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Henríquez-Beltrán M, Vaca R, Benítez ID, González J, Santisteve S, Aguilà M, Minguez O, Moncusí-Moix A, Gort-Paniello C, Torres G, Labarca G, Caballero J, Barberà C, Torres A, de Gonzalo-Calvo D, Barbé F, Targa ADS. Sleep and Circadian Health of Critical Survivors: A 12-Month Follow-Up Study. Crit Care Med 2024:00003246-990000000-00326. [PMID: 38597721 DOI: 10.1097/ccm.0000000000006298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVES To investigate the sleep and circadian health of critical survivors 12 months after hospital discharge and to evaluate a possible effect of the severity of the disease within this context. DESIGN Observational, prospective study. SETTING Single-center study. PATIENTS Two hundred sixty patients admitted to the ICU due to severe acute respiratory syndrome coronavirus 2 infection. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The cohort was composed of 260 patients (69.2% males), with a median (quartile 1-quartile 3) age of 61.5 years (52.0-67.0 yr). The median length of ICU stay was 11.0 days (6.00-21.8 d), where 56.2% of the patients required invasive mechanical ventilation (IMV). The Pittsburgh Sleep Quality Index (PSQI) revealed that 43.1% of the cohort presented poor sleep quality 12 months after hospital discharge. Actigraphy data indicated an influence of the disease severity on the fragmentation of the circadian rest-activity rhythm at the 3- and 6-month follow-ups, which was no longer significant in the long term. Still, the length of the ICU stay and the duration of IMV predicted a higher fragmentation of the rhythm at the 12-month follow-up with effect sizes (95% CI) of 0.248 (0.078-0.418) and 0.182 (0.005-0.359), respectively. Relevant associations between the PSQI and the Hospital Anxiety and Depression Scale (rho = 0.55, anxiety; rho = 0.5, depression) as well as between the fragmentation of the rhythm and the diffusing lung capacity for carbon monoxide (rho = -0.35) were observed at this time point. CONCLUSIONS Our findings reveal a great prevalence of critical survivors presenting poor sleep quality 12 months after hospital discharge. Actigraphy data indicated the persistence of circadian alterations and a possible impact of the disease severity on the fragmentation of the circadian rest-activity rhythm, which was attenuated at the 12-month follow-up. This altogether highlights the relevance of considering the sleep and circadian health of critical survivors in the long term.
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Affiliation(s)
- Mario Henríquez-Beltrán
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
- Núcleo de Investigación en Ciencias de la Salud, Universidad Adventista de Chile, Chillán, Chile
| | - Rafaela Vaca
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
- CIBER of Respiratory diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Iván D Benítez
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
- CIBER of Respiratory diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Jessica González
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
- CIBER of Respiratory diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Sally Santisteve
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | - Maria Aguilà
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | - Olga Minguez
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
- CIBER of Respiratory diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Anna Moncusí-Moix
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
- CIBER of Respiratory diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Clara Gort-Paniello
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
- CIBER of Respiratory diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Gerard Torres
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
- CIBER of Respiratory diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Gonzalo Labarca
- Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, University of Concepcion, Concepcion, Chile
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Jesús Caballero
- Intensive Care Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Carme Barberà
- Intensive Care Department, Hospital Universitari Santa Maria, Lleida, Spain
| | - Antoni Torres
- CIBER of Respiratory diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Servei de Pneumologia, Hospital Clinic, Universitat de Barcelona, IDIBAPS, Barcelona, Spain
| | - David de Gonzalo-Calvo
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
- CIBER of Respiratory diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Ferran Barbé
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
- CIBER of Respiratory diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Adriano D S Targa
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
- CIBER of Respiratory diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
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Salinas-Roca B, Sánchez E, Bermúdez-López M, Valdivielso JM, Farràs-Sallés C, Pamplona R, Torres G, Mauricio D, Castro E, Fernández E, Hernández M, Rius F, Lecube A. Association between adherence to the mediterranean diet, physical activity, and sleep apnea-hypopnea syndrome (SAHS) in a middle-aged population with cardiovascular risk: Insights from the ILERVAS cohort. Sleep Med 2024; 116:19-26. [PMID: 38408422 DOI: 10.1016/j.sleep.2024.02.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/31/2024] [Accepted: 02/19/2024] [Indexed: 02/28/2024]
Abstract
INTRODUCTION Sleep Apnea-Hypopnea Syndrome (SAHS) is a common sleep disorder influenced by factors like age, gender, and obesity. The Mediterranean Diet (MedDiet) and physical activity have shown health benefits in lung diseases, but their effects on SAHS remain underexplored. METHODS In a cross-sectional analysis of 678 middle-aged individuals with low-to-moderate cardiovascular risk from the ILERVAS cohort, we assessed adherence to the MedDiet and physical activity levels using validated tools. Sleep parameters, SAHS severity, and excessive daytime sleepiness were evaluated through non-attended cardiorespiratory polygraphy and the Epworth Sleepiness Scale. Multinomial logistic regression models were employed to assess the relationship between MedDiet adherence, physical activity, and SAHS severity. RESULTS The prevalence of severe, moderate, and mild SAHS was 15.5%, 23.2% and 36.1%, respectively. We found no significant associations between adherence to the MedDiet, physical activity levels, and the presence or severity of SAHS. However, we noted a significant interaction between MedDiet and physical activity with minimum SpO2 values (p = 0.049). Notably, consuming more than one serving of red meat per day was independently associated with a higher risk of moderate SAHS [OR = 2.65 (1.29-5.44), p = 0.008]. CONCLUSION Individually, MedDiet adherence and physical activity did not show independent correlations with SAHS. However, when considered together, a minimal but significant effect on minimum SpO2 was observed. Additionally, red meat consumption was associated with a moderate risk of SAHS. Further research is necessary to comprehend the intricate connections between lifestyle factors and sleep-breathing disorders, with a focus on personalized approaches for high-risk populations.
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Affiliation(s)
- Blanca Salinas-Roca
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida. University of Lleida, Lleida, Spain; Facultat de Ciències de la Salut-Universitat Ramón Llull Blanquerna, Barcelona, Spain
| | - Enric Sánchez
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida. University of Lleida, Lleida, Spain
| | - Marcelino Bermúdez-López
- Vascular and Renal Translational Research Group, IRBLleida. Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), Lleida, Spain; Department of Experimental Medicine, IRBLleida, University of Lleida, Lleida, Spain
| | - José Manuel Valdivielso
- Vascular and Renal Translational Research Group, IRBLleida. Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), Lleida, Spain
| | - Cristina Farràs-Sallés
- Centre d'Atenció Primària Cappont. Gerència Territorial de Lleida, Institut Català de la Salut. Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gorina (IDIAPJGol), Barcelona, Spain
| | - Reinald Pamplona
- Department of Experimental Medicine, IRBLleida, University of Lleida, Lleida, Spain
| | - Gerard Torres
- Respiratory Medicine Department, University Hospital Arnau de Vilanova and Santa María. Group of Translational Research in Respiratory Medicine, IRBLleida. University of Lleida, Lleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Dídac Mauricio
- Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau. Sant Pau Biomedical Research Institute (IIB Sant Pau). Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII). Madrid, Spain
| | - Eva Castro
- Vascular and Renal Translational Research Group, IRBLleida. Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), Lleida, Spain
| | - Elvira Fernández
- Vascular and Renal Translational Research Group, IRBLleida. Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), Lleida, Spain
| | - Marta Hernández
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida. University of Lleida, Lleida, Spain
| | - Ferran Rius
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida. University of Lleida, Lleida, Spain
| | - Albert Lecube
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida. University of Lleida, Lleida, Spain.
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Ramírez Martínez T, Blanco Ponce E, García-Guimarães M, Torres G, Gayán Ordán J. Iatrogenic Pneumopericardium Following Pericardiocentesis. Eur Heart J Cardiovasc Imaging 2024:jeae065. [PMID: 38462964 DOI: 10.1093/ehjci/jeae065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 03/05/2024] [Indexed: 03/12/2024] Open
Affiliation(s)
- Tania Ramírez Martínez
- Cardiology department. Hospital Universitari Arnau de Vilanova, Lleida, Spain
- Institut de Recerca Biomèdica de Lleida (IRBLleida)
| | - Emilia Blanco Ponce
- Cardiology department. Hospital Universitari Arnau de Vilanova, Lleida, Spain
- Institut de Recerca Biomèdica de Lleida (IRBLleida)
| | - Marcos García-Guimarães
- Cardiology department. Hospital Universitari Arnau de Vilanova, Lleida, Spain
- Institut de Recerca Biomèdica de Lleida (IRBLleida)
| | - Gerard Torres
- Institut de Recerca Biomèdica de Lleida (IRBLleida)
- Department of Internal Medicine. Hospital Universitari Santa María, Lleida, Spain
| | - Jara Gayán Ordán
- Cardiology department. Hospital Universitari Arnau de Vilanova, Lleida, Spain
- Institut de Recerca Biomèdica de Lleida (IRBLleida)
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Torres G, Sánchez de la Torre M, Pinilla L, Barbé F. Obstructive sleep apnea and cardiovascular risk. Clin Investig Arterioscler 2024:S0214-9168(24)00016-0. [PMID: 38413245 DOI: 10.1016/j.arteri.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 01/17/2024] [Indexed: 02/29/2024]
Abstract
Patients with obstructive sleep apnea (OSA) experience repetitive episodes of upper airway obstruction due to recurrent collapse during sleep. This leads to intermittent hypoxia episodes, which, through complex pathophysiological mechanisms, trigger sympathetic overactivation, endothelial dysfunction, hypercoagulation, and metabolic dysregulation. Consequently, other cardiovascular risk factors such as hypertension, metabolic syndrome, and diabetes are induced. Furthermore, this enhances target organ damage, affecting the heart, arteries, and kidneys, leading to an increased risk of cardiovascular morbidity and mortality. Among the various treatments for OSA, Continuous Positive Airway Pressure (CPAP) has been extensively studied. To date, this treatment has shown mild benefits in reducing blood pressure, particularly noticeable in patients with resistant hypertension. Furthermore, CPAP treatment appears to reduce cardiovascular events, both in primary and secondary prevention, though this benefit is limited to individuals with good compliance (CPAP use ≥4h/night). Future research perspectives in OSA seem to focus on identifying patients in whom the condition significantly influences cardiovascular risk, thus determining those who would benefit the most from treatment in the reduction of cardiovascular risk.
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Affiliation(s)
- Gerard Torres
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, España; CIBER of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, España.
| | - Manuel Sánchez de la Torre
- CIBER of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, España; Precision Medicine in Chronic Diseases, Hospital Universitari de Santa Maria, IRBLleida, Lleida, España; Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, España
| | - Lucia Pinilla
- CIBER of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, España; Precision Medicine in Chronic Diseases, Hospital Universitari de Santa Maria, IRBLleida, Lleida, España; Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, España
| | - Ferran Barbé
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, España; CIBER of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, España
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5
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Neophytou N, Torres G, Madoka R, Mari E, Ndlovu MK, Bope EB, Van Heerden L, Constantinou D, Phaswana M. Comparing cardiorespiratory fitness and physical activity levels between third- and fifth-year medical students in a South African university. S Afr J Sports Med 2024; 36:v36i1a15245. [PMID: 38384860 PMCID: PMC10878414 DOI: 10.17159/2078-516x/2024/v36i1a15245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
Background Cardiovascular disease (CVD) risk factors such as sedentary behaviour, decreased physical activity (PA), and low cardiorespiratory fitness lead to an increased and accelerated risk of cardiovascular disease and mortality. Medical students tend to adopt sedentary lifestyles due to a demanding curriculum. This may have a negative effect on CVD risk factors and cardiorespiratory fitness levels of medical students. Objectives To compare physical activity and cardiorespiratory fitness levels in a cohort of third- and fifth-year undergraduate medical students in a South African university. Methods Data from 123 third-year and 139 fifth-year medical students in the Graduate Entry Medical Programme (GEMP) at the Faculty of Health Sciences, University of the Witwatersrand, were collected. Measurements included CVD risk factors, height, weight, blood pressure, waist circumference, cardiorespiratory fitness, physical activity vital signs and pre-participation health screening questionnaires. Descriptive statistics were presented as mean ± standard deviation or median [interquartile range] depending whether the data were normally distributed or not. Results Both groups had low cardiorespiratory fitness when compared to norm values (GEMPI VO2 peak was 29.1 ± 5.9 ml.kg-1.min-1 and GEMPIII VO2 peak was 30.0[11.0] ml.kg-1.min-1). Most participants did not meet WHO physical activity requirements (GEMP I: 72%; GEMP III: 78%). There were significant differences in BMI (p=0.046), diastolic blood pressure (p=0.034) and VO2 peak (p=0.00001) between students meeting and not meeting WHO physical activity requirements (p<0.05). Conclusion Third- and fifth-year medical students at a South African university fail to meet recommended WHO physical activity levels and are below cardiorespiratory fitness norms. Therefore, medical institutions should promote and implement targeted physical activity interventions to reduce the prevalence of low fitness levels and the associated health hazards among their students.
