Pulmonology最新文献

{"title":"Beyond pulmonary rehabilitation: can the PICk UP programme fill the gap? A randomised trial in COPD.","authors":"P Rebelo, D Brooks, J Cravo, M A Mendes, A C Oliveira, A S Rijo, M J Moura, A Marques","doi":"10.1016/j.pulmoe.2024.04.001","DOIUrl":"https://doi.org/10.1016/j.pulmoe.2024.04.001","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Pulmonary rehabilitation (PR) is a fundamental intervention to manage COPD, however, maintaining its benefits is challenging. Engaging in physical activity might help to prolong PR benefits. This study assessed the efficacy and effectiveness of a personalised community-based physical activity programme to sustain physical activity and other health-related PR benefits, in people with COPD.</p><p><strong>Materials and methods: </strong>This was a multicentre, assessor blinded, randomised controlled trial. Following 12-weeks of PR, people with COPD were assigned to a six-months personalised community-based physical activity programme (experimental group), or to standard care (control group). Physical activity was assessed via: time spent in moderate to vigorous physical activities per day (primary outcome measure), steps/day and the brief physical activity assessment tool. Secondary outcomes included sedentary behaviour, functional status, peripheral muscle strength, balance, symptoms, emotional state, health-related quality of life, exacerbations and healthcare utilization. Assessments were performed immediately post-PR and after three- and six-months. Efficacy and effectiveness were evaluated using intention-to-treat and per-protocol analysis with linear mixed models.</p><p><strong>Results: </strong>Sixty-one participants (experimental group: n = 32; control group: n = 29), with balanced baseline characteristics between groups (69.6 ± 8.5 years old, 84 % male, FEV₁ 57.1 ± 16.7 %predicted) were included. Changes in all physical activity outcomes and in one-minute sit-to-stand were significantly different (P < 0.05) between groups at the six-month follow-up. In the remaining outcomes there were no differences between groups.</p><p><strong>Conclusions: </strong>The community-based physical activity programme resulted in better physical activity levels and sit-to-stand performance, six-months after completing PR, in COPD. No additional benefits were observed for other secondary outcomes.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":""},"PeriodicalIF":11.7,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140908898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Issue 3-The occupational burden of respiratory diseases, an update.","authors":"N Murgia, M Akgun, P D Blanc, J T Costa, S Moitra, X Muñoz, K Toren, A J Ferreira","doi":"10.1016/j.pulmoe.2024.03.004","DOIUrl":"https://doi.org/10.1016/j.pulmoe.2024.03.004","url":null,"abstract":"<p><strong>Introduction and aims: </strong>Workplace exposures are widely known to cause specific occupational diseases such as silicosis and asbestosis, but they also can contribute substantially to causation of common respiratory diseases. In 2019, the American Thoracic Society (ATS) and the European Respiratory Society (ERS) published a joint statement on the occupational burden of respiratory diseases. Our aim on this narrative review is to summarise the most recent evidence published after the ATS/ERS statement as well as to provide information on traditional occupational lung diseases that can be useful for clinicians and researchers.</p><p><strong>Results: </strong>Newer publications confirm the findings of the ATS/ERS statement on the role of workplace exposure in contributing to the aetiology of the respiratory diseases considered in this review (asthma, COPD, chronic bronchitis, idiopathic pulmonary fibrosis, hypersensitivity pneumonitis, infectious pneumonia). Except for COPD, chronic bronchitis and infectious pneumonia, the number of publications in the last 5 years for the other diseases is limited. For traditional occupational lung diseases such as silicosis and asbestosis, there are old as well as novel sources of exposure and their burden continues to be relevant, especially in developing countries.