Publications
568 results found
Wilkinson A, Maslova E, Janson C, et al., 2022, Environmental Sustainability In Respiratory Care: An Overview of the healthCARe-Based envirONmental Cost of Treatment (CARBON) Programme, Advances in Therapy, ISSN: 0741-238X
Whittaker H, Rubino A, Mullerova H, et al., 2022, Frequency and severity of exacerbations of COPD associated with future Risk of exacerbations and mortality: A UK routine health care data study, The International Journal of Chronic Obstructive Pulmonary Disease, Vol: 17, Pages: 427-437, ISSN: 1176-9106
Background: Studies have shown that chronic obstructive pulmonary disease (COPD) exacerbation events are related to future events; however, previous literature typically reports frequent vs infrequent exacerbations per patient-year and no studies have investigated increasing number of severe exacerbations in relation to COPD outcomes.Objective: To investigate the association between baseline frequency and severity of exacerbations and subsequent mortality and exacerbation risk in a COPD cohort.Methods: Clinical Practice Research Datalink (CPRD) Aurum and Hospital Episode Statistics data were used to identify patients registered at general practices in the UK, who had a diagnosis of COPD, were over the age of 40 years, were smokers or ex-smokers and had data recorded from 2004 onwards. Frequency and severity of exacerbations in the baseline year were identified as moderate exacerbations (general practice events) and severe exacerbations (hospitalised events). Patients were categorised as having: none, 1 moderate only, 2 moderate only, 3+ moderate only, 1 severe (and any moderate), 2 severe (and any moderate), and 3+ severe (and any moderate exacerbations). Poisson regression was used to investigate the association between baseline exacerbation frequency/severity and exacerbation events and mortality over follow-up.Results: Overall, 340,515 COPD patients were included. Patients had higher rates of future exacerbations with increasing frequency and severity of baseline exacerbations compared to no baseline exacerbations. Adjusted incidence rate ratios (IRR) for patients with 1, 2, and 3+ moderate exacerbations compared to 0 exacerbations were 1.70 (95% CI 1.66– 1.74), 2.31 (95% CI 2.24– 2.37), and 3.52 (95% CI 3.43– 3.62), respectively. Patients with increased frequency of baseline exacerbations were more likely to die from all-cause, COPD-related, and cardiovascular-related mortality in a graduated fashion.Conclusion: Increasing number and severity o
Kadirvelu B, Burcea G, Costello C, et al., 2022, Variation in global COVID-19 symptoms by geography and by chronic disease: a global survey using the COVID-19 Symptom Mapper, EClinicalMedicine, Vol: 45, Pages: 1-15, ISSN: 2589-5370
BackgroundCOVID-19 is typically characterised by a triad of symptoms: cough, fever and loss of taste and smell, however, this varies globally. This study examines variations in COVID-19 symptom profiles based on underlying chronic disease and geographical location.MethodsUsing a global online symptom survey of 78,299 responders in 190 countries between 09/04/2020 and 22/09/2020, we conducted an exploratory study to examine symptom profiles associated with a positive COVID-19 test result by country and underlying chronic disease (single, co- or multi-morbidities) using statistical and machine learning methods.FindingsFrom the results of 7980 COVID-19 tested positive responders, we find that symptom patterns differ by country. For example, India reported a lower proportion of headache (22.8% vs 47.8%, p<1e-13) and itchy eyes (7.3% vs. 16.5%, p=2e-8) than other countries. As with geographic location, we find people differed in their reported symptoms if they suffered from specific chronic diseases. For example, COVID-19 positive responders with asthma (25.3% vs. 13.7%, p=7e-6) were more likely to report shortness of breath compared to those with no underlying chronic disease. InterpretationWe have identified variation in COVID-19 symptom profiles depending on geographic location and underlying chronic disease. Failure to reflect this symptom variation in public health messaging may contribute to asymptomatic COVID-19 spread and put patients with chronic diseases at a greater risk of infection. Future work should focus on symptom profile variation in the emerging variants of the SARS-CoV-2 virus. This is crucial to speed up clinical diagnosis, predict prognostic outcomes and target treatment.
