunctivitis prevalence, no differences were noticed nationwide. CONCLUSIONS Allergic rhinoconjunctivitis and asthma, if under control, did not represent risk factors for the susceptibility to SARS CoV2. Therefore, it is strongly recommended to continue therapies during COVID-19 outbreak, according to the international guidelines. However, being COVID-19 a new disease, actual knowledge will undergo continuous improvements over time.
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18
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Shin E, Jin J, Park SY, Yoo YS, Lee JH, An J, Song WJ, Kwon HS, Cho YS, Moon HB, Lee JB, Kim TB. Impact of asthma, chronic obstructive pulmonary disease (COPD), and asthma-COPD overlap on the prognosis of coronavirus disease 2019. Asia Pac Allergy 2022; 12:e21. [PMID: 35571550 PMCID: PMC9066077 DOI: 10.5415/apallergy.2022.12.e21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/27/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Eunyong Shin
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Juhae Jin
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seo Young Park
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Sang Yoo
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji-Hyang Lee
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin An
- Department of Pulmonary, Allergy and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Woo-Jung Song
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyouk-Soo Kwon
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - You Sook Cho
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee-Bom Moon
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung-Bok Lee
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae-Bum Kim
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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19
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Mahdi B. Asthma as a risk factor for The progression of COVID-19. ACTA FACULTATIS MEDICAE NAISSENSIS 2022. [DOI: 10.5937/afmnai39-33234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background: Asthma is one of the most common chronic respiratory diseases in the world, standing for the most frequent cause for hospitalization and emergency cases. Respiratory viruses are the most triggering cause. Aim: To assess the role of viral infections, especially COVID-19, in the pathogenesis of asthma initiation and exacerbations. Method: Electronic search was done for the manuscripts focusing on asthma as a risk factor for complications after COVID-19 infection. The outcomes were titles, materials, methods and classified studies related or not related to the review study. Three hundred publications were identified and only ten studies were selected for analysis. Seven studies were review, one retrospective, one longitudinal cohort study and one letter to the editor. Results: The included literature sources have highlighted different effect of asthma on COVID-19 progression. Asthma can be triggered by this virus and asthmatic patients with COVID-19 should not stop their treatment. Others suggest that asthma does not appear to be a significant risk factor for developing severe COVID-19 requiring hospitalization or intubation. Conclusions: Asthma is considered as comorbidity factor leading to complications and mortality in subjects infected with COVID-19.
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20
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Silva RAD. People with asthma: care during the COVID-19 pandemic and the importance of regular exercise for the immune system. MOTRIZ: REVISTA DE EDUCACAO FISICA 2022. [DOI: 10.1590/s1980-657420220021121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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21
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Chiang CY, Ellwood P, Ellwood E, García-Marcos L, Masekela R, Asher I, Badellino H, Sanz AB, Douros K, El Sony A, Diaz CG, Rodríguez MA, Moreno-Salvador A, Pérez-Martini LF, Filho NR, Shpakou A, Sulaimanov S, Tavakol M, Valverde-Molina J, Yousef AA, Pearce N. Infection with SARS-CoV-2 among children with asthma: evidence from Global Asthma Network. Pediatr Allergy Immunol 2022; 33:e13709. [PMID: 34856034 DOI: 10.1111/pai.13709] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/12/2021] [Accepted: 11/30/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Clinical presentations of coronavirus disease 2019 (COVID-19) among children with asthma have rarely been investigated. This study aimed to assess clinical manifestations and outcome of COVID-19 among children with asthma, and whether the use of asthma medications was associated with outcomes of interest. METHODS The Global Asthma Network (GAN) conducted a global survey among GAN centers. Data collection was between November 2020 and April 2021. RESULTS Fourteen GAN centers from 10 countries provided data on 169 children with asthma infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 was asymptomatic in 58 (34.3%), mild in 93 (55.0%), moderate in 14 (8.3%), and severe/critical in 4 (2.4%). Thirty-eight (22.5%) patients had exacerbation of asthma and 21 (12.4%) were hospitalized for a median of 7 days (interquartile range 3-16). Those who had moderate or more severe COVID-19 were significantly more likely to have exacerbation of asthma as compared to those who were asymptomatic or had mild COVID-19 (adjusted odds ratio (adjOR) 3.97, 95% CI 1.23-12.84). Those who used inhaled bronchodilators were significantly more likely to have a change of asthma medications (adjOR 2.39, 95% CI 1.02-5.63) compared to those who did not. Children who used inhaled corticosteroids (ICS) did not differ from those who did not use ICS with regard to being symptomatic, severity of COVID-19, asthma exacerbation, and hospitalization. CONCLUSIONS Over dependence on inhaled bronchodilator may be inappropriate. Use of ICS may be safe and should be continued in children with asthma during the pandemic of COVID-19.
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Affiliation(s)
- Chen-Yuan Chiang
- International Union Against Tuberculosis and Lung Disease, Paris, France.,Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Philippa Ellwood
- Department of Paediatrics, Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Eamon Ellwood
- Department of Paediatrics, Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Luis García-Marcos
- Pediatric Allergy and Pulmonology Units, Virgen de la Arrixaca University Children's Hospital, University of Murcia and IMIB Bioresearch Institute, Murcia, Spain.,ARADyAL Allergy Network, Edificio Departamental-Laib, El Palmar, Murcia, Spain
| | - Refiloe Masekela
- Department of Paediatrics and Child Health, Nelson R Mandela School of Clinical Medicine, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Innes Asher
- Department of Paediatrics, Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Héctor Badellino
- Pediatric Respiratory Medicine Department, UCES University and Clínica Regional del Este, Corrientes, San Francisco, Argentina
| | - Alberto Bercedo Sanz
- Cantabrian Health Service, Valdecilla Research Institute (IDIVAL), Dobra Health Center, Torrelavega, Cantabria, Spain
| | - Konstantinos Douros
- School of Medicine, 3rd Department of Pediatrics, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Asma El Sony
- Epidemiological Laboratory (Epi-Lab) for Public Health, Research and Development, Khartoum, Sudan
| | - Carlos González Diaz
- Department of Pediatrics, University of the Basque Country, Bilbao, Vizcaya, Spain.,UPV/EHU, Basurto University Hospital, Bilbao, Vizcaya, Spain
| | - Ms Albi Rodríguez
- Pediatric Pneumology and Allergy Unit, Hospital Universitario Doce de Octubre, Madrid, Spain
| | - Ana Moreno-Salvador
- Pediatric Allergy Unit, Virgen de la Arrixaca University Children's Hospital, University of Murcia, Spain
| | - Luis F Pérez-Martini
- Asociación Guatemalteca de Neumología y Cirugía de Tórax, Guatemala, Ciudad, Guatemala
| | | | - Andrei Shpakou
- Department of Theory of Physical Culture and Sport Medicine, Yanka Kupala State University of Grodno, Grodno, Belarus
| | | | - Marzieh Tavakol
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - José Valverde-Molina
- Department of Pediatrics, Hospital General Universitario Santa Lucia, Cartagena, Murcia, Spain
| | - Abdullah A Yousef
- College of Medicine, Imam Abdulrahman bin Faisal University, Al Khobar, Saudi Arabia.,Department of Pediatrics, King Fahd Hospital of the University Alkhobar, Al Khobar, Saudi Arabia
| | - Neil Pearce
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
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22
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Gaietto K, Freeman MC, DiCicco LA, Rauenswinter S, Squire JR, Aldewereld Z, Iagnemma J, Campfield BT, Wolfson D, Kazmerski TM, Forno E. Asthma as a risk factor for hospitalization in children with COVID-19: A nested case-control study. Pediatr Allergy Immunol 2022; 33:e13696. [PMID: 34775650 PMCID: PMC8646549 DOI: 10.1111/pai.13696] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/25/2021] [Accepted: 11/10/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Most pediatric studies of asthma and COVID-19 to date have been ecological, which offer limited insight. We evaluated the association between asthma and COVID-19 at an individual level. METHODS Using data from prospective clinical registries, we conducted a nested case-control study comparing three groups: children with COVID-19 and underlying asthma ("A+C" cases); children with COVID-19 without underlying disease ("C+" controls); and children with asthma without COVID-19 ("A+" controls). RESULTS The cohort included 142 A+C cases, 1110 C+ controls, and 140 A+ controls. A+C cases were more likely than C+ controls to present with dyspnea and wheezing, to receive pharmacologic treatment including systemic steroids (all p < .01), and to be hospitalized (4.9% vs. 1.7%, p = .01). In the adjusted analysis, A+C cases were nearly 4 times more likely to be hospitalized than C+ controls (adjusted OR = 3.95 [95%CI = 1.4-10.9]); however, length of stay and respiratory support level did not differ between groups. Among A+C cases, 8.5% presented with an asthma exacerbation and another 6.3% developed acute exacerbation symptoms shortly after testing positive for SARS-CoV-2. Compared to historic A+ controls, A+C cases had less severe asthma, were less likely to be on controller medications, and had better asthma symptom control (all p < .01). CONCLUSIONS In our cohort, asthma was a risk factor for hospitalization in children with COVID-19, but not for worse COVID-19 outcomes. SARS-CoV-2 does not seem to be a strong trigger for pediatric asthma exacerbations. Asthma severity was not associated with higher risk of COVID-19.