</p><p><strong>Conclusions: </strong>Occupational exposure remains an important risk factor for airways and interstitial lung diseases, causing occupational lung diseases and contributing substantially in the aetiology of common respiratory diseases. This information is critical for public health professionals formulating effective preventive strategies but also for clinicians in patient care. Effective action requires shared knowledge among clinicians, researchers, public health professionals, and policy makers.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":""},"PeriodicalIF":11.7,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperoxemia in invasively ventilated COVID–19 patients–Insights from the PRoVENT–COVID study","authors":"A.M. Tsonas ,&nbsp;D.M. van Meenen ,&nbsp;M. Botta ,&nbsp;G.S. Shrestha ,&nbsp;O. Roca ,&nbsp;F. Paulus ,&nbsp;A.S. Neto ,&nbsp;M.J. Schultz ,&nbsp;PRoVENT–COVID Collaborative Group","doi":"10.1016/j.pulmoe.2022.09.003","DOIUrl":"10.1016/j.pulmoe.2022.09.003","url":null,"abstract":"<div><h3>Objective</h3><p>We determined the prevalences of hyperoxemia and excessive oxygen use, and the epidemiology, ventilation characteristics and outcomes associated with hyperoxemia in invasively ventilated patients with coronavirus disease 2019 (COVID–19).</p></div><div><h3>Methods</h3><p>Post hoc analysis of a national, multicentre, observational study in 22 ICUs. Patients were classified in the first two days of invasive ventilation as ‘hyperoxemic’ or ‘normoxemic’. The co–primary endpoints were prevalence of hyperoxemia (PaO₂ &gt; 90 mmHg) and prevalence of excessive oxygen use (FiO₂ ≥ 60% while PaO₂ &gt; 90 mmHg or SpO₂ &gt; 92%). Secondary endpoints included ventilator settings and ventilation parameters, duration of ventilation, length of stay (LOS) in ICU and hospital, and mortality in ICU, hospital, and at day 28 and 90. We used propensity matching to control for observed confounding factors that may influence endpoints.</p></div><div><h3>Results</h3><p>Of 851 COVID–19 patients, 225 (26.4%) were classified as hyperoxemic. Excessive oxygen use occurred in 385 (45.2%) patients. Acute respiratory distress syndrome (ARDS) severity was lowest in hyperoxemic patients. Hyperoxemic patients were ventilated with higher positive end–expiratory pressure (PEEP), while rescue therapies for hypoxemia were applied more often in normoxemic patients. Neither in the unmatched nor in the matched analysis were there differences between hyperoxemic and normoxemic patients with regard to any of the clinical outcomes.</p></div><div><h3>Conclusion</h3><p>In this cohort of invasively ventilated COVID–19 patients, hyperoxemia occurred often and so did excessive oxygen use. The main differences between hyperoxemic and normoxemic patients were ARDS severity and use of PEEP. Clinical outcomes were not different between hyperoxemic and normoxemic patients.</p></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 3","pages":"Pages 272-281"},"PeriodicalIF":11.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9550012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synonymous mutations in TLR2 and TLR9 genes decrease COPD susceptibility in the Chinese Han population","authors":"X. Ding ,&nbsp;Q. Lin ,&nbsp;J. Zhao ,&nbsp;Y. Fu ,&nbsp;Y. Zheng ,&nbsp;R. Mo ,&nbsp;L. Zhang ,&nbsp;B. Zhang ,&nbsp;J. Chen ,&nbsp;T. Xie ,&nbsp;H. Wu ,&nbsp;Y. Ding","doi":"10.1016/j.pulmoe.2022.09.010","DOIUrl":"10.1016/j.pulmoe.2022.09.010","url":null,"abstract":"<div><h3>Introduction</h3><p>Previous studies have found associations between polymorphisms in some candidate genes and chronic obstructive pulmonary disease (COPD) risk. However, the association between <em>TLR2</em> and <em>TLR9</em> polymorphisms and COPD risk remains uncertain.</p></div><div><h3>Methods</h3><p>Four variants (rs352140, rs3804099, rs3804100, and rs5743705) of the <em>TLR2</em> and <em>TLR9</em> genes in 540 COPD patients and 507 healthy controls were genotyped using the Agena MassARRAY system. Odds ratio (OR) and 95% confidence interval (CI) were calculated to assess the association of <em>TLR2</em> and <em>TLR9</em> polymorphisms with COPD risk by logistic regression analysis.