Cabrera C, Quelen C, Ouwens M, et al., 2022, Evaluating a Cox marginal structural model to assess the comparative effectiveness of inhaled corticosteroids versus no inhaled corticosteroid treatment in chronic obstructive pulmonary disease, ANNALS OF EPIDEMIOLOGY, Vol: 67, Pages: 19-28, ISSN: 1047-2797
- Author Web Link
- Cite
- Citations: 3
Sundaram V, Nagai T, Chiang C-E, et al., 2022, Hospitalization for Heart Failure in the United States, UK, Taiwan, and Japan: An International Comparison of Administrative Health Records on 413,385 Individual Patients, JOURNAL OF CARDIAC FAILURE, Vol: 28, Pages: 353-366, ISSN: 1071-9164
- Author Web Link
- Cite
- Citations: 9
Cookson W, Moffatt M, Rapeport G, et al., 2022, A pandemic lesson for global lung diseases: exacerbations are preventable., American Journal of Respiratory and Critical Care Medicine, Vol: 205, Pages: 1271-1280, ISSN: 1073-449X
A dramatic global reduction in the incidence of common seasonal respiratory viral infections has resulted from measures to limit the transmission of SARS2-Cov-19 during the pandemic . This has been accompanied by falls reaching 50% internationally in the incidence of acute exacerbations of pre-existing chronic respiratory diseases that include asthma, Chronic Obstructive Pulmonary Disease (COPD) and Cystic Fibrosis (CF). At the same time, the incidence of acute bacterial pneumonia and sepsis has fallen steeply world-wide. Such findings demonstrate the profound impact of common respiratory viruses on the course of these global illnesses. Reduced transmission of common respiratory bacterial pathogens and their interactions with viruses appear also as central factors. This review summarises pandemic changes in exacerbation rates of asthma, COPD, Cystic Fibrosis (CF) and pneumonia. We draw attention to the substantial body of knowledge about respiratory virus infections in these conditions, and that it has not yet translated into clinical practice. Now the large-scale of benefits that could be gained by managing these pathogens is unmistakable, we suggest the field merits substantial academic and industrial investment. We consider how pandemic-inspired measures for prevention and treatment of common infections should become a cornerstone for managing respiratory diseases. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Stone P, Adamson A, Hurst JR, et al., 2022, Does pay-for-performance improve patient outcomes in acute exacerbation of COPD admissions?, Thorax, Vol: 77, Pages: 239-246, ISSN: 0040-6376
Background: The COPD Best Practice Tariff (BPT) is a pay-for-performance scheme in England that incentivises review by a respiratory specialist within 24 hours of admission and completion of a list of key care components prior to discharge, known as a discharge bundle, for patients admitted with acute exacerbation of COPD (AECOPD). We investigated whether the two components of the COPD BPT were associated with lower 30-day mortality and readmission in people discharged following AECOPD.Methods: Longitudinal study of national audit data containing details of AECOPD admissions in England and Wales between 01 February 2017 and 13 September 2017. Data were linked with national admissions and mortality data. Mixed-effects logistic regression, using a random intercept for hospital to adjust for clustering of patients, was used to determine the relationship between the COPD BPT criteria (combined and separately) and 30-day mortality and readmission. Models were adjusted for age, sex, socioeconomic status, length of stay, smoking status, Charlson comorbidity index, mental illness and requirement for oxygen or noninvasive ventilation during admission.Results: 28 345 patients discharged from hospital following AECOPD were included. 37% of admissions conformed to the two COPD BPT criteria. No relationship was observed between BPT conforming admissions and 30-day mortality (OR: 1.09 (95% CI 0.92 to 1.29)) or readmissions (OR: 0.96 (95% CI 0.90 to 1.02)). No relationship was observed between either of the individual COPD BPT components and 30-day mortality or readmissions. However, a specialist review at any time during admission was associated with lower inpatient mortality (OR: 0.69 (95% CI 0.58 to 0.81)).Conclusion: Completion of the combined COPD BPT criteria does not appear associated with a reduction in 30-day mortality or readmission. However, specialist review was associated with reduced inpatient mortality. While it is difficult to argue that discharge bundles do not im