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Affiliation(s)
- N Neophytou
- Department of Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - G Torres
- Department of Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - R Madoka
- Department of Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - E Mari
- Department of Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - M K Ndlovu
- Department of Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - E B Bope
- Department of Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - L Van Heerden
- Department of Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - D Constantinou
- Department of Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - M Phaswana
- Department of Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa
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García-Hidalgo MC, Benítez ID, Perez-Pons M, Molinero M, Belmonte T, Rodríguez-Muñoz C, Aguilà M, Santisteve S, Torres G, Moncusí-Moix A, Gort-Paniello C, Peláez R, Larráyoz IM, Caballero J, Barberà C, Nova-Lamperti E, Torres A, González J, Barbé F, de Gonzalo-Calvo D. MicroRNA-guided drug discovery for mitigating persistent pulmonary complications in critical COVID-19 survivors: A longitudinal pilot study. Br J Pharmacol 2024. [PMID: 38359818 DOI: 10.1111/bph.16330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/21/2023] [Accepted: 01/02/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND AND PURPOSE The post-acute sequelae of SARS-CoV-2 infection pose a significant global challenge, with nearly 50% of critical COVID-19 survivors manifesting persistent lung abnormalities. The lack of understanding about the molecular mechanisms and effective treatments hampers their management. Here, we employed microRNA (miRNA) profiling to decipher the systemic molecular underpinnings of the persistent pulmonary complications. EXPERIMENTAL APPROACH We conducted a longitudinal investigation including 119 critical COVID-19 survivors. A comprehensive pulmonary evaluation was performed in the short-term (median = 94.0 days after hospital discharge) and long-term (median = 358 days after hospital discharge). Plasma miRNAs were quantified at the short-term evaluation using the gold-standard technique, RT-qPCR. The analyses combined machine learning feature selection techniques with bioinformatic investigations. Two additional datasets were incorporated for validation. KEY RESULTS In the short-term, 84% of the survivors exhibited impaired lung diffusion (DLCO < 80% of predicted). One year post-discharge, 54.4% of this patient subgroup still presented abnormal DLCO . Four feature selection methods identified two specific miRNAs, miR-9-5p and miR-486-5p, linked to persistent lung dysfunction. The downstream experimentally validated targetome included 1473 genes, with heterogeneous enriched pathways associated with inflammation, angiogenesis and cell senescence. Validation studies using RNA-sequencing and proteomic datasets emphasized the pivotal roles of cell migration and tissue repair in persistent lung dysfunction. The repositioning potential of the miRNA targets was limited. CONCLUSION AND IMPLICATIONS Our study reveals early mechanistic pathways contributing to persistent lung dysfunction in critical COVID-19 survivors, offering a promising approach for the development of targeted disease-modifying agents.
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Affiliation(s)
- María C García-Hidalgo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Iván D Benítez
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Manel Perez-Pons
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Marta Molinero
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Thalía Belmonte
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Carlos Rodríguez-Muñoz
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - María Aguilà
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Sally Santisteve
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Gerard Torres
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Group of Precision Medicine in Chronic Diseases, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Anna Moncusí-Moix
- Group of Precision Medicine in Chronic Diseases, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Clara Gort-Paniello
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Rafael Peláez
- Biomarkers and Molecular Signaling Group, Neurodegenerative Diseases Area Center for Biomedical Research of La Rioja, CIBIR, Logroño, Spain
| | - Ignacio M Larráyoz
- Biomarkers and Molecular Signaling Group, Neurodegenerative Diseases Area Center for Biomedical Research of La Rioja, CIBIR, Logroño, Spain
- BIAS, Department of Nursing, University of La Rioja, Logroño, Spain
| | - Jesús Caballero
- Grup de Recerca Medicina Intensiva, Intensive Care Department Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Carme Barberà
- Intensive Care Department, University Hospital Santa María, IRBLleida, Lleida, Spain
| | - Estefania Nova-Lamperti
- Molecular and Translational Immunology Laboratory, Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, Universidad de Concepcion, Concepcion, Chile
| | - Antoni Torres
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Pneumology Department, Clinic Institute of Thorax (ICT), Hospital Clinic of Barcelona, Insitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), ICREA, University of Barcelona (UB), Barcelona, Spain
| | - Jessica González
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Ferran Barbé
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - David de Gonzalo-Calvo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
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Pinilla L, Esmaeili N, Labarca G, Martinez-Garcia MÁ, Torres G, Gracia-Lavedan E, Mínguez O, Martínez D, Abad J, Masdeu MJ, Mediano O, Muñoz C, Cabriada V, Duran-Cantolla J, Mayos M, Coloma R, Montserrat JM, de la Peña M, Hu WH, Messineo L, Sehhati M, Wellman A, Redline S, Sands S, Barbé F, Sánchez-de-la-Torre M, Azarbarzin A. Hypoxic burden to guide CPAP treatment allocation in patients with obstructive sleep apnoea: a post hoc study of the ISAACC trial. Eur Respir J 2023; 62:2300828. [PMID: 37734857 PMCID: PMC10701092 DOI: 10.1183/13993003.00828-2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/27/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Hypoxic burden (HB) has emerged as a strong predictor of cardiovascular risk in obstructive sleep apnoea (OSA). We aimed to assess the potential of HB to predict the cardiovascular benefit of treating OSA with continuous positive airway pressure (CPAP). METHODS This was a post hoc analysis of the ISAACC trial (ClinicalTrials.gov: NCT01335087) including non-sleepy patients with acute coronary syndrome (ACS) diagnosed with OSA (apnoea-hypopnoea index ≥15 events·h-1) by respiratory polygraphy. Patients were randomised to CPAP or usual care and followed for a minimum of 1 year. HB was calculated as the total area under all automatically identified desaturations divided by total sleep time. Patients were categorised as having high or low baseline HB according to the median value (73.1%min·h-1). Multivariable Cox regression models were used to assess whether the effect of CPAP on the incidence of cardiovascular outcomes was dependent on the baseline HB level. RESULTS The population (362 patients assigned to CPAP and 365 patients assigned to usual care) was middle-aged (mean age 59.7 years), overweight/obese and mostly male (84.5%). A significant interaction was found between the treatment arm and the HB categories. In the high HB group, CPAP treatment was associated with a significant reduction in the incidence of cardiovascular events (HR 0.57, 95% CI 0.34-0.96). In the low HB group, CPAP-treated patients exhibited a trend toward a higher risk of cardiovascular outcomes than those receiving usual care (HR 1.33, 95% CI 0.79-2.25). The differential effect of the treatment depending on the baseline HB level followed a dose-response relationship. CONCLUSION In non-sleepy ACS patients with OSA, high HB levels were associated with a long-term protective effect of CPAP on cardiovascular prognosis.
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Affiliation(s)
- Lucía Pinilla
- Group of Precision Medicine in Chronic Diseases, University Hospital Arnau de Vilanova and Santa María, University of Lleida, IRBLleida, Lleida, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- L. Pinilla and N. Esmaeili are co-first authors
| | - Neda Esmaeili
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Bioelectric and Biomedical Engineering Department, School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- L. Pinilla and N. Esmaeili are co-first authors
| | - Gonzalo Labarca
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Miguel Ángel Martinez-Garcia
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Pneumology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Gerard Torres
- Group of Precision Medicine in Chronic Diseases, University Hospital Arnau de Vilanova and Santa María, University of Lleida, IRBLleida, Lleida, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Esther Gracia-Lavedan
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Group of Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa María, University of Lleida, IRBLleida, Lleida, Spain
| | - Olga Mínguez
- Group of Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa María, University of Lleida, IRBLleida, Lleida, Spain
| | - Dolores Martínez
- Group of Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa María, University of Lleida, IRBLleida, Lleida, Spain
| | - Jorge Abad
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Pneumology Department, University Hospital Germans Trias i Pujol, Badalona, Spain
| | - Maria José Masdeu
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Pneumology Department, University Hospital Parc Taulí, Autonomous University of Barcelona, Sabadell, Spain
| | - Olga Mediano
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Pneumology Department, University Hospital of Guadalajara, Guadalajara, Spain
| | - Carmen Muñoz
- Pneumology Department, University Hospital of Burgos, Burgos, Spain
| | - Valentín Cabriada
- Pneumology Department, University Hospital of Cruces, Bizkaia, Spain
| | - Joaquín Duran-Cantolla
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Bioaraba Health Research Institute, University Hospital of Araba, Vitoria, Spain
| | - Mercè Mayos
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Sleep Unit, Pneumology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - Ramón Coloma
- Pneumology Department, University Hospital of Albacete, Albacete, Spain
| | - Josep María Montserrat
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Pneumology Department, Clinic Hospital, Barcelona, Spain
| | - Mónica de la Peña
- University Hospital Son Espases, Research Institute of Palma, Palma de Mallorca, Spain
| | - Wen-Hsin Hu
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Ludovico Messineo
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Mohammadreza Sehhati
- Bioelectric and Biomedical Engineering Department, School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Andrew Wellman
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Scott Sands
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Ferran Barbé
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Group of Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa María, University of Lleida, IRBLleida, Lleida, Spain
| | - Manuel Sánchez-de-la-Torre
- Group of Precision Medicine in Chronic Diseases, University Hospital Arnau de Vilanova and Santa María, University of Lleida, IRBLleida, Lleida, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- M. Sánchez-de-la-Torre and A. Azarbarzin contributed equally to this article as lead authors and supervised the work
| | - Ali Azarbarzin
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- M. Sánchez-de-la-Torre and A. Azarbarzin contributed equally to this article as lead authors and supervised the work
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Pinilla L, Benítez ID, Gracia-Lavedan E, Torres G, Mínguez O, Vaca R, Jové M, Sol J, Pamplona R, Barbé F, Sánchez-de-la-Torre M. Metabolipidomic Analysis in Patients with Obstructive Sleep Apnea Discloses a Circulating Metabotype of Non-Dipping Blood Pressure. Antioxidants (Basel) 2023; 12:2047. [PMID: 38136167 PMCID: PMC10741016 DOI: 10.3390/antiox12122047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/07/2023] [Accepted: 11/19/2023] [Indexed: 12/24/2023] Open
Abstract
A non-dipping blood pressure (BP) pattern, which is frequently present in patients with obstructive sleep apnea (OSA), confers high cardiovascular risk. The mechanisms connecting these two conditions remain unclear. In the present study we performed a comprehensive analysis of the blood metabolipidome that aims to provide new insights into the molecular link between OSA and the dysregulation of circadian BP rhythmicity. This was an observational prospective longitudinal study involving adults with suspected OSA who were subjected to full polysomnography (PSG). Patients with an apnea-hypopnea index ≥ 5 events/h were included. Fasting plasma samples were obtained the morning after PSG. Based on the dipping ratio (DR; ratio of night/day BP values) measured via 24 h ambulatory BP monitoring, two groups were established: dippers (DR ≤ 0.9) and non-dippers (DR > 0.9). Treatment recommendations for OSA followed the clinical guidelines. Untargeted metabolomic and lipidomic analyses were performed in plasma samples via liquid chromatography-tandem mass spectrometry. Non-dipper patients represented 53.7% of the cohort (88/164 patients). A set of 31 metabolic species and 13 lipidic species were differentially detected between OSA patients who present a physiologic nocturnal BP decrease and those with abnormal BP dipping. Among the 44 differentially abundant plasma compounds, 25 were putatively identified, notably glycerophospholipids, glycolipids, sterols, and fatty acid derivates. Multivariate analysis defined a specific metabotype of non-dipping BP, which showed a significant dose-response relationship with PSG parameters of OSA severity, and with BP dipping changes after 6 months of OSA treatment with continuous positive airway pressure (CPAP). Bioinformatic analyses revealed that the identified metabolipidomic profile was found to be implicated in multiple systemic biological pathways, with potential physiopathologic implications for the circadian control of BP among individuals with OSA.
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Affiliation(s)
- Lucía Pinilla
- Precision Medicine in Chronic Diseases Group, Respiratory Department, University Hospital Arnau de Vilanova and Santa María, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, IRBLleida, 25198 Lleida, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Iván D. Benítez
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Translational Research in Respiratory Medicine Group, Respiratory Department, University Hospital Arnau de Vilanova and Santa María, IRBLleida, 25198 Lleida, Spain
| | - Esther Gracia-Lavedan
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Translational Research in Respiratory Medicine Group, Respiratory Department, University Hospital Arnau de Vilanova and Santa María, IRBLleida, 25198 Lleida, Spain
| | - Gerard Torres
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Translational Research in Respiratory Medicine Group, Respiratory Department, University Hospital Arnau de Vilanova and Santa María, IRBLleida, 25198 Lleida, Spain
| | - Olga Mínguez
- Translational Research in Respiratory Medicine Group, Respiratory Department, University Hospital Arnau de Vilanova and Santa María, IRBLleida, 25198 Lleida, Spain
| | - Rafaela Vaca
- Translational Research in Respiratory Medicine Group, Respiratory Department, University Hospital Arnau de Vilanova and Santa María, IRBLleida, 25198 Lleida, Spain
| | - Mariona Jové
- Department of Experimental Medicine, University of Lleida-Biomedical Research Institute of Lleida (UdL-IRBLleida), 25198 Lleida, Spain
| | - Joaquim Sol
- Department of Experimental Medicine, University of Lleida-Biomedical Research Institute of Lleida (UdL-IRBLleida), 25198 Lleida, Spain
- Institut Català de la Salut, Atenció Primària, 25198 Lleida, Spain
- Research Support Unit Lleida, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Lleida, Spain
| | - Reinald Pamplona
- Department of Experimental Medicine, University of Lleida-Biomedical Research Institute of Lleida (UdL-IRBLleida), 25198 Lleida, Spain
| | - Ferran Barbé
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Translational Research in Respiratory Medicine Group, Respiratory Department, University Hospital Arnau de Vilanova and Santa María, IRBLleida, 25198 Lleida, Spain
| | - Manuel Sánchez-de-la-Torre
- Precision Medicine in Chronic Diseases Group, Respiratory Department, University Hospital Arnau de Vilanova and Santa María, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, IRBLleida, 25198 Lleida, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
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9
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Sánchez-de-la-Torre M, Gracia-Lavedan E, Benitez ID, Sánchez-de-la-Torre A, Moncusí-Moix A, Torres G, Loffler K, Woodman R, Adams R, Labarca G, Dreyse J, Eulenburg C, Thunström E, Glantz H, Peker Y, Anderson C, McEvoy D, Barbé F. Adherence to CPAP Treatment and the Risk of Recurrent Cardiovascular Events: A Meta-Analysis. JAMA 2023; 330:1255-1265. [PMID: 37787793 PMCID: PMC10548300 DOI: 10.1001/jama.2023.17465] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/20/2023] [Indexed: 10/04/2023]
Abstract
Importance The effect of continuous positive airway pressure (CPAP) on secondary cardiovascular disease prevention is highly debated. Objective To assess the effect of CPAP treatment for obstructive sleep apnea (OSA) on the risk of adverse cardiovascular events in randomized clinical trials. Data Sources PubMed (MEDLINE), EMBASE, Current Controlled Trials: metaRegister of Controlled Trials, ISRCTN Registry, European Union clinical trials database, CENTRAL (Cochrane Central Register of Controlled Trials), and ClinicalTrials.gov databases were systematically searched through June 22, 2023. Study Selection For qualitative and individual participant data (IPD) meta-analysis, randomized clinical trials addressing the therapeutic effect of CPAP on cardiovascular outcomes and mortality in adults with cardiovascular disease and OSA were included. Data Extraction and Synthesis Two reviewers independently screened records, evaluated potentially eligible primary studies in full text, extracted data, and cross-checked errors. IPD were requested from authors of the selected studies (SAVE [NCT00738179], ISAACC [NCT01335087], and RICCADSA [NCT00519597]). Main Outcomes and Measures One-stage and 2-stage IPD meta-analyses were completed to estimate the effect of CPAP treatment on risk of recurrent major adverse cardiac and cerebrovascular events (MACCEs) using mixed-effect Cox regression models. Additionally, an on-treatment analysis with marginal structural Cox models using inverse probability of treatment weighting was fitted to assess the effect of good adherence to CPAP (≥4 hours per day). Results A total of 4186 individual participants were evaluated (82.1% men; mean [SD] body mass index, 28.9 [4.5]; mean [SD] age, 61.2 [8.7] years; mean [SD] apnea-hypopnea index, 31.2 [17] events per hour; 71% with hypertension; 50.1% receiving CPAP [mean {SD} adherence, 3.1 {2.4} hours per day]; 49.9% not receiving CPAP [usual care], mean [SD] follow-up, 3.25 [1.8] years). The main outcome was defined as the first MACCE, which was similar for the CPAP and no CPAP groups (hazard ratio, 1.01 [95% CI, 0.87-1.17]). However, an on-treatment analysis by marginal structural model revealed a reduced risk of MACCEs associated with good adherence to CPAP (hazard ratio, 0.69 [95% CI, 0.52-0.92]). Conclusions and Relevance Adherence to CPAP was associated with a reduced MACCE recurrence risk, suggesting that treatment adherence is a key factor in secondary cardiovascular prevention in patients with OSA.
