Suchergebnisse

Eulogio Pleguezuelos,1,2 Amin Del Carmen,1 Eva Moreno,3 Pilar Ortega,4 Xavier Vila,4 Laura Ovejero,4 Mateu Serra-Prat,5 Elisabet Palomera,5 Manuel Vicente Garnacho-Castaño,6 Eduardo Loeb,7 Georgina Farago,7 Marc Miravitlles7 1Physical Medicine and Rehabilitation Department, Hospital de Mataró, Barcelona, Spain; 2Department of Experimental Science and Healthcare, Faculty of Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; 3Physical Medicine and Rehabilitation Department, Hospitalet General Hospital, L´Hospitalet de Llobregat, Barcelona, Spain; 4Pneumology Department, Hospital de Mataró Mataró, Barcelona, Spain; 5Research Unit, Consorci Sanitari del Maresme, Barcelona, Spain; 6TGRI-AFIRS, Department of Physical Activity and Sports Science, School of Health Sciences, Tecno Campus, Universitat Pompeu Fabra, Barcelona, Spain; 7Pneumology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, SpainCorrespondence: Eulogio PleguezuelosHospital de Mataró, C/Cirera s/n 08302, Mataró, Barcelona, SpainTel +34 93.7417728Fax +34 93.7417717Email epleguezuelos@csdm.catPurpose: On March 16, 2020, the Spanish government declared a state of alarm due to the rapid spread of coronavirus disease 2019 (COVID-19). Patients with chronic obstructive pulmonary disease (COPD) were restricted to remain confined at home, and medical visits were cancelled for 3 months. The impact of this lockdown on the manifestations of COPD and the quality-of-life of these patients has not been explored.Patients and Methods: One hundred patients with COPD were interviewed by telephone from May 2– 18, 2020. The interviews included questions about the lockdown, missed medical appointments, fears of the disease, possible COVID-19 infection, and exacerbations of COPD suffered during this period and their management. In addition, the COPD Assessment Test, the Hospital Anxiety and Depression, and the 5-Dimension Euro Quality-of-Life questionnaires were administered.Results: Sixty-four (64%) patients claimed to have strictly complied with the lockdown, and only 42 (42%) stated they had left home at least once during lockdown. Only one patient (1%) was hospitalized due to COVID-19, and 13 (13%) patients presented an exacerbation of COPD self-managed at home with no admissions due to exacerbation of COPD during this period. A medical consultation or complementary test was cancelled in 90% of the patients, but 61% had a medical telephone visit with a high degree of satisfaction (mean 9.3/10). Most patients declared that their feeling regarding lung disease and general health was similar or even better during lockdown (82% and 81%, respectively).Conclusion: Our results indicate that in general lockdown had a low impact on COPD patients. Only one patient was affected by COVID-19, but moderate exacerbations of COPD were not infrequent. Although many medical visits and test were cancelled, patients were very satisfied with the medical telephone visits.Keywords: COPD, lockdown, COVID-19

PURPOSE: On March 16, 2020, the Spanish government declared a state of alarm due to the rapid spread of coronavirus disease 2019 (COVID-19). Patients with chronic obstructive pulmonary disease (COPD) were restricted to remain confined at home, and medical visits were cancelled for 3 months. The impact of this lockdown on the manifestations of COPD and the quality-of-life of these patients has not been explored. PATIENTS AND METHODS: One hundred patients with COPD were interviewed by telephone from May 2–18, 2020. The interviews included questions about the lockdown, missed medical appointments, fears of the disease, possible COVID-19 infection, and exacerbations of COPD suffered during this period and their management. In addition, the COPD Assessment Test, the Hospital Anxiety and Depression, and the 5-Dimension Euro Quality-of-Life questionnaires were administered. RESULTS: Sixty-four (64%) patients claimed to have strictly complied with the lockdown, and only 42 (42%) stated they had left home at least once during lockdown. Only one patient (1%) was hospitalized due to COVID-19, and 13 (13%) patients presented an exacerbation of COPD self-managed at home with no admissions due to exacerbation of COPD during this period. A medical consultation or complementary test was cancelled in 90% of the patients, but 61% had a medical telephone visit with a high degree of satisfaction (mean 9.3/10). Most patients declared that their feeling regarding lung disease and general health was similar or even better during lockdown (82% and 81%, respectively). CONCLUSION: Our results indicate that in general lockdown had a low impact on COPD patients. Only one patient was affected by COVID-19, but moderate exacerbations of COPD were not infrequent. Although many medical visits and test were cancelled, patients were very satisfied with the medical telephone visits.