MacRae C, Whittaker H, Mukherjee M, et al., 2022, Deriving a standardised recommended respiratory disease codelist repository for future research, Pragmatic and Observational Research, Vol: 13, ISSN: 1179-7266
Background: Electronic health record (EHR) databases provide rich, longitudinal data on interactions with healthcare providers, and can be used to advance research into respiratory conditions. However, since these data are primarily collected to support health care delivery, clinical coding can be inconsistent, resulting in inherent challenges in using these data for research purposes.Methods: We systematically searched existing international literature and UK code repositories to find respiratory disease codelists for asthma from January 2018, and chronic obstructive pulmonary disease 1 and respiratory tract infections from January 2020, based on prior searches. Medline searches using key terms provided article lists. Full-text articles, supplementary files, and reference lists were examined for codelists, and codelists repositories were searched. A reproducible methodology for codelists creation was developed with recommended lists for each disease created based on multidisciplinary expert opinion and previously published literature. Results: Medline searches returned 1,126 asthma articles, 70 COPD articles, and 90 respiratory infection articles, with 3%, 22% and 5% including codelists, respectively. Repository searching returned 12 asthma, 23 COPD, and 64 respiratory infection codelists. We have systematically compiled respiratory disease codelists and from these derived recommended lists for use by researchers to find the most up-to-date and relevant respiratory disease codelists that can be tailored to individual research questions. Conclusions: Few published papers include codelists, and where published diverse codelists were used, even when answering similar research questions. Whilst some advances have been made. greater consistency and transparency across studies using routine data to study respiratory diseases are needed.
Philip K, Buttery S, Williams P, et al., 2022, Impact of COVID-19 on people with asthma: A mixed methods analysis from a UK wide survey, BMJ Open Respiratory Research, Vol: 9, ISSN: 2052-4439
Introduction: The impact of acute COVID-19 on people with asthma appears complex, being moderated by multiple interacting disease-specific, demographic and environmental factors. Research regarding longer-term effects in this group is limited. We aimed to assess impacts of COVID-19 and predictors of persistent symptoms, in people with asthma.Methods: Using data from an online UK-wide survey of 4500 people with asthma (median age 50–59 years, 81% female), conducted in October 2020, we undertook a mixed methods analysis of the characteristics and experience of those reporting having had COVID-19.Results: The COVID-19 group (n=471, 10.5%) reported increased inhaler use and worse asthma management, compared with those not reporting COVID-19, but did not differ by gender, ethnicity or household income. Among the COVID-19 group, 56.1% reported having long COVID, 20.2% were ‘unsure’. Those with long COVID were more likely than those without long COVID to describe: their breathing as worse or much worse after their initial illness (73.7% vs 34.8%, p<0.001), increased inhaler use (67.8% vs 34.8%, p<0.001) and worse or much worse asthma management (59.6% vs 25.6%, p<0.001). Having long COVID was not associated with age, gender, ethnicity, UK nation or household income.Analysis of free text survey responses identified three key themes: (1) variable COVID-19 severity, duration and recovery; (2) symptom overlap and interaction between COVID-19 and asthma; (3) barriers to accessing healthcare.Conclusions: Persisting symptoms are common in people with asthma following COVID-19. Measures are needed to ensure appropriate healthcare access including clinical evaluation and investigation, to distinguish between COVID-19 symptoms and asthma.
