Respir Med [JOURNAL]
Sun
200 papers
Patient's perspectives about the immediate online access of bronchoscopy biopsy results through a patient portal.
Alrosan S, Daraghma M, Aboudara M
Respir Med · 2026 Jun · PMID 42034253 · Publisher ↗
BACKGROUND: The 21st Century Cures Act Final Rule requires healthcare organizations to immediately release patient results through an online portal. This may improve patient safety and reduce anxiety. However, little is...
BACKGROUND: The 21st Century Cures Act Final Rule requires healthcare organizations to immediately release patient results through an online portal. This may improve patient safety and reduce anxiety. However, little is known about patient's perspective with cancer diagnoses. We conducted a quality improvement (QI) project to assess perspectives on immediate access to bronchoscopy results and interventions to improve patient experience. METHODS: This QI project was conducted over 3 months and all patients who had a bronchoscopy for any reason were approached pre-procedure with a questionnaire requesting demographic information, education, experiences using the portal and their perspectives as to receiving immediate results. A post-procedure questionnaire was administered 14 days later. Patient comments were collected pre and post procedure. Descriptive statistics were used. RESULTS: A total of 194 patients completed the pre-procedure questionnaire and 166 completed the post-procedure questionnaire. The average (SD) age was 66(12.3), 51% were male, 94% were White, and 40% had a college degree or higher. Pre-procedure, 66.5% used the portal; 51.5% routinely viewed results and 50% said it would reduce their anxiety. Post procedure, 66.7% with cancer viewed their results versus 70.5% without cancer. 37.6% did know how to interpret the result. 9% of cancer patients were completely satisfied with the explanation; 47.2% were more worried. In the future, 48.4% want a phone call and a link to an education video. CONCLUSION: The immediate release of biopsy results should be tailored to patient preferences to reduce negative psychological impact of receiving a cancer diagnosis without immediate provider support.
Impact of pre-existing interstitial lung abnormalities on pneumonitis risk and survival in chemo-naive patients with non-small-cell lung cancer receiving pembrolizumab plus chemotherapy.
Machiyama H, Matsumoto K, Shiroyama T … +20 more , Miyazaki A, Komuta K, Tamiya M, Tsukaguchi A, Tamiya A, Kinehara Y, Moritomo K, Shoshihara N, Kuge T, Mihashi Y, Mori M, Yamauchi K, Suzuki H, Kato S, Nishikawa Y, Niki T, Azuma K, Osa A, Takeda Y, Kumanogoh A
Respir Med · 2026 Jun · PMID 42025817 · Publisher ↗
BACKGROUND: Pre-existing interstitial lung abnormalities (ILAs) are risk factors for immune checkpoint inhibitor related pneumonitis (ICI-P). However, the effects of first-line pembrolizumab plus platinum-based chemother...
BACKGROUND: Pre-existing interstitial lung abnormalities (ILAs) are risk factors for immune checkpoint inhibitor related pneumonitis (ICI-P). However, the effects of first-line pembrolizumab plus platinum-based chemotherapy (PCT) on survival and ICI-P in chemo-naive patients with non-small cell lung cancer (NSCLC) and ILAs remain unclear. We, therefore, aimed to investigate these effects. METHODS: We retrospectively analyzed patients with NSCLC who received first-line PCT at 12 Japanese institutions between December 2018 and December 2022. Based on computed tomography findings, patients were classified into non-ILA, non-subpleural (NS)-ILA, subpleural non-fibrotic (SNF)-ILA, or subpleural fibrotic (SF)-ILA. Overall survival (OS) and pneumonitis data were collected. RESULTS: This study included 410 patients, comprising 307 without ILAs, 39 with NS-ILA, 47 with SNF-ILA, and 17 with SF-ILA. The cumulative incidences of any-grade ICI-P and grade ≥3 ICI-P differed among ILA subgroups (Gray's P < 0.001 and P = 0.008, respectively). In the multivariable analysis, SF-ILA was associated with higher cumulative incidences of any-grade pneumonitis (hazard ratio [HR], 4.75; 95% confidence interval [CI], 2.27-9.95; P < 0.001) and grade ≥3 pneumonitis (HR, 3.79; 95% CI, 1.43-10.1; P = 0.007) than non-ILA. Moreover, SF-ILA was an independent prognostic factor for OS (HR, 1.99; 95% CI, 1.06-3.73; P = 0.032). NS-ILA and SNF-ILA were not independently associated with an increased risk of death or severe pneumonitis compared with non-ILA. CONCLUSIONS: ILA subtype assessment may enable risk stratification and inform treatment decisions for patients with NSCLC receiving PCT.
Breathing and speech patterns for predictive modelling of exacerbations of asthma and COPD.
Najda M, Yan Y, van Bemmel L … +3 more , Franssen FME, Simons SO, Urovi V
Respir Med · 2026 Jun · PMID 42025816 · Publisher ↗
BACKGROUND: COPD and asthma cause significant morbidity and mortality across the globe. The development of non-invasive telemonitoring solutions offers the potential to improve patient care. OBJECTIVE: To examine whether...
