Impact of COVID-19 on quality of life in survivors with pulmonary sequelae.

SARS-CoV-2 respiratory infection is still under study today, mainly because of its long-term effects. This study aims to analyse health status and health-related quality of life (HRQoL) in survivors of coronavirus pneumonia (COVID-19) who have developed pulmonary sequelae. Prospective observational study of patients diagnosed with COVID-19 pneumonia between February and May 2020. Reviews were conducted at 3 and 12 months after hospital discharge. HRQoL was assessed by administration of the SF-36 questionnaire and data related to medical records and physical examination were also collected. In addition, chest X-ray, computed tomography and pulmonary function test were included as additional tests. 305 patients were admitted for COVID-19 pneumonia of which 130 (42.6%) completed follow-up. The mean age of the enrolled group was 55.9 ± 15.9 years. The most prevalent persistent symptoms were dyspnea (37.3%) and asthenia (36.9%). Pulmonary sequelae were detected in 20.8% of participants. The most frequent alteration was ground ground glass opacities (GGO) (88.9%), with mild extension. Fibrotic changes were found in only 2% of cases. When comparing the two groups, at 3 and 12 months of evolution, lower scores in the vitality (VT) and mental health (MH) domains were found only in the group without sequelae. Days of hospitalisation and Charlson index acted as influential factors on HRQoL. Minimal or mild pulmonary sequelae of SARS-CoV-2 do not cause further deterioration of HRQoL. Repeated medical care and pulmonary rehabilitation are effective tools to improve HRQoL.

Impact of COVID-19 on Health-Related Quality of Life: A Longitudinal Study in a Spanish Clinical Sample.

SARS-CoV-2 respiratory infection and the course of its sequelae remain to be defined. The aim of this study is to analyze health status and Health-Related Quality of Life (HRQoL) in a Spanish sample of survivors of coronavirus disease 2019 (COVID-19) pneumonia. METHODS: Prospective observational study of patients who survived SARS-CoV-2 pneumonia, between February 2020 and May 2020, with systematic evaluation at 3 and 12 months after the onset of the disease. The data were obtained by reviewing the clinical history and performing a physical examination, a chest X-ray, and a pulmonary function test on the patients. Additionally, the SF-36 questionnaire was administered for the HRQoL study. RESULTS: In total, 130 patients aged 55.9 ± 15.9 years were included. Dyspnea (36.9%) and asthenia (36.2%) were the most frequent persistent symptoms. Fibrotic pulmonary changes were detected in 20.8% of the participants. Compared to the general population, significant deterioration was detected in all domains of the SF-36 questionnaire at 3 and 12 months post-COVID-19 infection. The greatest differences were in the physical role (RF) and in the emotional role (RE). CONCLUSIONS: COVID-19 pneumonia causes a long-term deterioration in HRQoL compared to the general population. Over time, a trend toward improvement is detected in most domains of the SF-36.

Fagerström Test and Heaviness Smoking Index. Are they Interchangeable as a Dependence Test for Nicotine?

Objective: The purpose of this study was to evaluate the degree of agreement between the Fagerström Test for Cigarette Dependence (FTCD) and the Heaviness of Smoking Index (HSI) in daily smokers admitted to smoking cessation clinics from National Healthcare System in Spain and Argentine Republic. Material and methods: An observational, longitudinal, multicenter study (prospective cohort) conducted in smoking clinics in daily clinical practice. The patients were consecutively included as they attended the consultations. The statistical analysis was descriptive, and correlation and concordance tests as well as analysis and regression models were used. Results: In total, 308 subjects were included [161 women (52.3%)], with a mean age of 51.4 (10.8) years. We found an absence of agreement and the existence of a proportional difference between both tests [Regression coefficient for global series: 0.55 (0.52-0.59) p < .001]. This difference increased as the value of the FTCD score increased; that is, the higher the value of the FTCD score was, the greater the difference in relation to the value of the HSI score. Likewise, Cohen's kappa concordance coefficient, according to various combinations of categorization of both tests, showed that the agreement between these variables was only good. Approximately 20% of the subjects were not classified with the same degree of dependence by the two tests. Thus, a classification mismatch existed. Conclusions: We found an absence of agreement between both tests. These data imply that we should not substitute one test for the other when we analyze nicotine dependence in a population of smokers.

¿En qué momento deberíamos medir la autoeficacia para ayudar a dejar de fumar? / When Should We Measure Self-Efficacy as an Aid to Smoking Cessation?

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¿Existe asociación entre el grado de dependencia por la nicotina y la motivación para dejar de fumar? / Is There an Association Between the Degree of Nicotine Dependence and the Motivation to Stop Smoking?