Bachtiger P, Adamson A, Maclean W, et al., 2022, Increasing but inadequate intention to receive Covid-19 vaccination over the first 50 days of impact of the more infectious variant and roll-out of vaccination in UK: indicators for public health messaging, Publisher: MedRxiv
Objectives To inform critical public health messaging by determining how changes in Covid-19 vaccine hesitancy, attitudes to the priorities for administration, the emergence of new variants and availability of vaccines may affect the trajectory and achievement of herd immunity.Methods >9,000 respondents in an ongoing cross-sectional participatory longitudinal epidemiology study (LoC-19, n=18,581) completed a questionnaire within their personal electronic health record in the week reporting first effective Covid-19 vaccines, and then again after widespread publicity of the increased transmissibility of a new variant (November 13th and December 31st 2020 respectively). Questions covered willingness to receive Covid-19 vaccination and attitudes to prioritisation. Descriptive statistics, unadjusted and adjusted odds ratios (ORs) and natural language processing of free-text responses are reported, and how changes over the first 50 days of both vaccination roll-out and new-variant impact modelling of anticipated transmission rates and the likelihood and time to herd immunity.Findings Compared with the week reporting the first efficacious vaccine there was a 15% increase in acceptance of Covid-19 vaccination, attributable in one third to the impact of the new variant, with 75% of respondents “shielding” – staying at home and not leaving unless essential – regardless of health status or tier rules. 12.5% of respondents plan to change their behaviour two weeks after completing vaccination compared with 45% intending to do so only when cases have reduced to a low level. Despite the increase from 71% to 86% over this critical 50-day period, modelling of planned uptake of vaccination remains below that required for rapid effective herd immunity – now estimated to be 90 percent in the presence of a new variant escalating R0 to levels requiring further lockdowns. To inform the public messaging essential therefore to improve uptake, age and female
Gayle A, Minelli C, Quint J, 2022, Respiratory-related death in individuals with incident asthma and COPD: a competing risk analysis, BMC Pulmonary Medicine, Vol: 22, ISSN: 1471-2466
Background Distinguishing between mortality attributed to respiratory causes and other causes among people with asthma, COPD, and asthma-COPD overlap (ACO) is important. This study used electronic health records in England to estimate excess risk of death from respiratory-related causes after accounting for other causes of death.Methods We used linked Clinical Practice Research Datalink (CPRD) primary care and Office for National Statistics mortality data to identify adults with asthma and COPD from 2005-2015. Causes of death were ascertained using death certificates. Hazard ratios (HR) and excess risk of death were estimated using Fine-Gray competing risk models and adjusting for age, sex, smoking status, body mass index and socio economic status.Results 65,021 people with asthma and 45,649 with COPD in the CPRD dataset were frequency matched 5:1 with people without the disease on age, sex and general practice. Only 14 in 100,000 people with asthma are predicted to experience a respiratory-related death up to 10 years post-diagnosis, whereas in COPD this is 98 in 100,000. Asthma is associated with an 0.01% excess incidence of respiratory related mortality whereas COPD is associated with an 0.07% excess. Among people with asthma-COPD overlap (N=22,145) we observed an increased risk of respiratory-related death compared to those with asthma alone (HR=1.30; 95%CI: 1.21 – 1.40) but not COPD alone (HR=0.89; 95%CI: 0.83 – 0.94).Conclusions Asthma and COPD are associated with an increased risk of respiratory-related death after accounting for other causes; however, diagnosis of COPD carries a much higher probability. ACO is associated with a lower risk compared to COPD alone but higher risk compared to asthma alone.