BACKGROUND: COPD and asthma cause significant morbidity and mortality across the globe. The development of non-invasive telemonitoring solutions offers the potential to improve patient care. OBJECTIVE: To examine whether breathing and speech patterns extracted from audio recordings enhance model generalizability of distinguishing stable from exacerbation periods in COPD and asthma. METHODS: Patterns related to breathing and speech were extracted from a dataset that combined daily audio speech recordings with a patient-reported outcome measure (EXACT). Medical experts categorized patient health status as stable or exacerbation. A tree-based model was investigated for exacerbation prediction. The model was trained on signal-related features, breathing and speech patterns, and combination of both. Results were examined for variability among all people and feature importance. RESULTS: The study included 21 people (mean age 62.7 years; 66.7% female), 61.9% diagnosed with COPD and 38.1% with asthma. Minimum breath duration and speech duration differed between stable and exacerbation states (p < 0.05). The model, trained on combined features sets achieved Sensitivity of 0.78, 0.10 SD exceeding models trained on acoustic-only (0.70, 0.17 SD) and patterns-only sets (0.68, 0.13 SD). Inconsistencies were observed in patient-level results across exacerbation severity. Speech Duration, Spectral Contrast, Harmonic to Noise Ratio, Breath Group Duration and 26 Mel-Frequency Cepstral Coefficient were found to have the highest importance for the best performing model. CONCLUSION: Combining signal derived features with breathing and speech patterns helps models to achieve higher results. Detected clusters within the study group indicate patient-level variability. Presented results position breathing and speech patterns as valuable tool for remote patient screening.
Temporal trends in baseline severity and 12-month response to mepolizumab in severe asthma: The TYREX multicentre real-world study in Spain (2017-2024).
Domínguez-Ortega J, Almonacid C, Alvarez-Gutiérrez FJ … +6 more , Cisneros C, Dávila I, Bañas-Conejero D, Antelo-Cea E, Pérez de Llano L, TYREX study group
Respir Med · 2026 Jun · PMID 42025815 · Publisher ↗
BACKGROUND AND OBJECTIVE: Although mepolizumab has demonstrated efficacy and effectiveness in the treatment of severe asthma, it is unknown whether the characteristics of patients starting this biologic have changed over...
BACKGROUND AND OBJECTIVE: Although mepolizumab has demonstrated efficacy and effectiveness in the treatment of severe asthma, it is unknown whether the characteristics of patients starting this biologic have changed over the years and whether this impacts their response to mepolizumab. METHODS: TYREX was a multicenter, retrospective, observational study conducted in 24 asthma units across Spain to compare baseline clinical and demographic characteristics, and 12-month response to mepolizumab in two cohorts defined by the date of biologic initiation (cohort 1: 2017-2019 vs cohort 2: 2022-2024). RESULTS: Among the 446 patients included in the TYREX study, 191 were classified in cohort 1 and 108 in cohort 2. Cohort 1 had higher baseline exacerbation rates (3.45 vs. 2.40/year; p = 0.0002) and higher blood eosinophils (806 vs. 607 cells/μL; p = 0.0175). Twelve months after mepolizumab initiation, annual exacerbation rate were reduced to 0.46 in cohort 1 and to 0.51 in cohort 2, ACT scores increased from 14.23 to 21.84 vs. from 15.43 to 21.06; daily oral corticosteroid dependent patients dropped from 33.51% to 9.04% vs. from 12.96% to 2.78%; and clinical remission was achieved in 37.5% vs. 38.5% of patients after 12 months with mepolizumab. In multivariable analysis for 4-domain clinical remission (n = 108), higher baseline ppFEV1 increased the odds of remission while maintenance OCS use decreased them (Figure. 3). In the 3-domain remission model (n = 198), CRSwNP and higher baseline blood eosinophil count increased the odds of remission, whereas maintenance OCS use decreased them (Figure. 3). CONCLUSION: The decrease over time in severity and blood eosinophilia in asthma patients starting mepolizumab has not shown any impact on the clinical response to the drug.
High COPD prevalence among socially marginalized hospitalized patients. A pragmatic multicenter prospective cohort study.
Brünés N, Lindstroem MB, Kallemose T … +9 more , Marsaa K, Ulrik CS, Lisby M, Godtfredsen NS, Thomsen LH, Hansen TL, Pisinger C, Graven V, Andersen O
Respir Med · 2026 Jul · PMID 42025814 · Publisher ↗
BACKGROUND: Tobacco exposure is the main risk factor for chronic obstructive pulmonary disease (COPD), but other risk factors, including low socio-economic status (SES), may also contribute. Danish hospitals have introdu...
BACKGROUND: Tobacco exposure is the main risk factor for chronic obstructive pulmonary disease (COPD), but other risk factors, including low socio-economic status (SES), may also contribute. Danish hospitals have introduced social nurses who support patients with complex health and social conditions. These nurses represent a unique point of contact for identifying hospitalized marginalized individuals who may not have undergone prior diagnostic evaluation for COPD. This study aimed to assess the prevalence of COPD among hospitalized marginalized individuals in contact with social nurses in Denmark. METHODS: In this national pragmatic prospective cohort study inpatients in contact with social nurses, underwent spirometry and interview about risk factors, socioeconomic status, and respiratory symptoms, and, if required, underwent further diagnostic work-up. RESULTS: Among 513 patients (median age 52.7 years, 76% males and 442 (86%) without prior diagnosis of COPD), 410 (80%) were current smokers (median pack-years 27.4). The median COPD Assessment Test (CAT) score was 11.0, with 57% having a score above 10. At screening, 470 were able to perform spirometry, and 312 (66%) had airflow obstruction, suggesting COPD. Of these, 75 (24%) patients attended further diagnostic work-up. COPD was confirmed in 38 (52%) of the cases. Additionally, 162 (40%) of all current smokers reported being offered smoking cessation support previously, while 105 (48%) of smokers with obstruction expressed a desire to quit smoking. INTERPRETATION: This study revealed a very high prevalence of undiagnosed COPD among hospitalized socially marginalized individuals. The findings suggest a need for targeted smoking cessation support and COPD screening within this group.