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Affiliation(s)
- Manuel Sánchez-de-la-Torre
- Precision Medicine in Chronic Diseases, Hospital Universitari Arnau de Vilanova-Santa Maria, IRB Lleida, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Esther Gracia-Lavedan
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Ivan D. Benitez
- Precision Medicine in Chronic Diseases, Hospital Universitari Arnau de Vilanova-Santa Maria, IRB Lleida, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Alicia Sánchez-de-la-Torre
- Precision Medicine in Chronic Diseases, Hospital Universitari Arnau de Vilanova-Santa Maria, IRB Lleida, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Anna Moncusí-Moix
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Gerard Torres
- Precision Medicine in Chronic Diseases, Hospital Universitari Arnau de Vilanova-Santa Maria, IRB Lleida, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Kelly Loffler
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Richard Woodman
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Robert Adams
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Gonzalo Labarca
- Laboratorio de Inmunología Traslacional, Departamento de Bioquímica Clínica e Inmunología, Facultad de Farmacia, Universidad de Concepción, Concepción, Chile
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Christine Eulenburg
- Department for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Erik Thunström
- Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helena Glantz
- Department of Internal Medicine, Skarabrg Hospital, Lidköping, Sweden
| | - Yüksel Peker
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Pulmonary Medicine, Koç University School of Medicine, Istanbul, Turkey
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Clinical Sciences, Respiratory Medicine, and Allergology, Faculty of Medicine, Lund University, Lund, Sweden
| | - Craig Anderson
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Doug McEvoy
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Ferran Barbé
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
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Torres G, Gradidge P. The quality and pattern of rehabilitation interventions prescribed for post-COVID-19 infection patients: A systematic review and meta-analysis. Prev Med Rep 2023; 35:102395. [PMID: 37705882 PMCID: PMC10495653 DOI: 10.1016/j.pmedr.2023.102395] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023] Open
Abstract
Patients with prior COVID-19 infection may present with lasting multisystem symptoms that require intervention and includes exercise rehabilitation. The aim of this systematic review was to investigate the quality of articles, with emphasis on exercise rehabilitation, and conduct a meta-analysis on experimental and observational rehabilitation intervention studies on cardiorespiratory fitness and pulmonary function in post-COVID-19 infection patients. This systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines for evaluating rehabilitation interventions in clinical practice. A methodical search of cohort and experimental studies occurred from January 2019 up to March 2023. Thirty-two studies were included for complete analysis. The quality of the eligible studies for complete review was fair overall. The studies did not provide a detailed account of key descriptors of exercise such as volume, progression, motivational strategies, adherence and replication. There was a significant difference in the 6-minute walk test (Mean difference (MD) = 51.69 m; confidence intervals (CIs) = 36.99 to 66.38; p < 0.001, level of heterogeneity (I2) = 0), percent of predicted forced expiratory volume in one second (MD = 7.95%; CIs = 3.46 to 12.44; p = 0.0005, I2 = 65%) and percent of predicted forced vital capacity (MD = 3.49%; 95% CI = 1.25 to 5.73; p = 0.002; I2 = 37%) between the experiment and control groups. The current evidence suggests that rehabilitation interventions significantly improve cardiorespiratory fitness and pulmonary function in post-COVID-19 infection patients; however, there is a need for conceptualising high-quality and long-term rehabilitation interventions, especially exercise interventions.
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Affiliation(s)
- G. Torres
- Department of Exercise Science and Sports Medicine, Faculty of Health Sciences University of the Witwatersrand, Johannesburg, South Africa
| | - P.J. Gradidge
- Department of Exercise Science and Sports Medicine, Faculty of Health Sciences University of the Witwatersrand, Johannesburg, South Africa
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11
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Rojo-López MI, Bermúdez-López M, Castro E, Farràs C, Torres G, Pamplona R, Lecube A, Valdivielso JM, Fernández E, Julve J, Castelblanco E, Franch-Nadal J, Alonso N, Granado-Casas M, Mauricio D. Low adherence to the Mediterranean diet is associated with increased prevalence and number of atherosclerotic plaques in the ILERVAS cohort. Atherosclerosis 2023; 380:117191. [PMID: 37586219 DOI: 10.1016/j.atherosclerosis.2023.117191] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 07/12/2023] [Accepted: 07/26/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND AND AIMS Current research on the association between dietary patterns and subclinical atherosclerotic disease (SAD) is still limited, and published results are inconsistent and often consist of small population sizes. We aimed to evaluate the association between the Mediterranean diet (MDiet) and SAD in a large cohort of Mediterranean individuals. METHODS This was a cross-sectional study that included 8116 subjects from the ILERVAS cohort. The presence of atherosclerotic plaques (AP) was assessed by ultrasound examination. Adherence to the MDiet was assessed using the 14-item Mediterranean Diet Adherence Score (MEDAS). Inclusion criteria were subjects with at least one cardiovascular risk factor. Exclusion criteria were a clinical history of diabetes, chronic kidney disease, or a prior cardiovascular event. Bivariable and multivariable models were performed. RESULTS Compared with subjects without SAD, participants with SAD were older and had a higher frequency of smoking habit, hypertension, dyslipidemia, HbA1c and waist circumference. The adjusted multivariable analysis showed that a higher MEDAS was associated with a lower risk of AP (incidence rate ratios [IRR] 0.97, 95% CI [0.96-0.98]; p<0.001). Furthermore, moderate or high adherence to the MDiet was associated with a lower number of AP compared with a low MDiet adherence (IRR 0.90, 95% CI [0.87-0.94]; p<0.001). In both models, female sex was associated with a lower risk of AP. CONCLUSIONS Our findings point to a potentially protective role of MDiet for SAD in a Mediterranean population with low-to-moderate cardiovascular risk. Further research is needed to establish a causal relationship between both variables.
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Affiliation(s)
- Marina Idalia Rojo-López
- Research Group of Endocrinology, Diabetes and Nutrition, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Marcelino Bermúdez-López
- Vascular and Renal Translational Research Group, IRBLleida, Renal Research Network (RedInRen, ISCIII), Lleida, Spain
| | - Eva Castro
- Vascular and Renal Translational Research Group, IRBLleida, Renal Research Network (RedInRen, ISCIII), Lleida, Spain
| | - Cristina Farràs
- Cappont Primary Care Center. Territorial Management of Lleida, Catalan Institute of Health, Barcelona, Spain; Research Support Unit Lleida, Jordi Gol i Gorina Primary Health Care Research Institute Foundation (IDIAPJGol), Barcelona, Spain
| | - Gerard Torres
- Department of Respiratory Medicine, Arnau de Vilanova University Hospital, Translational Research Group Respiratory Medicine, IRBLleida, University of Lleida, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - Reinald Pamplona
- Department of Experimental Medicine, IRBLleida, University of Lleida, Lleida, Spain
| | - Albert Lecube
- Department of Endocrinology and Nutrition, Arnau de Vilanova University Hospital, Obesity and Metabolism Research Group (ODIM), IRBLleida, University of Lleida, Lleida, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
| | - José Manuel Valdivielso
- Vascular and Renal Translational Research Group, IRBLleida, Renal Research Network (RedInRen, ISCIII), Lleida, Spain
| | - Elvira Fernández
- Vascular and Renal Translational Research Group, IRBLleida, Renal Research Network (RedInRen, ISCIII), Lleida, Spain
| | - Josep Julve
- Research Group of Endocrinology, Diabetes and Nutrition, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
| | - Esmeralda Castelblanco
- Department of Internal Medicine, Endocrinology, Metabolism and Lipid Research Division, Washington University School of Medicine, St Louis, MO, 63110, USA; DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Josep Franch-Nadal
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain; DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Núria Alonso
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain; Endocrinology and Nutrition Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Minerva Granado-Casas
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain; Department of Nursing and Physiotherapy, Health Sciences Faculty, University of Lleida, Health Care Research Group (GRECS), IRBLleida, Lleida, Spain.
| | - Dídac Mauricio
- Research Group of Endocrinology, Diabetes and Nutrition, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain; DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Faculty of Medicine, University of Vic (UVIC/UCC), Vic, Spain.
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12
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Rugbeer N, Constantinou D, Torres G. Effect of a novel 90-second "Gear" exercise programme on markers of inflammation and cardiorespiratory fitness measurements in person at risk of cardiovascular disease. Res Sports Med 2023; 31:734-743. [PMID: 35135384 DOI: 10.1080/15438627.2022.2038158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 01/27/2022] [Indexed: 10/19/2022]
Abstract
The study compared the effect of the novel "Gear" exercise programmes on inflammatory markers and cardiorespiratory fitness measurements. The participants mean age was 38 ± 5.74 years, with a mean body mass of 83 ± 16.93kg. Participants were randomly assigned to either the "Gear" exercise programme repeated at different times during the day (GEP-DT): cycled for 90 seconds, repeated three times per day, three days per week; the "Gear" exercise programme repeated at one point in time (GEP-OT): cycled for 90 seconds followed by four minutes and 30 seconds rest, repeated three times at one point in time, three days per week; moderate-intensity continuous exercise group (MICE): cycled for 30 minutes at 55-69% of HRmax or the control group (CTRL): did not exercise. The GEP-DT demonstrated a moderate increase in load at ventilation threshold (VT-L) (MD = 8.18 ± 12.30, % Δ = 14.53, d = 0.77, d (95% CI): (-0.17, 1.64)). The GEP-OT group demonstrated a large effect size for VT-L (MD = 11.79 ± 18.77, % Δ = 18.86, d = 0.81, d (95% CI): (-0.02, 1.63)). The GEP-DT and GEP-OT raised the VT-L, which prevented premature fatigue and improved the efficiency of the cardiorespiratory system.
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Affiliation(s)
- N Rugbeer
- Department of Sport, Rehabilitation and Dental Sciences, Tshwane University of Technology, Pretoria, South Africa
- Faculty of Health Sciences University of the Witwatersrand, Centre for Exercise Science and Sports Medicine, School of Therapeutic Sciences, Johannesburg, South Africa
| | - D Constantinou
- Faculty of Health Sciences University of the Witwatersrand, Centre for Exercise Science and Sports Medicine, School of Therapeutic Sciences, Johannesburg, South Africa
| | - G Torres
- Faculty of Health Sciences University of the Witwatersrand, Centre for Exercise Science and Sports Medicine, School of Therapeutic Sciences, Johannesburg, South Africa
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13
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Torres G, Rains N, Gradidge PJ, Constantinou D. Exercise intervention for post-acute COVID-19 syndrome - do FITT-VP principles apply? A case study. S Afr J Sports Med 2023; 35:v35i1a15284. [PMID: 38249761 PMCID: PMC10798601 DOI: 10.17159/2078-516x/2023/v35i1a15284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024] Open
Abstract
The lack of standardisation of reporting exercise interventions hampers the development of best practice guidelines for long COVID patients. This case study on the effect of an exercise intervention in a long COVID patient applied the Consensus on Exercise Reporting Template (CERT) for reporting interventions. FITT-VP exercise prescription principles for long COVID rehabilitation are also suggested. A 58-year-old male, previously hospitalised for 14 days in the ward for the intensive care for the management of severe COVID-19 infection, joined an exercise rehabilitation programme. A medical history, anthropometric, biochemical, lung function, blood pressure, cardiorespiratory fitness and strength measures were all assessed before and after the eight week exercise intervention programme. Positive changes were found in all lung function test measures. Cardiorespiratory fitness, endurance capacity and muscle strength improved. However, the greatest improvements occurred in functional status, fatigue, dyspnoea and the state of depression levels. This case study suggested that in the absence of other instruments, the FITT-VP principles may be used for long COVID patients, and CERT for reporting interventions, but these should be further researched.