Lewer D, Cox S, Hurst JR, et al., 2022, Burden and treatment of chronic obstructive pulmonary disease among people using illicit opioids: matched cohort study in England., BMJ Med, Vol: 1
OBJECTIVE: To understand the burden of chronic obstructive pulmonary disease among people who use illicit opioids such as heroin, and evaluate inequalities in treatment. DESIGN: Cohort study. SETTING: Patients registered at primary care practices in England. PARTICIPANTS: 106 789 patients in the Clinical Practice Research Datalink with illicit opioid use recorded between 2001 and 2018, and a subcohort of 3903 patients with a diagnosis of chronic obstructive pulmonary disease. For both cohorts, the study sampled a comparison group with no history of illicit opioids that was matched by age, sex, and general practice. MAIN OUTCOME MEASURES: In the base cohort: diagnosis of chronic obstructive pulmonary disease and death due to the disease. In the subcohort: five treatments (influenza vaccine, pneumococcal vaccine, pulmonary rehabilitation, bronchodilators or corticosteroids, and smoking cessation support) and exacerbations requiring hospital admission. RESULTS: 680 of 106 789 participants died due to chronic obstructive pulmonary disease, representing 5.1% of all cause deaths. Illicit opioid use was associated with 14.59 times (95% confidence interval 12.28 to 17.33) the risk of death related to chronic obstructive pulmonary disease, and 5.89 times (5.62 to 6.18) the risk of a diagnosis of the disease. Among patients with a new diagnosis, comorbid illicit opioid use was associated with current smoking, underweight, worse lung function, and more severe breathlessness. After adjusting for these differences, illicit opioids were associated with 1.96 times (1.82 to 2.12) times the risk of exacerbations requiring hospital admission, but not associated with a substantially different probability of the five treatments. CONCLUSIONS: Death due to chronic obstructive pulmonary disease is about 15 times more common among people who use illicit opioids than the general population. This inequality does not appear to be explained by differences in treatment, but late diagnosi
Whittaker H, Gulea C, Koteci A, et al., 2021, GP consultation rates for post-acute COVID-19 sequelae in cases managed in the community or hospital in the UK: a population-based study, BMJ: British Medical Journal, Vol: 375, Pages: 1-13, ISSN: 0959-535X
ObjectiveTo describe GP consultation rates for post-COVID-19 sequelae in non-hospitalised and hospitalised COVID-19 patients, and among non-hospitalised individuals describe how GP consultation rates for post-COVID-19 sequelae change over time, as well as following COVID-19 vaccination. DesignPopulation-based cohort study.Setting1,392 general practices in England contributing to the Clinical Practice Research Datalink Aurum database.Participants456,002 COVID-19 cases diagnosed between 1st August 2020 to 14th February2021 (44.7% male; median age 61 years), either hospitalised within two weeks of diagnosis or not hospitalised and followed-up for a maximum of 9.2 months. A negative control group of individuals without COVID-19 (N=38,511) and patients with influenza before the pandemic (N=21,803) were used to contextualise findings.Main outcome measuresComparison of GP consultation rates for new symptoms, diseases, prescriptions and healthcare utilisation (HCU) in hospitalised and non-hospitalised individuals separately pre and post-COVID-19 infection using Cox regression and negative binomial regression for HCU. This was repeated for the negative control and influenza cohorts. In non-hospitalised individuals, outcomes were additionally described over time following COVID-19 diagnosis and compared pre and post-COVID-19 vaccine in individuals who were symptomatic post-COVID-19, using negative binomial regression. Results Relative to the negative control and influenza cohorts non-hospitalised patients (N=437,943) had significantly higher GP consultation rates for multiple sequelae, the most common being loss of smell/taste (HRadj 5.28 [95%CI 3.89 to 7.17]; p<0.001), venous thromboembolism (VTE) (3.35 [2.87 to 3.90]; p<0.001), lung fibrosis (2.41 [1.37 to 4.25]; p=0.002), and muscle pain (1.89 [1.6 3to 2.20]; p<0.001), as well as HCU post COVID-19 diagnosis compared with 1-year prior. In terms of absolute proportions, the most common outcomes ≥ 4-weeks post-CO
Gulea C, Zakeri R, Quint J, 2021, Differences in outcomes between heart failure phenotypes in patients with coexistent COPD: A cohort study, Annals of the American Thoracic Society, Vol: 19, ISSN: 1546-3222
Rationale: Differences in clinical presentation and outcomes between HF phenotypes in patients with COPD have not been assessed. Objectives: The aim of this study was to compare clinical outcomes and healthcare resource use (HRU) between patients with COPD and HF with preserved (HFpEF), mildly-reduced (HFmrEF), and reduced ejection fraction (HFrEF). Methods: Patients with COPD and HF were identified in the United States (US) administrative claims database OptumLabs® DataWarehouse between 2008-2018. All-cause and cause-specific (HF) hospitalization, acute exacerbation of COPD (AECOPD, severe and moderate combined), mortality and HRU were compared between HF phenotypes. Results: From 5,419 patients with COPD, 70% had HFpEF, 20% had HFrEF and 10% had HFmrEF. All-cause hospitalization did not differ across groups, however patients with COPD and HFrEF had a greater risk of HF-specific hospitalization (HR 1.54, 95%CI 1.29-1.84) and mortality (HR: 1.17, 95%CI 1.03-1.33) compared to patients with COPD and HFpEF. Conversely, patients with COPD and HFrEF had a lower risk of AECOPD compared with those with COPD and HFpEF (HR 0.75, 95%CI 0.66-0.87). Rates of long-term stays (in skilled-nursing facilities) and emergency room visits were lower for those with COPD and HFrEF than for those with COPD and HFpEF. Conclusion: Outcomes in patients with comorbid COPD and HFpEF are largely driven by COPD. Given the paucity in treatments for HFpEF, better differentiation between cardiac and respiratory symptoms may provide an opportunity to reduce the risk of AECOPD. Risk of death and HF hospitalization were highest among patients with COPD and HFrEF, emphasizing the importance of optimizing guideline-recommended HFrEF therapies in this group.
