Pediatric Pulmonology,
Год журнала:
2024,
Номер
unknown
Опубликована: Окт. 14, 2024
Abstract
Introduction
Despite
improvements
in
long‐term
asthma
treatment,
an
increasing
number
of
children
are
being
hospitalized
pediatric
intensive
care
units
(PICU)
for
asthma.
The
main
objective
this
study
was
to
describe
a
recent
cohort
PICU
identify
risk
factors
associated
with
need
respiratory
support,
and
multiple
stays.
Methods
We
conducted
retrospective
three
PICUs
Paris
(intensive
3A
Study),
using
medical
files
between
February
2019
October
2020.
Need
support
defined
by
the
high‐flow
nasal
cannula
or
mechanical
ventilation
(MV)
(either
noninvasive
[NIV]
invasive
[IMV]).
Results
During
period,
252
stays
corresponding
234
patients
were
analyzed.
MV
required
17.5%
stays,
significantly
younger
(2.37
vs.
4.18
years,
p
=
0.002).
On
multivariate
analysis,
higher
progression
found
requiring
magnesium
sulfate
oxygen
therapy
≥6
L/mn
before
admission
(RR
4.48;
CI95%
[1.85−10.89];
0.001,
RR
2.86;
[1.13−7.22];
0.03,
respectively),
those
atelectasis
detected
on
chest
radiography
3.38;
[1.43−8.00];
<
0.01).
Multiple
greater
social
deprivation
French
Deprivation
Index
1.25;
[1.03−1.51];
0.03).
Conclusion
Children
experiencing
at
severe
After
transfer
PICU,
radiograph
needing
support.
Thorax,
Год журнала:
2022,
Номер
unknown, С. thorax - 219591
Опубликована: Ноя. 23, 2022
Background
The
imposition
of
restrictions
on
social
mixing
early
in
the
COVID-19
pandemic
was
followed
by
a
reduction
asthma
exacerbations
multiple
settings
internationally.
Temporal
trends
mixing,
incident
acute
respiratory
infections
(ARI)
and
following
relaxation
have
not
yet
been
described.
Methods
We
conducted
population-based
longitudinal
study
2312
UK
adults
with
between
November
2020
April
2022.
Details
face
covering
use,
ARI
severe
were
collected
via
monthly
online
questionnaires.
changes
these
parameters
visualised
using
Poisson
generalised
additive
models.
Multilevel
logistic
regression
used
to
test
for
associations
risk
exacerbations,
adjusting
potential
confounders.
Results
Relaxation
from
2021
coincided
reduced
use
(p<0.001),
increased
frequency
indoor
visits
public
places
other
households
(p<0.001)
rising
incidence
non-COVID-19
(p=0.007).
Incident
associated
independently
exacerbation
(adjusted
OR
5.75,
95%
CI
4.75
6.97)
as
did
COVID-19,
both
prior
emergence
omicron
variant
SARS-CoV-2
(5.89,
3.45
10.04)
subsequently
(5.69,
3.89
8.31).
Conclusions
decreased
rebound
exacerbations.
Associations
similar
before
after
variant.
Study
registration
number
NCT04330599
.
Expert Review of Clinical Immunology,
Год журнала:
2023,
Номер
19(10), С. 1259 - 1272
Опубликована: Июль 20, 2023
Viral
infections
are
common
triggers
for
asthma
exacerbation.
Subjects
with
more
susceptible
to
viral
and
develop
severe
or
long-lasting
lower
respiratory
tract
symptoms
than
healthy
individuals
owing
impaired
immune
responses.
Of
the
many
viruses
associated
exacerbation,
rhinovirus
(RV)
is
most
frequently
identified
virus
in
both
adults
children.We
reviewed
epidemiological
clinical
links
mechanistic
studies
on
virus-associated
exacerbations.
We
included
sections
acute
syndrome
coronavirus
2
(SARS-CoV2),
latest
evidence
of
disease
2019
(COVID-19)
patients,
past
future
searches
therapeutic
prevention
targets.Early
treatment
might
significantly
reduce
rate
which
one
key
points
management.
Although
it
hypothetically
possible
nowadays
interfere
every
step
infectious
cycle
viruses,
vaccination
development
has
provided
some
encouraging
results.
Future
research
should
proceed
toward
a
wider
spectrum
vaccines
achieve
better
quality
life
patients
economic
burden
healthcare
system.
JAMA Network Open,
Год журнала:
2025,
Номер
8(4), С. e256219 - e256219
Опубликована: Апрель 23, 2025
Importance
Asthma
affects
an
estimated
7.7%
of
the
US
population
and
262
million
people
worldwide.
Symptom
monitoring
has
demonstrated
benefits
but
not
achieved
widespread
use.