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Affiliation(s)
- G Torres
- Department of Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - N Rains
- N.H.C Health Centre, Northcliff, South Africa
| | - P J Gradidge
- Department of Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - D Constantinou
- Department of Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, South Africa
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14
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de Batlle J, Benítez ID, Moncusí-Moix A, Androutsos O, Angles Barbastro R, Antonini A, Arana E, Cabrera-Umpierrez MF, Cea G, Dafoulas GΕ, Folkvord F, Fullaondo A, Giuliani F, Huang HL, Innominato PF, Kardas P, Lou VWQ, Manios Y, Matsangidou M, Mercalli F, Mokhtari M, Pagliara S, Schellong J, Stieler L, Votis K, Currás P, Arredondo MT, Posada J, Guillén S, Pecchia L, Barbé F, Torres G, Fico G. GATEKEEPER's Strategy for the Multinational Large-Scale Piloting of an eHealth Platform: Tutorial on How to Identify Relevant Settings and Use Cases. J Med Internet Res 2023; 25:e42187. [PMID: 37379060 PMCID: PMC10365628 DOI: 10.2196/42187] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/31/2023] [Accepted: 02/26/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The World Health Organization's strategy toward healthy aging fosters person-centered integrated care sustained by eHealth systems. However, there is a need for standardized frameworks or platforms accommodating and interconnecting multiple of these systems while ensuring secure, relevant, fair, trust-based data sharing and use. The H2020 project GATEKEEPER aims to implement and test an open-source, European, standard-based, interoperable, and secure framework serving broad populations of aging citizens with heterogeneous health needs. OBJECTIVE We aim to describe the rationale for the selection of an optimal group of settings for the multinational large-scale piloting of the GATEKEEPER platform. METHODS The selection of implementation sites and reference use cases (RUCs) was based on the adoption of a double stratification pyramid reflecting the overall health of target populations and the intensity of proposed interventions; the identification of a principles guiding implementation site selection; and the elaboration of guidelines for RUC selection, ensuring clinical relevance and scientific excellence while covering the whole spectrum of citizen complexities and intervention intensities. RESULTS Seven European countries were selected, covering Europe's geographical and socioeconomic heterogeneity: Cyprus, Germany, Greece, Italy, Poland, Spain, and the United Kingdom. These were complemented by the following 3 Asian pilots: Hong Kong, Singapore, and Taiwan. Implementation sites consisted of local ecosystems, including health care organizations and partners from industry, civil society, academia, and government, prioritizing the highly rated European Innovation Partnership on Active and Healthy Aging reference sites. RUCs covered the whole spectrum of chronic diseases, citizen complexities, and intervention intensities while privileging clinical relevance and scientific rigor. These included lifestyle-related early detection and interventions, using artificial intelligence-based digital coaches to promote healthy lifestyle and delay the onset or worsening of chronic diseases in healthy citizens; chronic obstructive pulmonary disease and heart failure decompensations management, proposing integrated care management based on advanced wearable monitoring and machine learning (ML) to predict decompensations; management of glycemic status in diabetes mellitus, based on beat to beat monitoring and short-term ML-based prediction of glycemic dynamics; treatment decision support systems for Parkinson disease, continuously monitoring motor and nonmotor complications to trigger enhanced treatment strategies; primary and secondary stroke prevention, using a coaching app and educational simulations with virtual and augmented reality; management of multimorbid older patients or patients with cancer, exploring novel chronic care models based on digital coaching, and advanced monitoring and ML; high blood pressure management, with ML-based predictions based on different intensities of monitoring through self-managed apps; and COVID-19 management, with integrated management tools limiting physical contact among actors. CONCLUSIONS This paper provides a methodology for selecting adequate settings for the large-scale piloting of eHealth frameworks and exemplifies with the decisions taken in GATEKEEPER the current views of the WHO and European Commission while moving forward toward a European Data Space.
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Affiliation(s)
- Jordi de Batlle
- Group of Translational Research in Respiratory Medicine, Institut de Recerca Biomedica de Lleida, Hospital Universitari Arnau de Vilanova-Santa Maria, Lleida, Spain
- Center for Biomedical Network Research in Respiratory Diseases, Madrid, Spain
| | - Ivan D Benítez
- Group of Translational Research in Respiratory Medicine, Institut de Recerca Biomedica de Lleida, Hospital Universitari Arnau de Vilanova-Santa Maria, Lleida, Spain
- Center for Biomedical Network Research in Respiratory Diseases, Madrid, Spain
| | - Anna Moncusí-Moix
- Group of Translational Research in Respiratory Medicine, Institut de Recerca Biomedica de Lleida, Hospital Universitari Arnau de Vilanova-Santa Maria, Lleida, Spain
- Center for Biomedical Network Research in Respiratory Diseases, Madrid, Spain
| | - Odysseas Androutsos
- Lab of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | | | - Alessio Antonini
- Knowledge Media Institute, The Open University, Milton Keynes, United Kingdom
| | - Eunate Arana
- Biocruces Bizkaia Health Research Institute, Osakidetza, Barakaldo, Spain
| | - Maria Fernanda Cabrera-Umpierrez
- Life Supporting Technologies, Escuela Técnica Superior de Ingenieros de Telecomunicaciones, Universidad Politécnica de Madrid, Madrid, Spain
| | - Gloria Cea
- Life Supporting Technologies, Escuela Técnica Superior de Ingenieros de Telecomunicaciones, Universidad Politécnica de Madrid, Madrid, Spain
| | - George Ε Dafoulas
- E-health Department, Digital Cities of Central Greece, Trikala, Greece
- Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, University of Thessaly, Larisa, Greece
| | - Frans Folkvord
- PredictBy, Barcelona, Spain
- Tilburg School of Humanities and Digital Sciences, Tilburg, Netherlands
| | - Ane Fullaondo
- Kronikgune Institute for Health Services Research, Barakaldo, Spain
| | - Francesco Giuliani
- Innovation and Research Department, Fondazione Casa Sollievo della Sofferenza Research Hospital, San Giovanni Rotondo, Italy
| | - Hsiao-Ling Huang
- Department of Healthcare Management, Office of International and Cross-Strait Affairs, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Pasquale F Innominato
- Oncology Department, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, United Kingdom
- Warwick Medical School & Cancer Research Centre, University of Warwick, Coventry, United Kingdom
- Faculty of Medicine, Paris-Saclay University, Villejuif, France
| | - Przemyslaw Kardas
- Medication Adherence Research Centre, Department of Family Medicine, Medical University of Lodz, Lodz, Poland
| | - Vivian W Q Lou
- Department of Social Work and Social Administration, Sau Po Center on Ageing, The University of Hong Kong, Hong Kong, China
| | - Yannis Manios
- Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | | | | | - Mounir Mokhtari
- Scientific Direction, Institut Mines-Telecom, Paris, France
- National University of Singapore, Singapore, Singapore
| | - Silvio Pagliara
- School of Engineering, University of Warwick, Coventry, United Kingdom
| | - Julia Schellong
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Lisa Stieler
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Konstantinos Votis
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Paula Currás
- Innova & European Projects Office, Integrated Health Solutions, Medtronic Ibérica S.A., Madrid, Spain
| | - Maria Teresa Arredondo
- Life Supporting Technologies, Escuela Técnica Superior de Ingenieros de Telecomunicaciones, Universidad Politécnica de Madrid, Madrid, Spain
| | - Jorge Posada
- Innova & European Projects Office, Integrated Health Solutions, Medtronic Ibérica S.A., Madrid, Spain
| | | | - Leandro Pecchia
- School of Engineering, University of Warwick, Coventry, United Kingdom
| | - Ferran Barbé
- Group of Translational Research in Respiratory Medicine, Institut de Recerca Biomedica de Lleida, Hospital Universitari Arnau de Vilanova-Santa Maria, Lleida, Spain
- Center for Biomedical Network Research in Respiratory Diseases, Madrid, Spain
| | - Gerard Torres
- Group of Translational Research in Respiratory Medicine, Institut de Recerca Biomedica de Lleida, Hospital Universitari Arnau de Vilanova-Santa Maria, Lleida, Spain
- Center for Biomedical Network Research in Respiratory Diseases, Madrid, Spain
| | - Giuseppe Fico
- Life Supporting Technologies, Escuela Técnica Superior de Ingenieros de Telecomunicaciones, Universidad Politécnica de Madrid, Madrid, Spain
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15
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de Gonzalo-Calvo D, Molinero M, Benítez ID, Perez-Pons M, García-Mateo N, Ortega A, Postigo T, García-Hidalgo MC, Belmonte T, Rodríguez-Muñoz C, González J, Torres G, Gort-Paniello C, Moncusí-Moix A, Estella Á, Tamayo Lomas L, Martínez de la Gándara A, Socias L, Peñasco Y, de la Torre MDC, Bustamante-Munguira E, Gallego Curto E, Martínez Varela I, Martin Delgado MC, Vidal-Cortés P, López Messa J, Pérez-García F, Caballero J, Añón JM, Loza-Vázquez A, Carbonell N, Marin-Corral J, Jorge García RN, Barberà C, Ceccato A, Fernández-Barat L, Ferrer R, Garcia-Gasulla D, Lorente-Balanza JÁ, Menéndez R, Motos A, Peñuelas O, Riera J, Bermejo-Martin JF, Torres A, Barbé F. A blood microRNA classifier for the prediction of ICU mortality in COVID-19 patients: a multicenter validation study. Respir Res 2023; 24:159. [PMID: 37328754 DOI: 10.1186/s12931-023-02462-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/25/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND The identification of critically ill COVID-19 patients at risk of fatal outcomes remains a challenge. Here, we first validated candidate microRNAs (miRNAs) as biomarkers for clinical decision-making in critically ill patients. Second, we constructed a blood miRNA classifier for the early prediction of adverse outcomes in the ICU. METHODS This was a multicenter, observational and retrospective/prospective study including 503 critically ill patients admitted to the ICU from 19 hospitals. qPCR assays were performed in plasma samples collected within the first 48 h upon admission. A 16-miRNA panel was designed based on recently published data from our group. RESULTS Nine miRNAs were validated as biomarkers of all-cause in-ICU mortality in the independent cohort of critically ill patients (FDR < 0.05). Cox regression analysis revealed that low expression levels of eight miRNAs were associated with a higher risk of death (HR from 1.56 to 2.61). LASSO regression for variable selection was used to construct a miRNA classifier. A 4-blood miRNA signature composed of miR-16-5p, miR-192-5p, miR-323a-3p and miR-451a predicts the risk of all-cause in-ICU mortality (HR 2.5). Kaplan‒Meier analysis confirmed these findings. The miRNA signature provides a significant increase in the prognostic capacity of conventional scores, APACHE-II (C-index 0.71, DeLong test p-value 0.055) and SOFA (C-index 0.67, DeLong test p-value 0.001), and a risk model based on clinical predictors (C-index 0.74, DeLong test-p-value 0.035). For 28-day and 90-day mortality, the classifier also improved the prognostic value of APACHE-II, SOFA and the clinical model. The association between the classifier and mortality persisted even after multivariable adjustment. The functional analysis reported biological pathways involved in SARS-CoV infection and inflammatory, fibrotic and transcriptional pathways. CONCLUSIONS A blood miRNA classifier improves the early prediction of fatal outcomes in critically ill COVID-19 patients.
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Affiliation(s)
- David de Gonzalo-Calvo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Marta Molinero
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Iván D Benítez
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Manel Perez-Pons
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Nadia García-Mateo
- Group for Biomedical Research in Sepsis (BioSepsis), Instituto de Investigación Biomédica de Salamanca, (IBSAL), Gerencia Regional de Salud de Castilla y León, Salamanca, Spain
| | - Alicia Ortega
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Group for Biomedical Research in Sepsis (BioSepsis), Instituto de Investigación Biomédica de Salamanca, (IBSAL), Gerencia Regional de Salud de Castilla y León, Salamanca, Spain
| | - Tamara Postigo
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Group for Biomedical Research in Sepsis (BioSepsis), Instituto de Investigación Biomédica de Salamanca, (IBSAL), Gerencia Regional de Salud de Castilla y León, Salamanca, Spain
| | - María C García-Hidalgo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Thalia Belmonte
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Carlos Rodríguez-Muñoz
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Jessica González
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Gerard Torres
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Clara Gort-Paniello
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Anna Moncusí-Moix
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Ángel Estella
- Department of Medicine, Intensive Care Unit University Hospital of Jerez, University of Cádiz, INIBiCA, Cádiz, Spain
| | - Luis Tamayo Lomas
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Critical Care Department, Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain
| | | | - Lorenzo Socias
- Intensive Care Unit, Hospital Son Llàtzer, Palma de Mallorca, Illes Balears, Spain
| | - Yhivian Peñasco
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Maria Del Carmen de la Torre
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Servei de Medicina Intensiva, Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Spain
| | - Elena Bustamante-Munguira
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Department of Intensive Care Medicine, Hospital Clínico Universitario Valladolid, Valladolid, Spain
| | - Elena Gallego Curto
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Unidad de Cuidados Intensivos, Hospital Universitario San Pedro de Alcántara, Cáceres, Spain
| | | | | | - Pablo Vidal-Cortés
- Intensive Care Unit, Complexo Hospitalario Universitario de Ourense, Ourense, Spain
| | | | - Felipe Pérez-García
- Servicio de Microbiología Clínica, Facultad de Medicina, Departamento de Biomedicina y Biotecnología, Hospital Universitario Príncipe de Asturias - Universidad de Alcalá, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Jesús Caballero
- Grup de Recerca Medicina Intensiva, Intensive Care Department Hospital, Universitari Arnau de Vilanova, Lleida, Spain
| | - José M Añón
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Servicio de Medicina Intensiva. Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - Ana Loza-Vázquez
- Unidad de Medicina Intensiva, Hospital Universitario Virgen de Valme, Seville, Spain
| | - Nieves Carbonell
- Intensive Care Unit, Hospital Clínico y Universitario de Valencia, Valencia, Spain
| | | | | | - Carmen Barberà
- Intensive Care Department, University Hospital Santa María, IRBLleida, Lleida, Spain
| | - Adrián Ceccato
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Laia Fernández-Barat
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Servei de Pneumologia, Hospital Clinic, Universitat de Barcelona, IDIBAPS, Barcelona, Spain
| | - Ricard Ferrer
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Intensive Care Department, SODIR Research Group, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | | | - Jose Ángel Lorente-Balanza
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Hospital Universitario de Getafe, Madrid, Spain
- Dep. of Medicine, Universidad Europea, Madrid, Spain
- Dep. of Bioengineering, Universidad Carlos III, Madrid, Spain
| | - Rosario Menéndez
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Pulmonology Service, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Ana Motos
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Servei de Pneumologia, Hospital Clinic, Universitat de Barcelona, IDIBAPS, Barcelona, Spain
| | - Oscar Peñuelas
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Hospital Universitario de Getafe, Madrid, Spain
| | - Jordi Riera
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Intensive Care Department, SODIR Research Group, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Jesús F Bermejo-Martin
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Group for Biomedical Research in Sepsis (BioSepsis), Instituto de Investigación Biomédica de Salamanca, (IBSAL), Gerencia Regional de Salud de Castilla y León, Salamanca, Spain
- Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain
| | - Antoni Torres
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Servei de Pneumologia, Hospital Clinic, Universitat de Barcelona, IDIBAPS, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Ferran Barbé
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.
