#WiNRespMed

Synairgen announces positive results from trial of SNG001 in hospitalised COVID-19 patients (data from a Press Release)

SNG001 is an inhaled treatment of providing high local concentrations of interferon beta

The odds of developing severe disease (e.g. requiring ventilation or resulting in death) during the treatment period (day 1 to day 16) were significantly reduced by 79% for patients receiving SNG001 compared to patients who received placebo (OR 0.21 [95% CI 0.04-0.97]; p=0.046).

Patients who received SNG001 were more than twice as likely to recover (defined as 'no limitation of activities' or 'no clinical or virological evidence of infection') over the course of the treatment period compared to those receiving placebo (HR 2.19 [95% CI 1.03-4.69]; p=0.043).

Diagnosis of Hypersensitivity Pneumonitis in Adults: An Official ATS/JRS/ALAT Clinical Practice Guideline

FREE paper in the Blue Journal

The guideline committee defined HP and clinical, radiographic, and pathologic features were described. HP was classified into non-fibrotic and fibrotic phenotypes. There was limited evidence that was directly applicable to all questions.

The need for a thorough history and a validated questionnaire to identify potential exposures was agreed upon.

Serum IgG testing against potential antigens associated with HP was suggested to identify potential exposures.

For patients with non-fibrotic HP, a recommendation was made in favor of obtaining bronchoalveolar lavage fluid for lymphocyte cellular analysis, as well as suggestions for transbronchial lung biopsy and surgical lung biopsy.

For patients with fibrotic HP, suggestions were made in favor of obtaining bronchoalveolar lavage fluid for lymphocyte cellular analysis, transbronchial lung cryobiopsy, and surgical lung biopsy.

Diagnostic criteria were established and a diagnostic algorithm was created by expert consensus.

Knowledge gaps were identified as future research directions.

Remote Monitoring of Patients with Covid-19: Design, implementation, and outcomes of the first 3,000 patients in COVID Watch

An innovation team at the University of Pennsylvania Health System demonstrates how an automated text-messaging system can remotely monitor patients with confirmed or suspected Covid-19 at home and quickly support worsening patients with human care.

To manage a large and heterogenous population of patients with confirmed or presumed Covid-19, but well enough to remain at home, the University of Pennsylvania Health System (UPHS) developed a program to monitor for worsening dyspnea or other concerning symptoms. “COVID Watch” combined automated twice-daily text message check-ins with a dedicated team of telemedicine clinicians who could respond 24/7 to escalations in patient need. We report our experience with the first 3,000 invited patients. Approximately 83% of patients were managed by the automated program without escalating to human care.

Derivation and validation of a clinical prediction rule for thrombolysis-associated major bleeding in patients with acute pulmonary embolism: the BACS score

The BACS score is an easily applicable aid for prediction of the risk of major bleeding in the population of PE patients who receive systemic thrombolysis.

Multivariable logistic regression identified four predictors for major bleeding: recent major Bleeding (3 points), Age >75 years (1 point), active Cancer (1 point), and Syncope (1 point) (BACS). Among 1172 patients receiving thrombolytic therapy in RIETE, 446 (38%) were classified as having low-risk (none of the variables present, 0 points) of major bleeding according to the BACS score, and the overall 30-day major bleeding rate of this group was 2.9% (95% CI, 1.6–4.9%), compared with 44% (95% CI, 14–79%) in the high-risk group (>3 points). In the validation cohort, 51% (149/290) of patients were classified as having low-risk, and the overall 30-day major bleeding rate of this group was 1.3%. In RIETE, the 30-day major bleeding event rates in the Kuijer and RIETE low-risk stratum were 5.3% and 4.4%, respectively.

Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19

Among patients hospitalized with mild-to-moderate Covid-19, the use of hydroxychloroquine, alone or with azithromycin, did not improve clinical status at 15 days as compared with standard care.

Thoracic Imaging at Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review

Two years ago, the fires in Mati, Greece and in California, US became the starting point of an ERJ editorial. It feels quite emotional to revisit this work... https://erj.ersjournals.com/content/52/6/1802163

Vitamin D Supplements for Prevention of Tuberculosis Infection and Disease No TB protection by Vit D supplementation in deficient schoolchildren Vitamin D supplementation did not result in a lower risk of tuberculosis infection, tuberculosis disease, or acute respiratory infection than placebo among vitamin D–deficient schoolchildren in Mongolia.

https://onlinelibrary.wiley.com/doi/abs/10.1111/all.14425?fbclid=IwAR3RgnHUIx1uE_acFxDvg6v4hNz91pWO0V3nJ1nphken8c0JcJlOF2bx5II