Quality of Life in Follow-Up up to 9 Months after COVID-19 Hospitalization among the Polish Population-A Prospective Single Center Study.

The consequences of COVID-19 constitute a significant burden to healthcare systems worldwide. Conducting an HRQoL assessment is an important aspect of the evaluation of the impact of the disease. The aim of this study was to investigate the prevalence of persistent symptoms and their impact on HRQoL and health status in COVID-19 convalescents. The study group consists of 46 patients who required hospitalization due to respiratory failure and who were subsequently evaluated 3 and 9 months after hospital discharge. At the follow-up visits, the patients were asked to assess their HRQoL using the EQ-5D-5L questionnaire. The results of chest CT, 6MWT, as well as the severity of the course of COVID-19 were also considered in the analysis. The obtained results have identified fatigue as the most common persistent symptom. The majority of the convalescents reported an impairment of HRQoL in at least one domain (80% and 82% after 3 and 9 months, respectively), of which the most common was that of pain/discomfort. The presence of ongoing symptoms may affect HRQoL in particular domains. The 6MWT outcome correlates with HRQoL 3 months after hospital discharge. Therefore, it may be useful in identifying patients with reduced HRQoL, allowing early interventions aimed at its improvement.

Pulmonary Function, Computed Tomography Lung Abnormalities, and Small Airway Disease after COVID-19: 3-, 6-, and 9-Month Follow-Up.

Background/Objectives: Coronavirus disease 2019 (COVID-19) course may differ among individuals-in particular, those with comorbidities may have severe pneumonia, requiring oxygen supplementation or mechanical ventilation. Post-COVID-19 long-term structural changes in imaging studies can contribute to persistent respiratory disturbance. This study aimed to investigate COVID-19 sequels affecting the possibility of persistent structural lung tissue abnormalities and their influence on the respiratory function of peripheral airways and gas transfer. Methods: Patients were divided into two groups according to severity grades described by the World Health Organization. Among the 176 hospitalized patients were 154 patients with mask oxygen supplementation and 22 patients with high-flow nasal cannula (HFNC) or mechanical ventilation. All tests were performed at 3, 6, and 9 months post-hospitalization. Results: Patients in the severe/critical group had lower lung volumes in FVC, FVC%, FEV1, FEV1%, LC, TLC%, and DLCO% at three months post-hospitalization. At 6 and 9 months, neither group had significant FVC and FEV1 value improvements. The MEF 25-75 values were not significantly higher in the mild/moderate group than in the severe/critical group at three months. There were weak significant correlations between FVC and FEV1, MEF50, MEF 75, plethysmography TLC, disturbances in DLCO, and total CT abnormalities in the severe/critical group at three months. In a mild/moderate group, there was a significant negative correlation between the spirometry, plethysmography parameters, and CT lesions in all periods. Conclusions: Persistent respiratory symptoms post-COVID-19 can result from fibrotic lung parenchyma and post-infectious stenotic small airway changes not visible in CT, probably due to persistent inflammation.

Impact of Symptomatology, Clinical and Radiological Severity of COVID-19 on Pulmonary Function Test Results and Functional Capacity during Follow-Up among Survivors.

One of the most commonly observed complications after COVID-19 is persistent pulmonary impairment. The aim of this study was to evaluate the impact of individual factors during the acute phase of COVID-19 on subsequent pulmonary function test results. The study involved 46 patients who were admitted to hospital due to respiratory failure caused by SARS-CoV-2 and who were assessed during follow-up visits at 3 and 9 months after discharge. Patients were divided into two subgroups according to the severity of respiratory failure. The severe group included patients requiring mechanical ventilation or HFNOT. The results of the study showed that a severe course of the disease was associated with a lower FVC and a higher FEV1/FVC ratio 3 months after discharge (both p < 0.05). In addition, it has been revealed that the length of hospitalization is a factor that negatively impacts the FEV1, FVC and TLC values measured at follow-up after 3 months. Furthermore, the obtained results identify the presence of cough in the acute phase of the disease as a factor having a positive impact on several PFT parameters (especially the FEV1/FVC ratio) as well as the 6MWT outcome after 3 months. The FVC improved significantly (p < 0.05) between the follow-up visits. The findings may indicate that COVID-19-induced respiratory dysfunction is usually temporary and spontaneously resolves during recovery. Recovery is slower in those who required more intensive oxygenation. The results of this study may be useful in identifying patients who require more intensive and longer rehabilitation after COVID-19.

