Showing papers by "Joan B. Soriano published in 2023"
4 citations
TL;DR: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 document as discussed by the authors proposes a new taxonomy of COPD and suggests six etiotypes on the origin of the disease.
Abstract: The population burden of COPD remains high well into the 21st century, although with great regional variability [1]. Changes in the geographical and secular distribution of COPD points to the interaction of a number of risk factors beyond tobacco and other forms of smoking, which is still considered the first and foremost causal risk factor of COPD. We read with interest the new Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 document, proposing a new taxonomy of COPD and suggesting six etiotypes on the origin of COPD [2]. This taxonomy is based on work found elsewhere [3, 4]. To the best of our knowledge, these etiotypes are not evidence-based, and the information required to obtain them has not been explored. We aimed to identify the information required to determine the classification of COPD etiotypes by GOLD 2023, by means of panel discussion and consensus by the authors. The information required to determine the classification of COPD etiotypes by GOLD 2023 is hard to obtain https://bit.ly/43ZJhCc
TL;DR: In this paper , the authors evaluated the frequency of physical capacity and daily physical activity dissociation in patients with COPD and subjects without airflow limitation (AL) and identified its risk factors.
Abstract: Physical capacity (PC) and daily physical activity (PA) are two crucial factors in the clinical course of COPD, although they do not always maintain a close relationship. The objectives were to evaluate the frequency of PC-PA dissociation in patients with COPD and subjects without airflow limitation (AL) and to identify its risk factors.A sample of 319 COPD patients and 399 subjects without AL was consecutively obtained from a population-based sample of 9092 subjects evaluated in the EPISCAN II study. Baseline evaluation included clinical questionnaires, lung function testing, blood analysis and low-dose computed tomography (CT) scan with evaluation of lung density and airway wall thickness. A distance walked in 6 min > 70% predicted was considered an indicator of normal PC, while a Yale Physical Activity Survey summary index score <51 was used to identify with sedentary lifestyle.166 COPD patients (52.0%) reported a sedentary lifestyle with evidence of preserved PC, while this phenomenon was present in 188 (47.1%) subjects without AL. In the COPD group, symptoms of chronic bronchitis, depression and elevated hematocrit and blood eosinophil count were identified as independent risk factors for PC-PA dissociation. In turn, in the subjects without AL, the risk factors for PC-PA dissociation were low fat-free mass, obesity and anxiety, as well as reduced levels of HDL-cholesterol and the absence of osteoporosis.Almost half of COPD patients and subjects without airflow limitation with preserved PC maintain a sedentary lifestyle, with different risk factors for sedentarism between both groups.
TL;DR: In this paper , ancillary analysis of an international, multicenter COVID-19 registry (HOPE: Health Outcome Predictive Evaluation) was performed to determine clinical characteristics and prognostic factors of interstitial lung disease (ILD) patients.
Abstract: Background: Concern has risen about the effects of COVID-19 in interstitial lung disease (ILD) patients. The aim of our study was to determine clinical characteristics and prognostic factors of ILD patients admitted for COVID-19. Methods: Ancillary analysis of an international, multicenter COVID-19 registry (HOPE: Health Outcome Predictive Evaluation) was performed. The subgroup of ILD patients was selected and compared with the rest of the cohort. Results: A total of 114 patients with ILDs were evaluated. Mean ± SD age was 72.4 ± 13.6 years, and 65.8% were men. ILD patients were older, had more comorbidities, received more home oxygen therapy and more frequently had respiratory failure upon admission than non-ILD patients (all p < 0.05). In laboratory findings, ILD patients more frequently had elevated LDH, C-reactive protein, and D-dimer levels (all p < 0.05). A multivariate analysis showed that chronic kidney disease and respiratory insufficiency on admission were predictors of ventilatory support, and that older age, kidney disease and elevated LDH were predictors of death. Conclusions: Our data show that ILD patients admitted for COVID-19 are older, have more comorbidities, more frequently require ventilatory support and have higher mortality than those without ILDs. Older age, kidney disease and LDH were independent predictors of mortality in this population.
TL;DR: In this paper , the authors developed a fatty liver disease-Sustainable Development Goal (SDG) country score to provide insights into country-level preparedness to address liver disease through a whole-of-society lens.
TL;DR: The concept of salud is mucho más difícil de definir que el concepto de enfermedad as discussed by the authors , así que it is difficult to define it.
