Revealing the significance of early detection of chronic obstructive pulmonary disease: insights from healthy lung initiative data at COP27 conference.

BACKGROUND: Climate change poses a significant threat to respiratory health, exacerbating conditions like asthma, Chronic Obstructive Pulmonary Disease (COPD), and respiratory infections increasing morbidity and mortality indirectly through exposure to greenhouse gases. During the 27th Climate Change Conference (COP27), the Healthy Lung Initiative (HLI) for the early detection of COPD among smokers was launched in Egypt. OBJECTIVE: We aimed to detect the prevalence and predictors of confirmed COPD among smokers and assess physicians' adherence to prescribing pulmonary function tests (PFTs) among the COP27 conference attendees. METHODS: This study utilized smokers' data from the HLI, employing a cross-sectional design with an interview-based questionnaire, supplemented by spirometry for lung function evaluation. Participants, comprising Egyptian and non-Egyptian residents in Sharm El-Sheikh city, were provided with educational materials and encouraged to seek further evaluation from a pulmonologist. RESULTS: The HLI study, conducted from November 6th to 20th, 2022, involved 1133 participants, 90% (1047) of whom were smokers. Most smokers were males (96.3%) and Egyptians (98.6%), with half aged 30-39 and the majority starting smoking within the last 20 years. Despite common respiratory symptoms, 47% suffered from dyspnea on exertion, and only 4.3% have undergone lung function tests, suggesting a potential underdiagnosis of COPD. Most participants (82.6%) had an FEV1/FVC ratio > 70%, indicating no spirometry-confirmed COPD diagnosis, while 147 participants (17% of them) exhibited all three cardinal COPD symptoms simultaneously. Male gender and daily cigarette consumption were significant predictors for confirmed COPD, while age showed no significance in regression analyses. CONCLUSION: The ongoing HLI focuses on early detection and education to combat smoking-related risks, particularly among middle-aged males, while also highlighting the need for comprehensive strategies to address the intersection of smoking and climate change.

Oxygen Saturation in Hospitalized COVID-19 Patients and Its Relation to Colchicine Treatment: A Retrospective Cohort Study with an Updated Systematic Review.

Background: Colchicine has been proposed as a cytokine storm-blocking agent for COVID-19 due to its efficacy as an anti-inflammatory drug. The findings of the studies were contentious on the role of colchicine in preventing deterioration in COVID-19 patients. We aimed to evaluate the efficacy of colchicine in COVID-19-hospitalized patients. Design: A retrospective observational cohort study was carried out at three major isolation hospitals in Alexandria (Egypt), covering multiple centers. In addition, a systematic review was conducted by searching six different databases for published studies on the utilization of colchicine in patients with COVID-19 until March 2023. The primary outcome measure was to determine whether colchicine could decrease the number of days that the patient needed supplemental oxygen. The secondary outcomes were to evaluate whether colchicine could reduce the number of hospitalization days and mortality rate in these patients. Results: Out of 515 hospitalized COVID-19 patients, 411 were included in the survival analysis. After adjusting for the patients' characteristics, patients not receiving colchicine had a shorter length of stay (median: 7.0 vs. 6.0 days) and fewer days of supplemental oxygen treatment (median: 6.0 vs. 5.0 days), p < 0.05, but there was no significant difference in mortality rate. In a subgroup analysis based on oxygen equipment at admission, patients admitted on nasal cannula/face masks who did not receive colchicine had a shorter duration on oxygen supply than those who did [Hazard Ratio (HR) = 0.76 (CI 0.59-0.97)]. Using cox-regression analysis, clarithromycin compared to azithromycin in colchicine-treated patients was associated with a higher risk of longer duration on oxygen supply [HR = 1.77 (CI 1.04-2.99)]. Furthermore, we summarized 36 published colchicine studies, including 114,878 COVID-19 patients. Conclusions: COVID-19-hospitalized patients who were given colchicine had poorer outcomes in terms of the duration of supplemental oxygen use and the length of their hospital stay. Therefore, based on these findings, the use of colchicine is not recommended for COVID-19-hospitalized adults.

Effectiveness and Safety of Inactivated SARS-CoV-2 Vaccine (BBIBP-CorV) among Healthcare Workers: A Seven-Month Follow-Up Study at Fifteen Central Hospitals.

BACKGROUND: During a pandemic, healthcare workers are at high risk of contracting COVID-19. To protect these important individuals, it is highly recommended that they receive the COVID-19 vaccine. Our study focused on evaluating the safety and efficacy of Egypt's first approved vaccine, the Sinopharm vaccine (BBIBP-CorV), and comparing these findings with other vaccines. METHODS: An observational study was conducted in fifteen triage and isolation hospitals, from the 1st of March until the end of September 2021. The study included fully vaccinated and unvaccinated participants, and we measured vaccine effectiveness (using 1-aHR), the incidence rate of severely to critically ill hospitalized cases, COVID-19-related work absenteeism, and the safety of the vaccine as outcomes. RESULTS: Of the 1364 healthcare workers who were interviewed, 1228 agreed to participate. After taking the hazard ratio into account, the vaccine effectiveness was found to be 67% (95% CI, 80-43%) for symptomatic PCR-confirmed cases. The incidence rate ratio for hospitalization was 0.45 (95% CI, 0.15-1.31) in the vaccinated group compared to the unvaccinated group, and there was a significant reduction in absenteeism among the vaccinated group (p < 0.007). Most adverse events were mild and well tolerated. Vaccinated pregnant and lactating mothers did not experience any sentinel adverse events. CONCLUSION: Our study found that the BBIBP-CorV vaccine was effective in protecting healthcare workers from COVID-19.