Objetivo: Evaluar la existencia de asociación entre el grado de dependencia por la nicotina medido por el test de Fagerström (FTCD) y diferentes test de motivación para dejar de fumar. Material y métodos: Estudio observacional y multicéntrico realizado en consultas de tabaquismo en la práctica clínica diaria. Se recogieron variables demográficas, de estatus de fumador y las puntuaciones del FTCD y los test de motivación: test de Richmond (TR), test motivacional Henri Mondor de París (HMP), test Khimji-Watts (KW) y la escala analógica visual de motivación para dejar de fumar. El análisis estadístico fue descriptivo y se utilizaron test de correlación y análisis y modelos de regresión. Resultados: Fueron incluidos 314 sujetos (162 mujeres [51,59%]). Los varones fumaron en promedio 3,3cig/día más que las mujeres (IC95%: 0,9-5,6cig/día, p = 0,006) y tuvieron un consumo acumulado superior a las mujeres en 7,8 años-paquete (IC95%: 2,1 a 13,5 años-paquete). No se encontró asociación entre el FTCD y los test de motivación para dejar de fumar empleados en este estudio. Conclusiones: No hemos encontrado asociación entre el grado de dependencia y la motivación para dejar de fumar medidos por los instrumentos mencionados

Objective: To evaluate the association between degrees of nicotine dependence measured by the Fagerström test (FTCD) and different tests of motivation to stop smoking. Material and methods: Observational study, multicenter conducted in smoking clinics in daily clinical practice. Demographics, smoking status, FTCD scores, and motivation test results were collected: Richmond test (TR), Henri Mondor Paris motivation test (HMP), Khimji-Watts test (KW), and the visual analog scale of motivation to stop smoking. The statistical analysis was descriptive, and correlation and analysis tests and regression models were used. Results: A total of 314 subjects were included [162 women (51.59%)]. Males smoked an average of 3.3 cigarettes/day more than women (95% CI: 0.9-5.6 cigarettes/day, p = 0.006) and their cumulative consumption was 7.8 pack-years higher than in women (95% CI: 2.1 to 13.5 pack-years). We found no association between FTCD and the motivation tests to stop smoking used in this study. Conclusions: We found no association between the degree of dependence and the motivation to quit smoking measured by the aforementioned instruments

Is There an Association Between the Degree of Nicotine Dependence and the Motivation to Stop Smoking? / ¿Existe asociación entre el grado de dependencia por la nicotina y la motivación para dejar de fumar?

OBJECTIVE: To evaluate the association between degrees of nicotine dependence measured by the Fagerström test (FTCD) and different tests of motivation to stop smoking. MATERIAL AND METHODS: Observational study, multicenter conducted in smoking clinics in daily clinical practice. Demographics, smoking status, FTCD scores, and motivation test results were collected: Richmond test (TR), Henri Mondor Paris motivation test (HMP), Khimji-Watts test (KW), and the visual analog scale of motivation to stop smoking. The statistical analysis was descriptive, and correlation and analysis tests and regression models were used. RESULTS: A total of 314 subjects were included [162 women (51.59%)]. Males smoked an average of 3.3 cigarettes/day more than women (95% CI: 0.9-5.6 cigarettes/day, p=0.006) and their cumulative consumption was 7.8 pack-years higher than in women (95% CI: 2.1 to 13.5 pack-years). We found no association between FTCD and the motivation tests to stop smoking used in this study. CONCLUSIONS: We found no association between the degree of dependence and the motivation to quit smoking measured by the aforementioned instruments.

Normativa sobre tratamiento del tabaquismo en pacientes hospitalizados / Guidelines for the Treatment of Smoking in Hospitalized Patients

Entre el 15 y el 27% de los pacientes que ingresan en los hospitales españoles son consumidores de tabaco. La hospitalización es un momento idóneo para que el fumador se plantee el abandono del tabaco. Se ha realizado una búsqueda bibliográfica en MEDLINE entre el 1 de enero de 2002 y el 30 de septiembre de 2015, de estudios, controlados y aleatorizados u observacionales, relacionados con la ayuda para dejar de fumar a pacientes ingresados en el hospital. Basándose en los resultados de dichos estudios se han emitido unas recomendaciones para el tratamiento del tabaquismo en pacientes hospitalizados. Las recomendaciones han sido formuladas de acuerdo con el sistema GRADE. Ofrecer al fumador asesoramiento psicológico más tratamiento farmacológico mientras está ingresado en el hospital y prolongar el seguimiento durante al menos 4 semanas después del alta es la recomendación más efectiva para ayudar a dejar de fumar a los pacientes ingresados (AU)

