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  1. Article ; Online: Characteristics and risk factors for post-COVID-19 breathlessness after hospitalisation for COVID-19

    Luke Daines / Bang Zheng / Omer Elneima / Ewen Harrison / Nazir I. Lone / John R. Hurst / Jeremy S. Brown / Elizabeth Sapey / James D. Chalmers / Jennifer K. Quint / Paul Pfeffer / Salman Siddiqui / Samantha Walker / Krisnah Poinasamy / Hamish McAuley / Marco Sereno / Aarti Shikotra / Amisha Singapuri / Annemarie B. Docherty /
    Michael Marks / Mark Toshner / Luke S. Howard / Alex Horsley / Gisli Jenkins / Joanna C. Porter / Ling-Pei Ho / Betty Raman / Louise V. Wain / Christopher E. Brightling / Rachael A. Evans / Liam G. Heaney / Anthony De Soyza / Aziz Sheikh

    ERJ Open Research, Vol 9, Iss

    2023  Volume 1

    Abstract: Background Persistence of respiratory symptoms, particularly breathlessness, after acute coronavirus disease 2019 (COVID-19) infection has emerged as a significant clinical problem. We aimed to characterise and identify risk factors for patients with ... ...

    Abstract Background Persistence of respiratory symptoms, particularly breathlessness, after acute coronavirus disease 2019 (COVID-19) infection has emerged as a significant clinical problem. We aimed to characterise and identify risk factors for patients with persistent breathlessness following COVID-19 hospitalisation. Methods PHOSP-COVID is a multicentre prospective cohort study of UK adults hospitalised for COVID-19. Clinical data were collected during hospitalisation and at a follow-up visit. Breathlessness was measured by a numeric rating scale of 0–10. We defined post-COVID-19 breathlessness as an increase in score of ≥1 compared to the pre-COVID-19 level. Multivariable logistic regression was used to identify risk factors and to develop a prediction model for post-COVID-19 breathlessness. Results We included 1226 participants (37% female, median age 59 years, 22% mechanically ventilated). At a median 5 months after discharge, 50% reported post-COVID-19 breathlessness. Risk factors for post-COVID-19 breathlessness were socioeconomic deprivation (adjusted OR 1.67, 95% CI 1.14–2.44), pre-existing depression/anxiety (adjusted OR 1.58, 95% CI 1.06–2.35), female sex (adjusted OR 1.56, 95% CI 1.21–2.00) and admission duration (adjusted OR 1.01, 95% CI 1.00–1.02). Black ethnicity (adjusted OR 0.56, 95% CI 0.35–0.89) and older age groups (adjusted OR 0.31, 95% CI 0.14–0.66) were less likely to report post-COVID-19 breathlessness. Post-COVID-19 breathlessness was associated with worse performance on the shuttle walk test and forced vital capacity, but not with obstructive airflow limitation. The prediction model had fair discrimination (concordance statistic 0.66, 95% CI 0.63–0.69) and good calibration (calibration slope 1.00, 95% CI 0.80–1.21). Conclusions Post-COVID-19 breathlessness was commonly reported in this national cohort of patients hospitalised for COVID-19 and is likely to be a multifactorial problem with physical and emotional components.
    Keywords Medicine ; R
    Subject code 610
    Language English
    Publishing date 2023-02-01T00:00:00Z
    Publisher European Respiratory Society
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: KCa3.1 K+ Channel Expression and Function in Human Bronchial Epithelial Cells.

    Greer K Arthur / S Mark Duffy / Katy M Roach / Rob A Hirst / Aarti Shikotra / Erol A Gaillard / Peter Bradding

    PLoS ONE, Vol 10, Iss 12, p e

    2015  Volume 0145259

    Abstract: The KCa3.1 K+ channel has been proposed as a novel target for pulmonary diseases such as asthma and pulmonary fibrosis. It is expressed in epithelia but its expression and function in primary human bronchial epithelial cells (HBECs) has not been ... ...

