Pulmonary embolism in patients with dyspnea after COVID-19 infection.

OBJECTIVE: Pulmonary embolism as a potential complication that may occur late in the course of COVID-19 cases. The aim of our study is to evaluate the frequency of pulmonary embolism in patients with new or ongoing dyspnea after a COVID-19 infection. PATIENTS AND METHODS: This is a single-center, prospective observational study to evaluate the clinical and radiological outcomes of consecutive patients presenting outpatient clinic diseases to the chest and a new or ongoing dyspnea after a COVID-19 infection. Demographic, clinical and laboratory data were collected. Dyspnea was evaluated according to the New York Heart Association (NYHA) classification. RESULTS: Pulmonary embolism was detected in 23.8% (25/105) of patients with new or ongoing dyspnea after a COVID-19 infection. Proportion of pulmonary embolism in patients with NYHA classes I, II, III and IV were respectively 8.7%, 20.0%, 30.0% and 35.3% (p for trend=0.02). Compared to NYHA class I and II patients with dyspnea, those in NYHA classes III and IV showed a higher rate of pulmonary embolism [31.6% vs. 14.6%, OR: 2.7 (1.0 to 7.1), p=0.04, respectively]. In Logistic Procedures, NYHA classes of dyspnea (OR: 4.3, 95% CI: 1.2 to 16.6, p=0.03) (NYHA class III and IV vs. NYHA class I and II) determine the likelihood of pulmonary embolism after COVID-19 infection. CONCLUSIONS: Pulmonary embolism is common in patients with new or ongoing shortness of breath after a COVID-19 infection. Pulmonary embolism is more likely to develop in patients with higher NYHA classes.

Evaluation of quality of life: impact of allergic rhinitis on asthma.

BACKGROUND: Health-related quality of Life (HRQOL) has been considered an important variable to be managed in airway diseases. Allergy and asthma can reduce HRQOL as a result of profound physical and psychosocial complications. Most patients with asthma also suffer from rhinitis, which also impairs quality of life. However, the impact of allergic rhinitis on asthmatic patients has not been investigated. OBJECTIVE: Our objective was to evaluate HRQOL in patients with asthma alone, allergic rhinitis alone, or both diseases. METHODS: We compared HRQOL in 316 patients with both diseases or either asthma or rhinitis using the Short Form-36 questionnaire. Data were also collected on patients' sociodemographic characteristics, atopic state, body mass index (BMI), and education. RESULTS: A total of 232 patients with allergic rhinitis, 40 with asthma, and 44 with both diseases were enrolled. The mean (SD) age was 32 (13) years and 65% were females. HRQL was significantly lower in patients with asthma, with or without rhinitis, than in those with allergic rhinitis alone. Female sex, older age, increased BMI and less educational status were found to be the major determinants of impaired quality of life in patients with allergic rhinitis or asthma. CONCLUSIONS: The impact of rhinitis on asthma seems to play a minor role in HRQOL.

Helicobacter pylori in allergic inflammation--fact or fiction?

BACKGROUND: Although it has been hypothesized that infections may play a preventive role in allergic diseases, the role of Helicobacter pylori (H. pylori) is not clear. In this study we aimed to determine the association between H. pylori infection and allergic inflammation. METHODS: H. pylori infection was assessed in gastric mucosa tissue by microscopy. Skin prick tests (SPT) were performed with a battery of common inhalant and certain food allergens. Serum samples were tested for total immunoglobulin E (T.IgE). Predictive factors for H. pylori infection and atopy were examined by a questionnaire. RESULTS: A total of 90 subjects suffering dyspeptic symptoms were enrolled into the study. SPT positivity was similar between H. pylori (+) and H. pylori (-) subjects. Among the possible factors examined: age; gender; educational status; pet at home; BMI, family size; number of children and siblings; monthly income; drinking water source; smoking; and serum T.IgE levels were not related with H. pylori infection. However, perennial allergic symptoms were significantly higher in the H. pylori (-) group, seasonal allergic symptoms were related with an increased risk for H. pylori infection. CONCLUSIONS: In this sample group from a developing country H. pylori infection was not shown to be associated with atopic diseases. Therefore, the eradication of H. pylori may not be assumed to have an effect on allergic inflammation.

Helicobacter pylori in allergic inflammation ­ Fact or fiction?

Background: Although it has been hypothised that infections may play a preventive role in allergic diseases, the role of Helicobacter pylori (H. pylori) is not clear. In this study we aimed to determine the association between H. pylori infection and allergic inflammation. Methods: H. pylori infection was assessed in gastric mucosa tissue by microscopy. Skin prick tests (SPT) were performed with a battery of common inhalant and certain food allergens. Serum samples were tested for total immunglobulin E (T.IgE). Predictive factors for H. pylori infection and atopy were examined by a questionnaire. Results: A total of 90 subjects suffering dyspeptic symptoms were enrolled into the study. SPT positivity was similar between H. pylori (+) and H. pylori (­) subjects. Among the possible factors examined: age; gender; educational status; pet at home; BMI, family size; number of children and siblings; monthly income; drinking water source; smoking; and serum T.IgE levels were not related with H. pylori infection. However, perennial allergic symptoms were significantly higher in the H. pylori (­) group, seasonal allergic symptoms were related with an increased risk for H. pylori infection. Conclusions: In this sample group from a developing country H. pylori infection was not shown to be associated with atopic diseases. Therefore, the eradication of H. pylori may not be assumed to have an effect on allergic inflammation

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