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Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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Coronavirus disease 2019 (COVID‐19) has had different waves within the same country. The spread rate and severity showed different properties within the COVID‐19 different waves. The present work aims to compare the spread and the severity of the different waves using the available data of confirmed COVID‐19 cases and death cases. Real‐data sets collected from the Johns Hopkins University Center for Systems Science were used to perform a comparative study between COVID‐19 different waves in 12 countries with the highest total performed tests for severe acute respiratory syndrome coronavirus 2 detection in the world (Italy, Brazil, Japan, Germany, Spain, India, USA, UAE, Poland, Colombia, Turkey, and Switzerland). The total number of confirmed cases and death cases in different waves of COVID‐19 were compared to that of the previous one for equivalent periods. The total number of death cases in each wave was presented as a percentage of the total number of confirmed cases for the same periods. In all the selected 12 countries, Wave 2 had a much higher number of confirmed cases than that in Wave 1. However, the death cases increase was not comparable with that of the confirmed cases to the extent that some countries had lower death cases than in Wave 1, UAE, and Spain. The death cases as a percentage of the total number of confirmed cases in Wave 1 were much higher than that in Wave 2. Some countries have had Waves 3 and 4. Waves 3 and 4 have had lower confirmed cases than Wave 2, however, the death cases were variable in different countries. The death cases in Waves 3 and 4 were similar to or higher than Wave 2 in most countries. Wave 2 of COVID‐19 had a much higher spread rate but much lower severity resulting in a lower death rate in Wave 2 compared with that of the first wave. Waves 3 and 4 have had lower confirmed cases than Wave 2; that could be due to the presence of appropriate treatment and vaccination. However, that was not reflected in the death cases, which were similar to or higher than Wave 2 in most countries. Further studies are needed to explain these findings.

The T-piece and large spacer were equally efficient for salbutamol delivery from the mesh nebulizer in patients with COPD and on single-limb noninvasive ventilation. Adding a preliminary bronchodilator dose by pMDI prenebulization showed a trend toward greater pulmonary bioavailability of nebulized salbutamol and may be worth considering to maximize delivery of salbutamol to patients who are severely ill.

Background The new coronavirus (SARS‐COV‐2) that emerged at the end of 2019 was stated in China and infected millions of people around the world, with the highest spread rate amongst humans compared with other coronaviruses. This paper aimed to review and analyse the published studies about COVID‐19 diagnosis, prevention, and treatment. Method The reviewed studies were clinical trials, in‐vivo, in‐vitro, guidelines, reports from the world health organization (WHO), and the centre for disease control and prevention (CDC) in addition to systemic reviews. All data extracted and analysed to stand on the latest updates and recommendations for fighting this severe attack of COVID‐19. Results Most important antiviral therapy of COVID‐19 clinical trials is still running without clear results, but a few trials have indicated the role of numerous drugs in the treatment of COVID‐19. Specific recommendations for aerosol therapy should be followed for the management of COVID‐19. Conclusion Nature of COVID‐19 is still not very clear, however, management of the condition is similar to the previous attacks of coronaviruses.

Aims There is a lack of an overview of determinants of incorrect inhaler technique among chronic obstructive pulmonary diseases (COPD) subjects. The aim of this study was to determine the prevalence and possible determinants of incorrect inhaler technique in COPD subjects with common inhalers. Methods A cross over study was conducted in 180 COPD subjects. Baseline assessment of inhaler technique was evaluated in 10 placebo inhalers including: [pressurised metered dose inhaler (pMDI), Aerolizer, Handihaler, Turbohaler, Discus, Breezhaler, Ellipta, Easyhaler, Diskhaler and Respimat] without receiving any instructions. Subjects were then crossed over to other inhalers in random order. Inhaler technique was assessed. The proper technique of inhalers was demonstrated and the number of counselling attempts needed to achieve a correct technique was recorded. Patient past‐experience, demographics/clinical variables were recorded. Results Incorrect inhaler techniques were highly prevalent among COPD subjects, ranging from 80% of participants demonstrated incorrect use, a minimum of 1 error, with Ellipta, to 100% with Respimat/Diskhaler (P < .001). Past‐experience (OR = 14.639 at P < .001) and inhaler‐type (OR = 10.397 at P < .001, 4.267 at P =. 007, 2.664 at P =. 057, 8.666 at P =. 001, 10.250 at P < .001, 0.613 at P =. 212 and 0.265 at P< .001 for pMDI, Aerolizer, Handihaler, Turbohaler, Discus, Breezhaler and Ellipta, respectively) were the strongest determinants of incorrect technique followed by gender (OR = 0.310 at P < .001), age category (OR = 0.307 at P < .001) and GOLD group (OR = 2.289 at P =. 005). Conclusion Incorrect inhaler techniques are highly prevalent among COPD subjects. Lack of past‐experience, certain inhaler types, female gender, older age and lower GOLD group are the most significant determinants of incorrect technique.