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Affiliation(s)
- Kristina Gaietto
- Division of Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Megan Culler Freeman
- Division of Infectious Diseases, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Leigh Anne DiCicco
- Division of Hospital Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Joseph R Squire
- Children's Community Pediatrics, Pittsburgh, Pennsylvania, USA
| | - Zachary Aldewereld
- Division of Infectious Diseases, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Division of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Brian T Campfield
- Division of Infectious Diseases, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - David Wolfson
- Children's Community Pediatrics, Pittsburgh, Pennsylvania, USA
| | - Traci M Kazmerski
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Erick Forno
- Division of Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Pediatric Asthma Center, UPMC Children's Hospital of Pittsburgh and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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23
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Çalışkaner Öztürk B, Güngördü Mazıcan N, Çalışkan EB, Tuz AA, Gemicioğlu B. Coronavirus Disease 2019 in Patients with Asthma: Case Study from a Tertiary Center Regarding Their Phenotypes and Their Adherence to Asthma Treatment by Telemedicine. Turk Thorac J 2022. [PMID: 35110197 PMCID: PMC9450126 DOI: 10.5152/turkthoracj.2022.21097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to determine the prevalence and the characteristics of coronavirus disease 2019 (COVID-19) in a tertiary outpatient clinic of asthma patients, find the predisposing asthma phenotype to COVID-19, and to see their adherence to asthma treatment. MATERIAL AND METHODS A retrospective, cross-sectional, real life study was conducted via phone interviews with the patients being followed in the asthma outpatient clinic. From the files of the patient information was obtained about their demographics, asthma phenotype, co-morbidity, prick tests, spirometry test results and their medications at the last visit before the COVID-19 pandemic. Information's about asthma exacerbations, ACT, asthma treatment adherence and history of COVID-19 were obtained via telephone interviews. RESULTS Of the 573 patients with asthma, 13 (2.26%) had COVID-19 history. The mean age of patients with asthma and COVID-19 was 51.84±14.92 year. Two patients were on mepolizumab and one was on omalizumab treatment. Mean ACT was 19.84±2.73. Lack of adherence was reported in 8% of all patients with asthma compared to 23% in the patients who had COVID-19. Asthma exacerbation was seen during the course of SARS-CoV2 infection in 3 of 13 patients with asthma. Asthma exacerbations were reported during the period of one month following COVID-19 in 2 patients. CONCLUSION The most common asthma phenotype in the cases of COVID-19 was obese phenotype. Rates of using biological agents and non-adherence to the treatment were found to be higher. Asthma exacerbation may be seen during course of COVID-19 albeit being less common.
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Affiliation(s)
- Buket Çalışkaner Öztürk
- Department of Pulmonary Diseases, İstanbul University-Cerrahpaşa, Faculty of Medicine, İstanbul, Turkey,Corresponding author: Buket Çalışkaner Öztürk, e-mail:
| | - Nejdiye Güngördü Mazıcan
- Department of Pulmonary Diseases, İstanbul University-Cerrahpaşa, Faculty of Medicine, İstanbul, Turkey
| | - Elif Buse Çalışkan
- Faculty of Medicine Student, İstanbul University-Cerrahpaşa, İstanbul, Turkey,Corresponding author: Buket Çalışkaner Öztürk, e-mail:
| | - Ali Ata Tuz
- Faculty of Medicine Student, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Bilun Gemicioğlu
- Department of Pulmonary Diseases, İstanbul University-Cerrahpaşa, Faculty of Medicine, İstanbul, Turkey
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24
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Alakeel YS, Alharbi EF, Alhaidal HA, Jumaa AM, Albaiahy LK, Alsagami NS, Alshahrani SA. The effects of the antecedent use of inhaled steroid on the clinical course of COVID-19: A retrospective study of asthmatic patients. J Infect Public Health 2022; 15:56-64. [PMID: 34922224 PMCID: PMC8653412 DOI: 10.1016/j.jiph.2021.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/15/2021] [Accepted: 12/05/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND There is conflicting evidence regarding the effect of asthma and its different therapeutic options on COVID-19 severity and the clinical outcomes. AIM This study aimed to investigate the relationship between using inhaled corticosteroids (ICS) by asthmatic patients and the severity of COVID-19. MATERIALS AND METHODS This retrospective observational study was conducted from March 15 to October 23, 2020 and included data of all COVID-19 asthmatic patients (n = 287) at King Abdulaziz Medical City. Twelve patients were excluded due to poor medication history documentation or using ICS for non-asthma indication. Ordinal logistic regression was used to determine the clinical variables that affect COVID-19 severity. The clinical outcomes of ICS and non-ICS users were compared. RESULTS Of the sample (n = 275), 198 (72%) were using ICS therapy. No significant difference was found between ICS and non-ICS users in disease severity (P = 0.12), mortality (P = 0.45), ICU admission (P = 0.78), and the occurrence of complications. However, the number of days on ventilation were significantly increased in ICS users (P = 0.006). Being prescribed the ICS/LABA combination (adj OR: 0.72 [0.15,1.2]; P = 0.021), being hypertensive (adj OR: 0.98 [0.28,1.6]; P = 0.006), having cancer (adj OR: 1.49 [0.12, 2.8]; P = 0.033), or having diabetes (adj OR: 0.75 [0.09, 1.4]; P = 0.024) could not increase the risk for more severe disease. CONCLUSION Overall, ICS therapy did not alter the COVID-19 severity or mortality in asthmatic patients. The continued use of ICS during the pandemic should be encouraged to prevent asthma exacerbations.
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Affiliation(s)
- Yousif S Alakeel
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; Pharmaceutical Care Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
| | - Ebtihal F Alharbi
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; College of Applied Medical Sciences, Respiratory therapy Department, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
| | - Haifa A Alhaidal
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Aisha M Jumaa
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; Respiratory Services, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Latifah K Albaiahy
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Noura S Alsagami
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; College of Applied Medical Sciences, Respiratory therapy Department, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Shatha A Alshahrani
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; College of Applied Medical Sciences, Respiratory therapy Department, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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25
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General Stress Among Young Adults with Asthma During the COVID-19 Pandemic. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:108-115. [PMID: 34785389 PMCID: PMC8590620 DOI: 10.1016/j.jaip.2021.10.069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 10/12/2021] [Accepted: 10/29/2021] [Indexed: 11/22/2022]
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has profoundly affected the lives of the global population. Objective To explore anxiety and stress in relation to COVID-19 among young adults, and the potential influence of asthma and allergic rhinitis. Methods This cross-sectional study included 1644 participants from the population-based birth cohort BAMSE (Swedish abbreviation for Children, Allergy, Milieu, Stockholm, Epidemiology), participating in a follow-up at age 24 years and a COVID-19 follow-up conducted in August-November 2020 (mean age, 25.3 years). Anxiety and concern related to COVID-19 were analyzed as general anxiety, concern of own health and health of family members, and contact with online health care providers due to concern about COVID-19. Stress was measured with the perceived stress scale. Results Around half the participants reported increased anxiety due to COVID-19, and this was more common among females (57.0%, compared with 42.6% in males; P < .001). Young adults with asthma reported more concern about their own health (adjusted odds ratio, 1.50; 95% CI, 1.12-2.02) and perceived stress (adjusted regression coefficient [adjusted β], 1.49; 95% CI, 0.52-2.45) compared with peers without asthma, and this was more pronounced among females and those with uncontrolled asthma. Symptoms of allergic rhinitis were not associated with increased concern or anxiety in relation to COVID-19. Conclusions Young adults with asthma experience more COVID-19–related health concerns, compared with those without asthma, especially females and participants with uncontrolled asthma This needs to be considered in the care of young people with asthma.
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26
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Faour WH, Choaib A, Issa E, Choueiry FE, Shbaklo K, Alhajj M, Sawaya RT, Harhous Z, Alefishat E, Nader M. Mechanisms of COVID-19-induced kidney injury and current pharmacotherapies. Inflamm Res 2022; 71:39-56. [PMID: 34802072 PMCID: PMC8606168 DOI: 10.1007/s00011-021-01520-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 01/08/2023] Open
Abstract
The COVID-19 pandemic created a worldwide debilitating health crisis with the entire humanity suffering from the deleterious effects associated with the high infectivity and mortality rates. While significant evidence is currently available online and targets various aspects of the disease, both inflammatory and noninflammatory kidney manifestations secondary to COVID-19 infection are still largely underrepresented. In this review, we summarized current knowledge about COVID-19-related kidney manifestations, their pathologic mechanisms as well as various pharmacotherapies used to treat patients with COVID-19. We also shed light on the effect of these medications on kidney functions that can further enhance renal damage secondary to the illness.
