Pre- and post-COVID practice of interventional pulmonology in adults in Portugal

Guedes, Fernando; Ferreira, António Jorge; Dionísio, Jorge; Rodrigues, Luís Vaz; Bugalho, António

doi:10.1016/j.pulmoe.2022.02.009

Cited by 2 publications

(3 citation statements)

References 35 publications

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“…Since Hürter et al 24 firstly used r-EBUS for the assessment of normal lungs and bronchial carcinomas in 1992, r-EBUS has gained popularity for the identification of PPLs before biopsy and currently, it was the most widely used bronchoscopic guidance technology according to our survey in China. Similar reports were presented in other countries, such as Czech Republic 18 and Portugal 20 . Relatively low technical difficulty, moderate cost, and avoidance of radiation to personnel are thought to be the reasons for the popularity of r-EBUS 25 .…”

Section: Discussionsupporting

confidence: 89%

“…Furthermore, endoscopic technology evolved in the past decades and bronchoscopy also has potential to be an alternative to open surgical treatments of PPLs, particularly for patients with significant medical comorbidities or poor performance status [4,11,12]. There already have been international reports on the diagnosis and treatment of respiratory endoscopy in many countries [13][14][15][16][17][18][19][20]; however, rare clinical studies concerning the application of bronchoscopy in the management of PPLs have been involved. Therefore, this study was performed with network questionnaires nationwide in 2022 in order to make a comprehensive understanding of clinical practice of bronchoscopy in the diagnosis and treatment of PPLs in China.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Application of bronchoscopy in the diagnosis and treatment of peripheral pulmonary lesions in China: a national cross-sectional study

Huang¹,

Wu²,

Tian³

et al. 2023

J. Cancer

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Background: Bronchoscopy has gradually become valuable armamentarium in evaluating and applying endoscopic therapy to peripheral pulmonary lesions (PPLs) around the world. We aimed to make a comprehensive understanding of the application of bronchoscopy in the diagnosis and treatment of PPLs in China. Methods: A cross-sectional survey was carried out in China between January 2022 and March 2022. The survey was in the form of an online questionnaire which was filled in with real-time data by the respondents. Results: A total of 347 doctors from 284 tertiary hospitals (81.8%) and 63 secondary general hospitals (18.2%) were included in the data analysis. More than half of the surveyed doctors (55.0%) had independently performed respiratory endoscopy for 5-15 years. Higher proportions of hospitals with a fixed nursing team, anesthesiologists and rapid on-site evaluation (ROSE) during bronchoscopic procedures were performed in tertiary hospitals than those in secondary general hospitals (P<0.001 each). There were 316 hospitals (91.7%) eligible for performing biopsies of PPLs less than 30mm, while more than 300 PPLs biopsies were performed in only 78 hospitals (24.7%) per year. Radial probe endobronchial ultrasound (r-EBUS) (50.3%) was the commonest type of technique used in the guidance of a bronchoscope to PPLs, followed by navigational bronchoscopy (30.3%) and cone beam CT (CBCT) (17.0%). Although two thirds of the surveyed hospitals had at least one bronchoscopic guidance devices, the actual utilization of these devices was not high due to high capital costs and absence of training. To note, more diagnostic procedures and allocated devices were concentrated in the southeast region and coastal cities. Furthermore, therapeutic bronchoscopic interventions for peripheral lung cancer and/or high-risk PPLs could be performed in 124 (35.7%) of the 347 involved hospitals. Conclusions: Bronchoscopy for the diagnosis of PPLs has been carried out in most hospitals in China and yields in different hospitals and regions varied greatly. To date, only a few hospitals in China can develop therapeutic bronchoscopy for PPLs.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Application of bronchoscopy in the diagnosis and treatment of peripheral pulmonary lesions in China: a national cross-sectional study

Huang¹,

Wu²,

Tian³

et al. 2023

J. Cancer

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“…The pattern of monthly counts for patients admitted with aspergillosis who were younger or older than 65 years was broadly similar; however, prolonged divergence was seen for patients with candidiasis during the first wave of the pandemic. Fewer bronchoscopies and necropsies were performed during the pandemic, especially in the first months, due to the risks of aerosol generation, [20][21][22] which may have resulted in an apparent reduction in the occurrence of IA during the pandemic due to reduced diagnoses, although the actual number of infections may not have reduced. Conversely, some cases of Aspergillus spp colonisation may have been incorrectly interpreted as IA as the classification and severity of aspergillosis-for example, devised by Koehler et al for CAPA 23 -is not available from the HES data.…”

Section: Open Accessmentioning

confidence: 99%

Hospital-treated serious and invasive aspergillosis and candidiasis infections during the COVID-19 pandemic: a retrospective analysis of Hospital Episode Statistics data from England

Sung,

Kiely,

Singh

et al. 2023

BMJ Open

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ObjectivesTo investigate the impact of COVID-19 on the burden of hospital-treatedAspergillusandCandidainfections in England.DesignA retrospective study using Hospital Episodes Statistics data to estimate the burden of serious and invasive fungal infections (SIFIs) in all patients admitted in England during March 2018–February 2020 (pre-COVID-19) and during March 2020–October 2021 (the COVID-19 period).SettingHospitals in England.PopulationAll patients with codes corresponding to serious and invasive aspergillosis and candidiasis in any diagnosis position during their admission pre-COVID-19 and during the COVID-19 period.Outcome measuresAge, spells, patient counts, mean length of stay, admission to critical care unit (CCU), length of stay in CCU, 30-day readmissions, failed discharges (readmission within 7 days) and comorbidities.ResultsDuring the COVID-19 period, hospitalisation spells with an invasive candidiasis code fell by 3.2% and spells with an aspergillosis code by 24.8%. Mean length of stay was higher for patients with aspergillosis with or without COVID-19 and candidiasis with or without COVID-19 during the pandemic than before the pandemic. During the pandemic, mean length of stay was higher for patients with aspergillosis with COVID-19 than those with aspergillosis alone but slightly lower for patients with candidiasis with COVID-19 than for those with candidiasis alone. Of patients with a diagnosis of COVID-19, 52.5% with aspergillosis and 60.0% with candidiasis were treated in CCU compared with 13.2% and 37.1%, respectively, without a COVID-19 diagnosis. The percentage of 30-day readmissions and failed discharges for patients with SIFI was higher for those with COVID-19 than for those without.ConclusionsThe burden of aspergillosis and candidiasis has been affected by COVID-19. Aspergillosis diagnoses fell among hospitalised patients during the pandemic, while candidiasis continued to fluctuate in patterns similar to pre-COVID-19. A higher burden for patients with SIFI was observed, whether or not they also had a diagnosis of COVID-19. Our findings highlight extra considerations and burden on management of serious SIFI as a result of the COVID-19 pandemic.

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Pre- and post-COVID practice of interventional pulmonology in adults in Portugal

Cited by 2 publications

References 35 publications

Application of bronchoscopy in the diagnosis and treatment of peripheral pulmonary lesions in China: a national cross-sectional study

Application of bronchoscopy in the diagnosis and treatment of peripheral pulmonary lesions in China: a national cross-sectional study

Hospital-treated serious and invasive aspergillosis and candidiasis infections during the COVID-19 pandemic: a retrospective analysis of Hospital Episode Statistics data from England

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