The Journal of asthma : official journal of the Association for the Care of Asthma
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Letter
Preadmission use of inhaled corticosteroids and risk of fatal or severe COVID-19: A meta-analysis.
Objective: With emerging of observational evidence, we aimed to perform a meta-analysis to summarize the overall effect of the chronic use of inhaled corticosteroids on the clinical outcomes in patients with coronavirus disease 2019 (COVID-19). Methods:Systematic literature search in electronic databases was performed to identify observational studies that investigated the preadmission use of inhaled corticosteroids on the risk of a fatal or severe course of illness in patients with COVID-19 and reported adjusted measures of association. ⋯ Similarly, the meta-analysis observed no significant difference in the risk for the development of a severe course of COVID-19 with preadmission use of inhaled corticosteroids in patients with COVID-19 relative to non-use of inhaled corticosteroids (pooled odds ratio=1.45; 95% confidence interval 0.96-2.20). Conclusions: Our findings assured the safety of continued use of inhaled corticosteroids during the COVID-19 pandemic.
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Observational Study
Efficacy of bronchial thermoplasty in patients with severe asthma.
Objective: To investigate the efficacy and safety of bronchial thermoplasty (BT) in clinical practice in adults with severe, refractory asthma. Methods: Prospective, single-center, open, observational study comprising patients with uncontrolled asthma (asthma control questionnaire (ACQ) >1.5) and/or frequent exacerbations despite treatment with at least high dose inhaled corticosteroids plus a second controller. Efficacy outcomes was change from baseline 4, 8, 12 and 24 months in FEV1, FVC and FEV1/FVC ratio, asthma control questionnaire (ACQ) score and asthma quality of life score (mini-AQLQ). ⋯ FEV1 (IQR) 1.98 L (1.65-2.45) vs. 2.45 L (2.09-2.93) (p = 0.006), FVC (IQR) 3.23 L (2.76-4.05) vs. 3.75 L (3.22-4.36) (p = 0.041), FEV1/FVC 0.60 (IQR: 0.55-0.70) vs. 0.66 (IQR: 0.63-0.71) (p = 0.016), mini-AQLQ 4.0 (IQR: 3.2-4.9) vs. 5.6 (IQR 4.5-6.5) (p = 0.008, and ACQ 2.9 (IQR: 2.1-3.7) versus 1.5 (IQR 1.0-2.4) (p = 0.004). On the other hand, an increase was observed in unscheduled visits (p = 0.005), as well as use of OCS and antibiotics (p = 0.009 and p = 0.003, respectively). Conclusion: BT in adults with severe asthma improved ACQ, mini-AQLQ and lung function, but resulted in an increased frequency of unscheduled doctor-visits and rescue courses of OCS and antibiotics.