Abstract: El concepto de salud es mucho más difícil de definir que el concepto de enfermedad. Este trabajo resume la trayectoria histórica del concepto de salud desde las civilizaciones azteca y egipcia, hasta la definición de la Organización Mundial de la Salud en 1948: “Un estado de completo bienestar físico, mental y social, y no solamente la ausencia de afecciones o enfermedades”. Más recientemente, la definición de salud de la OMS se ha modificado y complementado con la cuarta dimensión: la salud espiritual. Implica un sentido de plenitud y satisfacción con la propia vida, sistema de valores, autoconfianza y autoestima, autoconciencia y presencia, paz y tranquilidad con equilibrio emocional dinámico, tanto interno como hacia el entorno, moralidad y veracidad, desinterés, emociones positivas, compasión y voluntad de ayudar y apoyar a los demás, responsabilidad y contribución al bien común y manejo exitoso de los problemas y demandas de la vida cotidiana, así como del estrés social. En definitiva, ‘salud’ es un concepto evolutivo y cambiante, que además es muy personal. Depende de la edad del individuo, sus condiciones y su entorno, y también del estado inicial de cada persona, entre otras variables. El transhumanismo y sus novedades aplicadas a la salud pueden revolucionar todos estos conceptos.
TL;DR: In this paper , the authors show that no long COVID patient ever steps in the same river twice, as their condition changes continuously due to its natural history, or because of treatment http://bit.ly/3QMFhyK
Abstract: Heraclitus, the Greek, pre-Socratic philosopher (figure 1), believed the world was ultimately made of fire, a metaphor for change. He wrote five centuries BC: panta rhei (Πάντα ῥεῖ, “everything flows”), exemplifying it with his quote: “No man ever steps in the same river twice.” No long COVID patient ever steps in the same river twice, as their condition changes continuously due to its natural history, or because of treatment http://bit.ly/3QMFhyK
TL;DR: In an observational, large study using official National Institute of Statistics data, this paper explored deaths due to respiratory diseases, that is, all causes of death by the standard WHO list of diseases of the respiratory system plus COVID-19, tuberculosis and lung cancer.
Abstract: We previously reported an increase in respiratory mortality in 2020 in Spain after COVID-19. It is unclear if this rise is sustained in the longer-term. We aimed to determine whether respiratory mortality in 2021 in Spain returned to pre-pandemic levels.In an observational, large study using official National Institute of Statistics data, we explored deaths due to respiratory diseases, that is, all causes of death by the standard WHO list of diseases of the respiratory system plus COVID-19, tuberculosis and lung cancer. Using the latest available official data of Spain, we analyzed changes in the mortality pattern in Spain from January 2019 to December 2021. We endorsed STROBE guidance for observational research.There were 98,714 deaths due to respiratory diseases in 2021 in Spain, corresponding to 21.9% of all deaths, becoming second in the ranking of causes of death. Respiratory diseases mortality in Spain has not returned to pre-pandemic levels in 2021, still with an increase of 30.3% (95% CI 30.2-30.4) compared to rates in 2019. All respiratory-specific causes of death decreased in 2021, except for lung cancer, that increased in women and decreased in men compared to 2019 (both p<0.05). In a multivariate analysis some established risk factors for respiratory diseases mortality were confirmed, such as male gender and older age; further, an association with reduced mortality in rural Spain was observed, still with a large geographical variability.The COVID-19 pandemic has had a lasting impact on deaths due to respiratory diseases and certain specific causes of death in 2021, and it has disproportionately affected certain regions.
TL;DR: In this paper , the authors examined if exposure to PM2.5 particles in outdoor smoking areas changed breathing rates in 60 patients with asthma (n = 30) or with COPD, in an open, non-randomised, interventional study model in Czechia, Ireland and Spain.
Abstract: Smokefree laws are intended to protect against second-hand smoke (SHS) in outdoor areas. We examined if exposure to PM2.5 particles in outdoor smoking areas changed breathing rates in 60 patients with asthma (n = 30) or with COPD (n = 30), in an open, non-randomised, interventional study model in Czechia, Ireland and Spain. The patients wore a PM2.5 particle monitor (AirSpeck) and a breath monitor (RESpeck) for 24 h to determine changes in breathing rates (Br) at rest and during a visit to an outside smoking area. Spirometry and breath CO were measured before and the day after visiting an outdoor smoking area. The PM2.5 levels at the 60 venues were highly variable, ranging from ≥2000 µg/m3 (in 4 premises) to ≤10 µg/m3 (in 3 premises, which had only a single wall in the structure). At 39 venues, the mean PM 2.5 levels were ≥25 µg/m3. The breathing rate changed significantly in 57 of the 60 patients, resulting in an increase in some patients and a decrease in others. Comprehensive smokefree laws were ineffective in protecting asthma and COPD patients from exposure to high levels of SHS in outside areas of pubs and terraces, which should be avoided by these patients. These findings also support the extension of smokefree laws to outside areas.
TL;DR: In this article , the authors conducted a multicenter, prospective, observational cohort study of patients admitted to hospital with bilateral COVID-19 pneumonia and found that early periostin post-discharge could predict the presence of fibrotic pulmonary changes.
