Background

Tuberculosis (TB) is considered one of the most common causes of bronchiectasis. Bronchiectasis increases clinical and financial burden of patients with TB. Here, we aim to assess the prevalence of bronchiectasis and its characteristics in patients with TB.

Results

Over 1 year duration, 85 patients with confirmed TB were enrolled in the study. Those patients were clinically, laboratory, and radiologically evaluated. Any patient with other chest diseases was excluded from the study. Out of those patients, 19/85 (22.4%) patients had bronchiectasis. It was found that patients with bronchiectasis had higher frequency of urban residence, current cigarette or goza smoking, and diabetes mellitus. Hemoptysis and expectoration were the most frequent symptoms. Pulmonary function tests were significantly impaired in patients with bronchiectasis. Disease burden was significantly higher among bronchiectasis group …

Abstract

Background: A consensus about the best weaning procedure, haven't been reached. Patient–ventilator dyssynchrony can lead to considerable patient distress, prolongs mechanical ventilation and (ICU) length of stay. PAV+ delivers positive pressure ventilation in proportion to instantaneous inspiratory effort, reduces ventilator dyssynchrony and the duration of weaning from the ventilator.

Aim: Evaluate weaning outcome for COPD patients using PAV+ versus PSV, assess patient ventilator asynchrony during weaning, compare ICU outcome (hospital length of stay, ICU and hospital mortality).

Patients & Methods: 150 mechanically ventilated COPD patients were enrolled in this prospective, parallel randomized clinical trial and assigned to either PAV+ or PSV spontaneous breathing trial for weaning (after meeting specific eligibility criteria). Asynchrony was detected with bedside waveform interpretation of flow and airway pressure for 30 minutes.

Results: Weaning success was recorded in 73.3% PAV+ vs. 66.7% PSV (P= 0.373). Asynchrony events was significantly less in PAV+ vs. PSV; ineffective triggering (14.9 ± 10.3 vs. 37.6 ± 26.6, p

Abstract

Background

Severe acute respiratory syndrome coronavirus 2 (SARS‐COV‐2) is mostly associated with upper and lower respiratory tract manifestations. However, coronavirus disease 19 (COVID-19) can result in a wide range of other systemic symptomatology, including neuropsychiatric, psychological, and psychosocial impairments. Literature regarding neurological compromise, including neuropathy and sensory and motor affection associated with COVID-19, is still limited.

This study aims to evaluate the sensory, motor neuropathy, and secondary neurological impairment among patients with mild to moderate coronavirus disease associated with peripheral neuropathy within 1 month.

Methods

Forty participants, including 20 mild to moderate COVID-19 patients with peripheral neuropathy and 20 age and gender-matched healthy volunteers, were recruited in this case/control study. Laboratory evaluation focused on C-reactive protein (CRP) and D-dimer levels. Oxygen saturation for all participants was recorded. The neurophysiological study included motor nerve study, sensory nerve study, and F wave study for upper and lower limbs were done.

Results

The two groups were similar regarding baseline data. Neurological symptoms’ onset in the COVID-19 group ranged from 4 to 24 days. Levels of CRP and D-dimer levels were significantly higher in patients versus the control group. Motor nerve conduction (MNC) amplitude and latency for the median nerve were significantly compromised among the COVID-19 group. The MNC latency and F wave latency for the posterior tibial nerve were significantly higher in the COVID-19 group. The CRP and D-dimer levels were associated with a significant positive correlation with a latency of median nerve MNC, sensory nerve conduction (SNC), and f-wave; latency of MNC and F wave of the posterior tibial nerve; and SNC latency for sural nerve.

Conclusion

neurological involvement can occur in mild to moderate cases of SARS-COV-2 infection and add to the burden of the disease. Neurological symptoms in the course of COVID-19 disease should be interpreted cautiously, and appropriate diagnosis, including nerve conduction studies and management, should be considered.

Abstract

Background

SARS‐COV‐2 infection reframed medical knowledge in many aspects, yet there is still a lot to be discovered. Coronavirus disease 19 (COVID-19) can cause neuropsychiatric, psychological, and psychosocial impairments. Literature regarding the cognitive impact of COVID-19 is still limited.