[Intoxications caused by Staphylococcal enterotoxin B]. / Zatrucia gronkowcowa enterotoksyna B.

Staphylococcal enterotoxin B (SEB) is one of exotoxins produced by Staphylococcus aureus. Depending on the type exposure SEB may cause a food or inhalant poisoning. The course of food poisoning is usually lighter and resolves spontaneously. The course of inhalant poisoning depends on the inhaled dose. It can be tough and demanding intensive treatment. Given the lack of specific therapy, led therapy is purely symptomatic.

[Contemporary threat of tuberculosis]. / Wspólczesne zagrozenie gruzlica.

Tuberculosis is an infectious disease caused by mycobacteria which belongs to the genus Mycobacterium and the family Mycobacteriaceae. Although tuberculosis is known for thousands of years, it is still an important diagnostic and therapeutic problem throughout the world, especially in poorer countries. Still correct diagnosis of active infection with M. tuberculosis causes many difficulties. The paper presents the most relevant issues concerning the diagnosis and treatment of tuberculosis, to be reflected in daily practice.

[Mycobacterioses as still current clinical problem]. / Mykobakteriozy jako wciaz aktualny problem kliniczny.

Mycobacterioses are caused by nontuberculous mycobacteria which are common in natural environment. They were isolated from water and soil. Patients with suppressed immune system are most likely to be affected. Mycobacteria are transferred to human through damaged skin, the respiratory system, and digestive system. The most common clinical manifestation has been observed in the lungs. Diagnosis of disease is still current clinical problem and the effectiveness of therapy is not satisfy.

[Influence of Broncho-Vaxom treatment on serum concentration of metalloproteinase-9 in patients with chronic obstructive pulmonary disease]. / Wplyw leczenia Broncho-Vaxomem na stezenie metaloproteinazy-9 w surowicy chorych na przewlekla obturacyjna chorobe pluc.

UNLABELLED: Immunomodulatory activity of bacterial extracts such as Broncho-Vaxom results in stimulation of different immune cells, increase of expression of proinflammatory cytokines and enhancement of resistance to infection. Lyophilized extracts from bacteria are particularly recommended for patients with chronic respiratory tract diseases, in whom infectious exacerbations irreversibly worsen lung damage. Despite the fact that treatment with bacterial lysates is considered safe, it is not clear if such immunomodulation does not negatively affect the proteinase--antiproteinase balance in patients with COPD. AIM OF THE STUDY: Evaluation of influence of treatment with Broncho-Vaxom on the concentration of metalloproteinase-9 in serum of patients with chronic obstructive pulmonary disease. MATERIAL AND METHODS: Forty one patients with moderate COPD were included in the study The patients were divided into two groups: smokers and nonsmokers. Each patient received Broncho-Vaxom for the first ten days each month for three consecutive months. The patients were examined twice: before treatment and in the third month of treatment. During each visit clinical symptoms of COPD were assessed, spirometric tests and blood tests were performed, the concentrations of immunoglobulins, C-reactive protein and metalloproteinase-9 in serum (MMP-9) were measured. RESULTS: No significant differences were found between the groups in predicted value of FEV1%, concentrations of immunoglobulins and C-reactive protein in serum and the number of leukocytes in blood after treatment with Broncho-Vaxom. A significant decrease of intensity of COPD symptoms in both groups after immunostimulatory treatment was observed. There were no differences in metalloproteinase-9 concentration in serum between the smokers and nonsmokers. Administration of bacterial extract did not significantly influence MMP-9 concentration in serum of the patients. RESULTS: Treatment with Broncho-Vaxom does not increase the concentration of metalloproteinase-9 in serum of patients with COPD, while it decreases the symptoms of stable COPD.

[Alexithymia and depression: relationship to cigarette smoking, nicotine dependence and motivation to quit smoking]. / Aleksytymia i depresja: zwiazek z paleniem papierosów, uzaleznieniem od nikotyny i motywacja do rzucenia palenia.

