Impact of radiologically stratified exacerbations: insights into pneumonia aetiology in COPD

Williams, Nicholas; Ostridge, Kristoffer; Devaster, Jeanne-Marie; Kim, Viktoriya; Coombs, Ngaire; Bourne, Simon; Clarke, Stuart C.; Harden, S.; Abbas, Ausami; Aris, Emmanuel; Lambert, Christophe; Tuck, Andrew; Williams, Anthony P.; Wootton, Stephen; Staples, Karl J.; Wilkinson, Tom

doi:10.1186/s12931-018-0842-8

Cited by 28 publications

(26 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…summary agrees with other results currently available only in pre-print [35,36]. Viral infections in COPD patients increase systemic inflammation with slow recovery of reported symptoms [37,38]. In addition to the effects of COVID-19, patients with COPD have various comorbidities, some of which are associated with increased risk of hospitalization [39][40][41].…”

Section: Plos Onesupporting

confidence: 87%

Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis

Oyelade²,

et al. 2020

View full text Add to dashboard Cite

BackgroundCoronavirus disease 2019 is an evolving infectious disease that dramatically spread all over the world in the early part of 2020. No studies have yet summarized the potential severity and mortality risks caused by COVID-19 in patients with chronic obstructive pulmonary disease (COPD), and we update information in smokers. MethodsWe systematically searched electronic databases from inception to March 24, 2020. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale. We synthesized a narrative from eligible studies and conducted a meta-analysis using a random-effects model to calculate pooled prevalence rates and 95% confidence intervals (95%CI). ResultsIn total, 123 abstracts were screened and 61 full-text manuscripts were reviewed. A total of 15 studies met the inclusion criteria, which included a total of 2473 confirmed COVID-19 patients. All studies were included in the meta-analysis. The crude case fatality rate of COVID-19 was 7.4%. The pooled prevalence rates of COPD patients and smokers in COVID-19 cases were 2% (95% CI, 1%-3%) and 9% (95% CI, 4%-14%) respectively. COPD patients were at a higher risk of more severe disease (risk of severity = 63%, (22/35) PLOS ONEPLOS ONE | https://doi.

show abstract

Section: Plos Onesupporting

confidence: 87%

Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis

Oyelade²,

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The imaging features visible on a chest radiograph during an exacerbation were all reported as prevalence values for radiographic features. Of the five highest-ranking studies: 9,[32][33][34][35]…”

Section: Chest X-raymentioning

confidence: 99%

<p>Thoracic Imaging at Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review</p>

Rangelov

Young

Jacob

et al. 2020

COPD

View full text Add to dashboard Cite

Exacerbations of chronic obstructive pulmonary disease (COPD) are currently diagnosed based on changes in respiratory symptoms. Characterizing the imaging manifestation of exacerbations could be useful for objective diagnosis of exacerbations in the clinic and clinical trials, as well as provide a mechanism for monitoring exacerbation treatment and recovery. In this systematic review, we employed a comprehensive search across three databases (Medline, EMBASE, Web of Science) to identify studies that performed imaging of the thorax at COPD exacerbation. We included 51 from a total of 5,047 articles which met all our inclusion criteria. We used an adapted version of the Modified Newcastle-Ottawa Quality Assessment Scale for cohort studies to assess the quality of the included studies. Conclusions were weighted towards higher-quality articles. We identified a total of 36 thoracic imaging features studied at exacerbation of COPD. Studies were generally heterogeneous in their measurements and focus. Nevertheless, considering studies which performed consecutive imaging at stable state and exacerbation, which scored highest for quality, we identified salient imaging biomarkers of exacerbations. An exacerbation is characterized by airway wall and airway calibre changes, hyperinflation, pulmonary vasoconstriction and imaging features suggestive of pulmonary arterial hypertension. Most information was gained from CT studies. We present the first ever composite imaging signature of COPD exacerbations. While imaging during an exacerbation is comparatively new and not comprehensively studied, it may uncover important insights into the acute pathophysiologic changes in the cardiorespiratory system during exacerbations of COPD, providing objective confirmation of events and a biomarker of recovery and treatment response.

show abstract

“…Furthermore, exacerbations that occur in the winter, when respiratory viruses are more prevalent in the community, are associated with slow symptom recovery [29]. In the UK, the presence of pneumonic infiltrates during an exacerbation was more common in winter than in summer, and was associated with increased systemic inflammation [30].…”

Section: Triggersmentioning

confidence: 99%

Understanding the impact of chronic obstructive pulmonary disease exacerbations on patient health and quality of life

Hurst

Skolnik

Hansen

et al. 2020

European Journal of Internal Medicine

105

View full text Add to dashboard Cite

Exacerbations of chronic obstructive pulmonary disease (COPD) represent a significant clinical problem, and are associated with decreased lung function, worsening quality of life and decreased physical activity levels, with even a single exacerbation having detrimental effects. The occurrence of COPD exacerbations can also have a considerable impact on healthcare costs and mortality rates, with over one-fifth of patients hospitalized for a COPD exacerbation for the first time dying within one year of discharge. This highlights the need for COPD exacerbations to be a major focus in clinical practice. Furthermore, the substantial effect that COPD exacerbations can have on patient mental health should not be underestimated. Despite their clinical importance, COPD exacerbations are poorly recognized and reported by patients, and improving patient understanding and reporting of exacerbations to ensure prompt treatment may minimize their deleterious effects. Renewed focus on improving current clinical practice with support from evidence-based guidelines is required. This also raises a challenge to payors, healthcare systems and government policies to do more to tackle the considerable outstanding burden of COPD exacerbations. Search methodsRelevant articles for this non-systematic, narrative literature review were identified via PubMed searches and from author knowledge. Only articles published in English were included.

show abstract

Impact of radiologically stratified exacerbations: insights into pneumonia aetiology in COPD

Cited by 28 publications

References 38 publications

Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis

Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis

<p>Thoracic Imaging at Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review</p>

Understanding the impact of chronic obstructive pulmonary disease exacerbations on patient health and quality of life

Contact Info

Product

Resources

About