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Oliver J. McElvaney, MD, PhD1,2,3,4 Brian Cleary, MD1 Daniel D. Fraughen, MD1,2 Geraldine Kelly, MBA5 Oisin F. McElvaney, MD, PhD1 Mark P. Murphy, PhD1 Peter Branagan, MD1,2 Cedric Gunaratnam, MD1,2 Tomás P. Carroll, PhD1,5 Christopher H. Goss, MD, MSc3,4,6 Noel G. McElvaney, MD1,2
Author Affiliations
- Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
- National Centre for Alpha-1 Antitrypsin Deficiency, Beaumont Hospital, Dublin, Ireland
- Seattle Children’s Research Institute, Seattle, Washington, United States
- Department of Medicine, University of Washington, Seattle, Washington, United States
- Alpha-1 Foundation of Ireland, Dublin, Ireland
- Department of Pediatrics, University of Washington, Seattle, Washington, United States
Address correspondence to:
Oliver J. McElvaney, MD, PhD
Department of Medicine
Royal College of Surgeons in Ireland
Dublin, Ireland
Phone: +353 18093763
Email: olivermcelvaney@rcsi.ie
Abstract
Background: Patients with alpha-1 antitrypsin deficiency (AATD) exhibit dysregulated inflammatory responses and a predilection for autoimmunity. While the adverse event (AE) profiles of COVID-19 vaccines in several chronic inflammatory conditions are now available, safety and tolerability data for patients with severe AATD have yet to be described. The feasibility of coadministering vaccines against COVID-19 and influenza in this population is similarly unclear.
Methods: We conducted a prospective study of 170 patients with Pi*ZZ genotype AATD receiving their initial vaccination series with ChAdOx1 nCoV-19 (AstraZeneca). Patients were monitored clinically for AEs over the week that followed their first and second doses. In parallel, we conducted the same assessments in patients with Pi*MM genotype chronic obstructive pulmonary disease (COPD) (n=160) and Pi*MM individuals without lung disease (n=150). The Pi*ZZ cohort was subsequently followed through 2 consecutive mRNA-based booster vaccines (monovalent and bivalent BNT162b2, Pfizer/BioNTech). To assess the safety of combined vaccination against COVID-19 and influenza, the quadrivalent influenza vaccine was administered to participants attending for their second COVID-19 booster vaccination, either on the same day or following a 1-week interval.
Results: Pi*ZZ AATD participants did not display increased AEs compared to Pi*MM COPD or Pi*MM non-lung disease controls. Although unexpected and serious vaccine-associated AEs did occur, the majority of AEs experienced across the 3 groups were mild and self-limiting. The AATD demographic at highest risk for AEs (especially systemic and prolonged AEs) was young females. No increase in AE risk was observed in patients with established emphysema, sonographic evidence of liver disease, or in those receiving intravenous augmentation therapy. AE incidence declined sharply following the initial vaccine series. Same-day coadministration of the COVID-19 mRNA bivalent booster vaccine and the annual influenza vaccine did not result in increased AEs compared to sequential vaccines 1 week apart.
Conclusions: Despite their pro-inflammatory state, patients with severe AATD are not at increased risk of AEs or serious AEs compared to patients with nonhereditary COPD and patients without lung disease. Same-day coadministration of COVID-19 booster vaccines with the annual influenza vaccine is feasible, safe, and well-tolerated in this population.
Citation
Citation: McElvaney OJ, Cleary B, Fraughen DD, et al. Safety and reactogenicity of COVID-19 vaccination in severe alpha-1 antitrypsin deficiency. Chronic Obstr Pulm Dis. 2024; 11(1): 3-12. doi: http://dx.doi.org/10.15326/jcopdf.11.1.2023.0432
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Margaret A. Hay, MD1 Kristen E. Holm, PhD2,3 Jean McCathern,2 Robert A. Sandhaus, MD, PhD2,3 Charlie Strange, MD1,2
Author Affiliations
- Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina, United States
- AlphaNet, Inc., Coral Gables, Florida, United States
- Department of Medicine, National Jewish Health, Denver, Colorado, United States
Address correspondence to:
Charlie Strange, MD
MSC630
Medical University of South Carolina
Charleston, SC, 29425
Phone: (843) 792-3174
Email: strangec@musc.edu
Abstract
Background: Individuals with alpha-1 antitrypsin deficiency (AATD)-associated chronic obstructive pulmonary disease (COPD) may be at increased risk of coronavirus disease 2019 (COVID-19) pneumonia since COPD is associated with an increased risk of severe COVID-19 infection.