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Affiliation(s)
- Wissam H Faour
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, P.O. Box 36, Byblos, Lebanon.
| | - Ali Choaib
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, P.O. Box 36, Byblos, Lebanon
| | - Elio Issa
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, P.O. Box 36, Byblos, Lebanon
| | - Francesca El Choueiry
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, P.O. Box 36, Byblos, Lebanon
| | - Khodor Shbaklo
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, P.O. Box 36, Byblos, Lebanon
| | - Maryline Alhajj
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, P.O. Box 36, Byblos, Lebanon
| | - Ramy Touma Sawaya
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, P.O. Box 36, Byblos, Lebanon
| | - Zeina Harhous
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, P.O. Box 36, Byblos, Lebanon
| | - Eman Alefishat
- Department of Pharmacology, College of Medicine and Health Sciences, Khalifa University of Science and Technology, P.O. Box 127788, Abu Dhabi, United Arab Emirates
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Moni Nader
- Department of Physiology and Immunology, College of Medicine and Health Sciences, Khalifa University of Science and Technology, P.O. Box 127788, Abu Dhabi, United Arab Emirates.
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates.
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27
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Matsuno O, Minamoto S. COVID-19 in a Patient With Severe Eosinophilic Asthma on Benralizumab Therapy: A Case Report and Review of Literature. Cureus 2021; 13:e20644. [PMID: 35103205 PMCID: PMC8783696 DOI: 10.7759/cureus.20644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
Patients with coronavirus disease 2019 (COVID-19) can develop eosinopenia. Eosinophils have various functions, including immunoregulation and antiviral activity, in addition to modulation of an inflammatory reaction. Benralizumab is an anti-interleukin-5Rα monoclonal antibody that selectively depletes eosinophils through enhanced antibody-dependent cell-mediated cytotoxicity. Whether eosinophil depletion affects COVID-19 prognosis is yet to be elucidated. Here, we present a case of a 60-year-old patient with severe asthma on benralizumab therapy, who tested positive for an acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The patient experienced an asymptomatic COVID-19 course without deterioration of asthma control. Eosinophil depletion did not contribute to a deterioration of the clinical status. Comorbidities play a major role in the severity of COVID-19 in patients with asthma. The findings of our case and a literature review revealed that benralizumab therapy is not associated with a significant negative impact on the disease course in COVID-19 patients.
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28
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Kong-Cardoso B, Ribeiro A, Aguiar R, Pité H, Morais-Almeida M. Understanding and Managing Severe Asthma in the Context of COVID-19. Immunotargets Ther 2021; 10:419-430. [PMID: 34926333 PMCID: PMC8675091 DOI: 10.2147/itt.s342636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/25/2021] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) continues to spread across the world. Since the beginning of the pandemic, the question of whether asthma is a risk factor for getting the infection or for poor outcomes motivated a great debate. In the field of severe asthma and its treatment during COVID-19 pandemic, several issues are also pending. A literature review focused on the management of severe asthma patients in the context of COVID-19 is performed. The available evidence suggests that severe asthma patients do not have an increased risk of poor COVID-19 outcomes and that it is safe to treat asthmatic patients with inhaled corticosteroids (ICS) and biologics during the pandemic, even though some studies indicate that high doses of ICS may predispose to COVID-19. The chronic use of oral corticosteroid (OCS) might be associated with poor COVID-19 outcomes, although there is no complete agreement. There is very limited evidence concerning the use of triple therapy for asthma in the context of this pandemic. Ultimately, severe asthma patients should maintain their medication during the COVID-19 pandemic, including biologic agents. More studies are needed to address the role of asthma medications and asthma’s different phenotypes on the incidence and course of COVID-19.
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Affiliation(s)
- Bárbara Kong-Cardoso
- Allergy Center, CUF Descobertas Hospital and CUF Tejo Hospital, Lisbon, Portugal
| | - Amélia Ribeiro
- Pneumology Department, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal
| | - Rita Aguiar
- Allergy Center, CUF Descobertas Hospital and CUF Tejo Hospital, Lisbon, Portugal
| | - Helena Pité
- Allergy Center, CUF Descobertas Hospital and CUF Tejo Hospital, Lisbon, Portugal
| | - Mário Morais-Almeida
- Allergy Center, CUF Descobertas Hospital and CUF Tejo Hospital, Lisbon, Portugal
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29
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Lodge CJ, Doherty A, Bui DS, Cassim R, Lowe AJ, Agusti A, Russell MA, Dharmage SC. Is asthma associated with COVID-19 infection? A UK Biobank analysis. ERJ Open Res 2021; 7:00309-2021. [PMID: 34849374 PMCID: PMC8449950 DOI: 10.1183/23120541.00309-2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 08/20/2021] [Indexed: 12/15/2022] Open
Abstract
Background The relationship between asthma and coronavirus disease 2019 (COVID-19) risk is not clear and may be influenced by level of airway obstruction, asthma medication and known COVID-19 risk factors. We aimed to investigate COVID-19 risk in people with asthma. Methods We used UK Biobank data from all participants tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (n=107 412; 17 979 test positive). Questions at baseline defined ever asthma and asthma medications. Baseline forced expiratory volume in 1 s (FEV1) was categorised into quartiles. Logistic regression modelled relationships between asthma, and asthma categories (age at onset, medications, FEV1 quartiles), and risk of SARS-CoV-2 positive test. We investigated modification by sex, ethnic group, smoking and body mass index. Results There was a reduced risk of a positive test associated with early-onset asthma (<13 years) (OR 0.91, 95% CI 0.84-0.99). This was found for participants with early-onset asthma who were male (OR 0.87, 95% CI 0.78-0.98), nonsmokers (OR 0.87, 95% CI 0.78-0.98), overweight/obese (OR 0.85, 95% CI 0.77-0.93) and non-Black (OR 0.90, 95% CI 0.82-0.98). There was increased risk amongst early-onset individuals with asthma in the highest compared to lowest quartile of lung function (1.44, 1.05-1.72). Conclusion Amongst male, nonsmoking, overweight/obese and non-Black participants, having early-onset asthma was associated with lower risk of a SARS-CoV-2 positive test. We found no evidence of a protective effect from asthma medication. Individuals with early-onset asthma of normal weight and with better lung function may have lifestyle differences placing them at higher risk. Further research is needed to elucidate the contribution of asthma pathophysiology and different health-related behaviour, across population groups, to the observed risks.
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Affiliation(s)
- Caroline J Lodge
- Allergy and Lung Health Unit, Centre of Epidemiology and Biostatistics, Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, VIC, Australia.,Equal first/senior
| | - Alice Doherty
- Allergy and Lung Health Unit, Centre of Epidemiology and Biostatistics, Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, VIC, Australia.,Equal first/senior
| | - Dinh S Bui
- Allergy and Lung Health Unit, Centre of Epidemiology and Biostatistics, Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, VIC, Australia
| | - Raisa Cassim
- Allergy and Lung Health Unit, Centre of Epidemiology and Biostatistics, Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, VIC, Australia
| | - Adrian J Lowe
- Allergy and Lung Health Unit, Centre of Epidemiology and Biostatistics, Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, VIC, Australia
| | - Alvar Agusti
- Centro de Investigation Biomédica en Red Enfermedades Respiratorias (CIBERES), Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Respiratory Institute, Hospital Clinic, Barcelona, Spain.,University of Barcelona, Spain
| | - Melissa A Russell
- Allergy and Lung Health Unit, Centre of Epidemiology and Biostatistics, Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, VIC, Australia.,Equal first/senior
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre of Epidemiology and Biostatistics, Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, VIC, Australia.,Equal first/senior
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Abstract
PURPOSE OF REVIEW As of June 2021, coronavirus disease 2019 (COVID-19) exceeded 180 million reported cases and was responsible for almost 4 million deaths globally. Asthma affects approximately 262 million people worldwide and is an important cause of morbidity and mortality. Presently, it appears asthma is neither associated with an increased risk of contracting COVID-19 nor with a risk of severe COVID-19 or COVID-19 related death. Regarding the severe asthma patients on biologics, questions remain. The purpose of this review is to discuss the evidence regarding the relationship between asthma, biologics and COVID-19. RECENT FINDINGS The available evidence does not suggest that severe asthmatics on treatment with biologics have a higher risk of severe acute respiratory syndrome coronavirus 2 infection compared to the general population. It does not appear that they have a higher risk of severe disease or COVID-19 related death either. SUMMARY This review suggests that treatment with biologics for severe asthma is safe and should be maintained during the COVID-19 pandemic. However, more studies are needed to address this question and the role of biological therapy on different asthma phenotypes.
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31
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Moreno-Sánchez E, Castillo-Viera E, Vélez-Moreno E, Gago-Valiente FJ. Facts and Challenges about Asthma and COVID-19 among the Paediatric Population: A Systematic Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57121306. [PMID: 34946251 PMCID: PMC8706787 DOI: 10.3390/medicina57121306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/26/2021] [Accepted: 11/28/2021] [Indexed: 01/02/2023]
Abstract
A systematic review of the literature was conducted to analyse the factors that affect the probability of the paediatric asthma population suffering from COVID-19 or SARS-CoV-2, such as asthma phenotypes, inhaled corticosteroids, and the effects of lockdown. This systematic review was based on PRISMA guidelines. A bibliographic search was conducted using BNE, BVS (LILAC), CSIC (IME, ISOC), IBECS, Scielo, Scopus, Medline, and PubMed, using the following search profile: (COVID-19 or 2019-NCOV or SARS-CoV-2 or COV-19) AND asthma AND (children or adolescents or youths or children or teenagers). The results were limited to those articles published between December 2019 and December 2020, selecting only articles published in Spanish, English and French that included the study population (children aged 0–18 years). Among the 1066 results of the bibliographic search and seven articles selected from a manual search, only 19 articles were found to fit our eligibility criteria. Most of the articles highlight the effects of lockdown on the paediatric asthma population, increased therapeutic compliance, and the role of inhaled corticosteroids and intrinsic factors such as ACE2 receptors as causes of the decreased prevalence of COVID-19 among the paediatric asthma population. This population has unique characteristics that serve as protective factors against COVID-19. The safety measures implemented during the lockdown period along with inhaled corticosteroid treatment also contributed to this protection.