Between 15 and 27% of patients admitted to Spanish hospitals are smokers. Hospitalization is an ideal time for a smoker to decide to quit. We performed a MEDLINE search of controlled, randomized or observational studies associated with helping hospitalized patients quit smoking, published between January 1, 2002 and September 30, 2015. On the basis of the results of those studies, we have issued some recommendations for the treatment of smoking in hospitalized patients. The recommendations were drawn up according to the GRADE system. Offering the smoker psychological counselling and prolonging follow-up for at least 4 weeks after discharge is the most effective recommendation for helping hospitalized patients to quit (AU)

Guidelines for the Treatment of Smoking in Hospitalized Patients. / Normativa sobre tratamiento del tabaquismo en pacientes hospitalizados.

Between 15 and 27% of patients admitted to Spanish hospitals are smokers. Hospitalization is an ideal time for a smoker to decide to quit. We performed a MEDLINE search of controlled, randomized or observational studies associated with helping hospitalized patients quit smoking, published between January 1, 2002 and September 30, 2015. On the basis of the results of those studies, we have issued some recommendations for the treatment of smoking in hospitalized patients. The recommendations were drawn up according to the GRADE system. Offering the smoker psychological counselling and prolonging follow-up for at least 4 weeks after discharge is the most effective recommendation for helping hospitalized patients to quit.

Metodología estadística en los estudios de comparación de métodos de medida / No disponible

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[Smoking cessation after 12 months follow-up at a smoking cessation unit]. / Abstinencia de tabaquismo tras 12 meses de seguimiento en una unidad de tabaquismo integral.

BACKGROUND AND OBJECTIVE: To assess the cessation and relapse rates of smoking, and analyze the associated variables in a 12-month follow-up study at a smoking cessation unit. SUBJECTS AND METHOD: Patients from the Area de Salud 19 of the Conselleria de Sanitat of the Generalitat Valenciana, coming to a smoking cessation unit. VARIABLES: sociodemographic, smoking habits, smoking social context, psychiatric or medical problems, use of other substances, and treatment. Treatment was administered either individually or in group, and with or without pharmacological support. Type of pharmacological treatment: nicotine replacement therapy and/or bupropion. Evaluation of smoking cessation and relapse: at the end of the treatment, and at follow-up months 1, 3, 6, 9, and 12. Criteria to accept cessation were: it had to be uninterrupted, referred as such by the patient and corroborated by relatives or other witnesses, and supported by a co-oxymetry level < or = 6 ppm. STATISTICAL ANALYSES: description of quantitative and qualitative variables, evaluation of the relationship between relapse rate and follow-up time when it happens by means of Kaplan-Meier curves, Cox regression, construction of curves of prediction of cessation for subjects with different patterns in the independent variables, and estimations of risk of relapse between any 2 subjects, according to those patterns. RESULTS: 255 subjects (46.7% males); 41.8 (10.8) years of mean age (standard deviation); 25 years of mean duration of the smoking habit; a mean of 2 to 3 previous attempts of cessation smoking, mean duration of the longest period of cessation 6 to 7 months; smoking habit 26.5 (12.1) mean of cigarrettes per day, the average nicotine dependency was moderate, and the average co-oxymetry levels high. Of all the subjects included, 53.3% received single therapy (60% together with pharmacological treatment) and 46.7% had group therapy (18.4% also with pharmacological treatment). Pharmacological treatment was 14.9% nicotine replacement therapy, 17.3% bupropion, and 7.1% both. At the end of the treatment, 42.7% of the subjects kept smoking and, at the end of the follow-up period only 11.4% remained abstinent. Median cessation extent was one month. VARIABLES associated to the extent of the cessation: type of therapy (individual or in a group), pharmacological support, and previous daily amount of cigarrette consume. CONCLUSIONS: There were high relapse rates, that depended on the previous amount of consume and on the treatment applied. Both group therapy and pharmacological treatment are significantly useful in order to obtain the best results in long-term cessation rates.

