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European Respiratory Journal 08/03/2020 11:35
As an emerging infectious disease, COVID-19 pneumonia which was caused by a novel coronavirus (SARS-CoV-2) has resulted in a severe global public health emergency. According to the WHO COVID-19 epidemic interactive dashboard, as of 19 June 2020, there have been 8 385 440 confirmed cases all over the world, including 450 686 deaths, reported to the WHO. Under such urgent conditions, it is of great clinical significance to distinguish patients with poor clinical outcome (such as severe, critical or death) from so large number of patients with COVID-19 using regular parameters (such as demographic data, past health history, and common laboratory examination results). Du R. H. and his colleagues have performed a single center prospective cohort.
European Respiratory Journal 08/03/2020 11:35
Rationale. Given the vast number of CFTR mutations, biomarkers predicting benefit from CFTR modulator therapies are needed for subjects with cystic fibrosis (CF). Objectives. To study CFTR function in organoids of subjects with common and rare CFTR mutations and evaluate correlations between CFTR function and clinical data. Methods. Intestinal organoids were grown from rectal biopsies in a cohort of 97 subjects with CF.
European Respiratory Journal 08/03/2020 11:35
That the above two quotes are arguably truer now than at the time they were written is perhaps surprising. That this truth resonates equally for the authors who have experienced the two most recent respiratory infection pandemics (HINI(09) Influenza and Covid19) and the ongoing bias towards relatively small, uncontrolled treatment trials from very different perspectives – across, between and within hemispheres, countries, health-care systems, socio-economic-political cultures, populations and individuals [1–6], is even more so .
European Respiratory Journal 08/03/2020 11:35
The coronavirus disease (COVID)-19 pandemic has elicited a swift response by the scientific community to elucidate the pathogenesis of severe acute respiratory syndrome coronavirus (SARS-CoV)-2-induced lung injury and develop effective therapeutics. Clinical data indicate that severe COVID-19 most commonly manifests as viral pneumonia-induced acute respiratory distress syndrome (ARDS), a clinical entity mechanistically understood best in the context of influenza A virus-induced pneumonia. Similar to influenza, advanced age has emerged as the leading host risk factor for developing severe COVID-19. In this review we connect the current understanding of the SARS-CoV-2 replication cycle and host response to the clinical presentation of COVID-1.
European Respiratory Journal 08/03/2020 11:35
Sleep-related breathing disorders include obstructive apnoea, central apnoea and sleep-related hypoventilation. These nocturnal events have the potential to increase pulmonary arterial pressure during sleep but also in the waking state. "Pure" obstructive sleep apnoea syndrome is responsible for a small increase in pulmonary arterial pressure whose clinical impact has not been demonstrated. By contrast, in obesity hypoventilation syndrome or overlap syndrome (association of COPD with obstructive sleep apnoea), nocturnal respiratory events contribute to the development of pulmonary hypertension, which is often severe. In the latter circumstances, treatment of sleep-related breathing disorders is essential in order to improve pulmonary haemod.
European Respiratory Journal 08/03/2020 11:35
Patients with COVID-19 pneumonia can develop hypoxemic acute respiratory failure (hARF) with the need for positive end-expiratory pressure (PEEP). The administration of a continuous positive airway pressure (CPAP) through a helmet improves oxygenation and avoids intubation [1, 2]. A European consensus document suggests that helmet CPAP should be the first therapeutic choice for hARF caused by COVID-19 pneumonia, mainly for minimising aerosol generation [3–5]. However, recommendations are based on experts' opinion and consider only evidence obtained in critically ill COVID-19 patients [3]. The Surviving Sepsis Campaign does not recommend the administration of CPAP for the initial management of severe COVID-19 [6].
European Respiratory Journal 07/30/2020 10:01
Background. There is insufficient information about risk factors for COVID-19 diagnosis and adverse outcomes from low and middle-income countries (LMICs). Objectives. We estimated the association between patients’ characteristics and COVID-19 diagnosis, hospitalisation and adverse outcome in Mexico. Methods. This retrospective case series used a publicly available nation-level dataset released on May 31, 2020 by the Mexican Ministry of Health, with patients classified as suspected cases of viral respiratory disease.
European Respiratory Journal 07/30/2020 10:01
Coronaviruses have been known to cause respiratory infections in humans and intestinal infections in other mammals. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which causes COVID-19, is the 7th virus of the Coronaviridae family that is known to infect humans. Until 2002, four Coronaviruses infecting humans were described (HCoV- NL63, HCoV-229E, HCoV- OC43 and HKU1). These viruses caused only mild respiratory diseases in immunocompetent hosts. Since 2002, three highly pathogenic viruses from this family have been identified. SARS-CoV (also referred to as SARS-CoV-1) is an enveloped, positive-sense, single-stranded RNA virus which infects the epithelial cells within the lungs. The virus enters the host cell by binding to ang.
European Respiratory Journal 07/30/2020 10:01
Background. Early and accurate diagnosis of interstitial lung diseases (ILDs) remains a major challenge. Better non-invasive diagnostic tools are highly needed. We aimed to assess the accuracy of exhaled breath analysis using eNose technology to discriminate between ILD patients and healthy controls, and to distinguish ILD subgroups. Methods. In this cross-sectional study, exhaled breath of consecutive ILD patients and healthy controls (HCs) was analysed using eNose technology (SpiroNose). Statistical analyses were done using Partial Least Square Discriminant Analysis (PLS-DA) and Receiver Operating Characteristic (ROC) analysis. An independent training and validation set (2:1) was used in larger subgroups. Results. A total of 322 ILD patients.