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Mallofré N, Torres G, Roca C, Rojas P, Sutil M, Casanovas N, Lloreda M, Castaldo F, Bosch E, Martínez-Rubio A. Oral Presentation Award Winner: LDL-C Reduction in Diabetic Patients after Percutaneous Coronary Intervention: Is There any Difference with Non-diabetic? Eur Cardiol 2023; 18:e19. [PMID: 37405339 PMCID: PMC10316379 DOI: 10.15420/ecr.2023.18.po2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023] Open
Affiliation(s)
- N Mallofré
- Hospital Universitari Parc Taulí, Cardiology, Universitat Autònoma de Barcelona Sabadell, Spain
| | - G Torres
- Hospital Universitari Parc Taulí, Cardiology, Universitat Autònoma de Barcelona Sabadell, Spain
| | - C Roca
- Hospital Universitari Parc Taulí, Cardiology, Universitat Autònoma de Barcelona Sabadell, Spain
| | - P Rojas
- Hospital Universitari Parc Taulí, Cardiology, Universitat Autònoma de Barcelona Sabadell, Spain
| | - M Sutil
- Hospital Universitari Parc Taulí, Cardiology, Universitat Autònoma de Barcelona Sabadell, Spain
| | - N Casanovas
- Hospital Universitari Parc Taulí, Cardiology, Universitat Autònoma de Barcelona Sabadell, Spain
| | - M Lloreda
- Hospital Universitari Parc Taulí, Cardiology, Universitat Autònoma de Barcelona Sabadell, Spain
| | - F Castaldo
- Hospital Universitari Parc Taulí, Cardiology, Universitat Autònoma de Barcelona Sabadell, Spain
| | - E Bosch
- Hospital Universitari Parc Taulí, Cardiology, Universitat Autònoma de Barcelona Sabadell, Spain
| | - A Martínez-Rubio
- Hospital Universitari Parc Taulí, Cardiology, Universitat Autònoma de Barcelona Sabadell, Spain
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17
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Pinilla L, Benítez ID, Gracia-Lavedan E, Torres G, Minguez O, Aguilà M, Targa A, Dalmases M, Mediano O, Masa JF, Masdeu MJ, Barbé F, Sánchez-de-la-Torre M. Polysomnographic Characterization of Circadian Blood Pressure Patterns in Patients with Obstructive Sleep Apnea. Sleep 2023; 46:7045987. [PMID: 36806948 DOI: 10.1093/sleep/zsad031] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/14/2022] [Indexed: 02/20/2023] Open
Abstract
We characterized the polysomnography (PSG) parameters associated with alterations in the circadian blood pressure (BP) pattern aiming to identify the main contributors to explain the nondipper profile in obstructive sleep apnea (OSA). This is an observational-prospective-multicenter study that included subjects referred to the sleep unit for suspected OSA. Following a PSG study, subjects with an apnea-hypopnea index (AHI) ≥5 events/h were included. Two groups were established based on the 24-h ambulatory blood pressure monitoring (ABPM) dipping ratio (DR; night/day BP ratio): dippers (DR ≤0.9) and nondippers (DR >0.9). The cohort consisted of 299 patients: 131 (43.8%) dippers and 168 (56.2%) nondippers. A significant increase in the risk of presenting a nondipper BP pattern was found along with AHI gain [odds ratio (OR) (95% (CI) = 1.71 (1.28 to 2.28)]. The best AHI cut-off for predicting nondipper status was 25.2 events/h, increasing the OR (95% CI) to 3.50 (2.02 to 6.07). The hypopnea index [OR (95% CI) = 1.70 (1.27 to 2.26), TSat90 [OR (95% CI) = 1.41 (1.06 to 1.87)] and respiratory arousal index [OR (95% CI) = 1.74 (1.30 to 2.34)] were individually associated with the risk of a nondipping pattern. Multivariate variable selection processes identified the respiratory arousal index as the most relevant risk factor for the nondipper profile, beyond classical clinical risk factors and usual PSG metrics.
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Affiliation(s)
- Lucía Pinilla
- Group of Precision Medicine in Chronic Diseases, Respiratory Department, University Hospital Arnau de Vilanova and Santa María; Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida; IRBLleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Iván D Benítez
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Group of Translational Research in Respiratory Medicine, Respiratory Department, University Hospital Arnau de Vilanova and Santa María; IRB Lleida, Lleida, Spain
| | - Esther Gracia-Lavedan
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Group of Translational Research in Respiratory Medicine, Respiratory Department, University Hospital Arnau de Vilanova and Santa María; IRB Lleida, Lleida, Spain
| | - Gerard Torres
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Group of Translational Research in Respiratory Medicine, Respiratory Department, University Hospital Arnau de Vilanova and Santa María; IRB Lleida, Lleida, Spain
| | - Olga Minguez
- Group of Translational Research in Respiratory Medicine, Respiratory Department, University Hospital Arnau de Vilanova and Santa María; IRB Lleida, Lleida, Spain
| | - Maria Aguilà
- Group of Translational Research in Respiratory Medicine, Respiratory Department, University Hospital Arnau de Vilanova and Santa María; IRB Lleida, Lleida, Spain
| | - Adriano Targa
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Group of Translational Research in Respiratory Medicine, Respiratory Department, University Hospital Arnau de Vilanova and Santa María; IRB Lleida, Lleida, Spain
| | - Mireia Dalmases
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Group of Translational Research in Respiratory Medicine, Respiratory Department, University Hospital Arnau de Vilanova and Santa María; IRB Lleida, Lleida, Spain
| | - Olga Mediano
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Pneumology Department, University Hospital of Guadalajara, Guadalajara, Spain
| | - Juan F Masa
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,San Pedro de Alcántara Hospital, Instituto Universitario de Investigación Biosanitaria de Extremadura, Cáceres, Spain
| | - Maria J Masdeu
- Respiratory and Sleep Department, Parc Taulí University Hospital, Parc Taulí Research and Innovation Institute, Autonomous University of Barcelona, Sabadell, Spain
| | - Ferran Barbé
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Group of Translational Research in Respiratory Medicine, Respiratory Department, University Hospital Arnau de Vilanova and Santa María; IRB Lleida, Lleida, Spain
| | - Manuel Sánchez-de-la-Torre
- Group of Precision Medicine in Chronic Diseases, Respiratory Department, University Hospital Arnau de Vilanova and Santa María; Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida; IRBLleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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18
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Torres G, Vargas K, Reyes-Vélez J, Jiménez N, Blanchard A, Olivera-Angel M. High genetic diversity and zoonotic potential of Staphylococcus aureus strains recovered from bovine intramammary infections in Colombians dairy herds. Comp Immunol Microbiol Infect Dis 2023; 93:101940. [PMID: 36603241 DOI: 10.1016/j.cimid.2022.101940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/28/2022] [Accepted: 12/30/2022] [Indexed: 01/02/2023]
Abstract
Genotyping of Staphylococcus aureus isolated from mastitis has become a fundamental tool to understand its complex epidemiology and to evaluate spillover events. The aim of this study was to describe the frequency of genotypes of the S. aureus strains isolated from intramammary infections by spa typing technique, and to evaluate the association between genotypes and the ability to form biofilm under in vitro conditions. Sixty-six strains of S. aureus recovered from bovines intramammary infections on 56 dairy herds located in 14 municipalities of the department of Antioquia were characterized. The majority of strains (65/66) were isolated from milk samples collected from dairy cows with subclinical intramammary infections. Nineteen different spa types were found in this study, t521 (19.70%), t267 (15.15%), and t605 (12.12%) being the most frequent. The strains from the t605 spa type showed the highest biofilm production. The high frequency of spa types with zoonotic potential found in this study, identified cattle as an important reservoir of theses clones for people in close proximity, such as milkers and consumers of unpasteurized dairy products.
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Affiliation(s)
- G Torres
- Biogenesis Research Group, Department of Agricultural Sciences, University of Antioquia, Cra. 75 No. 65-87, Medellín, Antioquia, Colombia; Instituto Colombiano de Medicina Tropical - Universidad CES, Cra. 43A No. 52 sur-99, Sabaneta, Antioquia, Colombia.
| | - K Vargas
- Biogenesis Research Group, Department of Agricultural Sciences, University of Antioquia, Cra. 75 No. 65-87, Medellín, Antioquia, Colombia
| | - J Reyes-Vélez
- Biogenesis Research Group, Department of Agricultural Sciences, University of Antioquia, Cra. 75 No. 65-87, Medellín, Antioquia, Colombia; Instituto Colombiano de Medicina Tropical - Universidad CES, Cra. 43A No. 52 sur-99, Sabaneta, Antioquia, Colombia
| | - N Jiménez
- Basic and Applied Microbiology Research Group, School of Microbiology, University of Antioquia, Cl. 67 No. 53-108, Medellín, Antioquia, Colombia
| | - A Blanchard
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, United Kingdom
| | - M Olivera-Angel
- Biogenesis Research Group, Department of Agricultural Sciences, University of Antioquia, Cra. 75 No. 65-87, Medellín, Antioquia, Colombia
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19
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González J, de Batlle J, Benítez ID, Torres G, Santisteve S, Targa AD, Gort-Paniello C, Moncusí-Moix A, Aguilà M, Seck F, Ceccato A, Ferrer R, Motos A, Riera J, Fernández L, Menéndez R, Lorente JÁ, Peñuelas O, Garcia-Gasulla D, Peñasco Y, Ricart P, Abril Palomares E, Aguilera L, Rodríguez A, Boado Varela MV, Beteré B, Pozo-Laderas JC, Solé-Violan J, Salvador-Adell I, Novo MA, Barberán J, Amaya Villar R, Garnacho-Montero J, Gómez JM, Blandino Ortiz A, Tamayo Lomas L, Úbeda A, Catalán-González M, Sánchez-Miralles A, Martínez Varela I, Jorge García RN, Franco N, Gumucio-Sanguino VD, Bustamante-Munguira E, Valdivia LJ, Caballero J, Gallego E, Rodríguez C, Castellanos-Ortega Á, Trenado J, Marin-Corral J, Albaiceta GM, de la Torre MDC, Loza-Vázquez A, Vidal P, Añón JM, Carbajales Pérez C, Sagredo V, Carbonell N, Socias L, Barberà C, Estella A, Diaz E, de Gonzalo-Calvo D, Torres A, Barbé F. Key Factors Associated With Pulmonary Sequelae in the Follow-Up of Critically Ill COVID-19 Patients. Arch Bronconeumol 2023; 59:205-215. [PMID: 36690515 PMCID: PMC9824938 DOI: 10.1016/j.arbres.2022.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Critical COVID-19 survivors have a high risk of respiratory sequelae. Therefore, we aimed to identify key factors associated with altered lung function and CT scan abnormalities at a follow-up visit in a cohort of critical COVID-19 survivors. METHODS Multicenter ambispective observational study in 52 Spanish intensive care units. Up to 1327 PCR-confirmed critical COVID-19 patients had sociodemographic, anthropometric, comorbidity and lifestyle characteristics collected at hospital admission; clinical and biological parameters throughout hospital stay; and, lung function and CT scan at a follow-up visit. RESULTS The median [p25-p75] time from discharge to follow-up was 3.57 [2.77-4.92] months. Median age was 60 [53-67] years, 27.8% women. The mean (SD) percentage of predicted diffusing lung capacity for carbon monoxide (DLCO) at follow-up was 72.02 (18.33)% predicted, with 66% of patients having DLCO<80% and 24% having DLCO<60%. CT scan showed persistent pulmonary infiltrates, fibrotic lesions, and emphysema in 33%, 25% and 6% of patients, respectively. Key variables associated with DLCO<60% were chronic lung disease (CLD) (OR: 1.86 (1.18-2.92)), duration of invasive mechanical ventilation (IMV) (OR: 1.56 (1.37-1.77)), age (OR [per-1-SD] (95%CI): 1.39 (1.18-1.63)), urea (OR: 1.16 (0.97-1.39)) and estimated glomerular filtration rate at ICU admission (OR: 0.88 (0.73-1.06)). Bacterial pneumonia (1.62 (1.11-2.35)) and duration of ventilation (NIMV (1.23 (1.06-1.42), IMV (1.21 (1.01-1.45)) and prone positioning (1.17 (0.98-1.39)) were associated with fibrotic lesions. CONCLUSION Age and CLD, reflecting patients' baseline vulnerability, and markers of COVID-19 severity, such as duration of IMV and renal failure, were key factors associated with impaired DLCO and CT abnormalities.