The aim of the study was to examine an alexithymia score and depression among people smoking cigarettes and also to examine association between alexithymia, depression and smoking index, nicotine addiction, the motivation to quit smoking. The study comprised 46 people from Warsaw and its environs, without pulmonary, cardiovascular or neoplastic diseases, with at least medium education. The subjects were qualified into two groups: group I (n = 22) - subjects who had never smoked cigarettes, and group II - currently smoking (n=24). The total alexithymia score and scores of alexithymia subscales: difficulty in identifying feelings (TIE), b) difficulty in communicating feelings (TOU), c) externally oriented thinking (OSM) were assessed with Toronto Alexi. thymia Scale 20 (TAS-20). Beck Depression Inventory (Scale) (BDI) was used to evaluate presence and intensification of depression symptoms. The tobacco addiction rate was assessed with the Fagestrom questionnaire, and the motivation to quit smoking with the Schneider test. All data were obtained during individual exami. nations. The mean alexithymia score in the nonsmokers group was 38.6+/-8.8, in the smokers group: 46.6+/-13.0. The differences between the groups were statistically significant (p=0.02). Both difficulty in identifying feelings (TIE) and difficulty in communicating feelings (TOU) scores were significantly higher in the smokers (TIE p=0.01; TOU p=0.03). There were no differences in externally oriented thinking. It was found that people smoking cigarettes had a significantly higher level of intensification of depression symptoms than the controls. There was not any correlation between the total alexithymia score and depression symptoms or smoking index, the degree of nicotine addiction, the motivation to quit smoking.

[The influence of smoking on the metalloproteinase 1 (MMP-1) concentration in serum in the group of patients with chronic obstructive pulmonary disease]. / Wplyw palenia tytoniu na stezenie metaloproteinazy 1 (MMP-1) w surowicy u osób chorych na przewlekla obturacyjna chorobe pluc.

The aim of the study was to assess the influence of smoking on the metalloproteinase 1 (MMP-1) concentration in serum in the group of patients with chronic obstructive pulmonary disease (COPD). The study comprised 26 patients with COPD. The control group was created of 15 healthy non-smoking subjects. In the both group spirometry test was performed. The concentration of MMP-1, C-reactive protein, OB level was estimated in serum. Significant differences were noticed in the MMP-1 concentration in serum between groups (p=0.013). Significantly higher OB level (p=0.011) and C-reactive protein concentration (p=0.03) was found in the COPD group. In this same group positive correlation between MMP-1 concentration in serum and the packyears was noticed (r=0.50). No significant correlation was found between inflammatory indicators and the number of packyears. No significant correlation was noticed between MMP-1 level and FEV1 in COPD group. The analysis of the data shows significant influence of smoking on the increase of MMP-1 concentration in serum in the group of COPD patients.

[Influence of nicotine addiction on telomerase activity in malignant non-small cell lung tumors]. / Wplyw nikotynizmu na aktywnosc telomerazy w niedrobnokomórkowych guzach zlosliwych pluc.

Telomerase synthesizes telomeric DNA repeats at the ends of eukaryotic chromosomes and inhibits the natural senescence of different cells. Its increased activity in malignant tumors is considered to be an independent prognostic factor of the disease course. Aim of the study was valuation of influence of prolonged tobacco smoking on telomerase expression in non-small cell lung cancer (NSCLC). The study comprised 33 patients with NSCLC (divided into two groups: smokers - n=21 and nonsmokers n=12), who had telomerase activity quantitatively assessed (PCR-ELISAPLUS, ROCHE, Mannheim, Germany) in aspirates collected from peripheral lung tumors through transthoracic fine-needle biopsy. No statistically significant differences were found between the studied groups with regard to the clinical stage of tumor. Telomerase activity in biopsy samples from smoking patients was higher than in samples from nonsmoking patients (statistically insignificant difference p=0.09). It was found that telomerase activity in tumor cells was significantly lower in patients smoking less than 40 pack years in comparison to patients smoking more than 40 pack-years (p=0.01). Telomerase activity in NSCLC cells correlated significantly with clinical stage of tumor in all the patients (r=0.66 for nonsmokers and r=0.58 for smokers; p< or =0.01), and in the smokers' group - additionally with pack-years (r=0.47; p=0.04). Tobacco smoking by patients with non-small cell lung cancer increases telomerase activity in tumor cells.

[Effect of some demographic and social factors on the degree of nicotine addiction and motivation to quit smoking in healthy people]. / Wplyw niektórych czynników demograficznych i socjalnych na stopien uzaleznienia od nikotyny oraz motywacje do rzucenia palenia tytoniu u zdrowych.