Bassam H Mahboub,1,2 Mayank Gian Vats,2 Ashraf Al Zaabi,3 Mohammed Nizam Iqbal,2 Tarek Safwat,4 Fatma Al-Hurish,5 Marc Miravitlles,6 Dave Singh,7 Khaled Asad,8 Salah Zeineldine,9,10 Mohamed S Al Hajjaj11College of Medicine, University of Sharjah, Sharjah, 2Department of Pulmonary Medicine, Rashid Hospital, Dubai Health Authority, Dubai, 3Department of Pulmonary Medicine, Zayed Military Hospital, Abu Dhabi, United Arab Emirates; 4Chest Department, Ain Shams University, Cairo, Egypt; 5Department of Pulmonology and Allergy, Al-Sabah Hospital, Kuwait City, Kuwait; 6Department of Pneumology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; 7Centre for Respiratory Medicine and Allergy, University of Manchester, University Hospital of South Manchester, Manchester, UK; 8Pulmonary and Critical Care, Istishari Hospital, Amman, Jordan; 9Faculty of Medicine, 10Hariri School of Nursing, American University of Beirut, Beirut, Lebanon Abstract: Smoking and subsequent development of COPD is an ever-increasing epidemic in Arabian Gulf and Middle East countries, with no signs of decline. The important fact to be highlighted is that this COPD epidemic of increasing incidence and prevalence is mostly unrecognized by patients, due to the common attribution of symptoms to "smoker's cough", and the underdiagnosis and undertreatment by physicians because the common signs and symptoms masquerade as asthma. Consequently, there are long-term adverse effects of missing the diagnosis. The purpose of this review article is to focus upon the status of COPD in Arabian Gulf and Middle East countries, stressing the increasing burden of smoking and COPD, to emphasize the specific factors leading to rise in prevalence of COPD, to bring to light the underdiagnosis and undermanagement of COPD, and to treat COPD in conformity with standard guidelines with local and regional modifications. This review ends with suggestions and recommendations to the health department to formulate policies and to generate awareness among the general public about the side effects of smoking and consequences of COPD. Keywords: COPD, Gulf Cooperation Council countries, Middle East, prevalence of smoking, water pipe, shisha, medwakh, bakhourCorrigendum for this paper has been published

After the development of the COPD Strategy of the National Health Service in Spain, all scientific societies, patient organisations, and central and regional governments formed a partnership to enhance care and research in COPD. At the same time, the Spanish Society of Pneumology and Thoracic Surgery (SEPAR) took the initiative to convene the various scientific societies involved in the National COPD Strategy and invited them to participate in the development of the new Spanish guidelines for COPD (Guía Española de la EPOC; GesEPOC). Probably the more innovative approach of GesEPOC is to base treatment of stable COPD on clinical phenotypes, a term which has become increasingly used in recent years to refer to the different clinical forms of COPD with different prognostic implications. The proposed phenotypes are: (A) infrequent exacerbators with either chronic bronchitis or emphysema; (B) overlap COPD-asthma; (C) frequent exacerbators with emphysema predominant; and (D) frequent exacerbators with chronic bronchitis predominant. The assessment of severity has also been updated with the incorporation of multidimensional indices. The severity of the obstruction, as measured by forced expiratory volume in 1 second, is essential but not sufficient. Multidimensional indices such as the BODE index have shown excellent prognostic value. If the 6-minute walking test is not performed routinely, its substitution by the frequency of exacerbations (BODEx index) provides similar prognostic properties. This proposal aims to achieve a more personalised management of COPD according to the clinical characteristics and multidimensional assessment of severity.