Chest Medicine (all articles)
M-A | Past SARS-CoV-2 infection provides long-lasting protection against severe disease caused by all variants
22 Feb, 2023 | 12:48h | UTCSummary: The article describes a systematic review and meta-analysis of studies assessing protection from past SARS-CoV-2 infection against subsequent re-infection, symptomatic COVID-19 disease, and severe disease. The researchers identified 65 studies from 19 different countries and found that protection from past infection against re-infection from pre-omicron variants was high and remained so even after 40 weeks. However, protection was substantially lower for the omicron BA.1 variant and declined more rapidly over time than protection against previous variants. Protection from severe disease was high for all variants, estimated at 90·2% for ancestral, alpha, and delta variants, and 88·9% for omicron BA.1 at 40 weeks. The study highlights the importance of considering past infection in assessing future disease burden from COVID-19, providing guidance on when individuals should be vaccinated, and designing policies that mandate vaccination for workers or restrict access. The findings also suggest that individuals with a documented infection should be treated similarly to those who have been fully vaccinated with high-quality vaccines.
Commentaries:
Previous COVID-19 may slash severe illness at reinfection by 89% – CIDRAP
RCT | Another study shows Ivermectin does not benefit patients with Covid-19
22 Feb, 2023 | 12:45h | UTCSummary: The study aimed to evaluate whether Ivermectin, at a maximum dose of 600 μg/kg daily for 6 days, shortened symptom duration or prevented hospitalization among outpatients with mild to moderate COVID-19. A total of 1206 US adults were enrolled in the double-blind, randomized, placebo-controlled platform trial, with follow-up data through November 10, 2022. The study found that the median time to sustained recovery was 11 days in both the ivermectin and placebo groups. Among those receiving Ivermectin, 5.7% were hospitalized, died, or had urgent or emergency care visits compared with 6.0% receiving placebo. These findings, along with all the previous studies to date, do not support using Ivermectin in patients with mild to moderate COVID-19.
Editorials:
At a Higher Dose and Longer Duration, Ivermectin Still Not Effective Against COVID-19 – JAMA
The Ethics of Clinical Research: Managing Persistent Uncertainty – JAMA
Related:
RCT | Ivermectin does not improve time to recovery in outpatients with mild to moderate COVID-19.
RCT | Metformin, Ivermectin, and Fluvoxamine are not beneficial for obese outpatients with Covid-19.
Ivermectin for COVID-19 Cochrane review update: 11 trials and no evidence of benefit shown.
RCT: Early treatment with ivermectin does not improve outcomes in patients with Covid-19.
Case Series: Toxic effects from ivermectin use associated with prevention and treatment of Covid-19.
Long-term consequences of the misuse of ivermectin data.
Ivermectin: How false science created a Covid ‘miracle’ drug.
Fraudulent ivermectin studies open up new battleground between science and misinformation.
The lesson of ivermectin: meta-analyses based on summary data alone are inherently unreliable.
Ivermectin: Cochrane’s most talked about review so far, ever. Why?
Flawed ivermectin preprint highlights challenges of COVID drug studies.
Systematic review: no evidence to support the use of Ivermectin for treating or preventing COVID-19.
Why was a major study on ivermectin for covid-19 just retracted?
RCT: Ivermectin does not prevent hospitalizations in patients with COVID-19.
RCT: Ivermectin does not improve time to resolution of symptoms among adults with mild COVID-19
Review | Comorbidities, multimorbidity and COVID-19
22 Feb, 2023 | 12:39h | UTCComorbidities, multimorbidity and COVID-19 – Nature Medicine
Sleep irregularity linked to subclinical markers of cardiovascular disease
21 Feb, 2023 | 11:51h | UTCSummary: The study examined the association between sleep irregularity and subclinical markers of cardiovascular disease in a population of over 2000 participants with a mean age of 68. The participants completed 7-day wrist actigraphy that detected when they were asleep and awake. The results showed that sleep irregularity, particularly sleep duration irregularity, was associated with subclinical atherosclerosis, including high coronary artery calcium burden and abnormal ankle-brachial index. These associations persisted even after adjusting for cardiovascular disease risk factors and other sleep characteristics such as obstructive sleep apnea, sleep duration, and sleep fragmentation. While it is important to note that observational studies like this one cannot establish causation and may be subject to residual confounding, the findings suggest that promoting regular sleep schedules could be an essential aspect of lifestyle recommendations for preventing cardiovascular disease.