AIM: Estimation of the influence of some demographical and social factors on degree of nicotine addiction and motivation to quit smoking. MATERIAL AND METHOD: 208 healthy, smoking people entered the study. The Fagerström test was used for analyzing degree of nicotine addiction (heavy addiction > 7 points). Motivation for smoking cessation was estimated by Schneider test (high motivation > 5 positive answers). Tests results were analyzed in connection with age, gender, education and intensity of nicotine addiction defined as pack-years. RESULTS: In 37% of patients (77/208) heavy nicotine addiction was diagnosed. High motivation for quitting smoking was recognized in 74% people (150/208). Subjects with wild nicotine addiction had significantly higher motivation for smoking cessation (chi2, p=0.002). There was not influence of gender, age, education and addiction intensity (defined as pack-years) on the grade of nicotine addiction. We didn't notice relation between gender and motivation to quit. Young, well educated patients are significantly stronger motivated for smoking cessation. CONCLUSIONS: There was not direct dependence between the number of smoked cigarettes and degree of nicotine addiction. In the group of healthy subjects, young, well educated people have a better chance for smoking cessation.

[Comparative analysis of nicotine dependence and motivation to quit smoking in patients with bronchial asthma or COPD]. / Analiza porównawcza uzaleznienia od nikotyny i motywacji do rzucenia palenia tytoniu u chorych na astme oskrzelowa lub POChP.

The aim of the study was to assess differences in tobacco addiction rate and motivation to quit tobacco smoking in patients with bronchial asthma and chronic obstructive pulmonary disease (COPD). The study comprised 384 males from Warsaw and its environs, aiming to quit smoking within the nearest year, without cardiovascular or neoplastic diseases, with at least medium education (17.19). The subjects were qualified into one of three groups: a control group--subjects without pulmonary diseases (n=143), patients with COPD (n=126) and patients with bronchial asthma (n=115). The smoking index (pack-years) was calculated in each group. The tobacco addiction rate was assessed with the Fageström questionnaire, and the motivation to quit smoking with the Schneider test. All data were obtained during individual examinations. The mean smoking index in the study population was 29.0 +/- 20.6 pack-years (control--27.0 +/- 20.6; asthma--25.2 +/- 14.2 and COPD--38.0 +/- 21.4). A high tobacco addiction rate was found in 40.5% of the patients with COPD, 37.1% of the patients with asthma and 30.3% of the subjects from the control group. The differences between the groups were not statistically significant (p>0.05). In the asthmatic group the percentage of subjects with a high motivation to quit smoking was significantly lower (48%) than in the COPD group (74%, p=0.005) and the control group (75%, p=0.002). It was found that patients with COPD significantly more frequently than asthmatics and people without pulmonary diseases need medical assistance in overcoming nicotine addiction.

[Analysis of the treatment method in patients with COPD]. / Analiza sposobu leczenia chorych na POChP.

UNLABELLED: According the mass spirometry, every third person over forty years old, suffer from COPD in Poland. Prophylaxis, early detection and proper treatment are necessary for the limitation of group of patients with severe COPD in the future. We analyzed the usage of particular group of medicines and estimated conformability of COPD treatment with actual recommendations. MATERIAL AND METHODS: We included 125 subjects--26% women (n = 33), and 74% men (n = 92). Mean age was 62 +/- 10. Current smokers were 46% (n = 58) with mean time of smoking was 28 +/- 14 pack-years, ex-smokers 41% (n = 51), non-smokers 13% (n = 16). We recorded the treatment way and HbCO level in expired air. Spirometry and flow-volume test were provided. We used Statistica program for results statistical analysis. RESULTS: Usually, patients with mild COPD are treated with theophilline (49%), long-acting beta 2-agonists (40%), short-acting beta 2-agonists (35%), inhaled steroids and anticholinergics (24%). In mild-severe and severe form of COPD are used: theophilline (50%), short-acting beta 2-agonists (40%), long-acting beta 2-agonists (27%), inhaled steroids (19%) and anticholinergics (12%). 8.1 subjects with mild, 1.7% with mild-severe and 5.5% with severe COPD are treated with recommended connection of anticholinergic and long-acting beta 2-agonist. CONCLUSIONS: Mostly theophilline and short-acting beta 2-agonists are used. Anticholinergics are used too seldom. COPD treatment is insufficient and inconsistent with actual recommendations. Only 1.7 to 5.5% patients are treated with recommended combination of anticholinergic and long-acting beta 2-agonist.