Research Question: We hypothesized that the AlphaNet disease management program would lower COVID-19 burdens. We evaluated the prevalence of COVID-19 infection, severe COVID-19, interruptions in augmentation therapy, and intention to vaccinate.
Study Design and Methods: Data regarding COVID-19 were collected monthly from March 2020 through February 2022. Responses from 8019 individuals were analyzed to evaluate the prevalence and severity of COVID-19 infections, interruptions in AATD care, and the likelihood of vaccination.
Results: By the end of 2020, 4% of patients reported a positive COVID-19 test. Of those, 35.3% were hospitalized, with 8.6% admitted to the intensive care unit (ICU). By February 2022, the prevalence of COVID-19 infections had increased to 18.6%, with hospitalization rates of 22.1% and ICU admissions at 4.7%. Attitudes about COVID-19 vaccination assessed in December 2020 before the vaccine was widely available suggested 10.3% of patients would definitely not get the vaccine. Notably, 38.2% of those subsequently self-reported receipt of a COVID-19 vaccine.
Interpretation: The prevalence of COVID-19 infections in patients with AATD was lower than the prevalence in the general U.S. population during 2020, although with a higher hospitalization rate. This health-managed population has a high vaccination intent. Those with an initially low vaccination intent changed their minds over time. We interpret these results as showing that most AlphaNet individuals with AATD had success at navigating the COVID-19 pandemic with lower case rates than the general U.S. population.
Citation
Citation: Hay M, Holm KE, McCathern J, Sandhaus RA, Strange C. Impact of coronavirus disease 2019 and vaccination attitudes on alpha-1 antitrypsin deficiency. Chronic Obstr Pulm Dis. 2023; 10(4): 335-342. doi: http://dx.doi.org/10.15326/jcopdf.10.4.2023.0406
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Michael Rydberg, MD1 Pete Burkett, BBM2 Erica Johnson, PhD3 M. Bradley Drummond, MD, MHS4
Author Affiliations
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Monitored Therapeutics, Inc., Dublin, Ohio, United States
- Midmark Corporation, Versailles, Ohio, United States
- Division of Pulmonary Diseases and Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
Address correspondence to:
M. Bradley Drummond, MD, MHS
University of North Carolina at Chapel Hill
Marsico Hall Room 7207, CB#7248
Chapel Hill, NC 27599
Phone: (919) 966-7054
Email: brad_drummond@med.unc.edu
Abstract
This article does not contain an abstract.
Citation
Citation: Rydberg M, Burkett P, Johnson E, Drummond MB. Home telemonitoring program in individuals with COPD during the coronavirus disease 2019 pandemic: a pilot study. Chronic Obstr Pulm Dis. 2023; 10(4): 437-443. doi: http://dx.doi.org/10.15326/jcopdf.10.4.2023.0431
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Eva Pappe, MD1 Ralf Hammerich, MD2 Jacopo Saccomanno, MD1 Thomas Sgarbossa, MD1 Anne Pohrt, PhD3 Bernd Schmidt, MD4 Christian Grah, MD5 Stephan Eisenmann, MD6 Angelique Holland, MD7 Stephan Eggeling, MD8 Franz Stanzel, MD9 Martin Witzenrath, MD1 Ralf-Harto Hübner, MD1
Author Affiliations
- Department of Infectious Diseases and Respiratory Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Administrative Office for Clinical Quality and Risk Management, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Institute of Biometry and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Respiratory Medicine, DRK Kliniken Berlin Mitte, Berlin, Germany
- Department of Internal Medicine and Respiratory Medicine, Clinic Havelhöhe Berlin, Berlin, Germany
- Department of Internal Medicine I, Pulmonary Medicine, University Hospital Halle (Saale), Germany
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Marburg, Germany
- Department of Thoracic Surgery, Vivantes Netzwerk für Gesundheit, Klinikum Neukölln, Berlin, Germany
- Lungenklinik Hemer, Hemer, Germany
Address correspondence to:
Eva Pappe, MD
Charitéplatz 1
10117
Berlin, Germany
Phone: 0049 30 450 653078
E-mail: eva.pappe@charite.de
Abstract
Introduction: Patients with chronic obstructive pulmonary disease (COPD) have an increased risk of acquiring severe coronavirus disease 2019 (COVID-19), which is why self-isolation was recommended. However, long periods of social isolation, accompanied by limited access to health care systems, might influence the outcome of patients with severe COPD negatively.