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Affiliation(s)
- Emilia Moreno-Sánchez
- Department of Pedagogy, Faculty of Education, Psychology and Sports Sciences, University of Huelva, 21071 Huelva, Spain;
| | - Estefanía Castillo-Viera
- Faculty of Education, Psychology and Sports Sciences, University of Huelva, 21071 Huelva, Spain
- Correspondence: ; Tel.: +34-959219272
| | - Emilia Vélez-Moreno
- Medicine Department, Faculty of Medicine, University of Malaga, 29071 Malaga, Spain;
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32
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Halperin DT, Hearst N, Hodgins S, Bailey RC, Klausner JD, Jackson H, Wamai RG, Ladapo JA, Over M, Baral S, Escandón K, Gandhi M. Revisiting COVID-19 policies: 10 evidence-based recommendations for where to go from here. BMC Public Health 2021; 21:2084. [PMID: 34774012 PMCID: PMC8590121 DOI: 10.1186/s12889-021-12082-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 10/22/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Strategies to control coronavirus 2019 disease (COVID-19) have often been based on preliminary and limited data and have tended to be slow to evolve as new evidence emerges. Yet knowledge about COVID-19 has grown exponentially, and the expanding rollout of vaccines presents further opportunity to reassess the response to the pandemic more broadly. MAIN TEXT We review the latest evidence concerning 10 key COVID-19 policy and strategic areas, specifically addressing: 1) the expansion of equitable vaccine distribution, 2) the need to ease restrictions as hospitalization and mortality rates eventually fall, 3) the advantages of emphasizing educational and harm reduction approaches over coercive and punitive measures, 4) the need to encourage outdoor activities, 5) the imperative to reopen schools, 6) the far-reaching and long-term economic and psychosocial consequences of sustained lockdowns, 7) the excessive focus on surface disinfection and other ineffective measures, 8) the importance of reassessing testing policies and practices, 9) the need for increasing access to outpatient therapies and prophylactics, and 10) the necessity to better prepare for future pandemics. CONCLUSIONS While remarkably effective vaccines have engendered great hope, some widely held assumptions underlying current policy approaches call for an evidence-based reassessment. COVID-19 will require ongoing mitigation for the foreseeable future as it transforms from a pandemic into an endemic infection, but maintaining a constant state of emergency is not viable. A more realistic public health approach is to adjust current mitigation goals to be more data-driven and to minimize unintended harms associated with unfocused or ineffective control efforts. Based on the latest evidence, we therefore present recommendations for refining 10 key policy areas, and for applying lessons learned from COVID-19 to prevent and prepare for future pandemics.
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Affiliation(s)
- Daniel T Halperin
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Norman Hearst
- Department of Family and Community Medicine, School of Medicine, University of California, San Francisco, CA, USA
| | - Stephen Hodgins
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Robert C Bailey
- School of Public Health, University of Illinois, Chicago, IL, USA
| | - Jeffrey D Klausner
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Richard G Wamai
- Integrated Initiative for Global Health, Northeastern University, Boston, MA, USA
- School of Public Health, University of Nairobi, Nairobi, Kenya
| | - Joseph A Ladapo
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Mead Over
- Center for Global Development, Washington, D.C, USA
| | - Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Kevin Escandón
- School of Medicine, Universidad del Valle, Cali, Colombia.
- Department of Microbiology, Universidad del Valle, Grupo de Investigación en Virus Emergentes VIREM, Cali, Colombia.
| | - Monica Gandhi
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
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Gao YD, Agache I, Akdis M, Nadeau K, Klimek L, Jutel M, Akdis CA. The effect of allergy and asthma as a comorbidity on the susceptibility and outcomes of COVID-19. Int Immunol 2021; 34:177-188. [PMID: 34788827 PMCID: PMC8689956 DOI: 10.1093/intimm/dxab107] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 11/10/2021] [Indexed: 12/12/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic causes an overwhelming number of hospitalization and deaths with a significant socioeconomic impact. The vast majority of studies indicate that asthma and allergic diseases do not represent a risk factor for COVID-19 susceptibility nor cause a more severe course of disease. This raises the opportunity to investigate the underlying mechanisms of the interaction between an allergic background and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The majority of patients with asthma, atopic dermatitis, allergic rhinitis, chronic rhinosinusitis, food allergies and drug allergies exhibit an over-expression of type 2 immune and inflammatory pathways with the contribution of epithelial cells, innate lymphoid cells, dendritic cells, T cells, eosinophils, mast cells, basophils, and the type 2 cytokines interleukin (IL)-4, IL-5, IL-9, IL-13, and IL-31. The potential impact of type 2 inflammation-related allergic diseases on susceptibility to COVID-19 and severity of its course have been reported. In this review, the prevalence of asthma and other common allergic diseases in COVID-19 patients is addressed. Moreover, the impact of allergic and non-allergic asthma with different severity and control status, currently available asthma treatments such as inhaled and oral corticosteroids, short- and long-acting β2 agonists, leukotriene receptor antagonists and biologicals on the outcome of COVID-19 patients is reviewed. In addition, possible protective mechanisms of asthma and type 2 inflammation on COVID-19 infection, such as the expression of SARS-CoV-2 entry receptors, antiviral activity of eosinophils and cross-reactive T-cell epitopes, are discussed. Potential interactions of other allergic diseases with COVID-19 are postulated, including recommendations for their management.
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Affiliation(s)
- Ya-Dong Gao
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.,Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, Hubei, China
| | - Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Herman-Burchard Strasse, Davos, Switzerland
| | - Kari Nadeau
- Sean N. Parker Center for Allergy and Asthma Research, Department of Medicine, Stanford University, Palo Alto, California, USA
| | - Ludger Klimek
- Center for Rhinology and Allergology, An den Quellen, Wiesbaden, Germany
| | - Marek Jutel
- Department of Clinical Immunology, Wrocław Medical University.,All-MED Medical Research Institute, Wrocław, Poland
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Herman-Burchard Strasse, Davos, Switzerland
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Tchicaya A, Lorentz N, Leduc K, de Lanchy G. COVID-19 mortality with regard to healthcare services availability, health risks, and socio-spatial factors at department level in France: A spatial cross-sectional analysis. PLoS One 2021; 16:e0256857. [PMID: 34534226 PMCID: PMC8448369 DOI: 10.1371/journal.pone.0256857] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 08/17/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The 2019 coronavirus (COVID-19) epidemic began in Wuhan, China in December 2019 and quickly spread to the rest of the world. This study aimed to analyse the associations between the COVID-19 mortality rate in hospitals, the availability of health services, and socio-spatial and health risk factors at department level. METHODS AND FINDINGS This spatial cross-sectional study used cumulative mortality data due to the COVID-19 pandemic in hospitals until 30 November 2020 as a main outcome, across 96 departments of mainland France. Data concerning health services, health risk factors, and socio-spatial factors were used as independent variables. Independently, we performed negative binomial, spatial and geographically weighted regression models. Our results revealed substantial geographic disparities. The spatial exploratory analysis showed a global positive spatial autocorrelation in each wave indicating a spatial dependence of the COVID-19 deaths across departments. In first wave about 75% of COVID-19 deaths were concentrated in departments of five regions compared to a total of 13 regions. The COVID-19 mortality rate was associated with the physicians density, and not the number of resuscitation beds. Socio-spatial factors were only associated with the COVID-19 mortality rate in first wave compared to wave 2. For example, the COVID-19 mortality rate increased by 35.69% for departments densely populated. Health risk factors were associated with the COVID-19 mortality rate depending on each wave. This study had inherent limitations to the ecological analysis as ecological bias risks and lack of individual data. CONCLUSIONS Our results suggest that the COVID-19 pandemic has spread more rapidly and takes more severe forms in environments where there is already a high level of vulnerability due to social and health factors. This study showed a different dissemination pattern of COVID-19 mortality between the two waves: a spatial non-stationarity followed by a spatial stationarity in the relationships between the COVID-19 mortality rate and its potential drivers.