Real-world impact of elexacaftor/tezacaftor/ivacaftor on health-related quality of life in adults with cystic fibrosis: A 12-month multicenter cohort study.
Kharraz R, Tullis E, Sykes J … +10 more , Ma X, Sandhu A, Gryz Z, Shulman Y, Tam J, Love A, Ratjen F, Rayment JH, Quon BS, Stephenson AL
Respir Med · 2026 Jun · PMID 42019640 · Publisher ↗
BACKGROUND: Elexacaftor/tezacaftor/ivacaftor (ETI) has demonstrated significant improvements in lung function, body mass index (BMI), symptom control, and health-related quality of life (HRQoL) in individuals with cystic...
BACKGROUND: Elexacaftor/tezacaftor/ivacaftor (ETI) has demonstrated significant improvements in lung function, body mass index (BMI), symptom control, and health-related quality of life (HRQoL) in individuals with cystic fibrosis (CF). However, real-world evidence regarding its long-term impact on HRQoL, particularly in people without significant lung function improvement, remains limited. OBJECTIVES: This study aimed to (1) assess HRQoL changes across multiple domains in individuals initiating ETI and (2) explore the relationship between clinical outcomes and HRQoL, particularly in those who do not experience a significant improvement in lung function. METHODS: We conducted a prospective cohort study of adults initiating ETI at CF clinics across Canada. HRQoL was assessed using the Cystic Fibrosis Questionnaire-Revised (CFQ-R), Cystic Fibrosis Quality-of-Life Evaluative Self-Administered Test (CF-QUEST), and Sino-Nasal Outcome Test (SNOT-22) at baseline and at 3, 6, 9, and 12 months post-initiation. Lung function (percent predicted forced expiratory volume in 1 s [ppFEV1]) and BMI were also monitored. Individuals were classified as lung function responders (≥5% increase in ppFEV1) or non-responders (<5% increase). RESULTS: Among 353 individuals, significant improvements in CFQ-R, CF-QUEST, and SNOT-22 scores were observed within one month of ETI initiation and sustained over 12 months. Notably, both lung function responders and non-responders experienced significant HRQoL improvements, with no evidence of a difference between groups in terms of mean changes in CFQ-R respiratory scores (28.8 vs. 24.2, p = 0.2), CF-QUEST global scores (14.8 vs. 13.0, p = 0.48), or SNOT-22 scores (-13.8 vs. -13.7, p = 0.97). CONCLUSION: Our real-world data involving a large cohort of PwCF demonstrate that HRQoL improvements are sustained across multiple domains regardless of lung function response. These findings underscore the importance of using a multimodal approach to evaluate the effectiveness of modulator therapy in people with CF.
Treatable traits of asthma in adults: a population-based study based on the National Health and Nutrition Examination Survey.
Wu WW, Wang XL
Respir Med · 2026 Jun · PMID 42013941 · Publisher ↗
BACKGROUND: Data on treatable traits (TTs) in different populations are still limited. OBJECTIVE: To evaluate TT prevalence in asthma patients versus non-asthmatic controls using Nutrition Examination Survey (NHANES) dat...
BACKGROUND: Data on treatable traits (TTs) in different populations are still limited. OBJECTIVE: To evaluate TT prevalence in asthma patients versus non-asthmatic controls using Nutrition Examination Survey (NHANES) data, and investigate TT associations with prior asthma attacks. METHODS: This is an observational study based on data of the NHANES from 2001 to 2018 and 2021 to 2023. We evaluated the prevalence of TTs in patients with asthma and compared it with a group of participants without asthma. Additionally, logistic regressions were used to examine the cross-sectional associations between TTs and a self-reported history of asthma attack in the past 12 months. RESULTS: A total of 4949 adults with asthma were studied. We assessed 41 TTs in total, including 13 pulmonary traits, 19 extrapulmonary traits, and nine behavioral/risk-factor traits. Almost all of these traits were more common in patients with asthma than in those without asthma. Univariate logistic regression analysis identified nine traits were associated with a history of asthma attack in the past year. These associations remained significant for a core set of traits in the multivariable logistic regression analysis, including blood eosinophil-marked T2 inflammation, emphysema/chronic bronchitis/COPD, hay fever, angina, stroke, systemic inflammation, and insufficient sleep time. CONCLUSIONS: Patients with asthma bear a significantly higher burden of TTs, and some traits are associated with increased odds of prior asthma attack, suggesting the added disease burden in this population. Large-scale prospective studies are required to confirm these associations.
Effects of photobiomodulation by infrared LED-therapy on improving cardiopulmonary functions and hematologic parameters in patients with community-acquired pneumonia (CAP).
Pereira PC, de Lima CJ, Fernandes AB … +4 more , Carvalho HC, Alves LP, Zângaro RA, Villaverde AB
Respir Med · 2026 Jun · PMID 42009264 · Publisher ↗
BACKGROUND: Community-acquired pneumonia (CAP) is associated with restrictive pulmonary dysfunction and ventilation-perfusion imbalance. This study evaluated the effects of photobiomodulation (PBM) on pulmonary function...