Methods: Data from COPD and pneumonia patients at Charité-Universitätsmedizin Berlin and the volume of endoscopic lung volume reduction (ELVR) surgeries from the German Lung Emphysema Registry (Lungenemphysem Register e.V.) were analyzed from pre-pandemic (2012 to 2019) to the pandemic period (2020 and 2021). In addition, 52 patients with COPD Global initiative for chronic Obstructive Lung Disease (GOLD) stage 4 status included in the lung emphysema registry received questionnaires during lockdowns from June 2020 to April 2021.
Results: Admissions and ventilation therapies administered to COPD patients significantly decreased during the COVID-19 pandemic. Likewise, there was a reduction in ELVR treatments and follow-ups registered in German emphysema centers. Mortality was slightly higher among patients hospitalized with COPD during the pandemic. Increasing proportions of COPD patients with GOLD stage 3 and GOLD stage 4 status reported behavioral changes and subjective feelings of increasing COPD symptoms the longer the lockdown lasted. However, COPD symptom questionnaires revealed stable COPD symptoms over the pandemic time period.
Summary: This study reveals reduced COPD admissions and elective treatment procedures of COPD patients during the pandemic, but a slight increase in mortality among patients hospitalized with COPD, irrespective of COVID-19. Correspondingly, patients with severe COPD reported subjective deterioration of their health status, probably caused by their very strict compliance with lockdown measures.
Citation
Citation: Pappe E, Hammerich R, Saccomanno J, et al. Impact of coronavirus disease 2019 on hospital admissions, health status, and behavioral changes of patients with COPD. Chronic Obstr Pulm Dis. 2023; 10(3): 211-223. doi: http://dx.doi.org/10.15326/jcopdf.10.3.2022.0383
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Kiki Waeijen-Smit, MSc1,2 Sarah Houben-Wilke, PhD1 Rein Posthuma, MD1,2 Fenne de Jong, BSc1 Daisy J. A. Janssen, PhD, MD1,3 Nicole P. H. van Loon, MD1,4 Bita Hajian, PhD, MD1,2 Sami O. Simons, PhD, MD2 Martijn A. Spruit, PhD1,2 Frits M. E. Franssen, PhD, MD1,2
Author Affiliations
- Department of Research and Development, Ciro, Horn, the Netherlands
- Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Centre, Maastricht, the Netherlands
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
Address correspondence to:
Kiki Waeijen-Smit, MSc
Ciro
Department of Research and Development
P.O. Box 4009
6080 AA Haelen, the Netherlands
Email: KikiSmit@ciro-horn.nl
Phone: 31 (0) 475 587 602
Abstract
Rationale: A significant reduction in hospitalizations for acute exacerbations of COPD (AECOPDs) has been reported during the coronavirus disease 2019 (COVID-19) pandemic. It remains unclear whether this reduction is the result of health care avoidance by patients, or of infection prevention and control (IPC) measures.
Objectives: Our objective was to explore the impact of COVID-19–related IPC measures on the occurrence of AECOPD in a real-life inpatient pulmonary rehabilitation (PR) setting, thereby ruling out potential effects of health care avoidance.