</p></div><div><h3>Results</h3><p><em>TLR9</em>-rs352140, <em>TLR2</em>-rs3804100, and <em>TLR2</em>-rs5743705 were related to a lower risk of COPD among Chinese people and the significance still existed after Bonferroni correction. Additionally, rs3804099, rs3804100, and rs352140 were found to be associated with COPD development in different subgroups (males, age ≤ 68 years, smokers, BMI &lt; 24 kg/m², and acute exacerbation).</p></div><div><h3>Conclusions</h3><p>Our findings indicated that <em>TLR9</em> and <em>TLR2</em> polymorphisms had protective effects on the development of COPD among Chinese people.</p></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 3","pages":"Pages 230-238"},"PeriodicalIF":11.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2531043722002203/pdfft?md5=7a0bb046ab2fb8c35fb382504f975f40&pid=1-s2.0-S2531043722002203-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10360427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infections in lung transplanted patients: A review","authors":"M. Dettori ,&nbsp;N. Riccardi ,&nbsp;D. Canetti ,&nbsp;R.M. Antonello ,&nbsp;A.F. Piana ,&nbsp;A. Palmieri ,&nbsp;P. Castiglia ,&nbsp;A.A. Azara ,&nbsp;M.D. Masia ,&nbsp;A. Porcu ,&nbsp;G.C. Ginesu ,&nbsp;M.L. Cossu ,&nbsp;M. Conti ,&nbsp;P. Pirina ,&nbsp;A. Fois ,&nbsp;I. Maida ,&nbsp;G. Madeddu ,&nbsp;S. Babudieri ,&nbsp;L. Saderi ,&nbsp;G. Sotgiu","doi":"10.1016/j.pulmoe.2022.04.010","DOIUrl":"10.1016/j.pulmoe.2022.04.010","url":null,"abstract":"<div><p>Lung transplantation can improve the survival of patients with severe chronic pulmonary disorders. However, the short- and long-term risk of infections can increase morbidity and mortality rates.</p><p>A non-systematic review was performed to provide the most updated information on pathogen, host, and environment-related factors associated with the occurrence of bacterial, fungal, and viral infections as well as the most appropriate therapeutic options.</p><p>Bacterial infections account for about 50% of all infectious diseases in lung transplanted patients, while viruses represent the second cause of infection accounting for one third of all infections.</p><p>Almost 10% of patients develop invasive fungal infections during the first year after lung transplant. Pre-transplantation comorbidities, disruption of physical barriers during the surgery, and exposure to nosocomial pathogens during the hospital stay are directly associated with the occurrence of life-threatening infections.</p><p>Empiric antimicrobial treatment after the assessment of individual risk factors, local epidemiology of drug-resistant pathogens and possible drug-drug interactions can improve the clinical outcomes.</p></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 3","pages":"Pages 287-304"},"PeriodicalIF":11.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2531043722001180/pdfft?md5=3e964f561e772a66bc30323b785dbdee&pid=1-s2.0-S2531043722001180-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86194654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A contribution towards a world without tobacco – The TabacoPed study","authors":"A. Gama da Silva ,&nbsp;C. Constant ,&nbsp;S. Madeira ,&nbsp;A.R. Sousa ,&nbsp;T. Bandeira","doi":"10.1016/j.pulmoe.2023.08.004","DOIUrl":"10.1016/j.pulmoe.2023.08.004","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 3","pages":"Pages 307-309"},"PeriodicalIF":11.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2531043723001575/pdfft?md5=d6f4dc98df146a1c845a9201c6421aea&pid=1-s2.0-S2531043723001575-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41165352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of pulmonary hypertension in COPD patients living at high altitude","authors":"C. Aguirre-Franco ,&nbsp;CA. Torres-Duque ,&nbsp;G. Salazar ,&nbsp;A. Casas ,&nbsp;C. Jaramillo ,&nbsp;M. Gonzalez-Garcia","doi":"10.1016/j.pulmoe.2021.12.006","DOIUrl":"10.1016/j.pulmoe.2021.12.006","url":null,"abstract":"<div><h3>Background</h3><p>Pulmonary hypertension (PH) is associated with poor prognosis for patients with chronic obstructive pulmonary disease (COPD). Most of the knowledge about PH in COPD has been generated at sea level, with limited information associated with high altitude (HA).