European Respiratory Journal 07/30/2020 10:01
Purpose. HIV infection is an exclusion criterion in lung cancer trials. This multicenter phase II trial aimed to assess feasibility, efficacy and safety of first-line carboplatin plus pemetrexed (CaP) followed by pemetrexed ℗ maintenance in people living with HIV (PLHIV) with advanced non-squamous non-small cell lung cancer (NS-NSCLC). Methods. Four cycles of CaP were followed by P-maintenance therapy in patients with Eastern Cooperative Oncology Group performance status (PS) ≤2. The primary objective was a disease control rate (DCR) ≥30% after 12 weeks. Results. Of the 61 PLHIV enrolled 49 (80%) had a PS 0–1, 19 (31%) brain metastases. Median CD4 lymphocyte count was 418 cells·µL –1 (range: 18–1230), median CD4 lymphocyte nadir 169.5 cells·µL.
European Respiratory Journal 07/30/2020 10:01
The EarlyCDT-Lung test is a high specificity blood-based autoantibody biomarker that could contribute to predicting lung cancer risk. Here we report on the results of a phase IV biomarker evaluation of whether using the EarlyCDT-Lung test and any subsequent CT scanning to identify those at high risk of lung cancer reduces the incidence of patients with stage III/IV/Unspecified lung cancer at diagnosis, compared with the standard clinical practice at the time the study began. ECLS was a randomised controlled trial of 12 208 participants at risk of developing lung cancer in Scotland. The intervention arm received the EarlyCDT-Lung test and, if test positive, low-dose CT scanning six-monthly for up to 2 years. EarlyCDT-Lung test negative and c.
European Respiratory Journal 07/30/2020 10:01
We are interested in an article published in the journal recently, entitled "The potential impact of COVID-19-related disruption on tuberculosis (TB) burden". The study used a mathematical model to estimate the relative impact of reductions in social contacts and health services on TB burden due to the COVID-19 epidemic. There included data and projections on China, being one of 22 high TB burden countries for both TB and multidrug resistant TB cases. COVID-19, which has spread rapidly and enveloped most of the world, is a unique global public health crisis for the century. By the end of January 2020, The World Health Organization declared COVID-19 outbreak a global health emergency and called for moves to stop the transmission of this viru.
European Respiratory Journal 07/30/2020 10:01
Background. Asthma is a heterogeneous and complex disease, and the description of asthma phenotypes based on extrapulmonary treatable traits has not been previously reported. Objective. to identify and characterise clusters based on clinical, functional, anthropometrical, and psychological characteristics in participants with moderate-to-severe asthma. Methods. This is a cross-sectional multicentre study involving centres from Brazil and Australia.
European Respiratory Journal 07/30/2020 10:01
Large-conductance, Ca 2+ -activated, voltage-dependent K + (BK) channel function is critical for adequate airway hydration and mucociliary function. In airway epithelia, BK function is regulated by its subunit leucine-rich repeat-containing protein 26 (LRRC26). Since patients with cystic fibrosis (CF)-related diabetes mellitus (CFRD) have worse lung function outcomes, this study determined the effects of hyperglycaemia on BK function in CF bronchial epithelial (CFBE) cells in vitro and evaluated the correlation between glycaemic excursions and mRNA expression of LRRC26 in the upper airways of CF and CFRD patients. CFBE cells were re-differentiated at the air-liquid interface (ALI) in media containing either 5.5 mM or 12.5 mM glucose. BK act.
European Respiratory Journal 07/30/2020 10:01
Cystic fibrosis transmembrane conductance regulator (CFTR) modulators are the first approved drugs targeting underlying epithelial ion/fluid transport defects in patients with cystic fibrosis (CF). Current CFTR modulators restore mutant CFTR activity to up to ~50% of normal CFTR Cl – channel function, translating into improvements in percentage predicted FEV 1 and other clinical outcomes. In addition, reductions in airway bacterial colonisation are observed; however, patients fail to eradicate bacteria over time and still experience pulmonary exacerbations, and long-term safety of CFTR modulator therapy remains unknown. Currently approved CFTR modulators are predicted to be effective for up to 90% of patients. A mutation-agnostic approach c.
European Respiratory Journal 07/30/2020 10:01
Background. Viral respiratory infections are the main causes of asthma exacerbation. The susceptibility of asthmatics to develop an exacerbation when they present with severe pneumonia due to SARS-CoV-2 infection is unknown. The objective of this study was to investigate the characteristics and outcomes of asthmatic patients with COVID-19 pneumonia who required hospitalisation during the spring 2020 outbreak in Paris, France. Methods. A prospective cohort follow-up was carried out from March 15 to April 15, 2020 in Bicêtre Hospital, University Paris-Saclay, France. All hospitalised patients with a SARS-CoV-2 infection who reported a history of asthma were included. Results. Among 768 hospitalised patients, 37 (4.8%) reported a history of asthm.
European Respiratory Journal 07/30/2020 10:01
Whole genome sequencing (WGS) can be used for molecular typing and characterisation of Mycobacterium tuberculosis complex (MTBC) strains. We evaluated the systematic use of a WGS-based approach for MTBC surveillance involving all European Union/European Economic Area (EU/EEA) countries and highlight the challenges and lessons learned to be considered for the future development of a WGS-based surveillance system. WGS and epidemiological data of patients with rifampicin (RR) and multi-drug resistant (MDR)-tuberculosis (TB) were collected from EU/EEA countries between January 2017 and December 2019. WGS-based genetic relatedness analysis was performed using a standardised approach including both core genome multilocus sequence typing (cgMLST),

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