Methods: Patients with COPD admitted for 8 weeks of inpatient PR at Ciro (Horn, the Netherlands) between October 2020 and March 2021, the first winter with full COVID-19–related IPC measures,were compared to patients admitted during the same period in previous years (2017–2018, 2018–2019, and 2019–2020). Electronic medical records were retrospectively screened for the occurrence of moderate to severe AECOPDs, drop-out, and mortality.
Results: A total of 501 patients with COPD (median age 66.6 [interquartile range (IQR) 60.3–71.9] years, 43.1% male, forced expiratory volume in 1 second [FEV1] 35.9 [26.8–50.6] % predicted) were analyzed. During 2020–2021, 22 patients (31.0%) experienced ≥1 AECOPD compared to 43 patients (33.6%) in 2019–2020, 55 patients (36.9%) in 2018–2019, and 83 patients (54.2%) in 2017–2018. This represents a 25.4% reduction in 2020–2021 compared to the average of the previous 3 periods, p=0.077. No differences in AECOPD severity, drop-out, or mortality were observed.
Conclusions: COVID-19–related IPC measures did not significantly reduce the AECOPD rate during inpatient PR in a single-center setting. The current findings suggest that avoidance of health care may be an important factor in the observed reduction of AECOPD-related hospitalizations during the pandemic and that the value of the strict COVID-19-related IPC measures for the prevention of AECOPDs warrants further research.
Citation
Citation: Waeijen-Smit K, Houben-Wilke S, Posthuma R, et al. Impact of coronavirus disease 2019-related infection prevention and control measures on the occurrence of COPD exacerbations during inpatient pulmonary rehabilitation. Chronic Obstr Pulm Dis. 2023; 10(2): 127-138. doi: http://dx.doi.org/10.15326/jcopdf.10.2.2022.0345
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Laura C. Myers, MD, MPH1,2 Richard K. Murray, MD3 Bonnie M.K. Donato, PhD4 Vincent X. Liu, MD, MSc1,2 Patricia Kipnis, PhD1,2 Asif Shaikh, MD, DrPH5 Jessica Franchino-Elder, PhD, MPH4
Author Affiliations
- The Permanente Medical Group, Kaiser Permanente Northern California, Oakland, California, United States
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States
- Spire Health, San Francisco, California, United States
- Health Economics and Outcomes Research, Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, Connecticut, United States
- Clinical Development and Medical Affairs, Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, Connecticut, United States
Address correspondence to:
Laura C. Myers, MD, MPH
Division of Research
Kaiser Permanente Northern California
2000 Broadway
Oakland, California 94612
Email: laura.c.myers@kp.org
Phone: (925) 433-3491
Abstract
Background: It is unclear whether persistent inhaled steroid exposure in chronic obstructive pulmonary disease (COPD) patients before coronavirus disease 2019 (COVID-19) is associated with hospitalization risk.
Objective: Our objective was to examine the association between persistent steroid exposure and COVID-19–related hospitalization risk in COPD patients.
Study Design and Methods: This retrospective cohort study used electronic health records from the Kaiser Permanente Northern California health care system (February 2, 2020, to September 30, 2020) for patients aged ≥40 years with COPD and a positive polymerase chain reaction test result for COVID-19. Primary exposure was persistent oral and/or inhaled steroid exposure defined as ≥6 months of prescriptions filled in the year before the COVID-19 diagnosis. Multivariable logistic regression was performed for the primary outcome of COVID-19–related hospitalization or death/hospice referral. Steroid exposure in the month before a COVID-19 diagnosis was a covariate.
Results: Of >4.3 million adults, 697 had COVID-19 and COPD, of whom 270 (38.7%) had COVID-19–related hospitalizations. Overall, 538 (77.2%) were neither exposed to steroids in the month before COVID-19 diagnosis nor persistently exposed; 53 (7.6%) were exposed in the month before but not persistently; 23 (3.3%) were exposed persistently but not in the month before; and 83 (11.9%) were exposed both persistently and in the month before. Adjusting for all confounders including steroid use in the month before, the odds ratio for hospitalization was 0.77 (95% confidence interval 0.41–1.46) for patients persistently exposed to steroids before a COVID-19 diagnosis.