BACKGROUND: Community-acquired pneumonia (CAP) is associated with restrictive pulmonary dysfunction and ventilation-perfusion imbalance. This study evaluated the effects of photobiomodulation (PBM) on pulmonary function and hematological parameters in CAP patients. METHODS: This randomized clinical trial, registered in the Brazilian Registry of Clinical Trials (ReBEC: UTN U1111-1229-1296; June 5, 2019), included 30 patients with CAP randomly allocated to two groups: an LED group receiving 940-nm PBM plus conventional therapy and a control group receiving conventional therapy alone (antibiotics and physiotherapy). PBM was delivered using a vest containing 300 near-infrared LEDs applied to the anterior thoracic and abdominal regions for 15 min daily over 7 consecutive days. Data were anonymized prior to analysis, and statistical comparisons were performed using paired and unpaired two-tailed Student's t-tests. RESULTS: The PBM adjunct to the conventional therapy improved the pulmonary recovery process and the clinical status, reduced respiratory symptoms, decreased hospital stay (9.3 vs 7.3 days) (p = 0.0015, g = -1.25), inducing an increase in peripheral oxygen saturation (SpO) (88.3 to 98%) (p = 0.0001; g = 1.70), maximum inspiratory pressure (MIP) (-40 to -65.3 cmHO) (p < 0.0001; g = -1.37), forced vital capacity (FVC) (62% to 80%) (p < 0.0021; g = 1.10), improvement in hematological data erythrocytes (3.51 to 5.54 mm) (p = 0.0071; g = 1.69), hematocrit (32.60 to 39.14 %) (p = 0.0105; g = 0.66), and typical lymphocytes (40 to 31%) (p = 0.0120; g = -1.22), as well as, pulmonary auscultation (6.1 to 3.1 days) (p < 0.0001). CONCLUSION: PBM treatment adjunctive to conventional therapy improved the pulmonary and clinical status of patients, reduced respiratory symptoms, and shortened the length of hospital stay.
Outcomes of patients with COPD before and after initiation of treatment with budesonide/glycopyrrolate/formoterol fumarate: Results from the US ARCTOS study.
Sethi S, Gozalo L, McMorrow D … +7 more , Feigler N, Spy A, Hirpara S, Szymanski K, Evangelista C, Tkacz J, Germack HD
Respir Med · 2026 Jun · PMID 42009263 · Publisher ↗
OBJECTIVE: To assess change in COPD exacerbations, healthcare resource utilization, and costs among patients diagnosed with COPD following initiation of budesonide/glycopyrrolate/formoterol fumarate (BGF), a single inhal...
OBJECTIVE: To assess change in COPD exacerbations, healthcare resource utilization, and costs among patients diagnosed with COPD following initiation of budesonide/glycopyrrolate/formoterol fumarate (BGF), a single inhaler triple therapy for COPD. METHODS: This study was a retrospective analysis of the Inovalon MORE2 Registry and 100% Medicare Fee-for-Service claims databases between 1/1/2021-3/31/2024. INCLUSION CRITERIA: 1) prescription claim for BGF and ≥1 refill within 60 days (earliest prescription = index date), 2) ≥12 months of health plan enrollment preceding and following the index date, 3) diagnosis of COPD, 4) age ≥40 years, 5) absence of cancer and select respiratory diseases, and 6) presence of ≥1 severe or ≥2 moderate COPD exacerbations during baseline. Subgroups were established based on treatment history, baseline blood eosinophil counts and asthma comorbidity. Outcomes included COPD exacerbations, healthcare resource utilization and costs, assessed for statistically significant differences between baseline and follow-up in the overall sample and subgroups. RESULTS: A total of 2204 patients were included. Following initiation of BGF, mean per patient per year (PPPY) total COPD exacerbations decreased by 28.7% (3.0 ± 1.7 to 2.1 ± 2.2; p < 0.0001), while mean severe COPD exacerbations decreased by 43.9% (0.3 ± 0.6 to 0.2 ± 0.5; p < 0.0001). PPPY COPD exacerbation-related medical costs decreased by 35.7% ($4664±$9355 to $2998±$8723; p < 0.001). Pre-defined subgroups showed similar changes in outcomes. CONCLUSIONS: Results demonstrate that patients with COPD and a history of exacerbations had substantial reductions in exacerbations, healthcare resource utilization, and healthcare costs after initiating BGF across a variety of subgroups including patients treated with ICS/LABA during baseline and across a range of eosinophil counts.
YouTube as a source of information on the non-pharmacological treatment of COPD.
Klöczl Kring S, Kristensen R, Høj S … +2 more , Andersen JR, Meteran H
Respir Med · 2026 Jun · PMID 42001976 · Publisher ↗
BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) requires both pharmacological and non-pharmacological treatments. Patients increasingly seek health-related information on platforms such as YouTube. However, the...
BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) requires both pharmacological and non-pharmacological treatments. Patients increasingly seek health-related information on platforms such as YouTube. However, the usefulness of YouTube videos on the treatment of COPD is unknown. OBJECTIVE: This study evaluated the usefulness of YouTube videos on the non-pharmacological treatment of COPD. METHODS: Search terms were "COPD", "Chronic Obstructive Pulmonary Disease" and "Chronic Obstructive Lung Disease", and videos with >30,000 views and non-pharmacological content were included. Two independent reviewers assessed quality using standardized tools: Modified DISCERN, Journal of American Medical Association benchmark criteria, and Global Quality Score. RESULTS: Among 97 videos, 86% were "useful", 13% "misleading", and 1% "neither". 62% of the misleading videos contained misinformation on the nutritional management of COPD. 85% of all misleading videos were uploaded by healthcare professionals. Misleading videos received significantly more engagement (total p-values <0.05). Scores on the Modified DISCERN (p = 0.015) and JAMA benchmark criteria (p = 0.021) were significantly higher for useful videos compared to misleading ones, while the Global Quality Score (p = 0.253) was less effective at distinguishing between the two categories. CONCLUSION: YouTube videos on non-pharmacological treatment of COPD are of high quality; however, nutrition-focused misinformation is widespread and tends to attract disproportionately high engagement.
