Background: Infection by SARS-CoV-2 has been associated with multiple symptoms; however, still, little is known about persistent symptoms and their probable association with the risk of developing pulmonary fibrosis in patients post-COVID-19. Methods: A longitudinal prospective study on health workers infected by SARS-CoV-2 was conducted. In this work, signs and symptoms were recorded of 149 health workers with a positive PCR test for SARS-CoV-2 at the beginning of the diagnosis, during the active infection, and during post-COVID-19 follow-up. The McNemar chi-square test was used to compare the proportions and percentages of symptoms between the baseline and each follow-up period. Results: The signs and symptoms after follow-up were cardiorespiratory, neurological, and inflammatory. Gastrointestinal symptoms were unusual at the disease onset, but unexpectedly, their frequency was higher in the post-infection stage. The multivariate analysis showed that pneumonia (HR 2.4, IC95%: 1.5–3.8, p < 0.001) and positive PCR tests still after four weeks (HR 5.3, IC95%: 2.3-12.3, p < 0.001) were factors associated with the diagnosis of post-COVID-19 pulmonary fibrosis in this study group. Conclusions: Our results showed that pneumonia and virus infection persistence were risk factors for developing pulmonary fibrosis post-COVID-19, after months of initial infection.
The concordance between PIKO-6® and spirometry was lower in patients with partially controlled or uncontrolled asthma compared to controlled or healthy children. The broad limits of agreement show that the FEV1, FEV6, and FEV1/FEV6 obtained with the PIKO-6® are not interchangeable with spirometry results. Longitudinal evaluations of asthma patients are necessary to assess the utility of PIKO-6®.
Objectives: To evaluate the patient characteristics and health care burden associated with chronic obstructive pulmonary disease (COPD) in the U.S. Medicare population. MethOds: COPD patients were identified (International Classification of Disease, 9th Revision, Clinical Modification [ICD-9-CM] codes: 491.xx, 492.xx and 496.xx) using U.S. national Medicare claims from 01JAN2007 to 31DEC2010. The first diagnosis date was designated as the index date. Patients were required to: a) be age ≥ 65 years on the index date; b) have continuous medical and pharmacy benefits for 12 months pre-index date (baseline period); c) have continuous enrollment for 12 months post-index date (follow-up period), unless there was earlier evidence of death; and d) have no COPD diagnosis pre-index date. The outcomes of interest included medication use, including a long-acting beta agonist (LABA) or LABA/inhaled corticosteroid (ICS) combination, mortality and health care resource utilization and costs. Results: A total of 543,249 COPD patients were identified. Patients were, on average, age 78 years. Most patients were white (94%) and resided in the South U.S. region (41%). The average Charlson Comorbidity Index score was 3.23, and hypertension (67%), diabetes (28%), congestive heart failure (21%) and chronic pulmonary disease (20%) were the most frequently diagnosed comorbidities. A 13.82% mortality rate was observed during the first year of the follow-up period. Post-index LABA medications, including arfomoterol (0.55%), formoterol (0.25%) and salmeterol (0.32%) were prescribed to 1.10% of the population. Identified LABA/ICS combinations included budesonide/formoterol (1.97%) and fluticasone/salmeterol (10.02%). High health care resource utilization was encountered for Medicare carrier (99.40%), pharmacy (90.27%), outpatient (76.52%) and inpatient visits (48.83%). The main cost drivers were inpatient ($10,645), Medicare carrier ($4,888), outpatient ($3,322) and skilled nursing facility ($2,695) costs, resulting in $25,397 in total health care costs. cOnclusiOns: U.S. Medicare patients have a high COPD-related health care burden.
Background: Chronic obstructive pulmonary disease (COPD) and lung cancer are associated through tobacco use. COPD is underdiagnosed in both the primary care and lung cancer populations.
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