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Affiliation(s)
- Anastase Tchicaya
- Luxembourg Institute of Socio-Economic Research, Living Conditions Department, Esch-sur-Alzette, Luxembourg
| | - Nathalie Lorentz
- Luxembourg Institute of Socio-Economic Research, Living Conditions Department, Esch-sur-Alzette, Luxembourg
| | - Kristell Leduc
- Luxembourg Institute of Socio-Economic Research, Living Conditions Department, Esch-sur-Alzette, Luxembourg
| | - Gaetan de Lanchy
- Luxembourg Institute of Socio-Economic Research, Living Conditions Department, Esch-sur-Alzette, Luxembourg
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Maison N, Herbrüggen H, Schaub B, Schauberger C, Foth S, Grychtol R, Abdo M, Watz H, Nikolaizik W, Rabe KF, Kopp MV, Hansen G, von Mutius E, Bahmer T, Omony J. Impact of imposed social isolation and use of face masks on asthma course and mental health in pediatric and adult patients with recurrent wheeze and asthma. Allergy Asthma Clin Immunol 2021; 17:93. [PMID: 34530911 PMCID: PMC8444172 DOI: 10.1186/s13223-021-00592-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 08/27/2021] [Indexed: 11/10/2022] Open
Abstract
Background There is currently a dramatic increase in the number of COVID-19 cases worldwide, and further drastic restrictions in our daily life will be necessary to contain this pandemic. The implications of restrictive measures like social-distancing and mouth-nose protection on patients with chronic respiratory diseases have hardly been investigated. Methods Our survey, was conducted within the All Age Asthma Cohort (ALLIANCE), a multicenter longitudinal observational study. We assessed the effects of COVID-19 imposed social isolation and use of facial masks, on asthma course and mental health in patients with asthma and wheezing. Results We observed a high rate of problems associated with using facemasks and a significant reduction in the use of routine medical care. In addition to unsettling impacts, such as an increase in depression symptoms in adults, an astonishing and pleasing effect was striking: preschool children experienced an improvement in disease condition during the lockdown. This improvement can be attributed to a significant reduction in exposure to viral infections. Conclusion Long-term observation of this side effect may help improve our understanding of the influence of viral infections on asthma in early childhood.
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Affiliation(s)
- Nicole Maison
- Department of Paediatric Allergology, Dr Von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany. .,Comprehensive Pneumology Center, Munich (CPC-M), Munich, Germany. .,German Center for Lung Research (DZL), Munich, Germany. .,Institut Für Asthma- Und Allergieprävention (IAP), Helmholtz Zentrum Munich, Deutsches Forschungszentrum Für Gesundheit Und Umwelt (GmbH), Munich, Germany.
| | - Heidrun Herbrüggen
- German Center for Lung Research (DZL), Munich, Germany.,LungenClinic Grosshansdorf GmbH, Grosshansdorf, Germany.,Airway Research Center North (ARCN), Grosshansdorf, Germany
| | - Bianca Schaub
- Department of Paediatric Allergology, Dr Von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany.,Comprehensive Pneumology Center, Munich (CPC-M), Munich, Germany.,German Center for Lung Research (DZL), Munich, Germany
| | - Christina Schauberger
- Department of Paediatric Allergology, Dr Von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany.,Comprehensive Pneumology Center, Munich (CPC-M), Munich, Germany.,German Center for Lung Research (DZL), Munich, Germany
| | - Svenja Foth
- German Center for Lung Research (DZL), Munich, Germany.,University Children's Hospital Marburg, University of Marburg, Marburg, Germany.,University of Giessen Marburg Lung Center (UGMLC), Giessen, Germany
| | - Ruth Grychtol
- German Center for Lung Research (DZL), Munich, Germany.,Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Mustafa Abdo
- German Center for Lung Research (DZL), Munich, Germany.,LungenClinic Grosshansdorf GmbH, Grosshansdorf, Germany.,Airway Research Center North (ARCN), Grosshansdorf, Germany
| | - Henrik Watz
- German Center for Lung Research (DZL), Munich, Germany.,Airway Research Center North (ARCN), Grosshansdorf, Germany.,Pulmonary Research Institute at LungenClinic Grosshansdorf, Grosshansdorf, Germany
| | - Wilfried Nikolaizik
- German Center for Lung Research (DZL), Munich, Germany.,University Children's Hospital Marburg, University of Marburg, Marburg, Germany.,University of Giessen Marburg Lung Center (UGMLC), Giessen, Germany
| | - Klaus F Rabe
- German Center for Lung Research (DZL), Munich, Germany.,LungenClinic Grosshansdorf GmbH, Grosshansdorf, Germany.,Airway Research Center North (ARCN), Grosshansdorf, Germany
| | - Matthias V Kopp
- German Center for Lung Research (DZL), Munich, Germany.,Airway Research Center North (ARCN), Grosshansdorf, Germany.,Institute for Medical Biometry and Statistics, University Luebeck, University Medical Centre Schleswig-Holstein, Campus, Luebeck, Germany
| | - Gesine Hansen
- German Center for Lung Research (DZL), Munich, Germany.,Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Erika von Mutius
- Department of Paediatric Allergology, Dr Von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany.,Comprehensive Pneumology Center, Munich (CPC-M), Munich, Germany.,German Center for Lung Research (DZL), Munich, Germany.,Institut Für Asthma- Und Allergieprävention (IAP), Helmholtz Zentrum Munich, Deutsches Forschungszentrum Für Gesundheit Und Umwelt (GmbH), Munich, Germany
| | - Thomas Bahmer
- German Center for Lung Research (DZL), Munich, Germany.,LungenClinic Grosshansdorf GmbH, Grosshansdorf, Germany.,Airway Research Center North (ARCN), Grosshansdorf, Germany.,Internal Medicine Department I, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Jimmy Omony
- Institut Für Asthma- Und Allergieprävention (IAP), Helmholtz Zentrum Munich, Deutsches Forschungszentrum Für Gesundheit Und Umwelt (GmbH), Munich, Germany
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Yılmaz Demirci N, Uğraş Dikmen A, Taşçı C, Doğan D, Arslan Y, Öcal N, Taşar M, Bozlar U, Artuk C, Yılmaz G, Karacaer Z, Avcı İY, Tuncer Ertem G, Erdinç FŞ, Kınıklı S, Altun Demircan Ş, Ergün E, Nercis Koşar P, Karakoç AE, Gökçek A, Aloğlu M, Gülgösteren S, Atikcan Ş, Akçay Ş, Erol Ç, Hekimoğlu K, Cerit MN, Erbaş G, Özger HS, Bozdayı G, Şenol E, Yurdakul AS, Yılmaz A. Relationship between chest computed tomography findings and clinical conditions of coronavirus disease (COVID-19): A multicentre experience. Int J Clin Pract 2021; 75:e14459. [PMID: 34105857 DOI: 10.1111/ijcp.14459] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/06/2021] [Indexed: 12/12/2022] Open
Abstract
AIMS This study aimed to investigate the clinical and chest computed tomography (CT) features associated with clinical parameters for coronavirus disease (COVID-19) in the capital of Turkey, Ankara. MATERIALS AND METHODS Epidemiological, clinical features, laboratory findings and radiological characteristics of 1563 hospitalised patients with COVID-19 in Ankara were collected, reviewed and analysed in this study. The risk factors associated with disease severity were investigated. RESULTS Non-severe (1214; 77.7%) and severe cases (349; 22.3%) were enrolled in the study. Compared with the non-severe group, the severe group were significantly older and had more comorbidities (ie, hypertension, diabetes mellitus, cardiovascular disease and chronic kidney disease). Smoking was more common in the severe group. Severe patients had higher respiratory rates and higher incidences of cough and dyspnoea compared with non-severe patients. Compared with the non-severe patients, the severe patients had increased C-reactive protein (CRP), procalcitonin, neutrophil to lymphocyte ratio (NLR) and CRP/albumin ratio and decreased albumin. The occurrence rates of consolidation, subpleural sparing, crazy-paving pattern, cavity, halo sign, reversed halo sign, air bronchogram, pleural thickening, micronodule, subpleural curvilinear line and multilobar and bilateral involvement in the CT finding of the severe patients were significantly higher than those of the non-severe patients. CONCLUSIONS Many factors are related to the severity of COVID-19, which can help clinicians judge the severity of the patient and evaluate the prognosis. This cohort study revealed that male sex, age (≥55 years), patients with any comorbidities, especially those with cardiovascular disease, dyspnoea, increased CRP, D-dimer and NLR, and decreased lymphocyte count and CT findings of consolidation and multilobar involvement were predictors of severe COVID-19.