Investigation of the use of urinary proteomics in the prediction of childhood asthma.
Khanam UA, Katselis GS, Gao Z … +8 more , Rennie D, Adamko DJ, Kusalik A, Goodridge D, Oluwole O, Thompson B, Chumala P, Lawson JA
Respir Med · 2026 Jul · PMID 42001975 · Publisher ↗
PURPOSE: Urinary proteomics may help us improve our understanding and classification of asthma. We sought to identify clusters of children based on urinary protein profiles and explore associations between these clusters...
PURPOSE: Urinary proteomics may help us improve our understanding and classification of asthma. We sought to identify clusters of children based on urinary protein profiles and explore associations between these clusters, specific proteins, and asthma. METHODS: We analyzed urine samples from 146 children (Kindergarten-Grade 8) using tandem mass-spectrometry. The presence of 4,080 urinary proteins was assessed. Unsupervised k-means clustering (KMN) identified clusters. Ten notable proteins per cluster were identified. We then tested three asthma prediction approaches: (1) all proteins only, (2) all proteins and non-protein features (e.g., socio-demographics, clinical), and (3) clusters and non-protein features. Each approach was run using four supervised machine learning (ML) algorithms. Traditional binary logistic regression (traditional analysis) was also conducted. RESULTS: We identified two clusters from the KMN. Among the notable proteins, only collagen alpha-1 chain was statistically different between those with and without asthma (p = 0.02). Approach 3 (cluster and non-protein features) using random forest methods had the best predictive performance. While cluster was listed as an important variable within Approach 3, it was not associated with asthma based on traditional analysis. Wheeze and mother's history of asthma were consistently associated with asthma. Unique predictors for the ML included %predicted FEF, %predicted FEV/FVC, child's age, and mother's history of allergy; whereas, urban residence was unique to traditional analysis. CONCLUSION: We identified collagen alpha-1 chain as a potential biomarker for asthma. External validation in independent cohorts and stratification by clinical phenotypes are needed to confirm its diagnostic utility and clarify its role in asthma pathophysiology.
Long-term safety of the Pfizer-BioNTech COVID-19 vaccine: Results from the HERO-together study.
O'Brien EC, Wong C, DeLaRosa JM … +15 more , Aberle LH, Webb L, Rubino H, Kendrick K, Mather S, Huynh J, Skinner HG, Cohen LW, Shostak J, Cai B, Caubel P, Rockhold FW, Stallings A, Lopes RD, Hernandez AF
Respir Med · 2026 Jun · PMID 42001974 · Publisher ↗
BACKGROUND: COVID-19 vaccines were initially authorized based on short-term data from Phase 3 clinical trials in a highly selected population. OBJECTIVES: This study assessed the long-term safety of the Pfizer-BioNTech C...
BACKGROUND: COVID-19 vaccines were initially authorized based on short-term data from Phase 3 clinical trials in a highly selected population. OBJECTIVES: This study assessed the long-term safety of the Pfizer-BioNTech COVID-19 vaccine BNT162b2 and variation in adverse event rates across clinically important subgroups. METHODS: This 24-month prospective safety surveillance study was conducted using a participant-facing portal with centralized event adjudication. Participants included 19,858 adults receiving a COVID-19 vaccine in the US from any manufacturer in the 60 days before enrollment. The main outcome measures were adverse events of special interest (AESIs) and all-cause hospitalizations, with event rate ratios evaluated using the self-controlled risk interval method. RESULTS: Of the 9518 participants (median age 36.6 years) in the primary safety population (vaccinated with BNT162b2 within 10 days of enrollment), most were female (69.0%), White (66.1%), and non-Hispanic (75.2%). The most frequent baseline health conditions were obesity/overweight (24.4%), hypertension (11.9%), and asthma (11.6%). The overall AESI rate was 13.65 per 1000 person-years. Most AESIs did not result in hospitalization (67.4%). The most common AESIs per 1000 person-years were arthritis/arthralgia (3.32), non-anaphylactic allergic reactions (2.84), and spontaneous abortion/stillbirth (3.10). The rate of all other AESIs was <1.0 per 1000 person-years. Unadjusted AESI rates (IRR; 95% CI) were higher in risk intervals than control intervals (2.32; 1.54-3.51) but were attenuated following adjustment for age (0.95; 0.53-1.72). CONCLUSIONS: AESI risk was low; the most common AESIs were arthritis/arthralgia and non-severe allergic reactions, with no increased incidence of a composite AESI or all-cause hospitalization post-vaccination. BNT162b2 has a favorable long-term safety profile in real-world settings.
High prevalence of obstructive sleep apnea in patients with Long-COVID.
Mery V, Albacar N, Matute-Villacís M … +4 more , Dalmases M, Sibila O, Agustí À, Embid C
Respir Med · 2026 Jun · PMID 42001973 · Publisher ↗
BACKGROUND: Long-COVID (LC) is defined as the persistence of symptoms 12 weeks after the acute COVID infection not explained by any other alternative diagnosis. Its pathophysiology is poorly understood. Obstructive Sleep...