Interpretation: No association was observed between persistent steroid exposure and the risk of COVID-19–related hospitalization in COPD patients.
Citation
Citation: Myers LC, Murray RK, Donato BMK, et al. Persistent steroid exposure before coronavirus disease 2019 diagnosis and risk of hospitalization in patients with chronic obstructive pulmonary disease. Chronic Obstr Pulm Dis. 2023; 10(1): 64-76. doi: http://dx.doi.org/10.15326/jcopdf.10.1.2022.0351
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William Z. Zhang, MD1* Stephanie L. LaBedz, MD2* Janet T. Holbrook, PhD3 Andrew Gangemi, MD4 Ramasubramanian Baalachandran, MBBS5 Michelle N. Eakin, PhD, MD6 Robert A. Wise, MD6 Kaharu Sumino, MD, MPH7 for the American Lung Association Airways Clinical Research Centers.
Author Affiliations
- Division of Pulmonary and Critical Care Medicine, Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine, New York, New York, United States
- Division of Pulmonary, Critical Care, Sleep, and Allergy, University of Illinois at Chicago, Chicago, Illinois, United States
- Center for Clinical Trials and Evidence Synthesis, Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
- Pulmonary and Critical Care Medicine, University of Vermont, Burlington, Vermont, United States
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, United States
*Contributed equally as first author
Address correspondence to:
Janet T. Holbrook, PhD
415 N. Washington Street
Baltimore, MD 21231
Phone: 443-287-5791
Email: janet.holbrook@jhu.edu
Abstract
Background: Patients with chronic obstructive pulmonary disease (COPD) are at higher risk for severe coronavirus disease 2019 (COVID-19). From the pandemic’s onset there has been concern regarding effects on health and well-being of high-risk patients.
Methods: This was an ancillary study to the Losartan Effects on Emphysema Progression (LEEP) Trial and was designed to collect descriptive information longitudinally about the health and wellbeing of COPD patients who were enrolled in a clinical trial. Participants were interviewed by telephone about their health status every 2 weeks and their mental health, knowledge, and behaviors every 8 weeks from June 2020 to April 2021. There were no pre-specified hypotheses.
Results: We enrolled 157 of the 220 participants from the parent LEEP trial. Their median age was 69 years, 55% were male, and 82% were White; median forced expiratory volume in 1 second (FEV1)% predicted was 48%. Nine confirmed COVID-19 infections were reported, 2 resulting in hospitalization. Rates of elevated anxiety or depressive symptoms were 8% and 19% respectively in June 2020 and remained relatively stable during follow-up. By April 2021, 85% of participants said they were “very likely” to receive a vaccine; 91% were vaccinated (≥1 dose) by the end of December 2021.
Conclusion: Our select cohort of moderate to severe COPD patients who were well integrated into a health care network coped well with the COVID-19 pandemic. Few participants were diagnosed with COVID-19, levels of depression and anxiety were stable, most adopted accepted risk reduction behaviors, and did not become socially isolated; most were vaccinated by the end of 2021.
Citation
Citation: Zhang WZ, LaBedz SL, Holbrook JT, et al; the American Lung Association Airways Clinical Research Centers. Impact of the coronavirus disease 2019 pandemic on physical and mental health of patients with COPD: results from a longitudinal cohort study conducted in the United States (2020-2021). Chronic Obstr Pulm Dis. 2022; 9(4): 510-519. doi: http://dx.doi.org/10.15326/jcopdf.9.4.2022.0287
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Éliane Pelletier, MD1,2 Philippe Desmeules, PhD3 Yves Lacasse, MD, MSc1,2 Sophie Tanguay, BSc1,2 Julie Milot, MD, PhD1,2 Mathieu C. Morissette, PhD1,2 François Maltais, MD1,2
Author Affiliations
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Canada
- Département de Médecine et Faculté de Médecine, Montréal, Canada
- Centre Hospitalier Universitaire de Québec, Site IUCPQ, Université Laval, Québec, Canada
Address correspondence to:
François Maltais, MD
Centre de Pneumologie
Institut Universitaire de Cardiologie et de Pneumologie de Québec
2725, Chemin Ste-Foy
Québec, Canada, G1V 4G5
Phone: (418) 656-4747
Email: francois.maltais@med.ulaval.ca
Abstract
This article does not contain an abstract.
