Key toolkits of non-pharmacological management in COPD: during and beyond COVID-19

Individuals with COPD are at higher risk of severe disease and mortality if they contract COVID-19. Shielding and social distancing have negatively impacted the delivery of routine care for COPD patients, which should be maintained to avoid further deterioration. We aimed to review the literature about the key toolkits of non-pharmacological treatments of COPD patients before and during the COVID-19 pandemic. In particular, we focused on smoking cessation, pulmonary rehabilitation, and telehealth delivery approaches during the COVID-19 crisis. Smoking cessation services are important to mitigate the spread of the virus, especially in people with chronic lung disease; the pandemic, in one way or another, has helped to enhance people's motivation to quit smoking. Also, tele-rehabilitation is considered as effective as conventional pulmonary rehabilitation in controlling symptoms of disease, promoting physical activity, and enhancing self-management of COPD. Telerehabilitation offers flexibility and it could be the dominant mode for providing a pulmonary rehabilitation programme. Finally, the use of telehealth (TH) modes has trended during the pandemic. Consensus about the effectiveness of TH in reducing exacerbation events is still inconclusive. In the context of COPD, further clinical research must concentrate on understanding attitudes, behaviours, and motivations towards smoking cessation. Further recommendations include gauging the feasibility of a long-term tele-rehabilitation programme in large COPD populations, designing more COPD-related mobile apps, and evaluating the feasibility of tele-rehabilitation in clinical practice

Thoracic imaging outcomes in COVID-19 survivors

The coronavirus disease 2019 (COVID-19) pandemic presents a significant global public health challenge. One in five individuals with COVID-19 presents with symptoms that last for weeks after hospital discharge, a condition termed "long COVID". Thus, efficient follow-up of patients is needed to assess the resolution of lung pathologies and systemic involvement. Thoracic imaging is multimodal and involves using different forms of waves to produce images of the organs within the thorax. In general, it includes chest X-ray, computed tomography, lung ultrasound and magnetic resonance imaging techniques. Such modalities have been useful in the diagnosis and prognosis of COVID-19. These tools have also allowed for the follow-up and assessment of long COVID. This review provides insights on the effectiveness of thoracic imaging techniques in the follow-up of COVID-19 survivors who had long COVID

Smoking cessation during COVID-19: the top to-do list

As evidence continues to emerge, our understanding of the relationship between smoking and COVID-19 prognosis is steadily growing. An early outlook from World Health Organisation (WHO) indicates that smokers are more vulnerable to severe COVID-19 disease and are also more likely to be infected, as frequent motions from hand to mouth and sharing of tobacco products such as waterpipes increased the possibility of being infected. In this commentary, we discuss some of the latest evidence on smoking and COVID-19 and emphasise the need to promote the personal and public advantages of smoking cessation during the COVID-19 pandemic

Reduction in hospitalised COPD exacerbations during COVID-19: A systematic review and meta-analysis

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Malaltia pulmonar obstructiva crònica; Factors de risc mèdicsCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Enfermedad pulmonar obstructiva crónica; Factores de riesgo médicosCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Chronic obstructive pulmonary disease; Medical risk factorsBackground Reports have suggested a reduction in exacerbations of chronic obstructive pulmonary disease (COPD) during the coronavirus disease 2019 (COVID-19) pandemic, particularly hospital admissions for severe exacerbations. However, the magnitude of this reduction varies between studies. Method Electronic databases were searched from January 2020 to May 2021. Two independent reviewers screened titles and abstracts and, when necessary, full text to determine if studies met inclusion criteria. A modified version of the Newcastle-Ottawa Scale was used to assess study quality. A narrative summary of eligible studies was synthesised, and meta-analysis was conducted using a random effect model to pool the rate ratio and 95% confidence intervals (95% CI) for hospital admissions. Exacerbation reduction was compared against the COVID-19 Containment and Health Index. Results A total of 13 of 745 studies met the inclusion criteria and were included in this review, with data from nine countries. Nine studies could be included in the meta-analysis. The pooled rate ratio of hospital admissions for COPD exacerbations during the pandemic period was 0.50 (95% CI 0.44–0.57). Findings on the rate of community-treated exacerbations were inconclusive. Three studies reported a significant decrease in the incidence of respiratory viral infections compared with the pre-pandemic period. There was not a significant relationship between exacerbation reduction and the COVID-19 Containment and Health Index (rho = 0.20, p = 0.53). Conclusion There was a 50% reduction in admissions for COPD exacerbations during the COVID-19 pandemic period compared to pre-pandemic times, likely associated with a reduction in respiratory viral infections that trigger exacerbations. Future guidelines should consider including recommendations on respiratory virus infection control measures to reduce the burden of COPD exacerbations beyond the pandemic period.The author(s) received no specific funding for this work