Objective
To
assess
effect
a
scalable
asthma
symptom
intervention
on
outcomes.
Design,
Setting,
Participants
This
randomized
clinical
trial
was
conducted
between
July
2020
March
2023
at
7
primary
care
clinics
affiliated
with
academic
medical
center
(Brigham
Women’s
Hospital
in
Boston,
Massachusetts).
Candidate
patients
diagnosis
over
20-month
recruitment
period
(July
to
2022)
were
identified
categorized
into
tiers
varying
disease
activity
based
electronic
health
record
data.
Eligible
adults
(aged
≥18
years)
had
practitioner
1
participating
clinics.
Intervention
group
asked
use
mobile
app
complete
weekly
questionnaires;
track
notes,
peak
flows,
triggers;
view
educational
information.
Patients
who
reported
worsening
or
severe
symptoms
offered
callback
requests.
App
data
available
record.
Usual
received
general
guidance.
Main
Outcomes
Measures
The
outcome
mean
change
Mini
Quality
Life
Questionnaire
(MiniAQLQ)
score
for
intended
12-month
study
period.
A
0.5
scale
considered
minimally
important
change.
secondary
number
asthma-related
utilization
events
(urgent
visits,
emergency
department
hospitalizations).
Mean
differences
all
outcomes
groups
compared
using
robust
linear
regression
models
(generalized
estimating
equations)
treatment
as
only
covariate.
Results
Baseline
questionnaires
completed
by
413
(mean
[SD]
age,
52.2
[15.4]
years;
321
women
[77.7%]).
Of
these,
366
final
included
analysis.
MiniAQLQ
scores
increased
0.34
(95%
CI,
0.19-0.49)
0.11
−0.11
0.33)
usual
from
baseline
questionnaire
completion
(adjusted
difference-in-difference,
0.23
[95%
0.06-0.40];
P
=
.01);
although
difference
statistically
significant,
it
did
reach
threshold
subgroups
showed
positive
relative
group,
noteworthy
increases
among
individuals
aged
18
44
years
0.40
0.13-0.66]),
those
low
patient
activation
0.77
0.30-1.24]),
0.33
0.07-0.59]),
uncontrolled
0.30
0.05-0.54]).
0.59
0.42-0.77)
nonroutine
0.76
0.55-0.96)
size,
−0.16
−0.42
0.17];
.23).
Conclusions
Relevance
In
this
intervention,
increase
quality
life
Exploratory
analyses
suggest
possible
levels
activation.
Trial
Registration
ClinicalTrials.gov
Identifier:
NCT04401332
Monitoring
asthma
is
essential
for
self-management.
However,
traditional
monitoring
methods
require
high
levels
of
active
engagement,
and
some
patients
may
find
this
tedious.
Passive
with
mobile-health
devices,
especially
when
combined
machine-learning,
provides
an
avenue
to
reduce
management
burden.
Data
developing
machine-learning
algorithms
are
scarce,
gathering
new
data
expensive.
A
few
datasets,
such
as
the
Asthma
Mobile
Health
Study,
publicly
available,
but
they
only
consist
self-reported
diaries
lack
any
objective
passively
collected
data.
To
fill
gap,
we
carried
out
a
2-phase,
7-month
AAMOS-00
observational
study
monitor
using
three
smart-monitoring
devices
(smart-peak-flow-meter/smart-inhaler/smartwatch),
daily
symptom
questionnaires.
Combined
localised
weather,
pollen,
air-quality
reports,
rich
longitudinal
dataset
explore
feasibility
passive
attack
prediction.
This
valuable
anonymised
phase-2
(device
monitoring)
has
been
made
available.
Between
June-2021
June-2022,
in
midst
UK's
COVID-19
lockdowns,
22
participants
across
UK
provided
2,054
unique
patient-days
Allergy,
Год журнала:
2024,
Номер
79(10), С. 2589 - 2604
Опубликована: Авг. 1, 2024
The
role
of
eosinophils
in
airway
inflammation
and
asthma
pathogenesis
is
well
established,
with
raised
eosinophil
counts
blood
sputum
associated
increased
disease
severity
risk
exacerbation.
Conversely,
there
also
preliminary
evidence
suggesting
antiviral
properties
the
airways.
These
dual
roles
for
are
particularly
pertinent
as
respiratory
virus
infections
contribute
to
exacerbations.
Biologic
therapies
targeting
key
molecules
implicated
eosinophil-associated
pathologies
have
been
approved
patients
severe
and,
therefore,
effects
depleting
a
clinical
setting
considerable
interest.
This
review
discusses
pathological
We
highlight
significant
reduction
exacerbations
seen
biologic
therapies,
even
at
height
season.