Citation
Citation: Pelletier E, Desmeules P, Lacasse Y, et al. Antibody response to severe acute respiratory syndrome coronavirus-2 vaccination in COPD: a cohort study. Chronic Obstr Pulm Dis. 2022; 9(4): 591-595. doi: http://dx.doi.org/10.15326/jcopdf.9.4.2022.0315
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Pamela J. McShane, MD1 Julie V. Philley, MD1 Delia A. Prieto, MSEd2 Timothy R. Aksamit, MD3
Author Affiliations
- Division of Pulmonary and Critical Care Medicine, the University of Texas Health Science Center at Tyler, Tyler, Texas, United States
- National Bronchiectasis Research Registry, COPD Foundation, Washington, DC, United States
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, United States
Address correspondence to:
Pamela J. McShane, MD
Division of Pulmonary and Critical Care Medicine
The University of Texas Health Science Center at Tyler
11937 US Hwy 271
Tyler, TX 75708
Phone: (847) 226-8410
Email: pamela.mcshane@uthct.edu
Abstract
This article does not contain an abstract.
Citation
Citation: McShane PJ, Philley JV, Prieto DA, Aksamit TR. Global attitudes of health care providers about aerosolized airway clearance therapy in bronchiectasis patients during the coronavirus disease 2019 pandemic. Chronic Obstr Pulm Dis. 2021; 8(3): 319-325. doi: http://dx.doi.org/10.15326/jcopdf.8.3.2021.0214
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Gretchen McCreary, MA1 Danielle Boyce, MPH1 Mary Ellen Houlihan2 Jean Rommes, PhD2 Carol Rubin, MEd, MS3 Karen Deitemeyer2 William Clark, BS4 Cara B. Pasquale, MPH1 Richard A. Mularski, MD, MSHS, MCR5 Elisha Malanga, BS1 Barbara P. Yawn, MD, MSc, MPH1
Author Affiliations
- Research Department, COPD Foundation, Washington, DC, United States
- COPD Patient-Powered Research Network Governing Board, COPD Foundation, Washington, DC, United States
- Patient investigator for the COPD Foundation, Washington, DC, United States
- Community Engagement, COPD Foundation, Washington, DC, United States
- Kaiser Permanente Center for Health Research, Portland, Oregon, United States
Abstract
This article does not contain an abstract.
Citation
Citation: McCreary G, Boyce D, Houlihan ME, et al. Patient-driven research agenda: what needs to be studied in those living with COPD during the coronavirus disease 2019 pandemic. Chronic Obstr Pulm Dis. 2021; 8(3): 314-318. doi: http://dx.doi.org/10.15326/jcopdf.8.3.2021.0203
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Ron Balkissoon, MD, MSc, DIH, FRCPC1
Author Affiliations
- Denver, Colorado
Abstract
This article does not contain an abstract.
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Robert M. Marron, MD1 Matthew Zheng, MD1 Gustavo Fernandez Romero, MD1 Huaqing Zhao, PhD2 Raj Patel, MD3 Ian Leopold, MD3 Ashanth Thomas, MD3 Taylor Standiford, MD3 Maruti Kumaran, MD3 Nicole Patlakh, BS1 Jeffrey Stewart, MD1 Gerard J. Criner, MD1 and the Temple University COVID-19 Research Group
Author Affiliations
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
- Department of Clinical Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
- Department of Radiology, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
Abstract
Background: Comorbid disease is a risk factor for severe coronavirus disease 2019 (COVID-19) infection. However, initial rates of chronic obstructive pulmonary disease (COPD) in case series were low and severity of COVID-19 in COPD patients was variable.