Home monitoring of physiology and symptoms to detect interstitial lung disease exacerbations and progression:a systematic review

Background: Acute exacerbations (AEs) and disease progression in interstitial lung disease (ILD) pose important challenges to clinicians and patients. AEs of ILD are variable in presentation but may result in rapid progression of ILD, respiratory failure and death. However, in many cases AEs of ILD may go unrecognised so that their true impact and response to therapy is unknown. The potential for home monitoring to facilitate early, and accurate, identification of AE and/or ILD progression has gained interest. With increasing evidence available, there is a need for a systematic review on home monitoring of patients with ILD to summarise the existing data. The aim of this review was to systematically evaluate the evidence for use of home monitoring for early detection of exacerbations and/or progression of ILD. Method: We searched Ovid-EMBASE, MEDLINE and CINAHL using Medical Subject Headings (MeSH) terms in accordance with the PRISMA guidelines (PROSPERO registration number CRD42020215166). Results: 13 studies involving 968 patients have demonstrated that home monitoring is feasible and of potential benefit in patients with ILD. Nine studies reported that mean adherence to home monitoring was &gt;75%, and where spirometry was performed there was a significant correlation (r=0.72–0.98, p&lt;0.001) between home and hospital-based readings. Two studies suggested that home monitoring of forced vital capacity might facilitate detection of progression in idiopathic pulmonary fibrosis. Conclusion: Despite the fact that individual studies in this systematic review provide supportive evidence suggesting the feasibility and utility of home monitoring in ILD, further studies are necessary to quantify the potential of home monitoring to detect disease progression and/or AEs.</p

A population-based study of 15,000 people on Knowledge and awareness of lung cancer symptoms and risk factors in Saudi Arabia

Background: Lung cancer is currently the most fatal form of cancer worldwide, ranking as the fourth most prevalent type in Saudi Arabia, particularly among males. This trend is expected to increase with growing population, lifestyle changes, and aging population. Understanding the awareness of the Saudi population regarding the risk factors and symptoms of lung cancer is necessary to attenuate the predicted increase in cases. Method: A cross-sectional, population-based survey was performed using a previously validated questionnaire (Lung CAM). Multiple linear regression analysis was used to assess variables associated with deficiency in knowledge and awareness of risk factors and symptoms of lung cancer. Results: Majority of the 15,099 respondents were male (65%), aged between 18 and 30 years (53%), 50% of which were educated up to a bachelor’s degree level. Overall awareness of lung cancer signs and symptoms was 53%, with painful cough and coughing up blood being the best-known symptoms. Conversely, persistent shoulder pain (44%) and clubbing fingers (47%) were the least known lung cancer symptoms. Also, 60% of the respondents showed low confidence in identifying the signs and symptoms of lung cancer. The overall awareness of the risk factors for lung cancer development was 74%, with first-hand (74%) and second-hand (68%) smoking being the most known risk factors. However, only ≤ 62% know the other non-smoking risk factors. Awareness of the risk factors and symptoms of lung cancer depended on age, gender, education, marital and employment status (p &lt; 0.001). Conclusion: Public awareness of the risk factors and symptoms of lung cancer in Saudi Arabia is inadequate and heavily dependent on education and socio-economic status. Awareness can be improved through campaigns to raise awareness about other lesser-known lung cancer risk factors and symptoms

A population-based study of 15,000 people on Knowledge and awareness of lung cancer symptoms and risk factors in Saudi Arabia

Background: Lung cancer is currently the most fatal form of cancer worldwide, ranking as the fourth most prevalent type in Saudi Arabia, particularly among males. This trend is expected to increase with growing population, lifestyle changes, and aging population. Understanding the awareness of the Saudi population regarding the risk factors and symptoms of lung cancer is necessary to attenuate the predicted increase in cases. Method: A cross-sectional, population-based survey was performed using a previously validated questionnaire (Lung CAM). Multiple linear regression analysis was used to assess variables associated with deficiency in knowledge and awareness of risk factors and symptoms of lung cancer. Results: Majority of the 15,099 respondents were male (65%), aged between 18 and 30 years (53%), 50% of which were educated up to a bachelor’s degree level. Overall awareness of lung cancer signs and symptoms was 53%, with painful cough and coughing up blood being the best-known symptoms. Conversely, persistent shoulder pain (44%) and clubbing fingers (47%) were the least known lung cancer symptoms. Also, 60% of the respondents showed low confidence in identifying the signs and symptoms of lung cancer. The overall awareness of the risk factors for lung cancer development was 74%, with first-hand (74%) and second-hand (68%) smoking being the most known risk factors. However, only ≤ 62% know the other non-smoking risk factors. Awareness of the risk factors and symptoms of lung cancer depended on age, gender, education, marital and employment status (p &lt; 0.001). Conclusion: Public awareness of the risk factors and symptoms of lung cancer in Saudi Arabia is inadequate and heavily dependent on education and socio-economic status. Awareness can be improved through campaigns to raise awareness about other lesser-known lung cancer risk factors and symptoms