BACKGROUND: Long-COVID (LC) is defined as the persistence of symptoms 12 weeks after the acute COVID infection not explained by any other alternative diagnosis. Its pathophysiology is poorly understood. Obstructive Sleep Apnea (OSA) shares several clinical manifestations with LC, such as fatigue and low-quality sleep, however, thus far, their potential coexistence has been poorly addressed. OBJECTIVE: To investigate the prevalence of OSA in patients with LC. METHODS: Observational, prospective study. Patients with LC were recruited from a dedicated ambulatory hospital clinic. All patients underwent a comprehensive clinical evaluation, including standardized questionnaires to evaluate persistent symptoms, lung function tests and full polysomnography. RESULTS: We studied 73 patients with LC. Their mean age was 57.4 ± 10.5 years, they were predominantly male (56.2%), 73.9% of whom were hospitalized during the acute COVID episode. Median AHI was 17.2 (24.14) events/h with a proportion of mild (27.4%), moderate (24.6%) and severe OSA (31.5%). Objective questionnaires identified poor sleep quality and fatigue as the most prevalent symptoms and daytime sleepiness as the least prevalent. Self-reported symptoms were frequent, with dyspnea, fatigue, and insomnia being the most commonly reported. Neither objective nor subjective symptoms correlated with OSA severity, with the exception of insomnia. CONCLUSION: In this single-center, clinic-based LC cohort, OSA diagnosed by in-lab PSG was highly common. Given that OSA is treatable, a sleep study should be considered in LC patients even in the absence of daytime sleepiness or in the presence of insomnia.
Regional Differences in Sensitization Patterns Among Children with Allergic Asthma in China: A Latent Class Analysis and Age-Related Characteristics.
Guo Y, Wang G, Zhou C … +15 more , Gan Z, Tan K, Liang Z, Zhang J, Li Y, Chen Y, Chen Y, Xia J, Cao W, Deng Y, Liao R, Xiao X, Chen Z, Luo W, Sun B
Respir Med · 2026 Apr · PMID 42001972 · Publisher ↗
OBJECTIVES: To characterize regional and age-dependent sensitization patterns in Chinese children in clinical referral settings with allergic asthma using Latent Class Analysis (LCA). DESIGN SETTING AND PARTICIPANTS: Thi...
OBJECTIVES: To characterize regional and age-dependent sensitization patterns in Chinese children in clinical referral settings with allergic asthma using Latent Class Analysis (LCA). DESIGN SETTING AND PARTICIPANTS: This multicenter cross-sectional study (2019-2022) analyzed 580 children (aged 0-14 years) with diagnosed allergic asthma, strictly recruited from 13 tertiary referral centers across Northern and Southern China. METHODS: Standardized allergen-specific IgE (sIgE) testing for 18 allergens was performed using a unified platform. LCA was applied to identify distinct sensitization phenotypes, and age-related trajectories were examined. RESULTS: LCA identified four distinct patterns per region with significant distributional differences. Northern children were characterized by a High Pollen/Weed pattern (Class 3), accounting for 38.9% of the cohort, with Artemisia vulgaris (53.0%) and Leucanthemum vulgare (50.0%) as primary sensitizers. In contrast, Southern children were dominated by a High Dust Mite pattern (Class 3), comprising 63.3% of the population. The prevalence of Dermatophagoides farinae sensitization in the South was 72.0%, significantly higher than in the North (). Furthermore, the 3-6-year age group demonstrated the highest sensitization intensity across both regions. CONCLUSION: Sensitization phenotypes exhibit marked geographic heterogeneity, with plant pollens predominating in the North and dust mites in the South. While these findings support region-specific diagnostic strategies, they reflect patterns in a referral-center cohort and may imply a more severe clinical phenotype than the general population; thus, broader generalization should be approached with caution.
Respiratory muscle weakness after stroke: An exploratory mediation analysis of associated factors.
Domínguez-Sanz N, Ramírez-Vélez R
Respir Med · 2026 Jun · PMID 42001971 · Publisher ↗
OBJECTIVE: This study had two aims: first, to compare pulmonary function and ultrasound-derived parameters between individuals with stroke and apparently healthy controls; and second, to examine whether selected pulmonar...
OBJECTIVE: This study had two aims: first, to compare pulmonary function and ultrasound-derived parameters between individuals with stroke and apparently healthy controls; and second, to examine whether selected pulmonary and ultrasound-derived variables mediated the association between stroke status and respiratory muscle strength. METHODS: In this cross-sectional study, 49 individuals with chronic unilateral stroke (≥6 months) and 53 apparently healthy adults were evaluated. B-mode ultrasound assessed diaphragm and transversus abdominis thickness at functional residual capacity and total lung capacity, diaphragm thickening fraction (TF), transversus abdominis thickening fraction, and echo intensity (EI). Pulmonary function (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV], peak expiratory flow [PEF] % predicted and absolute values) and respiratory muscle strength (MIP and maximal expiratory pressure [MEP], % predicted) were measured according to ATS/ERS standards. Between-group differences were analyzed using t tests with Cohen d. Single-mediator models with bootstrap resampling evaluated mediation, adjusting for age and sex. RESULTS: Pulmonary function was lower in the stroke group, including FVC (% predicted; d = 1.45), FEV1 (% predicted; d = 1.55), and PEF (% predicted; d = 1.53). %MIP and %MEP were reduced (both P < 0.001). Ultrasound measures showed reduced TF and transversus abdominis thickening fraction, along with higher echo intensity. Mediation analyses indicated that PEF (% predicted) and TF were significant mediators in the association between stroke status and lower %MIP. TF accounted for 14.2% of the total effect (β = -3.28; 95% CI, -7.45 to -0.60), whereas PEF accounted for 48.4% (β = -10.78; 95% CI, -17.57 to -5.50). For %MEP, TFdi and PEF also showed statistically significant indirect effects, whereas EITrA showed a smaller indirect effect and TrA thickness at TLC did not. CONCLUSIONS: In this cross-sectional study, post-stroke inspiratory muscle weakness was associated with lower PEF and reduced diaphragmatic contractility in exploratory mediation analyses. These findings suggest that spirometric and ultrasound-derived measures capture complementary aspects of respiratory impairment.