Furthermore,
we
discuss
implications
these
findings
relation
responses
infection
asthma.
medRxiv (Cold Spring Harbor Laboratory),
Год журнала:
2025,
Номер
unknown
Опубликована: Янв. 10, 2025
Abstract
Background
Asthma,
a
chronic
inflammatory
airway
disorder,
can
increase
the
risk
of
hospitalizations
in
individuals
with
viral
infections
such
as
COVID-19.
The
impact
COVID-19
pandemic
on
asthma-related
United
States
remains
unknown.
Objective
We
hypothesized
that
led
to
an
economic
burden
society
and
decrease
hospitalization
rates
for
asthma.
Methods
analyzed
weighted
data
from
National
Inpatient
Sample
(NIS)
between
January
1,
2018,
December
31,
2020.
outcomes
were
asthma
rates,
length
stay
(LOS),
in-hospital
mortality
hospital
admission
costs.
Results
More
people
admitted
primary
diagnosis
2018
2019
compared
2020
(hospitalization
rate
per
100,000:
2018:
38.6
versus
(vs)
2019:37.0
vs
2020:
21.4;
P
<0.001).
Hospital
costs
increased
(2018:
median
[IQR]
5,251
[
3,426,
8,278];
2019:5,677
[3,725,
8.969];
5,881
[3,920-9,216];
Additionally,
in-patient
slightly
2020,
rising
0.44%,
0.20%
0.30%
(P
When
comparing
geographic
divisions,
mid-Atlantic
division
had
highest
Pacific
2018-2020
<0.05).
Conclusion
Asthma
decreased
previous
years.
Those
during
higher
significantly
This
investigation
provides
valuable
insights
policy
makers
about
shifts
healthcare
utilization
pandemic.
Public Health,
Год журнала:
2025,
Номер
243, С. 105719 - 105719
Опубликована: Апрель 14, 2025
A
worldwide
decrease
in
the
incidence
of
respiratory
diseases
during
coronavirus
disease
(COVID-19)
pandemic
has
been
reported,
largely
due
to
non-pharmaceutical
interventions
(NPIs).
However,
impact
lifting
NPIs
remains
unclear.
In
Japan,
were
lifted
rather
drastically
when
COVID-19
was
downgraded
on
May
8,
2023.
This
study
aimed
evaluate
and
its
downgrade
non-COVID-19
using
nationwide
databases.
Retrospective
cohort
study.
Monthly
hospitalisation
prescription
rates
between
January
2017
October
2023
collected
from
JMDC
insurance
claims
database
covering
16,485,812
insured
individuals.
The
monthly
mortality
Japan
an
open
data
source
published
by
Ministry
Health,
Labour
Welfare
Japan.
Interrupted
time
series
analyses
seasonal
autoregressive
integrated
moving
average
models
performed.
While
for
such
as
pneumonia,
asthma,
aspiration
pneumonia
decreased
pandemic,
a
step
increase
hospitalisations
these
prescriptions
anti-asthma
drugs
observed
following
downgrade.
impacted
all
age
groups;
however,
more
pronounced
children
aged
0-5
years.
Although
no
immediate
increased
immediately
after
downgrading
COVID-19,
presumably
because
older
people
less
affected
than
children.
Pediatric Research,
Год журнала:
2025,
Номер
unknown
Опубликована: Май 7, 2025
Abstract
Background
The
objective
of
this
study
was
to
examine
the
associations
blood
inflammatory
phenotypes
with
acute
pediatric
asthma
exacerbations
during
different
seasons
and
COVID-19
pandemic.
Methods
A
retrospective
conducted
involving
32,160
patients
from
January
2008
December
2021.
Asthma
were
categorized
based
on
low
(L)
high
(H)
eosinophils
(E)
neutrophils
(N)
(LBE/HBE:
≥
0.25
×
10
9
/L
LBN/HBN:
5
/L,
respectively)
logistic
regression
used
odds
ratio
(OR)
outcome
variables.
Results
increase
associated
a
1.015-fold
(95%
CI:
1.009–1.021)
1.057-fold
in
OR
1.026–1.088)
for
hospitalized
patients.
An
HBE/LBN
phenotype
respective
1.232-fold
1.081–1.404)
1.248-fold
1.101–1.414)
before
pandemic
winter
autumn
seasons.
However,
an
LBE/LBN
0.873-fold
0.769–0.991),
0.872-fold
0.771–0.986),
0.813-fold
0.709–0.932)
decrease
winter,
spring
summer
Conclusions
had
higher
risk
among
autumn,
while
lower
spring,
summer.
Impact
Blood
have
been
indicated
potential
influence
development
severity.
increased
autumn.
Eosinophil
neutrophil
predominance
exhibited
exacerbations.