Chronic airflow obstruction and ambient particulate air pollution

Amaral, André F.S.; Burney, Peter; Patel, Jaymini; Minelli, Cosetta; Mejza, Filip; Mannino, David M.; Seemungal, Terence; Mahesh, P A; Lo, Li Cher; Janson, Christer; Juvekar, Sanjay; Denguezli, Myriam; Harrabi, Imed; Wouters, Emiel F.M.; Cherkaski, Hamid Hacene; Mortimer, Kevin; Jõgi, Rain; Bateman, Eric D.; Fuertes, Elaine; Ghobain, Mohammed Al; Tan, Wan C.; Obaseki, Daniel O.; Sony, Asma El; Studnicka, Michael; Aquart-Stewart, Althea; Koul, Parvaiz A; Lawin, Hervé; Nafees, Asaad Ahmed; Awopeju, O.F.; Erhabor, Gregory E; Gíslason, Þórarinn; Welte, Tobias; Gulsvik, Amund; Nielsen, Rune; Gnatiuc, Louisa; Kocabaş, Ali; Marks, Guy B.; Sooronbaev, Talant; Ngahane, Bertrand Hugo Mbatchou; Bárbara, Cristina; Buist, A. Sonia

doi:10.1136/thoraxjnl-2020-216223

Cited by 10 publications

(9 citation statements)

References 14 publications

(13 reference statements)

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“…Besides, patients with moderate to severe COVID-19 disease are more likely to develop multi-organ disease, e.g. myocardial injury, thromboembolic complications, liver failure, and pneumothorax [ 6 – 10 ]. Comparably, patients after Acute Respiratory Distress Syndrome (ARDS) suffer from long-term physical problems and lung function deterioration [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary function impairment of asymptomatic and persistently symptomatic patients 4 months after COVID-19 according to disease severity

et al. 2021

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Objective Evaluation of pulmonary function impairment after COVID-19 in persistently symptomatic and asymptomatic patients of all disease severities and characterisation of risk factors. Methods Patients with confirmed SARS-CoV-2 infection underwent prospective follow-up with pulmonary function testing and blood gas analysis during steady-state cycle exercise 4 months after acute illness. Pulmonary function impairment (PFI) was defined as reduction below 80% predicted of DLCOcSB, TLC, FVC, or FEV1. Clinical data were analyzed to identify risk factors for impaired pulmonary function. Results 76 patients were included, hereof 35 outpatients with mild disease and 41 patients hospitalized due to COVID-19. Sixteen patients had critical disease requiring mechanical ventilation, 25 patients had moderate–severe disease. After 4 months, 44 patients reported persisting respiratory symptoms. Significant PFI was prevalent in 40 patients (52.6%) occurring among all disease severities. The most common cause for PFI was reduced DLCOcSB (n = 39, 51.3%), followed by reduced TLC and FVC. The severity of PFI was significantly associated with mechanical ventilation (p < 0.001). Further risk factors for DLCO impairment were COPD (p < 0.001), SARS-CoV-2 antibody-Titer (p = 0.014) and in hospitalized patients CT score. A decrease of paO2 > 3 mmHg during cycle exercise occurred in 1/5 of patients after mild disease course. Conclusion We characterized pulmonary function impairment in asymptomatic and persistently symptomatic patients of different severity groups of COVID-19 and identified further risk factors associated with persistently decreased pulmonary function. Remarkably, gas exchange abnormalities were revealed upon cycle exercise in some patients with mild disease courses and no preexisting pulmonary condition.

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Section: Introductionmentioning

confidence: 99%

Pulmonary function impairment of asymptomatic and persistently symptomatic patients 4 months after COVID-19 according to disease severity

et al. 2021

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“…Biomass fuel use for cooking and heating was found not to be a risk factor for post-bronchodilator SAO [ 13 ] in keeping with previous research on CAO [ 50 ], although available data are limited. However, in a single study, exposure to high annual levels of PM2.5 was associated with increased risk of post-bronchodilator SAO [ 13 ], contradicting previous research in populations with CAO [ 51 ]. In support of an association between SAO, smoking and PM2.5, the five included cohort studies reported a greater decline in FEF 25–75 among current smokers, compared to never or former smokers [ 30 ], and a lesser decline in FEF 25–75 in individuals exposed to lower levels of air particulates.…”

Section: Discussionmentioning

confidence: 92%

Spirometry parameters used to define small airways obstruction in population-based studies: systematic review

et al. 2022

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Background The assessment of small airways obstruction (SAO) using spirometry is practiced in population-based studies. However, it is not clear what are the most used parameters and cut-offs to define abnormal results. Methods We searched three databases (Medline, Web of Science, Google Scholar) for population-based studies, published by 1 May 2021, that used spirometry parameters to identify SAO and/or provided criteria for defining SAO. We systematically reviewed these studies and summarised evidence to determine the most widely used spirometry parameter and criteria for defining SAO. In addition, we extracted prevalence estimates and identified associated risk factors. To estimate a pooled prevalence of SAO, we conducted a meta-analysis and explored heterogeneity across studies using meta regression. Results Twenty-five studies used spirometry to identify SAO. The most widely utilised parameter (15 studies) was FEF25–75, either alone or in combination with other measurements. Ten studies provided criteria for the definition of SAO, of which percent predicted cut-offs were the most common (5 studies). However, there was no agreement on which cut-off value to use. Prevalence of SAO ranged from 7.5% to 45.9%. As a result of high heterogeneity across studies (I2 = 99.3%), explained by choice of spirometry parameter and WHO region, we do not present a pooled prevalence estimate. Conclusion There is a lack of consensus regarding the best spirometry parameter or defining criteria for identification of SAO. The value of continuing to measure SAO using spirometry is unclear without further research using large longitudinal data. PROSPERO registration number CRD42021250206

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“…In patients with stable COPD continuous smoking cessation improves, over time, respiratory symptoms and decreases the accelerated decline in forced expiratory volume in one second (FEV1) and mortality 55 and improves the clinical efficacy of inhaled glucocorticoids 56,57 , although it does not completely remove chronic inflammation of their lower airways 57,58 . To help current smokers with stable COPD to stop smoking, supportive drug therapies are also available 59 . However, double-blind randomized placebo-controlled clinical trials on supportive drug therapies for smoking cessation conducted in stable COPD patients, have shown unsatisfactory long-term results 1,59 and therefore this important public health problem requires greater research efforts 60 .…”

Section: Management Of Stable Copd According To the Aetiology Of The ...mentioning

confidence: 99%

Treatable traits in COPD patients

et al. 2022

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There is no justification for a therapeutic nihilism in clinical practice because current management (pharmacological and non-pharmacological) of the patients with chronic obstructive pulmonary disease (COPD) according to treatable traits is effective in decreasing their respiratory symptoms, increasing their exercise tolerance and capacity, improving their quality of life, preventing (and treating) many of their exacerbations and decreasing their mortality.

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Chronic airflow obstruction and ambient particulate air pollution

Cited by 10 publications

References 14 publications

Pulmonary function impairment of asymptomatic and persistently symptomatic patients 4 months after COVID-19 according to disease severity

Pulmonary function impairment of asymptomatic and persistently symptomatic patients 4 months after COVID-19 according to disease severity

Spirometry parameters used to define small airways obstruction in population-based studies: systematic review

Treatable traits in COPD patients

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