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Affiliation(s)
- Jessica González
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Jordi de Batlle
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Iván D. Benítez
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Gerard Torres
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Sally Santisteve
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Adriano D.S. Targa
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Clara Gort-Paniello
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Anna Moncusí-Moix
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Maria Aguilà
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Fatty Seck
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Adrián Ceccato
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Critical Care Center, ParcTaulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain
| | - Ricard Ferrer
- Intensive Care Department, Vall d’Hebron Hospital Universitari, SODIR Research Group, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Anna Motos
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Department of Pneumology, Hospital Clinic of Barcelona, August Pi i Sunyer Biomedical Research Institute – IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Jordi Riera
- Intensive Care Department, Vall d’Hebron Hospital Universitari, SODIR Research Group, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Laia Fernández
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Department of Pneumology, Hospital Clinic of Barcelona, August Pi i Sunyer Biomedical Research Institute – IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Rosario Menéndez
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Pulmonology Service, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - José Ángel Lorente
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Hospital Universitario de Getafe, Madrid, Spain
| | - Oscar Peñuelas
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Hospital Universitario de Getafe, Madrid, Spain
| | | | - Yhivian Peñasco
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Pilar Ricart
- Servei de Medicina Intensiva, Hospital Universitari Germans Trias, Badalona, Spain
| | | | - Luciano Aguilera
- Servicio de Anestesiología y Reanimación, Hospital Universitario Basurto, Bilbao, Spain
| | | | | | - Belén Beteré
- Servicio de Análisis Clínicos, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - Juan Carlos Pozo-Laderas
- UGC-Medicina Intensiva, Hospital Universitario Reina Sofia, Instituto Maimonides IMIBIC, Córdoba, Spain
| | - Jordi Solé-Violan
- Critical Care Department, Hospital Dr. Negrín Gran Canaria, Universidad Fernando Pessoa, Las Palmas, Gran Canaria, Canarias, Spain
| | | | - Mariana Andrea Novo
- Servei de Medicina Intensiva, Hospital Universitari Son Espases, Palma de Mallorca, Illes Balears, Spain
| | - José Barberán
- Hospital Universitario HM Montepríncipe, Universidad San Pablo-CEU, Madrid, Spain
| | - Rosario Amaya Villar
- Intensive Care Clinical Unit, Hospital Universitario Virgen de Rocío, Sevilla, Spain
| | - José Garnacho-Montero
- Intensive Care Clinical Unit, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - José M. Gómez
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Aaron Blandino Ortiz
- Servicio de Medicina Intensiva, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Luis Tamayo Lomas
- Critical Care Department, Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain
| | - Alejandro Úbeda
- Servicio de Medicina Intensiva, Hospital Punta de Europa, Algeciras, Spain
| | | | | | | | | | | | - Víctor D. Gumucio-Sanguino
- Department of Intensive Care, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
| | | | | | - Jesús Caballero
- Critical Care Department, Hospital Universitari Arnau de Vilanova, IRBLleida, Lleida, Spain
| | - Elena Gallego
- Unidad de Cuidados Intensivos, Hospital Universitario San Pedro de Alcántara, Cáceres, Spain
| | | | | | - Josep Trenado
- Servicio de Medicina Intensiva, Hospital Universitario Mútua de Terrassa, Terrassa, Barcelona, Spain
| | | | - Guillermo M. Albaiceta
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Departamento de Biología Funcional, Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias, Hospital Central de Asturias, Oviedo, Spain
| | | | - Ana Loza-Vázquez
- Unidad de Medicina Intensiva, Hospital Universitario Virgen de Valme, Sevilla, Spain
| | - Pablo Vidal
- Complexo Hospitalario Universitario de Ourense, Ourense, Spain
| | - Jose M. Añón
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Servicio de Medicina Intensiva, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | | | | | - Nieves Carbonell
- Intensive Care Unit, Hospital Clínico y Universitario de Valencia, Valencia, Spain
| | - Lorenzo Socias
- Intensive Care Unit, Hospital Son Llàtzer, Palma de Mallorca, Illes Balears, Spain
| | | | - Angel Estella
- Intensive Care Unit, University Hospital of Jerez, Medicine Department University of Cadiz, INiBICA, Spain
| | - Emili Diaz
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), Critical Care Department, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain
| | - David de Gonzalo-Calvo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Antoni Torres
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Department of Pneumology, Hospital Clinic of Barcelona, August Pi i Sunyer Biomedical Research Institute – IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Ferran Barbé
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Corresponding author
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20
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García-Hidalgo MC, González J, Benítez ID, Carmona P, Santisteve S, Pérez-Pons M, Moncusí-Moix A, Gort-Paniello C, Rodríguez-Jara F, Molinero M, Belmonte T, Torres G, Labarca G, Nova-Lamperti E, Caballero J, Bermejo-Martin JF, Ceccato A, Fernández-Barat L, Ferrer R, Garcia-Gasulla D, Menéndez R, Motos A, Peñuelas O, Riera J, Torres A, Barbé F, de Gonzalo-Calvo D. Identification of circulating microRNA profiles associated with pulmonary function and radiologic features in survivors of SARS-CoV-2-induced ARDS. Emerg Microbes Infect 2022; 11:1537-1549. [PMID: 35603455 PMCID: PMC9176679 DOI: 10.1080/22221751.2022.2081615] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
There is a limited understanding of the pathophysiology of postacute pulmonary sequelae in severe COVID-19. The aim of current study was to define the circulating microRNA (miRNA) profiles associated with pulmonary function and radiologic features in survivors of SARS-CoV-2-induced ARDS. The study included patients who developed ARDS secondary to SARS-CoV-2 infection (n = 167) and a group of infected patients who did not develop ARDS (n = 33). Patients were evaluated 3 months after hospital discharge. The follow-up included a complete pulmonary evaluation and chest computed tomography. Plasma miRNA profiling was performed using RT-qPCR. Random forest was used to construct miRNA signatures associated with lung diffusing capacity for carbon monoxide (DLCO) and total severity score (TSS). Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analyses were conducted. DLCO < 80% predicted was observed in 81.8% of the patients. TSS showed a median [P25;P75] of 5 [2;8]. The miRNA model associated with DLCO comprised miR-17-5p, miR-27a-3p, miR-126-3p, miR-146a-5p and miR-495-3p. Concerning radiologic features, a miRNA signature composed by miR-9-5p, miR-21-5p, miR-24-3p and miR-221-3p correlated with TSS values. These associations were not observed in the non-ARDS group. KEGG pathway and GO enrichment analyses provided evidence of molecular mechanisms related not only to profibrotic or anti-inflammatory states but also to cell death, immune response, hypoxia, vascularization, coagulation and viral infection. In conclusion, diffusing capacity and radiological features in survivors from SARS-CoV-2-induced ARDS are associated with specific miRNA profiles. These findings provide novel insights into the possible molecular pathways underlying the pathogenesis of pulmonary sequelae. Trial registration:ClinicalTrials.gov identifier: NCT04457505.. Trial registration:ISRCTN.org identifier: ISRCTN16865246..
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Affiliation(s)
- María C García-Hidalgo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Jessica González
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Iván D Benítez
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Paola Carmona
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Sally Santisteve
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Manel Pérez-Pons
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Anna Moncusí-Moix
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Clara Gort-Paniello
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Fátima Rodríguez-Jara
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Marta Molinero
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Thalia Belmonte
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Gerard Torres
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Gonzalo Labarca
- Molecular and Translational Immunology Laboratory, Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, Universidad de Concepcion, Concepcion, Chile.,Internal Medicine Unit, Complejo Asistencial Dr. Víctor Ríos Ruiz, Los Ángeles, Chile
| | - Estefania Nova-Lamperti
- Molecular and Translational Immunology Laboratory, Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, Universidad de Concepcion, Concepcion, Chile
| | - Jesús Caballero
- Grup de Recerca Medicina Intensiva, Intensive Care Department Hospital Universitari Arnau de Vilanova, IRBLleida, Lleida, Spain
| | - Jesús F Bermejo-Martin
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Adrián Ceccato
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Laia Fernández-Barat
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Servei de Pneumologia, Hospital Clinic, Universitat de Barcelona; IDIBAPS, Barcelona, Spain
| | - Ricard Ferrer
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Intensive Care Department, Vall d'Hebron Hospital Universitari. SODIR Research Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | | | - Rosario Menéndez
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Pulmonology Service, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Ana Motos
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Servei de Pneumologia, Hospital Clinic, Universitat de Barcelona; IDIBAPS, Barcelona, Spain
| | - Oscar Peñuelas
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Hospital Universitario de Getafe, Madrid, Spain
| | - Jordi Riera
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Intensive Care Department, Vall d'Hebron Hospital Universitari. SODIR Research Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Antoni Torres
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Pneumology Department, Clinic Institute of Thorax (ICT), Hospital Clinic of Barcelona - Insitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) - ICREA, University of Barcelona (UB), Barcelona, Spain
| | - Ferran Barbé
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - David de Gonzalo-Calvo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
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- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
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Targa ADS, Benítez ID, González J, Torres G, Santisteve S, Vaca R, Minguez O, Aguilà M, Carmona P, Moncusí‐Moix A, Gort‐Paniello C, Labarca G, Caballero J, Barberà C, Torres A, de Gonzalo‐Calvo D, Barbé F. Sleep and circadian health 6 months after critical COVID-19 disease. Respirology 2022; 27:1083-1088. [PMID: 36210340 PMCID: PMC9874423 DOI: 10.1111/resp.14390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/19/2022] [Indexed: 01/28/2023]
Affiliation(s)
- Adriano D. S. Targa
- Translational Research in Respiratory MedicineHospital Universitari Arnau de Vilanova‐Santa Maria, Institut de Recerca Biomèdica de Lleida (IRBLleida)LleidaSpain,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES)MadridSpain
| | - Iván D. Benítez
- Translational Research in Respiratory MedicineHospital Universitari Arnau de Vilanova‐Santa Maria, Institut de Recerca Biomèdica de Lleida (IRBLleida)LleidaSpain,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES)MadridSpain
| | - Jessica González
- Translational Research in Respiratory MedicineHospital Universitari Arnau de Vilanova‐Santa Maria, Institut de Recerca Biomèdica de Lleida (IRBLleida)LleidaSpain
| | - Gerard Torres
- Translational Research in Respiratory MedicineHospital Universitari Arnau de Vilanova‐Santa Maria, Institut de Recerca Biomèdica de Lleida (IRBLleida)LleidaSpain,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES)MadridSpain
| | - Sally Santisteve
- Translational Research in Respiratory MedicineHospital Universitari Arnau de Vilanova‐Santa Maria, Institut de Recerca Biomèdica de Lleida (IRBLleida)LleidaSpain
| | - Rafaela Vaca
- Translational Research in Respiratory MedicineHospital Universitari Arnau de Vilanova‐Santa Maria, Institut de Recerca Biomèdica de Lleida (IRBLleida)LleidaSpain
| | - Olga Minguez
- Translational Research in Respiratory MedicineHospital Universitari Arnau de Vilanova‐Santa Maria, Institut de Recerca Biomèdica de Lleida (IRBLleida)LleidaSpain
| | - Maria Aguilà
- Translational Research in Respiratory MedicineHospital Universitari Arnau de Vilanova‐Santa Maria, Institut de Recerca Biomèdica de Lleida (IRBLleida)LleidaSpain
| | - Paola Carmona
- Translational Research in Respiratory MedicineHospital Universitari Arnau de Vilanova‐Santa Maria, Institut de Recerca Biomèdica de Lleida (IRBLleida)LleidaSpain
| | - Anna Moncusí‐Moix
- Translational Research in Respiratory MedicineHospital Universitari Arnau de Vilanova‐Santa Maria, Institut de Recerca Biomèdica de Lleida (IRBLleida)LleidaSpain,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES)MadridSpain
| | - Clara Gort‐Paniello
- Translational Research in Respiratory MedicineHospital Universitari Arnau de Vilanova‐Santa Maria, Institut de Recerca Biomèdica de Lleida (IRBLleida)LleidaSpain,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES)MadridSpain
| | - Gonzalo Labarca
- Department of Clinical Biochemistry and Immunology, Faculty of PharmacyUniversity of ConcepcionConcepcionChile,Division of Sleep and Circadian DisordersBrigham and Women's Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Jesús Caballero
- Intensive Care DepartmentHospital Universitari Arnau de VilanovaLleidaSpain
| | - Carme Barberà
- Intensive Care DepartmentHospital Universitari Santa MariaLleidaSpain
| | - Antoni Torres
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES)MadridSpain,Servei de Pneumologia, Hospital ClinicUniversitat de BarcelonaBarcelonaSpain
| | - David de Gonzalo‐Calvo
- Translational Research in Respiratory MedicineHospital Universitari Arnau de Vilanova‐Santa Maria, Institut de Recerca Biomèdica de Lleida (IRBLleida)LleidaSpain,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES)MadridSpain
| | - Ferran Barbé
- Translational Research in Respiratory MedicineHospital Universitari Arnau de Vilanova‐Santa Maria, Institut de Recerca Biomèdica de Lleida (IRBLleida)LleidaSpain,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES)MadridSpain
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22
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Targa A, Benítez I, Moncusí-Moix A, Vaca R, Gort-Paniello C, Minguez O, Santisteve S, Carmona P, Torres G, Labarca G, Caballero J, Barberà C, Torres A, González J, De Gonzalo-Calvo D, Barbé F. Sleep and circadian rest-activity pattern of critical COVID-19 survivors in the long-term: a 6-month follow-up study. Sleep Med 2022. [PMCID: PMC9300256 DOI: 10.1016/j.sleep.2022.05.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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García-Hidalgo MC, Peláez R, González J, Santisteve S, Benítez ID, Molinero M, Perez-Pons M, Belmonte T, Torres G, Moncusí-Moix A, Gort-Paniello C, Aguilà M, Seck F, Carmona P, Caballero J, Barberà C, Ceccato A, Fernández-Barat L, Ferrer R, Garcia-Gasulla D, Lorente-Balanza JÁ, Menéndez R, Motos A, Peñuelas O, Riera J, Bermejo-Martin JF, Torres A, Barbé F, de Gonzalo-Calvo D, Larráyoz IM. Genome-wide transcriptional profiling of pulmonary functional sequelae in ARDS- secondary to SARS-CoV-2 infection. Biomed Pharmacother 2022; 154:113617. [PMID: 36058144 PMCID: PMC9424524 DOI: 10.1016/j.biopha.2022.113617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/18/2022] [Accepted: 08/27/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Up to 80% of patients surviving acute respiratory distress syndrome (ARDS) secondary to SARS-CoV-2 infection present persistent anomalies in pulmonary function after hospital discharge. There is a limited understanding of the mechanistic pathways linked to post-acute pulmonary sequelae. AIM To identify the molecular underpinnings associated with severe lung diffusion involvement in survivors of SARS-CoV-2-induced ARDS. METHODS Survivors attended to a complete pulmonary evaluation 3 months after hospital discharge. RNA sequencing (RNA-seq) was performed using Illumina technology in whole-blood samples from 50 patients with moderate to severe diffusion impairment (DLCO<60%) and age- and sex-matched individuals with mild-normal lung function (DLCO≥60%). A transcriptomic signature for optimal classification was constructed using random forest. Transcriptomic data were analyzed for biological pathway enrichment, cellular deconvolution, cell/tissue-specific gene expression and candidate drugs. RESULTS RNA-seq identified 1357 differentially expressed transcripts. A model composed of 14 mRNAs allowed the optimal discrimination of survivors with severe diffusion impairment (AUC=0.979). Hallmarks of lung sequelae involved cell death signaling, cytoskeleton reorganization, cell growth and differentiation and the immune response. Resting natural killer (NK) cells were the most important immune cell subtype for the prediction of severe diffusion impairment. Components of the signature correlated with neutrophil, lymphocyte and monocyte counts. A variable expression profile of the transcripts was observed in lung cell subtypes and bodily tissues. One upregulated gene, TUBB4A, constitutes a target for FDA-approved drugs. CONCLUSIONS This work defines the transcriptional programme associated with post-acute pulmonary sequelae and provides novel insights for targeted interventions and biomarker development.