    Abstract The KCa3.1 K+ channel has been proposed as a novel target for pulmonary diseases such as asthma and pulmonary fibrosis. It is expressed in epithelia but its expression and function in primary human bronchial epithelial cells (HBECs) has not been described. Due to its proposed roles in the regulation of cell proliferation, migration, and epithelial fluid secretion, inhibiting this channel might have either beneficial or adverse effects on HBEC function. The aim of this study was to assess whether primary HBECs express the KCa3.1 channel and its role in HBEC function. Primary HBECs from the airways of healthy and asthmatic subjects, SV-transformed BEAS-2B cells and the neoplastic H292 epithelial cell line were studied. Primary HBECs, BEAS-2B and H292 cells expressed KCa3.1 mRNA and protein, and robust KCa3.1 ion currents. KCa3.1 protein expression was increased in asthmatic compared to healthy airway epithelium in situ, and KCa3.1 currents were larger in asthmatic compared to healthy HBECs cultured in vitro. Selective KCa3.1 blockers (TRAM-34, ICA-17043) had no effect on epithelial cell proliferation, wound closure, ciliary beat frequency, or mucus secretion. However, several features of TGFβ1-dependent epithelial-mesenchymal transition (EMT) were inhibited by KCa3.1 blockade. Treatment with KCa3.1 blockers is likely to be safe with respect to airway epithelial biology, and may potentially inhibit airway remodelling through the inhibition of EMT.
    Keywords Medicine ; R ; Science ; Q
    Subject code 610
    Language English
    Publishing date 2015-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Correction

    Chandra M. Ohri / Aarti Shikotra / Ruth H. Green / David A. Waller / Peter Bradding

    PLoS ONE, Vol 6, Iss

    The Tissue Microlocalisation and Cellular Expression of CD163, VEGF, HLA-DR, iNOS, and MRP 8/14 Is Correlated to Clinical Outcome in NSCLC.

    2011  Volume 11

    Keywords Medicine ; R ; Science ; Q
    Language English
    Publishing date 2011-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: The tissue microlocalisation and cellular expression of CD163, VEGF, HLA-DR, iNOS, and MRP 8/14 is correlated to clinical outcome in NSCLC.

    Chandra M Ohri / Aarti Shikotra / Ruth H Green / David A Waller / Peter Bradding

    PLoS ONE, Vol 6, Iss 7, p e

    2011  Volume 21874

    Abstract: BACKGROUND: We have previously investigated the microlocalisation of M1 and M2 macrophages in NSCLC. This study investigated the non-macrophage (NM) expression of proteins associated with M1 and M2 macrophages in NSCLC. METHODS: Using ... ...

    Abstract BACKGROUND: We have previously investigated the microlocalisation of M1 and M2 macrophages in NSCLC. This study investigated the non-macrophage (NM) expression of proteins associated with M1 and M2 macrophages in NSCLC. METHODS: Using immunohistochemistry, CD68(+) macrophages and proteins associated with either a cytotoxic M1 phenotype (HLA-DR, iNOS, and MRP 8/14), or a non-cytotoxic M2 phenotype (CD163 and VEGF) were identified. NM expression of the markers was analysed in the islets and stroma of surgically resected tumours from 20 patients with extended survival (ES) (median 92.7 months) and 20 patients with poor survival (PS) (median 7.7 months). RESULTS: The NM expression of NM-HLA-DR (p<0.001), NM-iNOS (p = 0.02) and NM-MRP 8/14 (p = 0.02) was increased in ES compared to PS patients in the tumour islets. The tumour islet expression of NM-VEGF, was decreased in ES compared to PS patients (p<0.001). There was more NM-CD163 expression (p = 0.04) but less NM-iNOS (p = 0.002) and MRP 8/14 (p = 0.01) expression in the stroma of ES patients compared with PS patients. The 5-year survival for patients with above and below median NM expression of the markers in the islets was 74.9% versus 4.7% (NM-HLA-DR p<0.001), 65.0% versus 14.6% (NM-iNOS p = 0.003), and 54.3% versus 22.2% (NM-MRP 8/14 p = 0.04), as opposed to 34.1% versus 44.4% (NM-CD163 p = 0.41) and 19.4% versus 59.0% (NM-VEGF p = 0.001). CONCLUSIONS: Cell proteins associated with M1 and M2 macrophages are also expressed by other cell types in the tumour islets and stroma of patients with NSCLC. Their tissue and cellular microlocalisation is associated with important differences in clinical outcome.
    Keywords Medicine ; R ; Science ; Q
    Subject code 616 ; 610
    Language English
    Publishing date 2011-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Correction

    Chandra M. Ohri / Aarti Shikotra / Ruth H. Green / David A. Waller / Peter Bradding

    PLoS ONE, Vol 6, Iss

    The Tissue Microlocalisation and Cellular Expression of CD163, VEGF, HLA-DR, iNOS, and MRP 8/14 Is Correlated to Clinical Outcome in NSCLC

    2011  Volume 11

    Keywords Medicine ; R ; Science ; Q
    Language English
    Publishing date 2011-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Prevalence of swallow, communication, voice and cognitive compromise following hospitalisation for COVID-19

    Linzy Houchen-Wolloff / Sally Singh / Jennifer K Quint / Michael Marks / Nicholas Hart / Matthew Richardson / Ling-Pei Ho / Charlotte E Bolton / Rachael A Evans / Amit Kulkarni / Amisha Singapuri / Felicity Evison / Sarah Wallace / Betty Raman / Trudie Chalder / Claire Marie Nolan / William Man / Ewen Harrison / Nazir I Lone /
    Chris Brightling / Julie Whitney / James Chalmers / Enya Daynes / Neil J Greening / Annemarie Docherty / Gavin Donaldson / Janet Scott / Camilla Dawson / Tom Yates / Louise V Wain / Marco Sereno / Krisnah Poinasamy / Gemma Clunie / Hamish McAuley / Alex Robert Horsley / Melitta McNarry / Sallyanne Duncan / Olivia C Leavy / Elneima Omer / Aarti Shikotra / Ruth M Saunders / Victoria C Harris / Dan Gower Wootton / Jack Sargent / John Pimm / Lettie Bishop / Neil Sharma / Margaret Coffey

    BMJ Open Respiratory Research, Vol 10, Iss

    the PHOSP-COVID analysis

    2023  Volume 1

    Abstract: Objective Identify prevalence of self-reported swallow, communication, voice and cognitive compromise following hospitalisation for COVID-19.Design Multicentre prospective observational cohort study using questionnaire data at visit 1 (2–7 months post ... ...

    Abstract Objective Identify prevalence of self-reported swallow, communication, voice and cognitive compromise following hospitalisation for COVID-19.Design Multicentre prospective observational cohort study using questionnaire data at visit 1 (2–7 months post discharge) and visit 2 (10–14 months post discharge) from hospitalised patients in the UK. Lasso logistic regression analysis was undertaken to identify associations.Setting 64 UK acute hospital Trusts.Participants Adults aged >18 years, discharged from an admissions unit or ward at a UK hospital with COVID-19.Main outcome measures Self-reported swallow, communication, voice and cognitive compromise.Results Compromised swallowing post intensive care unit (post-ICU) admission was reported in 20% (188/955); 60% with swallow problems received invasive mechanical ventilation and were more likely to have undergone proning (p=0.039). Voice problems were reported in 34% (319/946) post-ICU admission who were more likely to have received invasive (p<0.001) or non-invasive ventilation (p=0.001) and to have been proned (p<0.001). Communication compromise was reported in 23% (527/2275) univariable analysis identified associations with younger age (p<0.001), female sex (p<0.001), social deprivation (p<0.001) and being a healthcare worker (p=0.010). Cognitive issues were reported by 70% (1598/2275), consistent at both visits, at visit 1 respondents were more likely to have higher baseline comorbidities and at visit 2 were associated with greater social deprivation (p<0.001).Conclusion Swallow, communication, voice and cognitive problems were prevalent post hospitalisation for COVID-19, alongside whole system compromise including reduced mobility and overall health scores. Research and testing of rehabilitation interventions are required at pace to explore these issues.
    Keywords Medicine ; R ; Diseases of the respiratory system ; RC705-779
    Subject code 360
    Language English
    Publishing date 2023-12-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Prevalence of physical frailty, including risk factors, up to 1 year after hospitalisation for COVID-19 in the UK

    Hamish J.C. McAuley / Rachael A. Evans / Charlotte E. Bolton / Christopher E. Brightling / James D. Chalmers / Annemarie B. Docherty / Omer Elneima / Paul L. Greenhaff / Ayushman Gupta / Victoria C. Harris / Ewen M. Harrison / Ling-Pei Ho / Alex Horsley / Linzy Houchen-Wolloff / Caroline J. Jolley / Olivia C. Leavy / Nazir I. Lone / William D-C Man / Michael Marks /
    Dhruv Parekh / Krisnah Poinasamy / Jennifer K. Quint / Betty Raman / Matthew Richardson / Ruth M. Saunders / Marco Sereno / Aarti Shikotra / Amisha Singapuri / Sally J. Singh / Michael Steiner / Ai Lyn Tan / Louise V. Wain / Carly Welch / Julie Whitney / Miles D. Witham / Janet Lord / Neil J. Greening / K. Abel / H. Adamali / D. Adeloye / O. Adeyemi / R. Adrego / L.A. Aguilar Jimenez / S. Ahmad / N. Ahmad Haider / R. Ahmed / N. Ahwireng / M. Ainsworth / B. Al-Sheklly / A. Alamoudi

    EClinicalMedicine, Vol 57, Iss , Pp 101896- (2023)

    a multicentre, longitudinal cohort studyResearch in context

    2023  

    Abstract: Summary: Background: The scale of COVID-19 and its well documented long-term sequelae support a need to understand long-term outcomes including frailty. Methods: This prospective cohort study recruited adults who had survived hospitalisation with ... ...

    Abstract Summary: Background: The scale of COVID-19 and its well documented long-term sequelae support a need to understand long-term outcomes including frailty. Methods: This prospective cohort study recruited adults who had survived hospitalisation with clinically diagnosed COVID-19 across 35 sites in the UK (PHOSP-COVID). The burden of frailty was objectively measured using Fried's Frailty Phenotype (FFP). The primary outcome was the prevalence of each FFP group—robust (no FFP criteria), pre-frail (one or two FFP criteria) and frail (three or more FFP criteria)—at 5 months and 1 year after discharge from hospital. For inclusion in the primary analysis, participants required complete outcome data for three of the five FFP criteria. Longitudinal changes across frailty domains are reported at 5 months and 1 year post-hospitalisation, along with risk factors for frailty status. Patient-perceived recovery and health-related quality of life (HRQoL) were retrospectively rated for pre-COVID-19 and prospectively rated at the 5 month and 1 year visits. This study is registered with ISRCTN, number ISRCTN10980107. Findings: Between March 5, 2020, and March 31, 2021, 2419 participants were enrolled with FFP data. Mean age was 57.9 (SD 12.6) years, 933 (38.6%) were female, and 429 (17.7%) had received invasive mechanical ventilation. 1785 had measures at both timepoints, of which 240 (13.4%), 1138 (63.8%) and 407 (22.8%) were frail, pre-frail and robust, respectively, at 5 months compared with 123 (6.9%), 1046 (58.6%) and 616 (34.5%) at 1 year. Factors associated with pre-frailty or frailty were invasive mechanical ventilation, older age, female sex, and greater social deprivation. Frail participants had a larger reduction in HRQoL compared with before their COVID-19 illness and were less likely to describe themselves as recovered. Interpretation: Physical frailty and pre-frailty are common following hospitalisation with COVID-19. Improvement in frailty was seen between 5 and 12 months although two-thirds of the population remained ...
    Keywords COVID-19 ; Physical frailty ; Long-COVID ; Fried's frailty phenotype ; Hospitalisation ; Medicine (General) ; R5-920
    Subject code 360
    Language English
    Publishing date 2023-03-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Device-assessed sleep and physical activity in individuals recovering from a hospital admission for COVID-19

    Tatiana Plekhanova / Alex V. Rowlands / Rachael A. Evans / Charlotte L. Edwardson / Nicolette C. Bishop / Charlotte E. Bolton / James D. Chalmers / Melanie J. Davies / Enya Daynes / Paddy C. Dempsey / Annemarie B. Docherty / Omer Elneima / Neil J. Greening / Sharlene A. Greenwood / Andrew P. Hall / Victoria C. Harris / Ewen M. Harrison / Joseph Henson / Ling-Pei Ho /
    Alex Horsley / Linzy Houchen-Wolloff / Kamlesh Khunti / Olivia C. Leavy / Nazir I. Lone / Michael Marks / Ben Maylor / Hamish J. C. McAuley / Claire M. Nolan / Krisnah Poinasamy / Jennifer K. Quint / Betty Raman / Matthew Richardson / Jack A. Sargeant / Ruth M. Saunders / Marco Sereno / Aarti Shikotra / Amisha Singapuri / Michael Steiner / David J. Stensel / Louise V. Wain / Julie Whitney / Dan G. Wootton / Christopher E. Brightling / William D-C. Man / Sally J. Singh / Tom Yates / Writing group (on behalf of the PHOSP-COVID Collaborative Group)

    International Journal of Behavioral Nutrition and Physical Activity, Vol 19, Iss 1, Pp 1-

    a multicentre study

    2022  Volume 13

    Abstract: Abstract Background The number of individuals recovering from severe COVID-19 is increasing rapidly. However, little is known about physical behaviours that make up the 24-h cycle within these individuals. This study aimed to describe physical behaviours ...

    Abstract Abstract Background The number of individuals recovering from severe COVID-19 is increasing rapidly. However, little is known about physical behaviours that make up the 24-h cycle within these individuals. This study aimed to describe physical behaviours following hospital admission for COVID-19 at eight months post-discharge including associations with acute illness severity and ongoing symptoms. Methods One thousand seventy-seven patients with COVID-19 discharged from hospital between March and November 2020 were recruited. Using a 14-day wear protocol, wrist-worn accelerometers were sent to participants after a five-month follow-up assessment. Acute illness severity was assessed by the WHO clinical progression scale, and the severity of ongoing symptoms was assessed using four previously reported data-driven clinical recovery clusters. Two existing control populations of office workers and individuals with type 2 diabetes were comparators. Results Valid accelerometer data from 253 women and 462 men were included. Women engaged in a mean ± SD of 14.9 ± 14.7 min/day of moderate-to-vigorous physical activity (MVPA), with 12.1 ± 1.7 h/day spent inactive and 7.2 ± 1.1 h/day asleep. The values for men were 21.0 ± 22.3 and 12.6 ± 1.7 h /day and 6.9 ± 1.1 h/day, respectively. Over 60% of women and men did not have any days containing a 30-min bout of MVPA. Variability in sleep timing was approximately 2 h in men and women. More severe acute illness was associated with lower total activity and MVPA in recovery. The very severe recovery cluster was associated with fewer days/week containing continuous bouts of MVPA, longer total sleep time, and higher variability in sleep timing. Patients post-hospitalisation with COVID-19 had lower levels of physical activity, greater sleep variability, and lower sleep efficiency than a similarly aged cohort of office workers or those with type 2 diabetes. Conclusions Those recovering from a hospital admission for COVID-19 have low levels of physical activity and disrupted patterns of ...
    Keywords Accelerometer ; Long COVID ; MVPA ; Sleep timing ; PHOSP-COVID ; Nutritional diseases. Deficiency diseases ; RC620-627 ; Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2022-07-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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