Background Patients with coronavirus disease 2019 (COVID‐19) often suffer sudden deterioration of disease around 1‐2 weeks after onset. Once the disease progressed to severe phase, clinical prognosis of patients will significantly deteriorate. Methods This was a multicenter retrospective study on patients of all adult inpatients (≥18 years old) from Tianyou Hospital (Wuhan, China) and the Fourth Affiliated Hospital, Zhejiang University School of Medicine. All 139 patients had laboratory‐confirmed COVID‐19 in their early stage, which is defined as within 7 days of clinical symptoms. Univariate and multivariate logistic regression models were used to determine the predictive factors in the early detection of patients who may subsequently develop into severe cases. Results Multivariable logistic regression analysis showed that the higher level of hypersensitivity C‐reactive protein (OR = 4.77, 95% CI:1.92‐11.87, P = .001), elevated alanine aminotransferase (OR = 6.87, 95%CI:1.56‐30.21, P = .011), and chronic comorbidities (OR = 11.48, 95% CI:4.44‐29.66, P < .001) are the determining risk factors for the progression into severe pneumonia in COVID‐19 patients. Conclusion Early COVID‐19 patients with chronic comorbidities, elevated hs‐CRP or elevated ALT are significantly more likely to develop severe pneumonia as the disease progresses. These risk factors may facilitate the early diagnosis of critical patients in clinical practice.

No abstract

Chronic airway inflammatory diseases remain a major problem worldwide, such that there is a need for additional therapeutic targets and novel drugs. Transient receptor potential (TRP) channels are a group of non-selective cation channels expressed throughout the body that are regulated by various stimuli. TRP channels have been identified in numerous cell types in the respiratory tract, including sensory neurons, airway epithelial cells, airway smooth muscle cells, and fibroblasts. Different types of TRP channels induce cough in sensory neurons via the vagus nerve. Permeability and cytokine production are also regulated by TRP channels in airway epithelial cells, and these channels also contribute to the modulation of bronchoconstriction. TRP channels may cooperate with other TRP channels, or act in concert with calcium-dependent potassium channels and calcium-activated chloride channel. Hence, TRP channels could be the potential therapeutic targets for chronic airway inflammatory diseases. In this review, we aim to discuss the expression profiles and physiological functions of TRP channels in the airway, and the roles they play in chronic airway inflammatory diseases.

Background ERBB2 aberrations are oncogenic alterations in lung cancer. However, the reported therapeutic efficacy of ado-trastuzumab emtansine (T-DM1) varied. We therefore evaluated the efficacy and safety of T-DM1 in treating different types of ERBB2 aberrations. Methods We conducted a systematic search for original articles and meeting abstracts about ERBB2-aberrant lung cancer treating with T-DM1 in PubMed and EMBASE databases from inception to June, 2020. Statistical analysis was carried out in R software. Results A total of 120 patients with various ERBB2 aberrations were identified in five studies. ERBB2 upregulation (gene amplification and/or protein overexpression) was more common in smokers with adenocarcinoma, whereas mutations were more common in female non-smokers with adenocarcinoma. The overall objective response rate (ORR) for ERBB2 aberrations was 29% [95% confidence interval (CI): 15–56%]. Subgroup analysis showed an ORR of 41% (95% CI: 11–70%) for ERBB2 gene mutation, 66% (95% CI: 11–100%) for ERBB2 gene amplification, and 3% (95% CI: 0–9%) for ERBB2 protein overexpression. Notably, the ORR was 44% (95% CI: 25–63%) upon concomitant ERBB2 upregulation and mutation. Furthermore, the ORR was 26% (95% CI: 0–54%) for protein overexpression plus gene mutation but up to 80% (95% CI: 50–100%) for triple aberrations: gene amplification plus protein overexpression and gene mutation. Conclusions Collectively, T-DM1 might be a critical agent targeting ERBB2 mutated or/and amplified lung cancers.

Background: Transbronchial needle aspiration (TBNA) is a minimally invasive procedure performed to diagnose lymph node (LN) adenopathy. TBNA with and without endobronchial ultrasound (EBUS) guidance has a high diagnostic yield for malignant LN enlargement, but the value for diagnosing benign LN enlargement has been less thoroughly investigated. Methods: We retrospectively evaluated 3540 patients with mediastinal LN enlargement who received TBNA. One hundred sixty-six patients with benign mediastinal lymphadenopathy were included and 293 LNs were biopsied. A positive result was defined as a specific histological abnormality. Conventional TBNA (cTBNA) and EBUS-TBNA, as well as cTBNA and transbronchial forceps biopsy (TBFB), were compared. The subgroup analysis was stratified by disease type and LN size.Results: A diagnosis was made in 76.84% of the EBUS-TBNA and 61.31% of the cTBNA (P < 0.05). EBUS-TBNA was superior to cTBNA for both granulomatous (65.18% vs. 45.45%, P < 0.05) and non-granulomatous disease (96.92% vs. 84.06%, P < 0.05). In contrast, the diagnostic yield of EBUS-TBNA was higher than that of cTBNA for LNs < 20 mm (79.44% vs. 64.29%, P < 0.05), but for LNs > 20 mm the difference was marginal. These findings were confirmed in a group of independent patients who received cTBNA plus EBUS-TBNA. The diagnostic yield did not differ between cTBNA and TBFB, but significantly increased to 76.67% when both modalities were employed.Conclusions: EBUS-TBNA is the preferred minimally invasive diagnostic method for benign mediastinal LN disease. Combined cTBNA and TBFB is a safe and feasible alternative when EBUS is unavailable.

No abstract

Abstract Background: Patients with coronavirus disease 2019 (COVID-19) often suffer sudden deterioration of disease around 1 to 2 weeks after onset. Once the disease progressed to severe phase, clinical prognosis of patients will significantly deteriorate.Methods: This was a multicenter retrospective study on patients of all adult inpatients (≥18 years old) from Tianyou Hospital (Wuhan, China) and the Fourth Affiliated Hospital, Zhejiang University School of Medicine. All 139 patients had laboratory-confirmed COVID-19 in their early stage, which is defined as within 7 days of clinical symptoms or within 7 days of positive viral nucleic acid test for asymptomatic patients. Univariate and multivariate logistic regression models were used to determine the predictive factors in the early detection of patients who may subsequently develop into severe cases.Results: Multivariable logistic regression analysis showed that the higher level of hypersensitivity C-reactive protein (OR=4.77, 95% CI:1.92-11.87, P=0.001), elevated alanine aminotransferase (OR=6.87, 95%CI:1.56-30.21, P=0.011) and chronic comorbidities (OR=11.48, 95% CI:4.44-29.66, P<0.001) are the determining risk factors for the progression into severe pneumonia in COVID-19 patients.Conclusion: Early COVID-19 patients with chronic comorbidities, elevated hs-CRP or elevated ALT are significantly more likely to develop severe pneumonia as the disease progresses. These risk factors may facilitate the early diagnosis of critical patients in clinical practice.