Abstract: Beyond the acute infection of coronavirus disease (COVID-19), concern has arisen about long-term effects of SARS-CoV-2 infection. The aim of our study was to analyze if there is any biomarker of fibrogenesis in COVID-19 pneumonia patients capable of predicting post-COVID pulmonary sequelae. We conducted a multicenter, prospective, observational cohort study of patients admitted to hospital with bilateral COVID-19 pneumonia. We classified patients in two groups according to severity, and blood samples to measure MMP1, MMP7, periostin and VEGF, respiratory function tests and HRCT imaging were obtained at 2 and 12 months after hospital discharge. A total of 135 patients were evaluated at 12 months. Median age was 61 (IQR: 19) years and 58.5% were men. We found between-group differences in age, radiological involvement, length of hospital stay and inflammatory laboratory parameters. Differences were found between 2 and 12 months in all functional tests, including improvements in FVC% (98.0 vs. 103.9; p=0.001) and DLCO<80% (60.9% vs. 39.7%; p=0.001). At 12 months, 63% of patients had complete HRTC resolution, but fibrotic changes persisted in 29.4%. Biomarker analysis demonstrated differences at 2 months in periostin (ng/mL) (0.8893 vs. 1.437; p<0.001) and MMP-7 (ng/mL) (8.7249 vs. 15.2181; p<0.001). No differences were found at 12 months. In multivariable analysis, only 2-month periostin was associated with 12-month fibrotic changes (OR: 1.0013 95% CI: 1.0006-1.00231; p=0.003) and 12-month DLCO impairment (OR: 1.0006 95% CI: 1.0000-1.0013; p=0.047). Our data suggest that early periostin post-discharge could predict the presence of fibrotic pulmonary changes.
TL;DR: In this article , the authors explored the distribution of ABO blood group in patients hospitalized for acute COVID-19 and in those with Long COVID and found no significant association of any ABO subgroup with either acute or long COVID with an OR of 1.015 [0.669-1.541] and 95% CI of 0.965 [ 0.490-3] respectively.
Abstract: Background An association of ABO blood group and COVID-19 remains controversial. Methods Following STROBE guidance for observational research, we explored the distribution of ABO blood group in patients hospitalized for acute COVID-19 and in those with Long COVID. Contingency tables were made and risk factors were explored using crude and adjusted Mantle-Haentzel odds ratios (OR and 95% CI). Results Up to September 2022, there were a total of 5,832 acute COVID-19 hospitalizations in our hospital, corresponding to 5,503 individual patients, of whom blood group determination was available for 1,513 (27.5%). Their distribution by ABO was: 653 (43.2%) group 0, 690 (45.6%) A, 113 (7.5%) B, and 57 (3.8%) AB, which corresponds to the expected frequencies in the general population. In parallel, of 676 patients with Long COVID, blood group determination was available for 135 (20.0%). Their distribution was: 60 (44.4%) from group 0, 61 (45.2%) A, 9 (6.7%) B, and 5 (3.7%) AB. The distribution of the ABO system of Long COVID patients did not show significant differences with respect to that of the total group (p ≥ 0.843). In a multivariate analysis adjusting for age, sex, ethnicity, and severity of acute COVID-19 infection, subgroups A, AB, and B were not significantly associated with developing Long COVID with an OR of 1.015 [0.669–1.541], 1.327 [0.490–3.594] and 0.965 [0.453–2.058], respectively. The effect of the Rh+ factor was also not significant 1,423 [0.772–2,622] regarding Long COVID. Conclusions No association of any ABO blood subgroup with COVID-19 or developing Long COVID was identified.
TL;DR: In this paper , the authors describe the prevalence of reduced diffusing capacity of the lungs for carbon monoxide (DLCO) in smokers and describe its morphological, functional and clinical implications.
Abstract: Background Population distribution of reduced diffusing capacity of the lungs for carbon monoxide (DLCO) in smokers and main consequences are not properly recognised. The objectives of this study were to describe the prevalence of reduced DLCO in a population-based sample of current and former smoker subjects without airflow limitation and to describe its morphological, functional and clinical implications. Methods A sample of 405 subjects aged 40 years or older with postbronchodilator forced expiratory volume in 1 s/forced vital capacity (FVC) >0.70 was obtained from a random population-based sample of 9092 subjects evaluated in the EPISCAN II study. Baseline evaluation included clinical questionnaires, exhaled carbon monoxide (CO) measurement, spirometry, DLCO determination, 6 min walk test, routine blood analysis and low-dose CT scan with evaluation of lung density and airway wall thickness. Results In never, former and current smokers, prevalence of reduced DLCO was 6.7%, 14.4% and 26.7%, respectively. Current and former smokers with reduced DLCO without airflow limitation were younger than the subjects with normal DLCO, and they had greater levels of dyspnoea and exhaled CO, greater pulmonary artery diameter and lower spirometric parameters, 6 min walk distance, daily physical activity and plasma albumin levels (all p<0.05), with no significant differences in other chronic respiratory symptoms or CT findings. FVC and exhaled CO were identified as independent risk factors for low DLCO. Conclusion Reduced DLCO is a frequent disorder among smokers without airflow limitation, associated with decreased exercise capacity and with CT findings suggesting that it may be a marker of smoking-induced early vascular damage. Trial registration number NCT03028207.