Perspectives, practices, and challenges of online teaching during COVID-19 pandemic: A multinational survey

The result of the movement restrictions during the COVID-19 pandemic was an impromptu and abrupt switch from in-person to online teaching. Most focus has been on the perception and experience of students during the process. The aim of this international survey is to assess staffs' perspectives and challenges of online teaching during the COVID-19 lockdown. Cross-sectional research using a validated online survey was carried out in seven countries (Brazil, Saudi Arabia, Jordan, Indonesia, India, the United Kingdom, and Egypt) between the months of December 2021 and August 2022, to explore the status of online teaching among faculty members during the COVID-19 pandemic. Variables and response are presented as percentages while logistic regression was used to assess the factors that predict levels of satisfaction and the challenges associated with online instruction. A total of 721 response were received from mainly male (53%) staffs. Most respondents are from Brazil (59%), hold a Doctorate degree (70%) and have over 10 years of working experience (62%). Although, 67% and 79% have relevant tools and received training for online teaching respectively, 44% report that online teaching required more preparation time than face-to-face. Although 41% of respondents were uncertain about the outcome of online teaching, 49% were satisfied with the process. Also, poor internet bandwidth (51%), inability to track students' engagement (18%) and Lack of technical skills (11.5%) were the three main observed limitations. Having little or no prior experience of online teaching before the COVID-19 pandemic [OR, 1.58 (95% CI, 1.35–1.85)], and not supporting the move to online teaching mode [OR, 0.56 (95% CI,0.48–0.64)] were two main factors independently linked with dissatisfaction with online teaching. While staffs who support the move to online teaching were twice likely to report no barriers [OR, 2.15 (95% CI, 1.61–2.86)]. Although, relevant tools and training were provided to support the move to online teaching during COVID-19 lockdown, barriers such as poor internet bandwidth, inability to track students’ engagement and lack of technical skills were main limitations observed internationally by teaching staffs. Addressing these barriers should be the focus of higher education institution in preparation for future disruptions to traditional teaching modes

Current Knowledge, Satisfaction, and Use of E-Health Mobile Application (Seha) Among the General Population of Saudi Arabia: A Cross-Sectional Study

BACKGROUND: General population knowledge, satisfaction, and barriers to using Seha app have not been evaluated from a large-scale perspective. Therefore, this study aimed to explore current knowledge, satisfaction, and barriers of using Seha app and identify the most common mobile health application used among the general population in Saudi Arabia. METHODS: A cross-sectional online survey, consisting of 25 questions, was distributed among the general population of Saudi Arabia. Descriptive statistics were used to describe the respondents’ characteristics. Categorical variables were reported as frequencies and percentages. A chi-square (χ 2) test was conducted to assess the statistical difference between respondents’ demographic characteristics and their knowledge and use of the app. RESULTS: Overall, 5008 respondents, both Saudi (3723: 74%) and non-Saudi (1285: 26%) as well as male 2142 (43%) and female 2866 (57%), across the Kingdom of Saudi Arabia completed the online survey. A total of 2921 (58%) had heard of the Seha app, although only 1286 (25%) had used the app. Higher percentages of users were from the western region, females and those within the age group of ≥ 51 years old, 388 users (29%: P< 0.001), 804 (28%; P< 0.001) and 67 (35%; P=0.013), respectively. Consulting a doctor was the most frequently utilized service, 576 users (58%). Respondents strongly agreed 402 (41%) that Seha was easy to use, and 538 (54%) strongly agreed that they would recommend Seha to others. The most common barrier of using Seha was a lack of knowledge about the app and its benefits, at 1556 (35%). Overall, the Tawakkalna app was the most utilized mobile health application provided by MOH used 2170 (48%). CONCLUSIONS: Utilization of the Seha app is quite low due to a lack of knowledge about the app and its benefits. Thus, the MOH should promote public awareness about the app and its benefits