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Affiliation(s)
| | - Asiye Uğraş Dikmen
- Department of Public Health, Gazi University Medical Faculty, Ankara, Turkey
| | - Cantürk Taşçı
- Department of Chest Diseases, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Deniz Doğan
- Department of Chest Diseases, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Yakup Arslan
- Department of Chest Diseases, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Nesrin Öcal
- Department of Chest Diseases, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Mustafa Taşar
- Department of Radiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Uğur Bozlar
- Department of Radiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Cumhur Artuk
- Department of Infectious Diseases and Clinical Microbiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Gülden Yılmaz
- Department of Infectious Diseases and Clinical Microbiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Zehra Karacaer
- Department of Infectious Diseases and Clinical Microbiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - İsmail Yaşar Avcı
- Department of Infectious Diseases and Clinical Microbiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Günay Tuncer Ertem
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Fatma Şebnem Erdinç
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Sami Kınıklı
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Şerife Altun Demircan
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Elif Ergün
- Department of Radiology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Pınar Nercis Koşar
- Department of Radiology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Ayşe Esra Karakoç
- Department of Medical Microbiology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Atila Gökçek
- Department of Radiology, University of Health Sciences Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Melike Aloğlu
- Department of Chest Diseases, University of Health Sciences Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Sevtap Gülgösteren
- Department of Chest Diseases, University of Health Sciences Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Şükran Atikcan
- Department of Chest Diseases, University of Health Sciences Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Şule Akçay
- Department of Chest Diseases, Baskent University Medical Faculty, Ankara, Turkey
| | - Çiğdem Erol
- Department of Infectious Diseases and Clinical Microbiology, Baskent University Medical Faculty, Ankara, Turkey
| | - Koray Hekimoğlu
- Department of Radiology, Baskent University Medical Faculty, Ankara, Turkey
| | - Mahi Nur Cerit
- Department of Radiology, Gazi University Medical Faculty, Ankara, Turkey
| | - Gonca Erbaş
- Department of Radiology, Gazi University Medical Faculty, Ankara, Turkey
| | - Hasan Selçuk Özger
- Department of Infectious Diseases and Clinical Microbiology, Gazi University Medical Faculty, Ankara, Turkey
| | - Gülendam Bozdayı
- Department of Medical Microbiology, Division of Medical Virology, Gazi University Medical Faculty, Ankara, Turkey
| | - Esin Şenol
- Department of Infectious Diseases and Clinical Microbiology, Gazi University Medical Faculty, Ankara, Turkey
| | | | - Aydın Yılmaz
- Department of Chest Diseases, University of Health Sciences Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
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Chhapola Shukla S. ACE2 expression in allergic airway disease may decrease the risk and severity of COVID-19. Eur Arch Otorhinolaryngol 2021; 278:2637-2640. [PMID: 33025046 PMCID: PMC7538174 DOI: 10.1007/s00405-020-06408-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/28/2020] [Indexed: 01/08/2023]
Abstract
The coronavirus disease (COVID-19) is caused by Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and presents with respiratory symptoms which can be life threatening in severe cases. At the start of the pandemic, allergy, asthma, and chronic obstructive pulmonary disease (COPD) were considered as risk factors for COVID-19 as they tend to exacerbate during respiratory viral infections. Recent literature has not shown that airway allergic diseases is a high-risk factor or that it increases the severity of COVID-19. This is due to a decrease in Angiotensin-converting enzyme 2 (ACE2) gene expression in the nose and bronchial cells of allergic airway diseases. Conventional asthma treatment includes inhaled corticosteroids (ICS), allergen immunotherapy (AIT), and biologics, and should be continued as they might reduce the risks of asthmatics for coronavirus infection by enhancing antiviral defence and alleviating inflammation.
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Metbulut AP, Mustafaoğlu Ö, Şen G, Kanık Yüksek S, Külhaş Çelik İ, Akça H, Dibek Mısırlıoğlu E. Evaluation of the Clinical and Laboratory Findings of Asthmatic Children with SARS-CoV-2 Infection. Int Arch Allergy Immunol 2021; 182:989-996. [PMID: 34167114 PMCID: PMC8339021 DOI: 10.1159/000517153] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 05/10/2021] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION There are a limited number of studies about the clinical findings of coronavirus infection in pediatric patients with asthma. We aimed to evaluate the clinical and laboratory characteristics of pediatric patients with asthma and healthy children without chronic disease who infected with SARS-CoV-2. METHODS This is a retrospective, case-control study comparing the asthma diagnosed and healthy children who were diagnosed as COVID-19 in our hospital between March 11 and November 10, 2020. RESULTS During the study period, 6,205 children were diagnosed with CO-VID-19 in our hospital. Only 54 (0.87%) patients had a diagnosis of asthma. The mean of the age was 10.5 years and 53.7% (n:29) of the patients with asthma were male. Cough, shortness of breath, emesis, and diarrhea were found to be significantly higher in asthma group than in the control group (respectively p = 0.002, 0.000, 0.002, 0.019, 0.015). Patients who were given SABA was significantly higher in asthma diagnosed patients (p = 0.000). Hospitalization was significantly higher in asthma group (p = 0.025), and the duration of hospitalization was significantly higher in control group (p = 0.034). There was no significant difference between the 2 groups in terms of requiring oxygen treatment and in laboratory findings between groups. CONCLUSION This study revealed that pediatric patients diagnosed with asthma were in a mild clinic. According to these findings, asthma may not affect the course of the COVID-19 in children.
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Affiliation(s)
- Azize Pınar Metbulut
- Division of Pediatric Allergy and Immunology, Ankara City Hospital, Ankara, Turkey
| | - Özlem Mustafaoğlu
- Division of Pediatric Infectious Disease, Ankara City Hospital, Ankara, Turkey
| | - Gülşah Şen
- Division of Pediatric Allergy and Immunology, Ankara City Hospital, Ankara, Turkey
| | - Saliha Kanık Yüksek
- Division of Pediatric Infectious Disease, Ankara City Hospital, Ankara, Turkey
| | - İlknur Külhaş Çelik
- Division of Pediatric Allergy and Immunology, Ankara City Hospital, Ankara, Turkey
| | - Halise Akça
- Division of Pediatric, Emergency Care Department, Ankara City Hospital, Ankara, Turkey
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Abstract
OBJECTIVES It is well established in international literature that respiratory viruses can trigger asthma exacerbations. However, not all viruses affect patients in the same manner and extent. The pandemic of the SARS CoV-2 virus has brought interest to study the association of this novel virus on patients with mild-moderate and severe asthma in terms of susceptibility, severity and treatment. DATA SOURCES – STUDY SELECTION We performed an extensive search of current literature in the databases PubMed, Scopus and Google Scholar for original articles. We decided to include all types of articles, except for case studies, published until the end of February 2021 focusing on the effects of COVID-19 on the respiratory system and the main treatment recommendations up to date for patients with bronchial asthma. RESULTS Until now there is no clear evidence that asthmatics have a higher risk of experiencing exacerbations when infected, nor higher mortality rates than the general population. Nevertheless, our knowledge on molecular pathways behind asthma phenotypes in the past decades is growing, and it underlines the need to predict the unique response each patient may have to infection from the novel coronavirus. It is not clear yet if certain sub-populations of asthmatics are at higher risk than others. CONCLUSION Despite the lack of evidence for higher susceptibility and/or mortality in relation to COVID-19, all asthmatic patients, whether treated with inhaled bronchodilators/corticosteroids or even biologics, should maintain their controller therapy without making any alterations.
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Affiliation(s)
- Agamemnon Bakakos
- School of Health Sciences, 1st University Department Of Respiratory Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Krompa
- School of Health Sciences, 1st University Department Of Respiratory Medicine, National and Kapodistrian University of Athens, Athens, Greece
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The Impact of Comorbidities on the Outcomes of Egyptian COVID-19 Patients: A Follow-Up Study. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2021; 2021:6662476. [PMID: 34239576 PMCID: PMC8214485 DOI: 10.1155/2021/6662476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 03/26/2021] [Accepted: 06/10/2021] [Indexed: 12/24/2022]
Abstract
Objectives This study evaluated the clinical manifestation of COVID-19 and adverse outcomes in patients with comorbidities (outcome: death). Methods A comparative follow-up investigation involving 148 confirmed cases of COVID-19 was performed for a month (between April and May 2020) at Qaha Hospital to describe the clinical characteristics and outcomes resulting from comorbidities. Participants were divided into two clusters based on the presence of comorbidities. Group I comprised cases with comorbidities, and Group II included subjects without comorbidity. Survival distributions were outlined for the group with comorbidities after the follow-up period. Results Fever (74.3%), headache (78.4%), cough (78.4%), sore throat (78.4%), fatigue (78.4%), and shortness of breath (86.5%) were the most prevalent symptoms observed in COVID-19 patients with comorbidities. Such patients also suffered from acute respiratory distress syndrome (37.8%) and pneumonia three times more than patients without comorbidities. The survival distributions were statistically significant (chi-square = 26.06, p ≤ 0.001). Conclusion Multiple comorbidities in COVID-19 patients are linked to severe clinical symptoms, disease complications, and critical disease progression. The presence of one or more comorbidities worsened the survival rate of patients.