Adeloye D, Elneima O, Daines L, et al., 2021, The long-term sequelae of COVID-19: an international consensus on research priorities for patients with pre-existing and new-onset airways disease, LANCET RESPIRATORY MEDICINE, Vol: 9, Pages: 1467-1478, ISSN: 2213-2600
- Author Web Link
- Cite
- Citations: 62
Buttery S, Philip K, Williams P, et al., 2021, Patient symptoms and experience following COVID-19: results from a UK-wide survey, BMJ Open Respiratory Research, Vol: 8, ISSN: 2052-4439
Objectives: To investigate the experience of people who continue to be unwell after acute COVID-19, often referred to as ‘long COVID’, both in terms of their symptoms and their interactions with healthcare.Design: We conducted a mixed-methods analysis of responses to a survey accessed through a UK online post-COVID support and information hub between April and December 2020 about people’s experiences after having acute COVID-19.Participants: 3290 respondents, 78% female 92.1% white ethnicity and median age range 45-54 years; 12.7% had been hospitalised. 494(16.5%) completed the survey between 4 and 8 weeks of the onset of their symptoms, 641(21.4%) between 8 and 12 weeks and 1865(62.1%) >12 weeks after.Results: The ongoing symptoms most frequently reported were; breathing problems (92.1%), fatigue (83.3%), muscle weakness or joint stiffness (50.6%), sleep disturbances (46.2%), problems with mental abilities (45.9%) changes in mood, including anxiety and depression (43.1%) and cough (42.3%). Symptoms did not appear to be related to the severity of the acute illness or to the presence of pre-existing medical conditions. Analysis of free text responses revealed three main themes (1) Experience of living with COVID-19 – physical and psychological symptoms that fluctuate unpredictably; (2) Interactions with healthcare that were unsatisfactory; (3) Implications for the future – their own condition, society and the healthcare system, and the need for researchConclusion: Consideration of patient perspective and experiences will assist in the planning of services to address problems persisting in people who remain symptomatic after the acute phase of COVID-19.