News Release: Irregular sleeping habits may increase risk of atherosclerosis in older adults – American Heart Association
Commentaries:
Sleep Irregularity Linked to Measures of Subclinical Atherosclerosis – HealthDay
Irregular sleep may be harmful to your heart, study finds – CNN
Cohort Study | One third of patients hospitalized with Covid-19 persist with lung abnormalities after 2 years
21 Feb, 2023 | 11:47h | UTCSummary: The study aimed to assess changes in chest CT abnormalities and pulmonary function in patients two years after recovery from SARS-CoV-2 infection. The prospective study followed 144 participants discharged from the hospital after SARS-CoV-2 infection between January 15 and March 10, 2020. The participants underwent serial chest CT scans and pulmonary function tests at 6 months, 12 months, and 2 years after symptom onset. The study found that 39% of participants had persistent interstitial lung abnormalities at 2 years, and this was associated with respiratory symptoms and decreased diffusion pulmonary function.
Editorial: Radiologic Findings after COVID-19 and the Correlation with Lung Function – Radiology
Commentaries:
Post-COVID-19 CT scans show lung abnormalities persist two years later – News Medical
COVID’s aftermath: Persistent organ damage at 1 year, lung abnormalities at 2 – CIDRAP
Phase 2b RCT | Ad26.RSV.preF–Respiratory Syncytial Virus preF protein vaccine is immunogenic in older adults
17 Feb, 2023 | 13:30h | UTCSummary: A phase 2b clinical trial evaluated the Ad26.RSV.preF–RSV preF protein vaccine’s efficacy, immunogenicity, and safety in preventing RSV-mediated lower respiratory tract disease in adults aged 65 years and older. The vaccine was effective in preventing the disease and immunogenic, as demonstrated by the increase in RSV A2 neutralizing antibody titers after vaccination. The vaccine was associated with higher rates of adverse events than the placebo, but most were of mild to moderate severity. The trial concluded that Ad26.RSV.preF–RSV preF protein vaccine was effective in preventing RSV-mediated lower respiratory tract disease in older adults.*
Article: Efficacy and Safety of an Ad26.RSV.preF–RSV preF Protein Vaccine in Older Adults – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary: Ad26.RSV.preF-RSV preF Protein Vaccine Immunogenic in Seniors – HealthDay
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
RCT | Respiratory Syncytial Virus prefusion F protein vaccine provides protection for older adults
17 Feb, 2023 | 13:32h | UTCSummary: A phase 2b clinical trial evaluated the Ad26.RSV.preF–RSV preF protein vaccine in adults aged 65 years and older. The vaccine was effective and immunogenic, as demonstrated by the increase in RSV A2 neutralizing antibody titers after vaccination. The vaccine was associated with higher rates of adverse events than the placebo, but most were of mild to moderate severity.*
Article: Respiratory Syncytial Virus Prefusion F Protein Vaccine in Older Adults – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
Respiratory syncytial virus causes clinically significant illness in children and adults. In a placebo-controlled trial, a prefusion stabilized F protein vaccine led to an 83% lower risk of RSV infection. https://t.co/aU9BV0LXBU pic.twitter.com/0zy1hu0VH6
— NEJM (@NEJM) February 15, 2023
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
RCT | Effect of non-invasive ventilation after extubation in critically ill patients with obesity
17 Feb, 2023 | 13:10h | UTCEffect of non-invasive ventilation after extubation in critically ill patients with obesity in France: a multicentre, unblinded, pragmatic randomised clinical trial – The Lancet Respiratory Medicine (link to abstract – $ for full-text)
Commentary on Twitter
NEW Research—Among critically ill adults with obesity undergoing extubation, the use of NIV was effective to reduce treatment-failure within 3 days
Read the RCT from Audrey De Jong & colleagues here: https://t.co/nMB3W8NAYX #SCCM2023 pic.twitter.com/iEHExPEhSN
— The Lancet Respiratory Medicine (@LancetRespirMed) January 21, 2023
Case Reports | Seventeen cases of daptomycin-induced eosinophilic pneumonia in bone and joint infections
17 Feb, 2023 | 12:54h | UTC