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Nikoloski Z, Alqunaibet AM, Alfawaz RA, Almudarra SS, Herbst CH, El-Saharty S, Alsukait R, Algwizani A. Covid-19 and non-communicable diseases: evidence from a systematic literature review. BMC Public Health 2021; 21:1068. [PMID: 34090396 PMCID: PMC8178653 DOI: 10.1186/s12889-021-11116-w] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/21/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Since early 2020, the Covid-19 pandemic has engulfed the world. Amidst the growing number of infections and deaths, there has been an emphasis of patients with non-communicable diseases as they are particularly susceptible to the virus. The objective of this literature review is to systematize the available evidence on the link between non-communicable diseases and Covid-19. METHODS We have conducted a systematic review of the literature on Covid-19 and non-communicable diseases from December, 2019 until 15th of November, 2020. The search was done in PubMed and in doing so we used a variety of searching terms in order to isolate the final set of papers. At the end of the selection process, 45 papers were selected for inclusion in the literature review. RESULTS The results from the review indicate that patients with certain chronic illnesses such as diabetes, hypertension (and other cardiovascular diseases), chronic respiratory illnesses, chronic kidney and liver conditions are more likely to be affected by Covid-19. More importantly, once they do get infected by the virus, patients with chronic illnesses have a much higher likelihood of having worse clinical outcomes (developing a more severe form of the disease or dying) than an average patient. There are two hypothesized channels that explain this strong link between the chronic illnesses enumerated above and Covid 19: (i) increased ACE2 (angiotensin-converting enzyme 2) receptor expressions, which facilitates the entry of the virus into the host body; and (ii) hyperinflammatory response, referred to as "cytokine storm". Finally, the literature review does not find any evidence that diabetes or hypertension related medications exacerbate the overall Covid-19 condition in chronic illness patients. CONCLUSIONS Thus, the evidence points out to 'business as usual' disease management model, although with greater supervision. However, given the ongoing Covid-19 vulnerabilities among people with NCDs, prioritizing them for the vaccination process should also figure high on the agenda on health authorities.
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Affiliation(s)
| | | | | | | | - Christopher H Herbst
- Health, Nutrition and Population Global Practice, World Bank Group, Riyadh, Saudi Arabia
| | - Sameh El-Saharty
- Health, Nutrition and Population Global Practice, World Bank Group, Kuwait City, Kuwait
| | - Reem Alsukait
- Health, Nutrition and Population Global Practice, World Bank Group, Riyadh, Saudi Arabia
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Valverde-Monge M, Cañas JA, Barroso B, Betancor D, Ortega-Martin L, Gómez-López A, Rodríguez-Nieto MJ, Mahíllo-Fernández I, Sastre J, Del Pozo V. Eosinophils and Chronic Respiratory Diseases in Hospitalized COVID-19 Patients. Front Immunol 2021; 12:668074. [PMID: 34149705 PMCID: PMC8208034 DOI: 10.3389/fimmu.2021.668074] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/17/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Studies on the role of eosinophils in coronavirus disease 2019 (COVID-19) are scarce, though available findings suggest a possible association with disease severity. Our study analyzes the relationship between eosinophils and COVID-19, with a focus on disease severity and patients with underlying chronic respiratory diseases. METHODS We performed a retrospective analysis of 3018 subjects attended at two public hospitals in Madrid (Spain) with PCR-confirmed SARS-CoV-2 infection from January 31 to April 17, 2020. Patients with eosinophil counts less than 0.02×109/L were considered to have eosinopenia. Individuals with chronic respiratory diseases (n=384) were classified according to their particular underlying condition, i.e., asthma, chronic pulmonary obstructive disease, or obstructive sleep apnea. RESULTS Of the 3018 patients enrolled, 479 were excluded because of lack of information at the time of admission. Of 2539 subjects assessed, 1396 patients presented an eosinophil count performed on admission, revealing eosinopenia in 376 cases (26.93%). Eosinopenia on admission was associated with a higher risk of intensive care unit (ICU) or respiratory intensive care unit (RICU) admission (OR:2.21; 95%CI:1.42-3.45; p<0.001) but no increased risk of mortality (p>0.05). CONCLUSIONS Eosinopenia on admission conferred a higher risk of severe disease (requiring ICU/RICU care), but was not associated with increased mortality. In patients with chronic respiratory diseases who develop COVID-19, age seems to be the main risk factor for progression to severe disease or death.
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Affiliation(s)
| | - José A. Cañas
- Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Blanca Barroso
- Allergy Unit, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Diana Betancor
- Allergy Unit, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | - Alicia Gómez-López
- Allergy Unit, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - María Jesús Rodríguez-Nieto
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Pulmonology Unit, Hospital Universitario Fundación Jiménez Díaz and Hospital General de Villalba, Madrid, Spain
| | - Ignacio Mahíllo-Fernández
- Epidemiology and Biostatistics Unit, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain
| | - Joaquín Sastre
- Allergy Unit, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Victoria Del Pozo
- Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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Morais‐Almeida M, Barbosa MT, Sousa CS, Aguiar R, Bousquet J. Update on asthma prevalence in severe COVID-19 patients. Allergy 2021; 76:953-954. [PMID: 32639631 PMCID: PMC7361842 DOI: 10.1111/all.14482] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 06/18/2020] [Accepted: 06/21/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Mário Morais‐Almeida
- Allergy Centre CUF Descobertas Hospital Lisbon Portugal
- Portuguese Association of Asthmatics (APA) Porto Portugal
| | | | | | - Rita Aguiar
- Allergy Centre CUF Descobertas Hospital Lisbon Portugal
| | - Jean Bousquet
- Charité Universitätsmedizin Berlin Humboldt‐Universität zu Berlin Berlin Germany
- Comprehensive Allergy Center Department of Dermatology and Allergy Berlin Institute of Health Berlin Germany
- MACVIA‐France Montpellier France
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Eger K, Hashimoto S, Braunstahl GJ, Brinke AT, Patberg KW, Beukert A, Smeenk F, van der Sar-van der Brugge S, Weersink EJM, Bel EH. Poor outcome of SARS-CoV-2 infection in patients with severe asthma on biologic therapy. Respir Med 2021; 177:106287. [PMID: 33388603 PMCID: PMC7833566 DOI: 10.1016/j.rmed.2020.106287] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/04/2020] [Accepted: 12/09/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND It is unclear whether asthma and asthma medications increase or decrease the risk of severe COVID-19, and this is particularly true for patients with severe asthma receiving biologics. OBJECTIVES The aim of this study was to assess incidence and disease course of COVID-19 in patients with severe asthma on biologic therapy (omalizumab, mepolizumab, reslizumab, benralizumab, dupilumab), as compared with COVID-19 data from the general Dutch population. METHODS COVID-19 cases were identified through a prospective ongoing survey between March 17 and April 30, 2020 among all severe asthma specialists from 15 hospitals of the Dutch Severe Asthma Registry RAPSODI. From these cases, data was collected on patient characteristics, including co-morbidities, COVID-19 disease progression and asthma exacerbations. Findings were then compared with COVID-19 data from the general Dutch population. RESULTS Of 634 severe asthma patients who received biologic therapy in RAPSODI, 9 (1.4%) were diagnosed with COVID-19. Seven patients (1.1%) required hospitalization for oxygen therapy, of which 5 were admitted to the intensive care for intubation and mechanical ventilation. One patient died (0.16%). All intubated patients had ≥1 co-morbidities. Odds (95%CI) for COVID-19 related hospitalization and intubations were 14 (6.6-29.5) and 41 (16.9-98.5) times higher, respectively, compared to the Dutch population. One patient presented with an asthma exacerbation. CONCLUSION Patients with severe asthma using biologic therapy showed to have a more severe course of COVID-19 compared to the general population. This may be due to co-morbidities, the severity of asthmatic airway inflammation, the use of biologics, or a combination of these.
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Affiliation(s)
- Katrien Eger
- Dept. Respiratory Medicine, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands.
| | - Simone Hashimoto
- Dept. Respiratory Medicine, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands.
| | - Gert Jan Braunstahl
- Department of Pulmonology, Franciscus Gasthuis & Vlietland, Kleiweg 500, 3045, PM, Rotterdam, the Netherlands.
| | - Anneke Ten Brinke
- Department of Pulmonology, Medical Centre Leeuwarden, Henri Dunantweg 2, 8934, AD, Leeuwarden, the Netherlands.
| | - Kornelis W Patberg
- Department of Pulmonology, Isala Klinieken, Dokter van Heesweg 2, 8025, AB, Zwolle, the Netherlands.
| | - Annelies Beukert
- Department of Pulmonology, Martini Ziekenhuis, Van Swietenplein 1, 9728, NT, Groningen, the Netherlands.
| | - Frank Smeenk
- Department of Pulmonogy Catharina Ziekenhuis, Michelangelolaan 2, 5623, EJ, Eindhoven, the Netherlands.
| | | | - Els J M Weersink
- Dept. Respiratory Medicine, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands.
| | - Elisabeth H Bel
- Dept. Respiratory Medicine, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands.
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Leso V, Fontana L, Iavicoli I. Susceptibility to Coronavirus (COVID-19) in Occupational Settings: The Complex Interplay between Individual and Workplace Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1030. [PMID: 33503829 PMCID: PMC7908348 DOI: 10.3390/ijerph18031030] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 01/08/2023]
Abstract
In the current coronavirus (COVID-19) pandemic, the definition of risk factors for susceptibility to adverse outcomes seems essential to support public and occupational health policies. Some specific issues need to be addressed to understand vulnerability in occupational settings. Among these, individual factors, e.g., age, sex, and preexisting comorbidities (hypertension, cardiovascular diseases, diabetes, obesity, cancer), that can predispose individuals to more severe outcomes and post-COVID-19 symptoms that may represent conditions of acquired susceptibility, possibly impacting the return to-and fitness for-work. Additionally, the risk of contracting COVID-19 through work should be addressed, considering the probability of being in contact with infected people, physical proximity to others, and social aggregation during work. Occupational health settings may represent appropriate scenarios for the early identification of vulnerable subjects, with the final aim to guide risk assessment and management procedures. These should include the systematic surveillance of work-related risk factors, collective preventive policies, stringent actions for specific groups of workers, decisions on occupational placement of employees, and health promotion activities. Concerted actions of general practitioners, hospital specialists, occupational physicians, and all the stakeholders involved in the occupational health and safety management should be focused on planning suitable preventive measures for susceptible subjects.