Balinskaite V, Hayhoe B, Quint J, et al., 2021, Identifying patients with first chronic obstructive pulmonary disease diagnosis in routine databases: a descriptive study, Annual National Conference on Public Health Science dedicated to New Research in UK Public Health, Publisher: ELSEVIER SCIENCE INC, Pages: 21-21, ISSN: 0140-6736
Gupta R, Koteci A, Morgan A, et al., 2021, GLOBAL OVERVIEW OF INCIDENCE AND PREVALENCE OF INTERSTITIAL LUNG DISEASE: A SYSTEMATIC LITERATURE REVIEW, Publisher: BMJ PUBLISHING GROUP, Pages: A67-A67, ISSN: 0040-6376
Koteci A, Morgan AD, Whittaker HR, et al., 2021, INCIDENCE AND PREVALENCE OF LEFT-SIDED HEART FAILURE IN PATIENTS WITH IDIOPATHIC PULMONARY FIBROSIS: A POPULATION-BASED STUDY, Publisher: BMJ PUBLISHING GROUP, Pages: A148-A149, ISSN: 0040-6376
Williams AT, Shrine N, Naghra-van Gijzel H, et al., 2021, Genome-wide association study of susceptibility to hospitalised respiratory infections, Wellcome Open Research, Vol: 6, Pages: 290-290
<ns3:p><ns3:bold>Background</ns3:bold>: Globally, respiratory infections contribute to significant morbidity and mortality. However, genetic determinants of respiratory infections are understudied and remain poorly understood.</ns3:p><ns3:p> <ns3:bold>Methods</ns3:bold>: We conducted a genome-wide association study in 19,459 hospitalised respiratory infection cases and 101,438 controls from UK Biobank. We followed-up well-imputed top signals from the UK Biobank discovery analysis in 50,912 respiratory infection cases and 150,442 controls from 11 cohorts. We aggregated effect estimates across studies using inverse variance-weighted meta-analyses. Additionally, we investigated the function of the top signals in order to gain understanding of the underlying biological mechanisms.</ns3:p><ns3:p> <ns3:bold>Results</ns3:bold>: In the discovery analysis, we report 56 signals at <ns3:italic>P</ns3:italic><5<ns3:italic>×</ns3:italic>10<ns3:sup>-6</ns3:sup>, one of which was genome-wide significant (<ns3:italic>P</ns3:italic><5<ns3:italic>×</ns3:italic>10<ns3:sup>-8</ns3:sup>). The genome-wide significant signal was in an intron of <ns3:italic>PBX3</ns3:italic>, a gene that encodes pre-B-cell leukaemia transcription factor 3, a homeodomain-containing transcription factor. Further, the genome-wide significant signal was found to colocalise with gene-specific expression quantitative trait loci (eQTLs) affecting expression of <ns3:italic>PBX3</ns3:italic> in lung tissue, where the respiratory infection risk alleles were associated with decreased <ns3:italic>PBX3</ns3:italic> expression in lung tissue, highlighting a possible biological mechanism. Of the 56 signals, 40 were well-imputed in UK Biobank and were investigated in the 11 follow-up cohorts. None of the 40 signals replicated
Piggin M, Johnson H, Papadimitriou D, et al., 2021, Insight Report: Digital health online public involvement session on using real world evidence to improve health and care in North West London, Insight Report: Digital health online public involvement session on using real world evidence to improve health and care in North West London
Summary report on the views of members of the public on real world evidence studies undertaken aspart of building the digital healthcare programme of research in North West London
Stanley B, Davis A, Jones R, et al., 2021, Characteristics of patients in platform C19, a COVID-19 research database combining primary care electronic health record and patient reported information, PLoS One, Vol: 16, ISSN: 1932-6203
BACKGROUND: Data to better understand and manage the COVID-19 pandemic is urgently needed. However, there are gaps in information stored within even the best routinely-collected electronic health records (EHR) including test results, remote consultations for suspected COVID-19, shielding, physical activity, mental health, and undiagnosed or untested COVID-19 patients. Observational and Pragmatic Research Institute (OPRI) Singapore and Optimum Patient Care (OPC) UK established Platform C19, a research database combining EHR data and bespoke patient questionnaire. We describe the demographics, clinical characteristics, patient behavior, and impact of the COVID-19 pandemic using data within Platform C19. METHODS: EHR data from Platform C19 were extracted from 14 practices across UK participating in the OPC COVID-19 Quality Improvement program on a continuous, monthly basis. Starting 7th August 2020, consenting patients aged 18-85 years were invited in waves to fill an online questionnaire. Descriptive statistics were summarized using all data available up to 22nd January 2021. FINDINGS: From 129,978 invitees, 31,033 responded. Respondents were predominantly female (59.6%), white (93.5%), and current or ex-smokers (52.6%). Testing for COVID-19 was received by 23.8% of respondents, of which 7.9% received positive results. COVID-19 symptoms lasted ≥4 weeks in 19.5% of COVID-19 positive respondents. Up to 39% respondents reported a negative impact on questions regarding their mental health. Most (67%-76%) respondents with asthma, Chronic Obstructive Pulmonary Disease (COPD), diabetes, heart, or kidney disease reported no change in the condition of their diseases. INTERPRETATION: Platform C19 will enable research on key questions relating to COVID-19 pandemic not possible using EHR data alone.