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Affiliation(s)
- María C. García-Hidalgo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Rafael Peláez
- Biomarkers and Molecular Signaling Group, Neurodegenerative Diseases Area Center for Biomedical Research of La Rioja, CIBIR, Logroño, Spain
| | - Jessica González
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Sally Santisteve
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Iván D. Benítez
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Marta Molinero
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Manel Perez-Pons
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Thalía Belmonte
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Gerard Torres
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Anna Moncusí-Moix
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Clara Gort-Paniello
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Maria Aguilà
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Faty Seck
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Paola Carmona
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Jesús Caballero
- Grup de Recerca Medicina Intensiva, Intensive Care Department Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Carme Barberà
- Intensive Care Department, University Hospital Santa María, IRBLleida, Lleida, Spain
| | - Adrián Ceccato
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Hospital Universitari Sagrat Cor, Barcelona, Spain
| | - Laia Fernández-Barat
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Servei de Pneumologia, Hospital Clinic; Universitat de Barcelona; IDIBAPS, Barcelona, Spain
| | - Ricard Ferrer
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Intensive Care Department, Vall d’Hebron Hospital Universitari. SODIR Research Group, Vall d’Hebron Institut de Recerca (VHIR), Spain
| | | | - Jose Ángel Lorente-Balanza
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Hospital Universitario de Getafe, Madrid, Spain
| | - Rosario Menéndez
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Pulmonology Service, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Ana Motos
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Servei de Pneumologia, Hospital Clinic; Universitat de Barcelona; IDIBAPS, Barcelona, Spain
| | - Oscar Peñuelas
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Hospital Universitario de Getafe, Madrid, Spain
| | - Jordi Riera
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Intensive Care Department, Vall d’Hebron Hospital Universitari. SODIR Research Group, Vall d’Hebron Institut de Recerca (VHIR), Spain
| | - Jesús F. Bermejo-Martin
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Antoni Torres
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Pneumology Department, Clinic Institute of Thorax (ICT), Hospital Clinic of Barcelona, Insitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), ICREA, University of Barcelona (UB), Barcelona, Spain
| | - Ferran Barbé
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - David de Gonzalo-Calvo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain,Correspondence to: Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Avda. Alcalde Rovira Roure 80, Lleida 25198, Spain
| | - Ignacio M. Larráyoz
- Biomarkers and Molecular Signaling Group, Neurodegenerative Diseases Area Center for Biomedical Research of La Rioja, CIBIR, Logroño, Spain,GRUPAC, Department of Nursing, University of La Rioja, Logroño, Spain,Correspondence to: Biomarkers and Molecular Signaling Group, Neurodegenerative Diseases Area, Center for Biomedical Research of La Rioja, CIBIR. C. Piqueras, 98, Logroño 26006, Spain
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Rosell A, Baeza S, Garcia-Reina S, Mate J, Guasch I, Nogueira I, Torres G, Sanchez-Ramos C, Gil D. EP01.05-001 Radiomics to Increase the Effectiveness of Lung Cancer Screening Programs. Radiolung Preliminary Results. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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25
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Molinero M, Gómez S, Benítez ID, Vengoechea JJ, González J, Polanco D, Gort-Paniello C, Moncusí-Moix A, García-Hidalgo MC, Perez-Pons M, Belmonte T, Torres G, Caballero J, Barberà C, Ayestarán Rota JI, Socías Crespí L, Ceccato A, Fernández-Barat L, Ferrer R, Garcia-Gasulla D, Lorente-Balanza JÁ, Menéndez R, Motos A, Peñuelas O, Riera J, Torres A, Barbé F, de Gonzalo-Calvo D. Multiplex protein profiling of bronchial aspirates reveals disease-, mortality- and respiratory sequelae-associated signatures in critically ill patients with ARDS secondary to SARS-CoV-2 infection. Front Immunol 2022; 13:942443. [PMID: 35967328 PMCID: PMC9373836 DOI: 10.3389/fimmu.2022.942443] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Bronchial aspirates (BAS) obtained during invasive mechanical ventilation (IMV) constitutes a useful tool for molecular phenotyping and decision making. Aim To identify the proteomic determinants associated with disease pathogenesis, all-cause mortality and respiratory sequelae in BAS samples from critically ill patients with SARS-CoV-2-induced ARDS. Methods Multicenter study including 74 critically ill patients with COVID-19 and non-COVID-19 ARDS. BAS were obtained by bronchoaspiration after IMV initiation. Three hundred sixty-four proteins were quantified using proximity extension assay (PEA) technology. Random forest models were used to assess predictor importance. Results After adjusting for confounding factors, CST5, NADK, SRPK2 and TGF-α were differentially detected in COVID-19 and non-COVID-19 patients. In random forest models for COVID-19, CST5, DPP7, NADK, KYAT1 and TYMP showed the highest variable importance. In COVID-19 patients, reduced levels of ENTPD2 and PTN were observed in nonsurvivors of ICU stay, even after adjustment. AGR2, NQO2, IL-1α, OSM and TRAIL showed the strongest associations with in-ICU mortality and were used to construct a protein-based prediction model. Kaplan-Meier curves revealed a clear separation in mortality risk between subgroups of PTN, ENTPD2 and the prediction model. Cox regression models supported these findings. In survivors, the levels of FCRL1, NTF4 and THOP1 in BAS samples obtained during the ICU stay correlated with lung function (i.e., DLCO levels) 3 months after hospital discharge. Similarly, Flt3L and THOP1 levels were correlated with radiological features (i.e., TSS). These proteins are expressed in immune and nonimmune lung cells. Poor host response to viral infectivity and an inappropriate reparative mechanism seem to be linked with the pathogenesis of the disease and fatal outcomes, respectively. Conclusion BAS proteomics identified novel factors associated with the pathology of SARS-CoV-2-induced ARDS and its adverse outcomes. BAS-based protein testing emerges as a novel tool for risk assessment in the ICU.
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Affiliation(s)
- Marta Molinero
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Silvia Gómez
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Iván D Benítez
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - J J Vengoechea
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Jessica González
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Dinora Polanco
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Clara Gort-Paniello
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Anna Moncusí-Moix
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - María C García-Hidalgo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Manel Perez-Pons
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Thalía Belmonte
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Gerard Torres
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Jesús Caballero
- Intensive Care Department, University Hospital Arnau de Vilanova, IRBLleida, Lleida, Spain
| | - Carme Barberà
- Intensive Care Department, University Hospital Santa María, IRBLleida, Lleida, Spain
| | - Jose Ignacio Ayestarán Rota
- Intensive Care Unit, Son Espases University Hospital, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma de Mallorca, Spain
| | | | - Adrián Ceccato
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Laia Fernández-Barat
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Servei de Pneumologia, Hospital Clinic, Universitat de Barcelona, IDIBAPS, Barcelona, Spain
| | - Ricard Ferrer
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Intensive Care Department, Vall d'Hebron Hospital Universitari. SODIR Research Group, Vall d'Hebron Institut de Recerca VHIR), Barcelona, Spain
| | | | - Jose Ángel Lorente-Balanza
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Hospital Universitario de Getafe, Madrid, Spain
| | - Rosario Menéndez
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Pulmonology Service, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Ana Motos
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Servei de Pneumologia, Hospital Clinic, Universitat de Barcelona, IDIBAPS, Barcelona, Spain
| | - Oscar Peñuelas
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Hospital Universitario de Getafe, Madrid, Spain
| | - Jordi Riera
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Intensive Care Department, Vall d'Hebron Hospital Universitari. SODIR Research Group, Vall d'Hebron Institut de Recerca VHIR), Barcelona, Spain
| | - Antoni Torres
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Servei de Pneumologia, Hospital Clinic, Universitat de Barcelona, IDIBAPS, Barcelona, Spain
| | - Ferran Barbé
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - David de Gonzalo-Calvo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
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Bermúdez-López M, Martí-Antonio M, Castro-Boqué E, Bretones MDM, Farràs C, Torres G, Pamplona R, Lecube A, Mauricio D, Valdivielso JM, Fernández E. Development and Validation of a Personalized, Sex-Specific Prediction Algorithm of Severe Atheromatosis in Middle-Aged Asymptomatic Individuals: The ILERVAS Study. Front Cardiovasc Med 2022; 9:895917. [PMID: 35928938 PMCID: PMC9344070 DOI: 10.3389/fcvm.2022.895917] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundAlthough European guidelines recommend vascular ultrasound for the assessment of cardiovascular risk in low-to-moderate risk individuals, no algorithm properly identifies patients who could benefit from it. The aim of this study is to develop a sex-specific algorithm to identify those patients, especially women who are usually underdiagnosed.MethodsClinical, anthropometrical, and biochemical data were combined with a 12-territory vascular ultrasound to predict severe atheromatosis (SA: ≥ 3 territories with plaque). A Personalized Algorithm for Severe Atheromatosis Prediction (PASAP-ILERVAS) was obtained by machine learning. Models were trained in the ILERVAS cohort (n = 8,330; 51% women) and validated in the control subpopulation of the NEFRONA cohort (n = 559; 47% women). Performance was compared to the Systematic COronary Risk Evaluation (SCORE) model.ResultsThe PASAP-ILERVAS is a sex-specific, easy-to-interpret predictive model that stratifies individuals according to their risk of SA in low, intermediate, or high risk. New clinical predictors beyond traditional factors were uncovered. In low- and high-risk (L&H-risk) men, the net reclassification index (NRI) was 0.044 (95% CI: 0.020–0.068), and the integrated discrimination index (IDI) was 0.038 (95% CI: 0.029–0.048) compared to the SCORE. In L&H-risk women, PASAP-ILERVAS showed a significant increase in the area under the curve (AUC, 0.074 (95% CI: 0.062–0.087), p-value: < 0.001), an NRI of 0.193 (95% CI: 0.162–0.224), and an IDI of 0.119 (95% CI: 0.109–0.129).ConclusionThe PASAP-ILERVAS improves SA prediction, especially in women. Thus, it could reduce the number of unnecessary complementary explorations selecting patients for a further imaging study within the intermediate risk group, increasing cost-effectiveness and optimizing health resources.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [NCT03228459].