</p></div><div><h3>Objectives</h3><p>To assess the prevalence and severity of PH in COPD patients living in a HA city (2,640 m).</p></div><div><h3>Methods</h3><p>Cross-sectional study in COPD patients with forced expiratory volume in the first second / forced vital capacity ratio (FEV₁/FVC) post-bronchodilator &lt;0,7. Transthoracic echocardiography (TTE), spirometry, carbon monoxide diffusing capacity, and arterial blood gasses tests were performed. Patients were classified according to the severity of airflow limitation. PH was defined by TTE as an estimated systolic pulmonary artery pressure (sPAP) &gt; 36 mmHg or indirect PH signs; severe PH as sPAP &gt; 60 mmHg; and disproportionate PH as an sPAP &gt; 60 mmHg with non-severe airflow limitation (FEV₁ &gt; 50% predicted).</p></div><div><h3>Results</h3><p>We included 176 COPD patients. The overall estimated prevalence of PH was 56.3% and the likelihood of having PH increased according to airflow-limitation severity: mild (31.6%), moderate (54.9%), severe (59.6%) and very severe (77.8%) (<em>p</em> = 0.038). The PH was severe in 7.3% and disproportionate in 3.4% of patients.</p></div><div><h3>Conclusions</h3><p>The estimated prevalence of PH in patients with COPD at HA is high, particularly in patients with mild to moderate airflow limitation, and greater than that described for COPD patients at low altitude. These results suggest a higher risk of developing PH for COPD patients living at HA compared to COPD patients with similar airflow limitation living at low altitude.</p></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 3","pages":"Pages 247-253"},"PeriodicalIF":11.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2531043722000046/pdfft?md5=685dbc48802c7fba0677dc8269435514&pid=1-s2.0-S2531043722000046-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39609294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise capacity, lung and respiratory muscle function in substance use disorders","authors":"R. Mustafaoglu ,&nbsp;A. Gorek Dilektaslı ,&nbsp;R. Demir ,&nbsp;E. Zirek ,&nbsp;T. Birinci ,&nbsp;E. Kaya Mutlu ,&nbsp;C. Evren ,&nbsp;A. Razak Ozdincler","doi":"10.1016/j.pulmoe.2021.12.009","DOIUrl":"10.1016/j.pulmoe.2021.12.009","url":null,"abstract":"<div><h3>Background</h3><p>Substance use disorder (SUD) causes conditions such as cognitive and behavioral disorders, anxiety, depression, and social isolation it also causes acute airway inflammation by affecting airway bronchial dynamics. The current study aimed to investigate the lung function, respiratory muscle strength, and exercise capacity in patients with SUD.</p></div><div><h3>Methods</h3><p>One hundred-eighty three patients with SUD, a total of 119 healthy controls, 54 of whom were cigarette smokers and 65 of whom were non-smokers were included in the study. <strong>S</strong>pirometric tests, respiratory muscle strength (MIP and MEP), and the 6-Minute Walk Test (6-MWT) were assessed. The III National Health and Nutrition Examination Survey were used to evaluate respiratory symptoms in patients with SUD and cigarette smokers.</p></div><div><h3>Results</h3><p>86.3% of the SUD patients included in the study were using heroin, 9.2% were cannabis, and 5.5% were spice. The most common symptom in both SUD patients and cigarette smokers was shortness of breath, wheezing, and sputum production. After post-hoc tests, the FVC (<em>p</em> = 0.002), FVC (%predicted) (<em>p</em> &lt; 0.0001), FEV₁ (<em>p =</em> 0.002), FEV1 (%predicted) (<em>p &lt;</em> 0.0001), FEV₁/FVC (%) (<em>p &lt;</em> 0.0001), PEF (<em>p &lt;</em> 0.0001) and FEF_%25-75 (<em>p &lt;</em> 0.0001) lung function parameters were significantly lower in SUD patients than non-smokers. In addition, it was found that MIP (<em>p &lt;</em> 0.0001), MIP (%predicted) (<em>p &lt;</em> 0.0001), MEP (<em>p &lt;</em> 0.0001), and MEP (%predicted) (<em>p &lt;</em> 0.0001) values of SUD patients were significantly lower than non-smokers.