Abstinencia de tabaquismo tras 12 meses de seguimiento en una unidad de tabaquismo integral / Smoking cessation after 12 months follow-up at a smoking cessation unit

Fundamento y objetivo: El propósito del estudio es presentar los resultados obtenidos en la tasa de abstinencia y de recaída del hábito tabáquico y analizar las variables asociadas tras un seguimiento de 12 meses en una unidad de tabaquismo integral. Sujetos y método: Se incluyó a pacientes pertenecientes al Área de Salud 19 de la Conselleria de Sanitat de la Generalitat Valenciana remitidos a una unidad de tabaquismo integral. Se analizaron variables sociodemográficas, del hábito tabáquico y del contexto social tabáquico, problemas médicos o psiquiátricos, consumo de otras sustancias y tipo de tratamiento recibido. Se administró terapia individual o grupal, con o sin apoyo farmacológico. La intervención farmacológica consistió en tratamiento sustitutivo con nicotina y/o bupropión. Se evaluó el estado de abstinencia o las recaídas al final del tratamiento y en los meses 1, 3, 6, 9 y 12 de seguimiento. La abstinencia considerada fue la continua, obtenida por autodeclaración, corroborada por acompañantes o familiares y confirmada por un valor en la cooximetría de 6 ppm o inferior. Resultados: Se incluyó a 255 sujetos (un 46,7% varones), con una edad media (desviación estándar) de 41,8 (10,8) años y 25 años de media de consumo. El número medio de intentos previos de abandono fue de 2 o 3, con una duración media del intento más largo de 6 a 7 meses. El número medio de cigarrillos consumidos era de 26,5 (12,1) al día, la dependencia nicotínica media era moderada y los valores medios de cooximetría, altos. El 53,3% recibió terapia individual (un 60% con tratamiento farmacológico) y el 46,7% psicoterapia de grupo (un 18,4% con tratamiento farmacológico). El tratamiento farmacológico administrado fue en un 14,9% de los casos tratamiento sustitutivo con nicotina, en un 17,3% bupropión y en el 7,1% ambos. Al final del tratamiento el 42,7% de los sujetos seguía fumando y al final del seguimiento sólo el 11,4% permanecía abstinente. La mediana de abstinencia fue de un mes. Las variables asociadas con el tiempo de abstinencia fueron el tipo de terapia (individual o de grupo), recibir tratamiento médico y el número de cigarrillos consumidos. Tuvieron mayor probabilidad de éxito aquellos que recibieron terapia de grupo con medicación y presentaban menor consumo de cigarrillos. Conclusiones: En este estudio realizado en pacientes remitidos a una unidad de tabaquismo integral se han observado tasas altas de recaída, que se modifican en función del consumo y del tipo de tratamiento aplicado. Los efectos de la psicoterapia de grupo y de la medicación son considerablemente beneficiosos a la hora de conseguir mejores resultados en las tasas de abstinencia a largo plazo

Background and objective: To assess the cessation and relapse rates of smoking, and analyze the associated variables in a 12-month follow-up study at a smoking cessation unit. Subjects and method: Patients from the Área de Salud 19 of the Conselleria de Sanitat of the Generalitat Valenciana, coming to a smoking cessation unit. Variables: sociodemographic, smoking habits, smoking social context, psychiatric or medical problems, use of other substances, and treatment. Treatment was administered either individually or in group, and with or without pharmacological support. Type of pharmacological treatment: nicotine replacement therapy and/or bupropion. Evaluation of smoking cessation and relapse: at the end of the treatment, and at follow-up months 1, 3, 6, 9, and 12. Criteria to accept cessation were: it had to be uninterrupted, referred as such by the patient and corroborated by relatives or other witnesses, and supported by a co-oxymetry level ¾ 6 ppm. Statistical analyses: description of quantitative and qualitative variables, evaluation of the relationship between relapse rate and follow-up time when it happens by means of Kaplan-Meier curves, Cox regression, construction of curves of prediction of cessation for subjects with different patterns in the independent variables, and estimations of risk of relapse between any 2 subjects, according to those patterns. Results: 255 subjects (46.7% males); 41.8 (10.8) years of mean age (standard deviation); 25 years of mean duration of the smoking habit; a mean of 2 to 3 previous attempts of cessation smoking, mean duration of the longest period of cessation 6 to 7 months; smoking habit 26.5 (12.1) mean of cigarrettes per day, the average nicotine dependency was moderate, and the average co-oxymetry levels high. Of all the subjects included, 53.3% received single therapy (60% together with pharmacological treatment) and 46.7% had group therapy (18.4% also with pharmacological treatment). Pharmacological treatment was 14.9% nicotine replacemnte therapy, 17.3% bupropion, and 7.1% both. At the end of the treatment, 42.7% of the subjects kept smoking and, at the end of the follow-up period only 11.4% remained abstinent. Median cessation extent was one month. Variables associated to the extent of the cessation: type of therapy (individual or in a group), pharmacological support, and previous daily amount of cigarrete consume. Conclusions: There were high relapse rates, that depended on the previous amount of consume and on the treatment applied. Both group therapy and pharmacological treatment are significantly useful in order to obtain the best results in long-term cessation rates