Impact of elexacaftor/tezacaftor/ivacaftor on the presence of bacterial and fungal pathogens in the lower respiratory tract of children with cystic fibrosis.
Setnikar Kimovec G, Seme K, Matos T … +4 more , Cvitković Špik V, Krivec U, Praprotnik M, Rodman Berlot J
Respir Med · 2026 Jun · PMID 42001970 · Publisher ↗
BACKGROUND: Highly effective CFTR modulator therapy, such as elexacaftor/tezacaftor/ivacaftor (ETI), has been linked to significant clinical improvements in people with cystic fibrosis (pwCF). However, its effect on the...
BACKGROUND: Highly effective CFTR modulator therapy, such as elexacaftor/tezacaftor/ivacaftor (ETI), has been linked to significant clinical improvements in people with cystic fibrosis (pwCF). However, its effect on the presence of respiratory pathogens in the lower respiratory tract of younger, mainly non-expectorant children with CF remains poorly understood, especially using lower airway sampling methods. We aimed to investigate changes in lower airway microbiology and clinical outcomes in children with CF aged 6-12 years before and after starting ETI. METHODS: We conducted a prospective observational single-centre study including children with CF commencing ETI who had no prior exposure to CFTR modulators, inhaled antibiotics, or prophylactic antibiotics. Lower airway microbiology was assessed longitudinally using sputum or induced sputum (IS). Pathogen prevalence, sweat chloride concentration, pulmonary function, nutritional status, and rate of exacerbations were evaluated before and up to 12 months after ETI initiation. RESULTS: Sixteen pwCF were included (median age 8.4 years, 69 % boys, 75% were F508del homozygous). None of the children was expectorant at any point during the study. Following ETI initiation, we observed decreased growth of methicillin-sensitive Staphylococcus aureus and Aspergillus fumigatus, reduced variability in fungal populations, and an increase in negative bacterial and fungal culture results. CONCLUSIONS: In this exploratory study of young, modulator-naïve children with CF, ETI initiation was associated with changes in the lower airway microbiology composition assessed by IS. These findings highlight potential shifts in lower airway microbiology and the importance of age-appropriate lower airway sampling in future paediatric studies.
Intra-tracheal malposition of endotracheal tubes in newborns: a retrospective single-center study.
Gardeton P, Reynold De Seresin M, Lorton F … +4 more , Chapoutot AG, Joram N, Flamant C, Bodet LM
Respir Med · 2026 Jun · PMID 41999997 · Publisher ↗
OBJECTIVE: to describe intra-tracheal tube malposition in newborns and evaluate potential predictors. DESIGN: retrospective single-center study. SETTING: French quaternary referral hospital comprising 12 neonatal intensi...
OBJECTIVE: to describe intra-tracheal tube malposition in newborns and evaluate potential predictors. DESIGN: retrospective single-center study. SETTING: French quaternary referral hospital comprising 12 neonatal intensive care unit and 12 pediatric intensive care unit beds. PATIENTS: term newborns less than 28 days old and preterm newborns under 28 days corrected age, firstly intubated 01/01/2023 - 12/31/2023 irrespective of the intubation site. MAIN OUTCOME MEASURES: endotracheal tube (ET) distal tip on first chest X-ray after intubation, blindly reviewed by two independent observers, and extensive data regarding intubation and first post-intubation chest X-ray. RESULTS: one-hundred seventy-eight newborns were included, nearly half premature and half terms (median gestational age at intubation: 36 wk, IQR 28 - 40). Twenty-eight (15.7%) died within hospital discharge. Overall proportion of ET malposition was 63.5% (95% CI 56.4 - 70.6), including 17.4% mainstem intubations. Only weight at intubation was an independent determinant for ET malposition in a multivariate analysis (aOR 10.3; 95% CI 2.06 - 63.7 when intubation's weight was below 1000 g), with a strong trend between weight categories and ET malposition rates. However, ET malposition was not an independent risk factor for death (aOR 1.93; 95% CI 0.65 - 6.54). CONCLUSIONS: intra-tracheal malposition of endotracheal tubes is extremely frequent in the neonatal population and can be prominently explained by a low weight at intubation implying a short trachea. Clear new strategies are mandatory to determine prior to intubation the ideal endotracheal tube depth marking and to accurately assess the intra-tracheal position of the tube after intubation.
Splenic enlargement as a physiologic adaptation to obstructive sleep apnea and nocturnal hypoxemia: A retrospective cohort study.
Bittner M, Mejias C, Kumaran M … +1 more , Gangemi A
Respir Med · 2026 Jun · PMID 41999996 · Publisher ↗
STUDY OBJECTIVES: We sought to determine whether spleen volume is increased in patients with obstructive sleep apnea (OSA) and whether splenic enlargement correlates with disease severity, translating adaptive physiologi...
