Spirometry outcomes in survivors of COVID-19 pneumonia

Introduction: Acute COVID-19 infection could lead to long COVID, a heterogenous condition which includes the respiratory system. But data on long-term respiratory complications are scarce and limited especially from our part of the world. Methods: A total of 443 post COVID-19 patients were recruited from post COVID-19 clinic. The following assessments were performed in all patients; symptoms, 6-minute-walk-test (6MWT), 1-minute-sit-to-stand-test (1STST), spirometry, and chest radiograph. Results: Patient’s mean age was 51 (13) years old, majority were male (60%), and Malay ethnicity (73%). Majority were in category severe (n=254, 57%), critical (n=122, 28%) and moderate (n=67, 15%). Abnormal spirometry (FVC 4% during 6MWT and 1STST, OR 1.8 (1.1-2.9) and OR 1.7 (1.1-2.6) respectively, and abnormal chest radiograph, OR 3.9 (2.5-6.2) compared to those with normal spirometry findings. 125 patients have full lung function test and gas transfer done which showed reduced TLC (80%) in majority of cases; 80% (n = 100), 86.4% (n = 108) and 94% (n = 117). Conclusion: Abnormal spirometry findings are common among post COVID-19 patients with pneumonia and are associated with poorer respiratory outcomes; exertional oxygen desaturation and abnormal chest radiograph. Therefore, these groups of patients should be referred for spirometry assessmen

The everchanging epidemiology of meningococcal disease worldwide and the potential for prevention through vaccination.

Neisseria meningitidis is a major cause of bacterial meningitis and septicaemia worldwide and is associated with high case fatality rates and serious life-long complications among survivors. Twelve serogroups are recognised, of which six (A, B, C, W, X and Y) are responsible for nearly all cases of invasive meningococcal disease (IMD). The incidence of IMD and responsible serogroups vary widely both geographically and over time. For the first time, effective vaccines against all these serogroups are available or nearing licensure. Over the past two decades, IMD incidence has been declining across most parts of the world through a combination of successful meningococcal immunisation programmes and secular trends. The introduction of meningococcal C conjugate vaccines in the early 2000s was associated with rapid declines in meningococcal C disease, whilst implementation of a meningococcal A conjugate vaccine across the African meningitis belt led to near-elimination of meningococcal A disease. Consequently, other serogroups have become more important causes of IMD. In particular, the emergence of a hypervirulent meningococcal group W clone has led many countries to shift from monovalent meningococcal C to quadrivalent ACWY conjugate vaccines in their national immunisation programmes. Additionally, the recent licensure of two protein-based, broad-spectrum meningococcal B vaccines finally provides protection against the most common group responsible for childhood IMD across Europe and Australia. This review describes global IMD epidemiology across each continent and trends over time, the serogroups responsible for IMD, the impact of meningococcal immunisation programmes and future needs to eliminate this devastating disease

FOCUS 1: a randomized, double-blinded, multicentre, Phase III trial of the efficacy and safety of ceftaroline fosamil versus ceftriaxone in community-acquired pneumonia

International audienc