RCT | Home high-flow nasal cannula oxygen therapy for stable hypercapnic COPD
17 Feb, 2023 | 12:53h | UTC
SR | Prognostic models for mortality risk in patients requiring ECMO
15 Feb, 2023 | 15:49h | UTCPrognostic models for mortality risk in patients requiring ECMO – Intensive Care Medicine
SR | Inspiratory muscle training, with or without concomitant pulmonary rehabilitation, for COPD
15 Feb, 2023 | 15:42h | UTC
M-A | Complications of percutaneous tracheostomy in critically ill adults with obesity
13 Feb, 2023 | 12:37h | UTCComplication Rate of Percutaneous Dilatational Tracheostomy in Critically Ill Adults With Obesity: A Systematic Review and Meta-analysis – JAMA Otolaryngology-Head & Neck Surgery (free for a limited period)
Review | Advanced point-of-care bedside monitoring for acute respiratory failure
13 Feb, 2023 | 12:32h | UTCAdvanced Point-of-care Bedside Monitoring for Acute Respiratory Failure – Anesthesiology
Commentary on Twitter
Advanced respiratory monitoring involves several mini- or noninvasive tools, applicable at bedside, that have the potential to support clinicians in the management of acute respiratory failure. Learn more about the personalization of ventilatory strategy: https://t.co/RP4LAsdQHM pic.twitter.com/KFlwxDthe9
— Anesthesiology (@_Anesthesiology) February 10, 2023
RCT | AI improves nodule detection on chest radiographs in a health screening population
10 Feb, 2023 | 13:55h | UTCNews Release: AI Improves Lung Nodule Detection on Chest X-Rays – RSNA News
RCT | Sublobar resection noninferior to lobal resection for peripheral stage IA non–small-cell lung cancer
9 Feb, 2023 | 14:05h | UTCLobar or Sublobar Resection for Peripheral Stage IA Non–Small-Cell Lung Cancer – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: Less lung tissue removal needed for early-stage cancer, study finds – Weill Cornell Medical College
Related:
Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial – The Lancet (link to abstract – $ for full-text)
RCT | Pegylated Interferon Lambda reduces hospitalizations in predominantly vaccinated outpatients with Covid-19
9 Feb, 2023 | 14:03h | UTCEarly Treatment with Pegylated Interferon Lambda for Covid-19 – New England Journal of Medicine
RCT | BCG vaccine not effective for preventing COVID-19 and other respiratory tract infections in older adults
9 Feb, 2023 | 13:53h | UTCNews Release: Tuberculosis vaccine does not protect elderly against COVID-19, finds large Dutch study – University Medical Center Utrecht
Commentary on Twitter
Bacillus Calmette-Guérin vaccine in ineffective in prevention of COVID-19 and other respiratory tract infections in older adults with comorbiditieshttps://t.co/dS4h1bq3Ns
— Clinical Microbiology and Infection (@CMIJournal) February 1, 2023
Review | Liberation from mechanical ventilation in the cardiac intensive care unit
8 Feb, 2023 | 12:45h | UTCLiberation From Mechanical Ventilation in the Cardiac Intensive Care Unit – JACC: Advances
SR | The current evidence does not support a role for Vitamin D in the management of asthma
7 Feb, 2023 | 14:16h | UTCVitamin D for the management of asthma – Cochrane Library
Commentary: Vitamin D for asthma: new evidence, new message – Evidently Cochrane
RCT | Paxlovid did not improve outcomes in hospitalized patients with Covid-19
7 Feb, 2023 | 14:08h | UTC
M-A | Heparin full-dose anticoagulation is beneficial for non-critically ill COVID-19 patients
7 Feb, 2023 | 14:06h | UTCRelated:
Anticoagulants for people hospitalised with COVID‐19 – Cochrane Library
The ‘Ten Commandments’ of the 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension
6 Feb, 2023 | 13:24h | UTCOriginal Guideline: #ESCCongress | 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension.
Point/Counterpoint | Are obstructive sleep apnea phenotypes clinically useful?
6 Feb, 2023 | 13:21h | UTCPOINT: Are OSA Phenotypes Clinically Useful? Yes – CHEST
COUNTERPOINT: Are OSA Phenotypes Clinically Useful? No – CHEST
Rebuttal From Dr Edwards et al – CHEST
Rebuttal From Dr Tolbert et al – CHEST
Review | Dead space ventilation-related indices: bedside tools to evaluate the ventilation and perfusion relationship in patients with ARDS
6 Feb, 2023 | 13:18h | UTC