STUDY OBJECTIVES: We sought to determine whether spleen volume is increased in patients with obstructive sleep apnea (OSA) and whether splenic enlargement correlates with disease severity, translating adaptive physiologic responses observed in diving and high-altitude populations to a clinical sleep disorder. METHODS: We retrospectively analyzed 50 adults with OSA (AHI ≥5) who underwent abdominal computed tomography (CT) prior to sleep study at a single tertiary care center. Spleen volume was measured using the prolate ellipsoid formula by two blinded reviewers. OSA severity metrics (apnea-hypopnea index [AHI], oxygen desaturation index [ODI], SpO2 nadir, and percent time with oxygen saturation <90%) were extracted from polysomnography or home sleep apnea testing. Multivariate linear regression models assessed associations between log-transformed spleen volume and OSA severity, adjusting for demographic and clinical covariates. RESULTS: Log-transformed ODI (Estimate = 0.28, 95% CI: 0.08-0.49, p = 0.008) and log AHI (Estimate = 0.29, 95% CI: 0.08-0.49, p = 0.007) were significantly associated with increased spleen size. Percent time under 90% SpO2 was also a significant predictor (Estimate = 0.12, 95% CI: 0.04-0.21, p = 0.006). Age demonstrated a negative association with spleen volume. In reverse models, log spleen size predicted OSA severity metrics, supporting bidirectionality of the relationship. CONCLUSIONS: Spleen size is positively associated with clinical markers of OSA severity, suggesting that chronic intermittent hypoxemia may induce splenic adaptation. Spleen size may serve as a novel, pragmatic biomarker for OSA severity. Further study is warranted to clarify clinical significance.
Risk of influenza-related hospitalization and mortality in autoimmune inflammatory rheumatic diseases (AIIRD): Insights on polymyositis/dermatomyositis, Sjögren's disease, and systemic sclerosis.
Chang YS, Lin YC, Chien YN … +5 more , Su CF, Kao JH, Lin SH, Lai CC, Lee IP
Respir Med · 2026 Jun · PMID 41999995 · Publisher ↗
OBJECTIVES: To investigate the incidence and risk of influenza-related hospitalization and mortality among patients with autoimmune inflammatory rheumatic diseases (AIIRDs), with a specific focus on polymyositis/dermatom...
OBJECTIVES: To investigate the incidence and risk of influenza-related hospitalization and mortality among patients with autoimmune inflammatory rheumatic diseases (AIIRDs), with a specific focus on polymyositis/dermatomyositis (PM/DM), Sjögren's disease (SjD), and systemic sclerosis (SSc). METHODS: This nationwide, population-based cohort study analyzed data from Taiwan's National Health Insurance Research Database (2010-2020). We identified 116,609 patients with AIIRDs (53,514 rheumatoid arthritis [RA], 27,841 systemic lupus erythematosus [SLE], 29,203 SjD, 3123 PM/DM, and 2928 SSc) and 466,436 age-, sex-, and index date-matched controls. Influenza-related hospitalization and mortality were identified using ICD-9/10 codes, with mortality defined as death within 30 days of influenza diagnosis. Incidence rate ratios (IRRs) were calculated using Poisson regression. RESULTS: All AIIRD subtypes demonstrated significantly higher influenza-related hospitalization rates compared with matched controls, with PM/DM showing the highest proportion (3.04% vs. 0.86%). SLE and PM/DM exhibited the highest hospitalization risks (IRR 3.91, 95% CI 3.54-4.32, and IRR 3.84, 95% CI 2.97-4.96, respectively). For mortality, PM/DM showed the highest risk (IRR 14.88, 95% CI: 3.09-71.63), followed by SLE (IRR 11.6), RA (IRR 3.36), and SjD (IRR 1.97), while the increase in SSc was not statistically significant. Comorbidities were unevenly distributed between AIIRD patients and non-AIIRD controls, potentially influencing differences both compared with controls and among AIIRD subgroups. CONCLUSION: Patients with AIIRDs face significantly elevated risks of influenza-related hospitalization and mortality, with substantial variation across disease subtypes. Mortality findings in PM/DM and SSc should be interpreted with caution due to the limited number of events.
Pulmonary infections in cystic fibrosis: A bibliometric mapping of global research themes (1950-2025).
Altan G
Respir Med · 2026 Jun · PMID 41997546 · Publisher ↗
BACKGROUND: Pulmonary infections remain the main cause of morbidity and mortality in cystic fibrosis (CF), despite advances in supportive care and targeted therapies. Since the mid-20th century, research on CF-associated...
BACKGROUND: Pulmonary infections remain the main cause of morbidity and mortality in cystic fibrosis (CF), despite advances in supportive care and targeted therapies. Since the mid-20th century, research on CF-associated pulmonary infections has expanded substantially, reflecting increasing clinical complexity, evolving pathogens, and antimicrobial resistance. This study aimed to evaluate global research trends related to pulmonary infections in CF between 1950 and 2025 using a bibliometric approach. METHODS: A bibliometric analysis was performed using the Scopus database. A disease-centered search strategy was applied without restrictions on pathogens or interventions. Peer-reviewed articles and reviews published up to December 13, 2025 were included, while publications indexed in 2026 and records with missing country affiliation data were excluded. Bibliometric indicators including publication output, journals, countries, institutions, authors, and author keywords were analyzed. Keyword co-occurrence analysis was conducted using VOSviewer to identify major research themes. RESULTS: A total of 8484 publications were included. Research output increased steadily, with a notable rise after the early 2000s and a peak in 2021. Most publications were written in English and classified mainly under Medicine, Immunology and Microbiology, and Biochemistry, Genetics and Molecular Biology. The United States, the United Kingdom, and Germany were the most productive countries. Keyword analysis revealed major thematic clusters related to chronic pulmonary disease, antimicrobial therapy and resistance, and pathogen-focused research, with Pseudomonas aeruginosa emerging as the most prominent pathogen. CONCLUSION: This bibliometric analysis summarizes the evolution of global research on CF-associated pulmonary infections, highlighting sustained emphasis on chronic infection and antimicrobial resistance, and may help guide future research priorities.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe