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Article: Guideline for the management of COVID-19 patients during hospital admission in a non-intensive care setting.

Nielsen Jeschke, Klaus / Bonnesen, Barbara / Hansen, Ejvind Frausing / Jensen, Jens-Ulrik Stæhr / Lapperre, Therese Sophie / Weinreich, Ulla Møller / Hilberg, Ole

European clinical respiratory journal

2020 Volume 7, Issue 1, Page(s) 1761677

Abstract: Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has presented health-care systems worldwide with novel challenges and experiences and evidence is emerging during the pandemic. Patients requiring hospitalization frequently ... ...

Abstract	Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has presented health-care systems worldwide with novel challenges and experiences and evidence is emerging during the pandemic. Patients requiring hospitalization frequently suffer from respiratory failure of different severities. Aim: The aim of this guideline is the treatment of patients with SARS CoV-2 (COVID-19) in hospital; in particular, it addresses the treatment of respiratory failure treated in general Internal Medical- and Pulmonary Medical wards. Results: Elderly patients and patients with chronic disease are particularly vulnerable to COVID-19. Target oxygen saturation should be between 92% and 96% in patients without chronic lung diseases. Treatment with >5 L oxygen/min should be in close collaboration with intensive care colleagues and >15 l/min preferably in intensive care units. High-flow nasal canula (HFNC) and long-term Continuous Positive Airway Pressure (CPAP) are recommended for patients not responding to conventional oxygen therapy. Non-invasive ventilation (NIV) is only recommended for selected patients, such as those with a ceiling of treatment or patients presenting with hypercapnic failure. With the use of humidification protective equipment as FFP2-3 masks should be used. Nebulized medication should be avoided, and spacers should be used instead. Conclusion: Respiratory failure is frequently the cause of hospitalization in patients with COVID-19 and should be monitored closely.
Keywords	covid19
Language	English
Publishing date	2020-05-28
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2834928-3
ISSN	2001-8525
ISSN	2001-8525
DOI	10.1080/20018525.2020.1761677
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Corticosteroid Resistance in Smokers-A Substudy Analysis of the CORTICO-COP Randomised Controlled Trial.

Sivapalan, Pradeesh / Bikov, Andras / Suppli Ulrik, Charlotte / Lapperre, Therese Sophie / Mathioudakis, Alexander G / Højberg Lassen, Mats Christian / Grundtvig Skaarup, Kristoffer / Biering-Sørensen, Tor / Vestbo, Jørgen / Jensen, Jens-Ulrik S

Journal of clinical medicine

2021 Volume 10, Issue 12

Abstract: The CORTICO-COP trial showed that eosinophil-guided corticosteroid-sparing treatment for acute exacerbation of chronic obstructive pulmonary disease was non-inferior to standard of care and decreased the accumulated dose of systemic corticosteroids that ... ...

Abstract	The CORTICO-COP trial showed that eosinophil-guided corticosteroid-sparing treatment for acute exacerbation of chronic obstructive pulmonary disease was non-inferior to standard of care and decreased the accumulated dose of systemic corticosteroids that patients were exposed to by approximately 60%. Smoking status has been shown to affect corticosteroid responsiveness. This post hoc analysis investigated whether eosinophil-guided treatment is non-inferior to conventional treatment in current smokers. The main analysis of current smokers showed no significant difference in the primary endpoint, days alive, and out of hospital within 14 days between the control group (mean, 9.8 days; 95% confidence interval (CI), 8.7-10.8) and the eosinophil-guided group (mean, 8.7 days; 95% CI, 7.5-9.9;
Language	English
Publishing date	2021-06-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm10122734
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Article: Guideline for the management of COVID-19 patients during hospital admission in a non-intensive care setting

Nielsen Jeschke, Klaus / Bonnesen, Barbara / Hansen, Ejvind Frausing / Jensen, Jens-Ulrik Stæhr / Lapperre, Therese Sophie / Weinreich, Ulla Møller / Hilberg, Ole

Eur. Clin. Respir. J.

Abstract	Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has presented health-care systems worldwide with novel challenges and experiences and evidence is emerging during the pandemic. Patients requiring hospitalization frequently suffer from respiratory failure of different severities. Aim: The aim of this guideline is the treatment of patients with SARS CoV-2 (COVID-19) in hospital; in particular, it addresses the treatment of respiratory failure treated in general Internal Medical- and Pulmonary Medical wards. Results: Elderly patients and patients with chronic disease are particularly vulnerable to COVID-19. Target oxygen saturation should be between 92% and 96% in patients without chronic lung diseases. Treatment with >5 L oxygen/min should be in close collaboration with intensive care colleagues and >15 l/min preferably in intensive care units. High-flow nasal canula (HFNC) and long-term Continuous Positive Airway Pressure (CPAP) are recommended for patients not responding to conventional oxygen therapy. Non-invasive ventilation (NIV) is only recommended for selected patients, such as those with a ceiling of treatment or patients presenting with hypercapnic failure. With the use of humidification protective equipment as FFP2-3 masks should be used. Nebulized medication should be avoided, and spacers should be used instead. Conclusion: Respiratory failure is frequently the cause of hospitalization in patients with COVID-19 and should be monitored closely.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #599972
Database	COVID19

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Article ; Online: Guideline for the management of COVID-19 patients during hospital admission in a non-intensive care setting

Nielsen Jeschke, Klaus / Bonnesen, Barbara / Hansen, Ejvind Frausing / Jensen, Jens Ulrik Stæhr / Lapperre, Therese Sophie / Weinreich, Ulla Møller / Hilberg, Ole

Nielsen Jeschke , K , Bonnesen , B , Hansen , E F , Jensen , J U S , Lapperre , T S , Weinreich , U M & Hilberg , O 2020 , ' Guideline for the management of COVID-19 patients during hospital admission in a non-intensive care setting ' , European Clinical Respiratory Journal , vol. 7 , no. 1 , 1761677 . https://doi.org/10.1080/20018525.2020.1761677

2020

Abstract	Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has presented health-care systems worldwide with novel challenges and experiences and evidence is emerging during the pandemic. Patients requiring hospitalization frequently suffer from respiratory failure of different severities. Aim: The aim of this guideline is the treatment of patients with SARS CoV-2 (COVID-19) in hospital; in particular, it addresses the treatment of respiratory failure treated in general Internal Medical- and Pulmonary Medical wards. Results: Elderly patients and patients with chronic disease are particularly vulnerable to COVID-19. Target oxygen saturation should be between 92% and 96% in patients without chronic lung diseases. Treatment with >5 L oxygen/min should be in close collaboration with intensive care colleagues and >15 l/min preferably in intensive care units. High-flow nasal canula (HFNC) and long-term Continuous Positive Airway Pressure (CPAP) are recommended for patients not responding to conventional oxygen therapy. Non-invasive ventilation (NIV) is only recommended for selected patients, such as those with a ceiling of treatment or patients presenting with hypercapnic failure. With the use of humidification protective equipment as FFP2-3 masks should be used. Nebulized medication should be avoided, and spacers should be used instead. Conclusion: Respiratory failure is frequently the cause of hospitalization in patients with COVID-19 and should be monitored closely.
Keywords	corona virus ; COVID-19 ; CPAP ; Guideline ; HFNC ; high Flow ; hospital ; NIV ; oxygen ; SARS-CoV-2 ; covid19
Language	English
Publishing country	dk
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Guideline for the management of COVID-19 patients during hospital admission in a non-intensive care setting

Nielsen Jeschke, Klaus / Bonnesen, Barbara / Hansen, Ejvind Frausing / Jensen, Jens Ulrik Stæhr / Lapperre, Therese Sophie / Weinreich, Ulla Møller / Hilberg, Ole

2020

Keywords	corona virus ; COVID-19 ; CPAP ; Guideline ; HFNC ; high Flow ; hospital ; NIV ; oxygen ; SARS-CoV-2 ; covid19
Language	English
Publishing date	2020-07-01
Publishing country	dk
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Guideline for the management of COVID-19 patients during hospital admission in a non-intensive care setting

Nielsen Jeschke, Klaus / Bonnesen, Barbara / Hansen, Ejvind Frausing / Jensen, Jens-Ulrik Stæhr / Lapperre, Therese Sophie / Weinreich, Ulla Møller / Hilberg, Ole

European Clinical Respiratory Journal

2020 Volume 7, Issue 1, Page(s) 1761677

Keywords	covid19
Language	English
Publisher	Informa UK Limited
Publishing country	uk
Document type	Article ; Online
ZDB-ID	2834928-3
ISSN	2001-8525
ISSN	2001-8525
DOI	10.1080/20018525.2020.1761677
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Article ; Online: Chronic rhinosinusitis in COPD: A prevalent but unrecognized comorbidity impacting health related quality of life.

Arndal, Elisabeth / Sørensen, Anne Lyngholm / Lapperre, Therese Sophie / Said, Nihaya / Trampedach, Charlotte / Aanæs, Kasper / Alanin, Mikkel Christian / Christensen, Karl Bang / Backer, Vibeke / von Buchwald, Christian

Respiratory medicine

2020 Volume 171, Page(s) 106092

Abstract: Introduction: Unified airway disease where upper respiratory tract inflammation including chronic rhinosinusitis (CRS) affects lower airway disease is known from asthma, bronchiectasis, cystic fibrosis and primary ciliary dyskinesia but little is known ... ...

Abstract	Introduction: Unified airway disease where upper respiratory tract inflammation including chronic rhinosinusitis (CRS) affects lower airway disease is known from asthma, bronchiectasis, cystic fibrosis and primary ciliary dyskinesia but little is known about CRS and health related quality of life in COPD. We investigate firstly, the prevalence of CRS in COPD. Secondly the impact of CRS on HRQoL. Thirdly, risk factors for CRS in COPD. Methods: cross-sectional study of CRS in 222 COPD patients from 2017 to 2019 according to EPOS2012/2020 and GOLD2019 criteria. Patients completed the COPD assessment test (CAT), Medical Research Council dyspnea scale and Sinonasal outcome test 22 (SNOT22) and questions on CRS symptoms. They then had a physical examination including flexible nasal endoscopy, CT-sinus scan and HRCT-thorax. Results: 22.5% of COPD patients had CRS and 82% of these were undiagnosed prior to the study. HRQoL (CAT, SNOT22 and the SNOT22-nasal symptom subscore) was significantly worse in COPD patients with CRS compared with those without CRS and healthy controls. Multiple logistic regression analysis suggests that the most likely candidate for having CRS was a male COPD patient who actively smoked, took inhaled steroids, had a high CAT and SNOT22_nasal symptom subscore. Discussion: the largest clinical study of CRS in COPD and the only study diagnosing CRS according to EPOS and GOLD. This study supports unified airway disease in COPD. The SNOT22_nasal symptoms subscore is recommended as a standard questionnaire for COPD patients and patients at risk should be referred to an otorhinolaryngologist.
MeSH term(s)	Aged ; Chronic Disease ; Comorbidity ; Cross-Sectional Studies ; Diagnostic Techniques, Respiratory System ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Pulmonary Disease, Chronic Obstructive/epidemiology ; Pulmonary Disease, Chronic Obstructive/physiopathology ; Quality of Life ; Rhinitis/diagnosis ; Rhinitis/epidemiology ; Rhinitis/physiopathology ; Risk Factors ; Sinusitis/diagnosis ; Sinusitis/epidemiology ; Sinusitis/physiopathology ; Surveys and Questionnaires ; Symptom Assessment/methods
Language	English
Publishing date	2020-08-12
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1003348-8
ISSN	1532-3064 ; 0954-6111
ISSN (online)	1532-3064
ISSN	0954-6111
DOI	10.1016/j.rmed.2020.106092
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Article ; Online: Use of inhaled corticosteroids and risk of acquiring

Eklöf, Josefin / Ingebrigtsen, Truls Sylvan / Sørensen, Rikke / Saeed, Mohamad Isam / Alispahic, Imane Achir / Sivapalan, Pradeesh / Boel, Jonas Bredtoft / Bangsborg, Jette / Ostergaard, Christian / Dessau, Ram Benny / Jensen, Ulrich Stab / Hansen, Ejvind Frausing / Lapperre, Therese Sophie / Meteran, Howraman / Wilcke, Torgny / Seersholm, Niels / Jensen, Jens-Ulrik Stæhr

Thorax

2021 Volume 77, Issue 6, Page(s) 573–580

Abstract: Background: Inhaled corticosteroids (ICS) are commonly used to treat COPD and are associated with increased risk of pneumonia. The aim of this study was to assess if accumulated use of ICS is associated with a dose-dependent risk of a positive airway ... ...

Abstract	Background: Inhaled corticosteroids (ICS) are commonly used to treat COPD and are associated with increased risk of pneumonia. The aim of this study was to assess if accumulated use of ICS is associated with a dose-dependent risk of a positive airway culture with Methods: We conducted a multiregional epidemiological cohort study including Danish COPD patients followed in outpatient clinics during 2010-2017. ICS use was categorised based on accumulated prescriptions redeemed 365 days prior to cohort entry. Cox proportional hazard regression model was used to estimate the risk of acquiring Results: A total of 21 408 patients were included in the study, of which 763 (3.6%) acquired Conclusion: Use of ICS in patients with COPD followed in Danish outpatient clinics was associated with a substantially increased and dose-dependent risk of acquiring
MeSH term(s)	Administration, Inhalation ; Adrenal Cortex Hormones/adverse effects ; Bronchodilator Agents/therapeutic use ; Cohort Studies ; Humans ; Pseudomonas aeruginosa ; Pulmonary Disease, Chronic Obstructive
Chemical Substances	Adrenal Cortex Hormones ; Bronchodilator Agents
Language	English
Publishing date	2021-08-26
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	204353-1
ISSN	1468-3296 ; 0040-6376
ISSN (online)	1468-3296
ISSN	0040-6376
DOI	10.1136/thoraxjnl-2021-217160
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Article ; Online: Dysfunctional Bronchial Cilia Are a Feature of Chronic Obstructive Pulmonary Disease (COPD).

Thomas, Biju / Koh, Mariko Siyue / O'Callaghan, Christopher / Allen, John Carson / Rutman, Andrew / Hirst, Robert Anthony / Connolly, John / Low, Su Ying / Thun How, Ong / Chian Min, Loo / Lim, Wan Teck / Lin Ean Oon, Lynette / He, Qixian / Teoh, Oon Hoe / Lapperre, Therese Sophie

COPD

2021 Volume 18, Issue 6, Page(s) 657–663

Abstract: Impaired mucociliary clearance may increase COPD exacerbation risk. We aimed to compare bronchial ciliary function and epithelial ultrastructure of COPD patients to healthy controls and explore its relationship to exacerbator phenotypes (frequent [FE] ... ...

Abstract	Impaired mucociliary clearance may increase COPD exacerbation risk. We aimed to compare bronchial ciliary function and epithelial ultrastructure of COPD patients to healthy controls and explore its relationship to exacerbator phenotypes (frequent [FE] and infrequent [IFE] exacerbator). In this cross-sectional study, 16 COPD patients and 12 controls underwent bronchial brushings. Ciliary beat frequency (CBF) and dyskinesia index (DI; % of dyskinetic cilia) were assessed using digital high-speed video microscopy, and epithelial ultrastructure using transmission electron microscopy (TEM). Bronchial epithelium in COPD showed lower CBF and higher DI, compared to controls (median [IQR] CBF: 6.8 (6.1-7.2) Hz vs 8.5 (7.7-8.9) Hz,
MeSH term(s)	Bronchi ; Cilia/ultrastructure ; Cross-Sectional Studies ; Humans ; Pulmonary Disease, Chronic Obstructive ; Respiratory Mucosa
Language	English
Publishing date	2021-09-01
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2171107-0
ISSN	1541-2563 ; 1541-2555
ISSN (online)	1541-2563
ISSN	1541-2555
DOI	10.1080/15412555.2021.1963695
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Article: Sensitization to

Goh, Ken Junyang / Yii, Anthony Chau Ang / Lapperre, Therese Sophie / Chan, Adrian Kw / Chew, Fook Tim / Chotirmall, Sanjay H / Koh, Mariko Siyue

Journal of asthma and allergy

2017 Volume 10, Page(s) 131–140

Abstract: Background: Severe asthma is a largely heterogeneous disease with varying phenotypic profiles. The relationship between specific allergen sensitization and asthma severity, particularly in Asia, remains unclear. We aim to study the prevalence of ... ...

Abstract	Background: Severe asthma is a largely heterogeneous disease with varying phenotypic profiles. The relationship between specific allergen sensitization and asthma severity, particularly in Asia, remains unclear. We aim to study the prevalence of specific allergen sensitization patterns and investigate their association with outcomes in a severe asthma cohort in an Asian setting. Methods: We conducted a cross-sectional study of patients receiving step 4 or 5 Global Initiative for Asthma treatment. Univariate and multivariate analyses were performed to assess the association between sensitization to a specific identifiable allergen by skin prick test (SPT) and uncontrolled asthma (defined in our study as the use of ≥2 steroid bursts or hospitalization in the past year, a history of near-fatal asthma or evidence of airflow obstruction on spirometry). Results: Two hundred and six severe asthma patients (mean age 45±17 years, 99 [48.1%] male) were evaluated. Of them, 78.2% had a positive SPT to one or more allergens. The most common allergen to which patients were sensitized was house dust mites ( Conclusion: High allergen, specifically
Language	English
Publishing date	2017-04-21
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2494877-9
ISSN	1178-6965
ISSN	1178-6965
DOI	10.2147/JAA.S130459
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