Methods: We performed a retrospective study of patients admitted with COVID-19 and evaluated outcomes in those with and without COPD and/or emphysema. Patients were identified as having COPD if they had a diagnosis in the medical record and a history of airflow-obstruction on spirometry, or a history of tobacco use and prescribed long-acting bronchodilator(s). Computed tomography scans were evaluated by radiologists. Propensity matching was performed for age, body mass index (BMI), and serologic data correlated with severity of COVID-19 disease (D-dimer, C-reactive protein, ferritin, fibrinogen, absolute lymphocyte count, lymphocyte percentage, and lactate dehydrogenase).
Results: Of 577 patients admitted with COVID-19, 103 had a diagnosis of COPD and/or emphysema. The COPD/emphysema cohort was older (67 versus 58, p<0.0001) than the other cohort and had a lower BMI. Among unmatched cohorts those with COPD/emphysema had higher rates of intensive care unit (ICU) admission (35% versus 24.9%, p=0.036) and maximal respiratory support requirements, with more frequent invasive mechanical ventilation (21.4% versus 11.8%), but no significant difference in mortality. After propensity-matching there was no difference in ICU admission, maximal respiratory support requirements, or mortality. Univariate and multivariate regression analyses yielded similar results.
Discussion: Our propensity-matched retrospective cohort study suggests that patients hospitalized with COVID-19 who have COPD and/or emphysema may not have worse outcomes than those without these comorbid conditions.
Citation
Citation: Marron RM, Zheng M, Romero GF, et al.Impact of chronic obstructive pulmonary disease and emphysema on outcomes of hospitalized patients with coronavirus 2019 pneumonia. Chronic Obstr Pulm Dis. 2021; 8(2): 255-268. doi: http://dx.doi.org/10.15326/jcopdf.8.2.2020.0200
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Danielle M. Boyce, MPH1 Byron M. Thomashow, MD1,2 Jamie Sullivan, MPH1 Ruth Tal-Singer, PhD1
Author Affiliations
- COPD Foundation, Washington, DC, United States
- Columbia University Medical Center, New York, New York, United States
Abstract
Objectives: To investigate telemedicine adoption, emergency department avoidance, and related characteristics of patients with chronic obstructive pulmonary disease (COPD) with and without exacerbations since the coronavirus 2019 (COVID-19) pandemic began.
Methods: We conducted the second of a series of online surveys via SurveyMonkey.com of people with COPD between May 1, 2020 and May 31, 2020. Frequency, percentage, and Fisher’s exact test (2-sided) were calculated using SPSS version 26.
Results: More than half of respondents (157, 64%), indicated that they started using telemedicine in 2020. A total of 47% of respondents reported having had at least 1 exacerbation since January 1, 2020. Respondents who had at least 1 exacerbation in 2020 were more likely to start using telemedicine in 2020 than respondents who did not report any exacerbation in 2020 (75.7% versus 54.3%, p < 0.001). Respondents reporting a 2020 exacerbation indicated having a significantly higher avoidance of emergency health care since the pandemic began (27.8%) as compared to those who did not have an exacerbation in 2020 (10.1%), p < 0.001.
Conclusions: In response to social distancing and other COVID-19 precautions, people with COPD are avoiding traditional, in-person health care environments and turning to telemedicine to prevent and manage exacerbations. Further investigation is needed to identify best practices in and barriers to telemedicine in this population.
Citation
Citation: Boyce DM, Thomashow BM, Sullivan J, Tal-Singer R. New adopters of telemedicine during the coronavirus-19 pandemic in respondents to an online community survey: the case for access to remote management tools for individuals with chronic obstructive pulmonary disease. Chronic Obstr Pulm Dis. 2021; 8(2): 213-218. doi: http://dx.doi.org/10.15326/jcopdf.8.2.2020.0181
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Ron Balkissoon, MD, MSc, DIH, FRCPC1
Author Affiliations
- Denver, Colorado
Abstract
This article does not contain an abstract.