Evans RA, McAuley H, Harrison EM, et al., 2021, Physical, cognitive, and mental health impacts of COVID-19 after hospitalisation (PHOSP-COVID): a UK multicentre, prospective cohort study, The Lancet Respiratory Medicine, Vol: 9, Pages: 1275-1287, ISSN: 2213-2600
BACKGROUND: The impact of COVID-19 on physical and mental health and employment after hospitalisation with acute disease is not well understood. The aim of this study was to determine the effects of COVID-19-related hospitalisation on health and employment, to identify factors associated with recovery, and to describe recovery phenotypes. METHODS: The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a multicentre, long-term follow-up study of adults (aged ≥18 years) discharged from hospital in the UK with a clinical diagnosis of COVID-19, involving an assessment between 2 and 7 months after discharge, including detailed recording of symptoms, and physiological and biochemical testing. Multivariable logistic regression was done for the primary outcome of patient-perceived recovery, with age, sex, ethnicity, body-mass index, comorbidities, and severity of acute illness as covariates. A post-hoc cluster analysis of outcomes for breathlessness, fatigue, mental health, cognitive impairment, and physical performance was done using the clustering large applications k-medoids approach. The study is registered on the ISRCTN Registry (ISRCTN10980107). FINDINGS: We report findings for 1077 patients discharged from hospital between March 5 and Nov 30, 2020, who underwent assessment at a median of 5·9 months (IQR 4·9-6·5) after discharge. Participants had a mean age of 58 years (SD 13); 384 (36%) were female, 710 (69%) were of white ethnicity, 288 (27%) had received mechanical ventilation, and 540 (50%) had at least two comorbidities. At follow-up, only 239 (29%) of 830 participants felt fully recovered, 158 (20%) of 806 had a new disability (assessed by the Washington Group Short Set on Functioning), and 124 (19%) of 641 experienced a health-related change in occupation. Factors associated with not recovering were female sex, middle age (40-59 years), two or more comorbidities, and more severe acute illness. The magnitude of the persistent health bur
Quint J, Montonen J, He X, et al., 2021, EFFECTIVENESS OF COPD MAINTENANCE THERAPY WITH LAMA/LABA VS LAMA/LABA/ICS IN A UNITED STATES CLAIMS DATABASE, CHEST Annual Meeting, Publisher: ELSEVIER, Pages: 1863A-1864A, ISSN: 0012-3692
- Author Web Link
- Cite
- Citations: 1
Gulea C, Quint JK, Zakeri R, 2021, Clinical and methodological considerations when interpreting meta-analyses of beta-blocker use in patients with chronic obstructive pulmonary disease, EUROPEAN HEART JOURNAL, Vol: 42, Pages: 3407-3408, ISSN: 0195-668X
Lenoir A, Whittaker HR, Gayle A, et al., 2021, Clinical characteristics, mortality rates and causes of death in non-exacerbating COPD patients. A longitudinal cohort analysis of UK primary care data, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
- Author Web Link
- Cite
- Citations: 1
Wilkinson A, Maslova E, Janson C, et al., 2021, Greenhouse gas emissions associated with asthma care in the UK: results from SABINA CARBON, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
- Author Web Link
- Cite
- Citations: 3
Elneima O, Adeloye D, Daines L, et al., 2021, Research priorities for airway diseases in "long COVID", Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Ratnakumar R, Fraser J, Nicholls R, et al., 2021, Lung nodule management in Covid-19;does postponed surveillance matter?, European-Respiratory-Society (ERS) International Congress, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Adamson A, Sinha I, Roberts CM, et al., 2021, Management of children aged 1-5 admitted and treated for a clinical diagnosis of acute asthma compared to those aged 6-16 in secondary care in England and Wales, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.