</p></div><div><h3>Conclusion</h3><p>The study findings indicate that substance use has an effect on lung functions and the most commonly reported symptoms are shortness of breath, wheezing, and sputum production. In addition, respiratory muscle strength and exercise capacity were decreased in SUD patients compared to non-smokers.</p></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 3","pages":"Pages 254-264"},"PeriodicalIF":11.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S253104372200006X/pdfft?md5=4a187dbf14500f064e3cbd9cc3870cf6&pid=1-s2.0-S253104372200006X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39885425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmasking the hidden threat: COPD awareness and knowledge in Portugal","authors":"Ana Sofia Oliveira ,&nbsp;Nuno Cortesão ,&nbsp;Joana Gomes ,&nbsp;Paula Pinto ,&nbsp;Teresa Shiang ,&nbsp;Tiago Alfaro ,&nbsp;Cidália Rodrigues ,&nbsp;Luís Ferreira ,&nbsp;Ana Barros ,&nbsp;António Morais","doi":"10.1016/j.pulmoe.2023.11.005","DOIUrl":"10.1016/j.pulmoe.2023.11.005","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 3","pages":"Pages 207-209"},"PeriodicalIF":11.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2531043723002039/pdfft?md5=2ce5a8fe8a0972923e0f84ad020a6775&pid=1-s2.0-S2531043723002039-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139422571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between respiratory distress time and invasive mechanical ventilation in COVID-19 patients: A multicentre regional cohort study","authors":"S. Busani ,&nbsp;I. Coloretti ,&nbsp;M. Baciarello ,&nbsp;V. Bellini ,&nbsp;M. Sarti ,&nbsp;E. Biagioni ,&nbsp;R. Tonelli ,&nbsp;A. Marchioni ,&nbsp;E. Clini ,&nbsp;G. Guaraldi ,&nbsp;C. Mussini ,&nbsp;M. Meschiari ,&nbsp;T. Tonetti ,&nbsp;L. Pisani ,&nbsp;S. Nava ,&nbsp;E. Bignami ,&nbsp;M.V. Ranieri ,&nbsp;M. Girardis","doi":"10.1016/j.pulmoe.2022.03.004","DOIUrl":"10.1016/j.pulmoe.2022.03.004","url":null,"abstract":"<div><h3>Aim</h3><p>To determine whether the duration of respiratory distress symptoms in severe COVID-19 pneumonia affects the need for invasive mechanical ventilation and clinical outcomes.</p></div><div><h3>Materials and methods</h3><p>An observational multicentre cohort study of patients hospitalised in five COVID-19–designated ICUs of the University Hospitals of Emilia-Romagna Region. Patients included were adults with pneumonia due to SARS-CoV-2 with PaO₂/FiO₂ ratio &lt;300 mmHg, respiratory distress symptoms, and need for mechanical ventilation (invasive or non-invasive). Exclusion criteria were an uncertain time of respiratory distress, end-of-life decision, and mechanical respiratory support before hospital admission.</p></div><div><h3>Measurements and main results</h3><p>We analysed 171 patients stratified into tertiles according to respiratory distress duration (distress time, DT) before application of mechanical ventilation support. The rate of patients requiring invasive mechanical ventilation was significantly different (<em>p</em> &lt; 0.001) among the tertiles: 17/57 patients in the shortest duration, 29/57 in the intermediate duration, and 40/57 in the longest duration. The respiratory distress time significantly increased the risk of invasive ventilation in the univariate analysis (OR 5.5 [CI 2.48–12.35], <em>p</em> = 0.003). Multivariable regression analysis confirmed this association (OR 10.7 [CI 2.89–39.41], <em>p</em> &lt; 0.001). Clinical outcomes (mortality and hospital stay) did not show significant differences between DT tertiles.</p></div><div><h3>Discussion</h3><p>Albeit preliminary and retrospective, our data raised the hypothesis that the duration of respiratory distress symptoms may play a role in COVID-19 patients’ need for invasive mechanical ventilation. Furthermore, our observations suggested that specific strategies may be directed towards identifying and managing early symptoms of respiratory distress, regardless of the levels of hypoxemia and the severity of the dyspnoea itself.</p></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 3","pages":"Pages 282-286"},"PeriodicalIF":11.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91191427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}