This study aims to evaluate cognitive function, anxiety, and depression among patients with coronavirus disease 19.

Methods

Sixty COVID-19 patients were recruited and sub-grouped according to the site of care into three groups, home isolation, ward, and RICU, and compared with 60 matched control participants. Entire clinical history, O₂ saturation, mini-mental state examination (MMSE), Hamilton’s anxiety (HAM-A), and depression rating scales (HAM-D) were assessed.

Results

MMSE showed significantly lowest results for the ICU group, with a value of 21.65 ± 3.52. Anxiety levels were the highest for the ICU group, with a highly significant difference vs. the home isolation group (42.45 ± 4.85 vs. 27.05 ± 9.52; p< 0.001). Depression values assessed showed a highly significant difference in intergroup comparison (44.8 ± 6.64 vs. 28.7 ± 7.54 vs. 31.25 ± 8.89; p<0.001, for ICU vs. ward vs. home group, respectively).

MMSE revealed a significant negative correlation with age and education level, anxiety level had significant negative correlations with severity of illness and male gender, and depression level had highly significant negative correlations with severity of illness and male gender.

Conclusion

Both cognitive and neuropsychiatric symptoms were affected in COVID-19 cases, especially in ICU-admitted patients. The impact of these disorders was significant in older age, lower oxygen saturation, and severe disease.

Abstract

Background 

Chronic obstructive pulmonary disease (COPD) is ordinarily associated with social and economic burden. Pulmonary hypertension attributed to COPD varies greatly among studies; and accounts for worse quality of life and hence increased morbidity and mortality.

Aim

This study aimed to evaluate impact of pulmonary hypertension on exercise capacity, and possible predictors for exercise intolerance among COPD patients.

Methods 

Patients suffering from COPD (73 patients) were grouped according to echocardiographic assessment for the presence of pulmonary hypertension into two groups. The assessment included full clinical history, mMRC dyspnea scale, COPD assessment test, arterial blood gases before and after exercise testing, and assessment of resting pulmonary function test. Also transthoracic echocardiography, cardiopulmonary exercise testing (CPET) using incremental treadmill exercises protocol was done for all participants.

Results 

A total of 39 (53.4%) COPD patients have pulmonary hypertension. COPD patients with pulmonary hypertension had significantly lower parameters of pulmonary function tests either pre or postbronchodilator; significantly lower pH, PaO₂ and SaO₂ either before or after CPET. It was found that all parameters of metabolic response during exercise were significantly lower among COPD-PH patients (P<0.001). Pulmonary artery systolic pressure (PASP) showed significant negative correlations with peak VO₂ (r=−0.514, P<0.001), VO₂/kg (r=−0.443, P<0.001), oxygen pulse (% predicted) (r=−0.459, P<0.001), oxygen saturation post exercise (r=−0.427, P<0.001). Also PASP showed significant positive correlation with VE/VO₂ (at peak) (r=0.374, P=0.001), VE/VCO₂ (at peak) (r=0.609, P<0.001). Predictors of poor exercise capacity among COPD patients included in the study were COPD-PH group (OR=8.84, 95%CI= 1.79–43.65), PASP (OR=1.11, 95% CI=1.02–1.15), forced expiratory volume (FEV₁)% (OR=0.89, 95% CI=0.84–0.95) and mMRC (OR=3.10, 95% CI=1.13–8.47), CAT assessment (OR=1.37, 95% CI=1.14–1.65), MVV L/min (OR=0.91, 95% CI=0.86–0.96) and mean PAP (OR=1.16, 95% CI=1.11–1.29).

Conclusion 

Pulmonary hypertension in patients with COPD is negatively correlated with exercise capacity, specifically peak VO₂ percent predicted. Furthermore, pulmonary hypertension had a significant impact on gas exchange. Assessment of pulmonary hypertension using echocardiography among COPD patients is a valuable tool for predicting exercise impairment.