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Affiliation(s)
| | | | - Ivo Iavicoli
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (V.L.); (L.F.)
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Liuzzo Scorpo M, Ferrante G, La Grutta S. An Overview of Asthma and COVID-19: Protective Factors Against SARS-COV-2 in Pediatric Patients. Front Pediatr 2021; 9:661206. [PMID: 33996694 PMCID: PMC8116485 DOI: 10.3389/fped.2021.661206] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 03/31/2021] [Indexed: 12/14/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a pandemic infectious disease caused by severe acute respiratory syndrome coronavirus SARS-COV-2. Aberrant innate immunity response and cytokine storm are responsible for the syndrome. Apparently, in asthmatic patients, the inadequate antiviral immune response and the tendency for asthma exacerbation evoked by common respiratory viruses could explain increased susceptibility to SARS-COV-2 infection. However, asthma has not been suggested to be a risk factor in COVID-19 patients. Therefore, in asthmatic patients some potential protective mechanisms against SARS-COV-2 have been hypothesized, like type 2 immune response, number of eosinophils, overproduction of mucus, and asthma treatment, along with behavioral factors not strictly related to asthma, such as social distancing, hygiene measures and wearing facemasks, that contribute to reduce the individual susceptibility to SARS-COV-2 infection. In this mini-review, we will describe the current literature regarding potential protective factors against COVID-19 in children with asthma based on the evidence available so far.
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Affiliation(s)
- Maria Liuzzo Scorpo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Giuliana Ferrante
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Stefania La Grutta
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
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Alyammahi SK, Abdin SM, Alhamad DW, Elgendy SM, Altell AT, Omar HA. The dynamic association between COVID-19 and chronic disorders: An updated insight into prevalence, mechanisms and therapeutic modalities. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2021; 87:104647. [PMID: 33264669 PMCID: PMC7700729 DOI: 10.1016/j.meegid.2020.104647] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/27/2020] [Accepted: 11/26/2020] [Indexed: 02/06/2023]
Abstract
The devastating pandemic of coronavirus disease 2019 (COVID-19) has caused thousands of deaths and left millions of restless patients suffering from its complications. Increasing data indicate that the disease presents in a severe form in patients with pre-existing chronic conditions like cardiovascular diseases, diabetes, respiratory system diseases, and renal diseases. This denotes that these patients are more susceptible to COVID-19 and have higher mortality rates compared to patients with no comorbid conditions. Several factors can explain the heightened susceptibility and fatal presentation of COVID-19 in these patients, for example, the enhanced expression of the angiotensin-converting enzyme-2 (ACE2) in specific organs, cytokine storm, and drug interactions contribute to the increased morbidity and mortality. Adding to the findings that individuals with pre-existing conditions may be more susceptible to COVID-19, it has also been shown that COVID-19 can induce chronic diseases in previously healthy patients. Therefore, understanding the interlinked relationship between COVID-19 and chronic diseases helps in optimizing the management of susceptible patients. This review comprehensively described the molecular mechanisms that contribute to worse COVID-19 prognosis in patients with pre-existing comorbidities such as diabetes, cardiovascular diseases, respiratory diseases, gastrointestinal and renal diseases, blood disorders, autoimmune diseases, and finally, obesity. It also focused on how COVID-19 could, in some cases, lead to chronic conditions as a result of long-term multi-organ damage. Lastly, this work carefully discussed the tailored management plans for each specific patient population, aiming to achieve the best therapeutic outcome with minimum complications.
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Affiliation(s)
- Shatha K Alyammahi
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates; College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Shifaa M Abdin
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates; College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Dima W Alhamad
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates; College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Sara M Elgendy
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates; College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Amani T Altell
- School of Public Health and Health Sciences, University of Massachusetts, Amherst 01002, United States of America
| | - Hany A Omar
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates; College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates.
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48
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Chen C. A Glimpse of the First Eight Months of the COVID-19 Literature on Microsoft Academic Graph: Themes, Citation Contexts, and Uncertainties. Front Res Metr Anal 2020; 5:607286. [PMID: 33870064 PMCID: PMC8025977 DOI: 10.3389/frma.2020.607286] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/25/2020] [Indexed: 12/15/2022] Open
Abstract
As scientists worldwide search for answers to the overwhelmingly unknown behind the deadly pandemic, the literature concerning COVID-19 has been growing exponentially. Keeping abreast of the body of literature at such a rapidly advancing pace poses significant challenges not only to active researchers but also to society as a whole. Although numerous data resources have been made openly available, the analytic and synthetic process that is essential in effectively navigating through the vast amount of information with heightened levels of uncertainty remains a significant bottleneck. We introduce a generic method that facilitates the data collection and sense-making process when dealing with a rapidly growing landscape of a research domain such as COVID-19 at multiple levels of granularity. The method integrates the analysis of structural and temporal patterns in scholarly publications with the delineation of thematic concentrations and the types of uncertainties that may offer additional insights into the complexity of the unknown. We demonstrate the application of the method in a study of the COVID-19 literature.
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Affiliation(s)
- Chaomei Chen
- College of Computing and Informatics, Drexel University, Philadelphia, PA, United States
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Escosteguy CC, Eleuterio TDA, Pereira AGL, Marques MRVE, Brandão AD, Batista JPM. COVID-19: a cross-sectional study of suspected cases admitted to a federal hospital in Rio de Janeiro, Brazil, and factors associated with hospital death. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2020; 30:e2020750. [PMID: 33331600 DOI: 10.1590/s1679-49742021000100023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 10/18/2020] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To describe the clinical and epidemiological profile of suspected COVID-19 cases admitted to a federal hospital in Rio de Janeiro, RJ, Brazil, and to identify factors associated with death. METHODS This was a cross-sectional study using local epidemiological surveillance data as at epidemiological week 27 of 2020 and logistic regression. RESULTS 376 hospitalized suspected COVID-19 cases were included; 52.9% were female, 57.4% were 50 years old or over and 80.1% had comorbidities. 195 (51.9%) COVID-19 cases were confirmed and their lethality was higher (37.9%) than among discarded cases (24.2%). In the adjusted analysis, death among confirmed cases was associated with being in the 50-69 age group (OR=11.65 - 95%CI 1.69;80.33), being aged 70 or over (OR=8.43 - 95%CI 1.22;58.14), presence of neoplasms (OR=4.34 - 95%CI 1.28;14.76) and use of invasive ventilatory support (OR=70.20 - 95%CI 19.09;258.19). CONCLUSION High prevalence of comorbidities and lethality was found; the main factors associated with death were being older, neoplasms and invasive ventilatory support.
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Affiliation(s)
| | | | | | | | - Amanda Dantas Brandão
- Universidade Federal do Rio de Janeiro, Instituto de Estudos em Saúde Coletiva, Rio de Janeiro, RJ, Brasil
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Yildirim M, Serban N, Shih J, Keskinocak P. Reflecting on prediction strategies for epidemics: Preparedness and public health response. Ann Allergy Asthma Immunol 2020; 126:338-349. [PMID: 33307158 PMCID: PMC7836303 DOI: 10.1016/j.anai.2020.11.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/18/2020] [Accepted: 11/24/2020] [Indexed: 02/07/2023]
Abstract
Objective To provide an overview of the literature on respiratory infectious disease epidemic prediction, preparedness, and response (including pharmaceutical and nonpharmaceutical interventions) and their impact on public health, with a focus on respiratory conditions such as asthma. Data Sources Published literature obtained through PubMed database searches. Study Selections Studies relevant to infectious epidemics, asthma, modeling approaches, health care access, and data analytics related to intervention strategies. Results Prediction, prevention, and response strategies for infectious disease epidemics use extensive data sources and analytics, addressing many areas including testing and early diagnosis, identifying populations at risk of severe outcomes such as hospitalizations or deaths, monitoring and understanding transmission and spread patterns by age group, social interactions geographically and over time, evaluating the effectiveness of pharmaceutical and nonpharmaceutical interventions, and understanding prioritization of and access to treatment or preventive measures (eg, vaccination, masks), given limited resources and system constraints. Conclusion Previous epidemics and pandemics have revealed the importance of effective preparedness and response. Further research and implementation need to be performed to emphasize timely and actionable strategies, including for populations with particular health conditions (eg, chronic respiratory diseases) at risk for severe outcomes.
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Affiliation(s)
- Melike Yildirim
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia; Center for Health and Humanitarian Systems, Georgia Institute of Technology, Atlanta, Georgia
| | - Nicoleta Serban
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia.
| | - Jennifer Shih
- Department of Pediatrics, Emory University School of Medcine, Atlanta, Georgia; Department of Medicine, Emory University School of Medcine, Atlanta, Georgia
| | - Pinar Keskinocak
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia; Center for Health and Humanitarian Systems, Georgia Institute of Technology, Atlanta, Georgia; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
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