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Syed Shahzad Hasan, PhD1 Chia Siang Kow, MPharm2 Keivan Ahmadi, PhD3
Author Affiliations
- Department of Pharmacy, University of Huddersfield, Huddersfield, United Kingdom and School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, Australia
- School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia
- Lincoln Medical School, Universities of Nottingham and Lincoln, Lincolnshire, United Kingdom
Address correspondence to:
Chia Siang Kow, MPharm
School of Postgraduate Studies
International Medical University
Kuala Lumpur, Malaysia
Email: chiasiang_93@hotmail.com
Abstract
This article does not contain an abstract.
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Stephanie Tittaferrante, MD1* Rohit Gupta, MD2* Victor Kim, MD2 on behalf of the Temple University COVID-19 Research Group
Author Affiliations
- Department of Internal Medicine, Temple University Health System, Philadelphia, Pennsylvania
- Department of Thoracic Medicine and Surgery, Temple University Health System, Philadelphia, Pennsylvania
*These authors contributed equally as first authors. A list of individuals in the Temple University COVID-19 Research Group is provided in the online data supplement.
Address correspondence to:
Stephanie Tittaferrante, MD
Department of Internal Medicine and Surgery
Temple University Health System
Philadelphia, Pennsylvania
Email: stephanie.tittaferrante@tuhs.temple.edu
Abstract
This article does not contain an abstract.
Citation
Citation: Tittaferrante S, Gupta R, Kim V, Temple University Research Group. Thoracic computed tomography features of coronavirus disease 2019 patients with emphysema. Chronic Obstr Pulm Dis. 2020; 7(3): 290-296. doi: http://dx.doi.org/10.15326/jcopdf.7.3.2020.0166
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Ruth Tal-Singer, PhD1 Barbara P. Yawn, MD1,2 Robert Wise, MD3 Byron M. Thomashow, MD1,4 Danielle M. Boyce, MPH1
Author Affiliations
- COPD Foundation, Research Department, Washington, DC
- University of Minnesota, Family and Community Health, Minneapolis
- Pulmonary and Critical Care, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University, New York, New York
Abstract
This article does not contain an abstract.
Citation
Citation: Tal-Singer R, Yawn B, Wise B, Thomashow B, Boyce DM. The COPD Foundation Coronavirus Disease 2019 International Medical Experts Survey: results. Chronic Obstr Pulm Dis. 2020; 7(3): 139-146. doi: http://dx.doi.org/10.15326/jcopdf.7.3.2020.0164
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Donald P. Tashkin, MD1 Igor Z. Barjaktarevic, MD, PhD1
Author Affiliations
- David Geffen School of Medicine, University of California, Los Angeles
Abstract
This article does not contain an abstract.
Citation
Citation: Tashkin DP, Barjaktarevic IZ. Nebulized treatments and the possible risk of coronoavirus transmission: where is the evidence? Chronic Obstr Pulm Dis. 2020; 7(3): 136-138. doi: http://dx.doi.org/10.15326/jcopdf.7.3.2020.0161
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Sara Latham, BA1 Jamie Sullivan, MPH1 Stephanie Williams, RRT1 Michelle N. Eakin, PhD2
Author Affiliations
- COPD Foundation, Washington, DC
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
Address correspondence to:
Michelle N. Eakin, PhD
Johns Hopkins University
5501 Hopkins Bayview Circle Room 4b.74
Baltimore, MD 21224
Email: Meakin1@jhmi.edu
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Citation: Latham S, Sullivan J, Williams S, Eakin MN. Maintaining emotional well-being during the COVID-19 pandemic: a resource for your patients. Chronic Obstr Pulm Dis. 2020; 7(2): 76-78. doi: http://dx.doi.org/10.15326/jcopdf.7.2.2020.0150
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Ruth Tal-Singer, PhD1 James D. Crapo, MD2,3
Author Affiliations
- COPD Foundation, Washington, D.C.
- Editor in Chief, Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, COPD Foundation, Washington, DC
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, Colorado
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