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Affiliation(s)
- Marcelino Bermúdez-López
- Grupo de Investigación Translacional Vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen-ISCIII), Lleida, Spain
| | - Manuel Martí-Antonio
- Grupo de Investigación Translacional Vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen-ISCIII), Lleida, Spain
| | - Eva Castro-Boqué
- Grupo de Investigación Translacional Vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen-ISCIII), Lleida, Spain
| | - María del Mar Bretones
- Grupo de Investigación Translacional Vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen-ISCIII), Lleida, Spain
| | - Cristina Farràs
- Centre d’Atenció Primària Cappont, Gerència Territorial de Lleida, Institut Català de la Salut, Barcelona, Spain
- Research Support Unit Lleida, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gorina (IDIAPJGol), Barcelona, Spain
| | - Gerard Torres
- Departament de Medicina Respiratòria, Hospital Universitari Arnau de Vilanova, Grup Recerca Translational Medicina Respiratòria, IRBLleida, Universitat de Lleida, Lleida, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Reinald Pamplona
- Departament de Medicina Experimental, IRBLleida, Universitat de Lleida, Lleida, Spain
| | - Albert Lecube
- Departament d’Endocrinologia i Nutrició, Hospital Universitari Arnau de Vilanova, Grup de Recerca Obesitat i Metabolisme (ODIM), IRBLleida, Universitat de Lleida, Lleida, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Dídac Mauricio
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Departament d’Endocrinologia i Nutrició, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - José Manuel Valdivielso
- Grupo de Investigación Translacional Vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen-ISCIII), Lleida, Spain
- *Correspondence: José Manuel Valdivielso,
| | - Elvira Fernández
- Grupo de Investigación Translacional Vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen-ISCIII), Lleida, Spain
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González J, Zuil M, Benítez ID, de Gonzalo-Calvo D, Aguilar M, Santisteve S, Vaca R, Minguez O, Seck F, Torres G, de Batlle J, Gómez S, Barril S, Moncusí-Moix A, Monge A, Gort-Paniello C, Ferrer R, Ceccato A, Fernández L, Motos A, Riera J, Menéndez R, Garcia-Gasulla D, Peñuelas O, Labarca G, Caballero J, Barberà C, Torres A, Barbé F. One Year Overview and Follow-Up in a Post-COVID Consultation of Critically Ill Patients. Front Med (Lausanne) 2022; 9:897990. [PMID: 35911414 PMCID: PMC9329578 DOI: 10.3389/fmed.2022.897990] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/20/2022] [Indexed: 01/19/2023] Open
Abstract
The long-term clinical management and evolution of a cohort of critical COVID-19 survivors have not been described in detail. We report a prospective observational study of COVID-19 patients admitted to the ICU between March and August 2020. The follow-up in a post-COVID consultation comprised symptoms, pulmonary function tests, the 6-minute walking test (6MWT), and chest computed tomography (CT). Additionally, questionnaires to evaluate the prevalence of post-COVID-19 syndrome were administered at 1 year. A total of 181 patients were admitted to the ICU during the study period. They were middle-aged (median [IQR] of 61 [52;67]) and male (66.9%), with a median ICU stay of 9 (5–24.2) days. 20% died in the hospital, and 39 were not able to be included. A cohort of 105 patients initiated the follow-up. At 1 year, 32.2% persisted with respiratory alterations and needed to continue the follow-up. Ten percent still had moderate/severe lung diffusion (DLCO) involvement (<60%), and 53.7% had a fibrotic pattern on CT. Moreover, patients had a mean (SD) number of symptoms of 5.7 ± 4.6, and 61.3% met the criteria for post-COVID syndrome at 1 year. During the follow-up, 46 patients were discharged, and 16 were transferred to other consultations. Other conditions, such as emphysema (21.6%), COPD (8.2%), severe neurocognitive disorders (4.1%), and lung cancer (1%) were identified. A high use of health care resources is observed in the first year. In conclusion, one-third of critically ill COVID-19 patients need to continue follow-up beyond 1 year, due to abnormalities on DLCO, chest CT, or persistent symptoms.
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Affiliation(s)
- Jessica González
- Department of Pulmonary, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain
- Translational Research in Respiratory Medicine Group, Lleida, Spain
- Lleida Biomedical Research Institute, Lleida, Spain
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
| | - María Zuil
- Department of Pulmonary, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain
- Translational Research in Respiratory Medicine Group, Lleida, Spain
- Lleida Biomedical Research Institute, Lleida, Spain
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Iván D. Benítez
- Translational Research in Respiratory Medicine Group, Lleida, Spain
- Lleida Biomedical Research Institute, Lleida, Spain
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
| | - David de Gonzalo-Calvo
- Translational Research in Respiratory Medicine Group, Lleida, Spain
- Lleida Biomedical Research Institute, Lleida, Spain
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
| | - María Aguilar
- Department of Pulmonary, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain
- Translational Research in Respiratory Medicine Group, Lleida, Spain
| | - Sally Santisteve
- Department of Pulmonary, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain
- Translational Research in Respiratory Medicine Group, Lleida, Spain
- Lleida Biomedical Research Institute, Lleida, Spain
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Rafaela Vaca
- Department of Pulmonary, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain
- Translational Research in Respiratory Medicine Group, Lleida, Spain
| | - Olga Minguez
- Department of Pulmonary, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain
- Translational Research in Respiratory Medicine Group, Lleida, Spain
| | - Faty Seck
- Department of Pulmonary, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain
- Translational Research in Respiratory Medicine Group, Lleida, Spain
| | - Gerard Torres
- Department of Pulmonary, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain
- Translational Research in Respiratory Medicine Group, Lleida, Spain
- Lleida Biomedical Research Institute, Lleida, Spain
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Jordi de Batlle
- Translational Research in Respiratory Medicine Group, Lleida, Spain
- Lleida Biomedical Research Institute, Lleida, Spain
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Silvia Gómez
- Department of Pulmonary, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain
- Translational Research in Respiratory Medicine Group, Lleida, Spain
- Lleida Biomedical Research Institute, Lleida, Spain
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Silvia Barril
- Department of Pulmonary, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain
- Translational Research in Respiratory Medicine Group, Lleida, Spain
- Lleida Biomedical Research Institute, Lleida, Spain
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Anna Moncusí-Moix
- Translational Research in Respiratory Medicine Group, Lleida, Spain
- Lleida Biomedical Research Institute, Lleida, Spain
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Aida Monge
- Department of Pulmonary, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain
- Translational Research in Respiratory Medicine Group, Lleida, Spain
- Lleida Biomedical Research Institute, Lleida, Spain
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Clara Gort-Paniello
- Translational Research in Respiratory Medicine Group, Lleida, Spain
- Lleida Biomedical Research Institute, Lleida, Spain
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Ricard Ferrer
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
- Intensive Care Department, Vall d’Hebron Hospital Universitari, Shock, Organ Dysfunction and Resuscitation (SODIR) Research Group, Vall d’Hebron Institut de Recerca, Barcelona, Spain
| | - Adrián Ceccato
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Laia Fernández
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
- Department of Pulmonary, Hospital Clinic, Universitat de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Ana Motos
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
- Department of Pulmonary, Hospital Clinic, Universitat de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Jordi Riera
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
- Intensive Care Department, Vall d’Hebron Hospital Universitari, Shock, Organ Dysfunction and Resuscitation (SODIR) Research Group, Vall d’Hebron Institut de Recerca, Barcelona, Spain
| | - Rosario Menéndez
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
- Department of Pulmonary, University and Polytechnic Hospital La Fe, Valencia, Spain
| | | | - Oscar Peñuelas
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
- Hospital Universitario de Getafe, Madrid, Spain
| | - Gonzalo Labarca
- Faculty of Medicine, University of Concepción, Concepción, Chile
- Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, Concepción, Chile
| | - Jesús Caballero
- Intensive Care Department, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain
| | - Carme Barberà
- Intensive Care Department, Hospital Universitari Santa Maria de Lleida, Lleida, Spain
| | - Antoni Torres
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
- Department of Pulmonary, Hospital Clinic, Universitat de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Ferran Barbé
- Department of Pulmonary, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain
- Translational Research in Respiratory Medicine Group, Lleida, Spain
- Lleida Biomedical Research Institute, Lleida, Spain
- Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
- *Correspondence: Ferran Barbé,
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Benítez ID, de Batlle J, Torres G, González J, de Gonzalo-Calvo D, Targa AD, Gort-Paniello C, Moncusí-Moix A, Ceccato A, Fernández-Barat L, Ferrer R, Garcia-Gasulla D, Menéndez R, Motos A, Peñuelas O, Riera J, Bermejo-Martin JF, Peñasco Y, Ricart P, Martin Delgado MC, Aguilera L, Rodríguez A, Boado Varela MV, Suarez-Sipmann F, Pozo-Laderas JC, Solé-Violan J, Nieto M, Novo MA, Barberán J, Amaya Villar R, Garnacho-Montero J, García-Garmendia JL, Gómez JM, Lorente JÁ, Blandino Ortiz A, Tamayo Lomas L, López-Ramos E, Úbeda A, Catalán-González M, Sánchez-Miralles A, Martínez Varela I, Jorge García RN, Franco N, Gumucio-Sanguino VD, Huerta Garcia A, Bustamante-Munguira E, Valdivia LJ, Caballero J, Gallego E, Martínez de la Gándara A, Castellanos-Ortega Á, Trenado J, Marin-Corral J, Albaiceta GM, de la Torre MDC, Loza-Vázquez A, Vidal P, Lopez Messa J, Añón JM, Carbajales Pérez C, Sagredo V, Bofill N, Carbonell N, Socias L, Barberà C, Estella A, Valledor Mendez M, Diaz E, López Lago A, Torres A, Barbé F. Prognostic implications of comorbidity patterns in critically ill COVID-19 patients: A multicenter, observational study. Lancet Reg Health Eur 2022; 18:100422. [PMID: 35655660 PMCID: PMC9148543 DOI: 10.1016/j.lanepe.2022.100422] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background The clinical heterogeneity of COVID-19 suggests the existence of different phenotypes with prognostic implications. We aimed to analyze comorbidity patterns in critically ill COVID-19 patients and assess their impact on in-hospital outcomes, response to treatment and sequelae. Methods Multicenter prospective/retrospective observational study in intensive care units of 55 Spanish hospitals. 5866 PCR-confirmed COVID-19 patients had comorbidities recorded at hospital admission; clinical and biological parameters, in-hospital procedures and complications throughout the stay; and, clinical complications, persistent symptoms and sequelae at 3 and 6 months. Findings Latent class analysis identified 3 phenotypes using training and test subcohorts: low-morbidity (n=3385; 58%), younger and with few comorbidities; high-morbidity (n=2074; 35%), with high comorbid burden; and renal-morbidity (n=407; 7%), with chronic kidney disease (CKD), high comorbidity burden and the worst oxygenation profile. Renal-morbidity and high-morbidity had more in-hospital complications and higher mortality risk than low-morbidity (adjusted HR (95% CI): 1.57 (1.34-1.84) and 1.16 (1.05-1.28), respectively). Corticosteroids, but not tocilizumab, were associated with lower mortality risk (HR (95% CI) 0.76 (0.63-0.93)), especially in renal-morbidity and high-morbidity. Renal-morbidity and high-morbidity showed the worst lung function throughout the follow-up, with renal-morbidity having the highest risk of infectious complications (6%), emergency visits (29%) or hospital readmissions (14%) at 6 months (p<0.01). Interpretation Comorbidity-based phenotypes were identified and associated with different expression of in-hospital complications, mortality, treatment response, and sequelae, with CKD playing a major role. This could help clinicians in day-to-day decision making including the management of post-discharge COVID-19 sequelae. Funding ISCIII, UNESPA, CIBERES, FEDER, ESF.
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Zapater A, Solelhac G, Sánchez-de-la-Torre A, Gracia-Lavedan E, Benitez ID, Torres G, De Batlle J, Haba-Rubio J, Berger M, Abad J, Duran-Cantolla J, Urrutia A, Mediano O, Masdeu MJ, Ordax-Carbajo E, Masa JF, De la Peña M, Mayos M, Coloma R, Montserrat JM, Chiner E, Mínguez O, Pascual L, Cortijo A, Martínez D, Dalmases M, Lee CH, McEvoy RD, Barbé F, Heinzer R, Sánchez-de-la-Torre M. Respiratory Polygraphy Patterns and Risk of Recurrent Cardiovascular Events in Patients With Acute Coronary Syndrome. Front Med (Lausanne) 2022; 9:870906. [PMID: 35833104 PMCID: PMC9271863 DOI: 10.3389/fmed.2022.870906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Obstructive sleep apnea (OSA) severity is based on the apnea-hypopnea index (AHI). The AHI is a simplistic measure that is inadequate for capturing disease severity and its consequences in cardiovascular diseases (CVDs). Deleterious effects of OSA have been suggested to influence the prognosis of specific endotypes of patients with acute coronary syndrome (ACS). We aim to identify respiratory polygraphy (RP) patterns that contribute to identifying the risk of recurrent cardiovascular events in patients with ACS. Methods Post hoc analysis of the ISAACC study, including 723 patients admitted for a first ACS (NCT01335087) in which RP was performed. To identify specific RP patterns, a principal component analysis (PCA) was performed using six RP parameters: AHI, oxygen desaturation index, mean and minimum oxygen saturation (SaO2), average duration of events and percentage of time with SaO2 < 90%. An independent HypnoLaus population-based cohort was used to validate the RP components. Results From the ISAACC study, PCA showed that two RP components accounted for 70% of the variance in the RP data. These components were validated in the HypnoLaus cohort, with two similar RP components that explained 71.3% of the variance in the RP data. The first component (component 1) was mainly characterized by low mean SaO2 and obstructive respiratory events with severe desaturation, and the second component (component 2) was characterized by high mean SaO2 and long-duration obstructive respiratory events without severe desaturation. In the ISAACC cohort, component 2 was associated with an increased risk of recurrent cardiovascular events in the third tertile with an adjusted hazard ratio (95% CI) of 2.44 (1.07 to 5.56; p-value = 0.03) compared to first tertile. For component 1, no significant association was found for the risk of recurrent cardiovascular events. Conclusion A RP component, mainly characterized by intermittent hypoxemia, is associated with a high risk of recurrent cardiovascular events in patients without previous CVD who have suffered a first ACS.
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Affiliation(s)
- Andrea Zapater
- Precision Medicine in Chronic Diseases, Hospital Universitari Arnau de Vilanova-Santa Maria, IRB Lleida, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Geoffroy Solelhac
- Center for Investigation and Research in Sleep, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Alicia Sánchez-de-la-Torre
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Esther Gracia-Lavedan
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Ivan David Benitez
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Gerard Torres
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Jordi De Batlle
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - José Haba-Rubio
- Center for Investigation and Research in Sleep, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mathieu Berger
- Center for Investigation and Research in Sleep, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jorge Abad
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Respiratory Department, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Joaquín Duran-Cantolla
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Investigación OSI, IIS Bioaraba, Hospital Universitario Araba, Vitoria-Gasteiz, Spain
| | - Amaia Urrutia
- Servicio Neumologia, Hospital Universitario Cruces, Bizkaia, Spain
| | - Olga Mediano
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Respiratory Department, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - María José Masdeu
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Respiratory and Sleep Department, Hospital Universitari Parc Taulí, Institut Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Juan Fernando Masa
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Respiratory Department, Hospital San Pedro Alcántara, Cáceres, Spain
| | - Mónica De la Peña
- Clinic Analysis and Respiratory Services, Institut de Investigació Sanitaria de Palma, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Mercé Mayos
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Sleep Unit, Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ramon Coloma
- Respiratory Department, Hospital General Universitario de Albacete, Albacete, Spain
| | - Josep María Montserrat
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Respiratory Department, Hospital Clinic, Barcelona, Spain
| | - Eusebi Chiner
- Respiratory Department, Hospital Universitari Sant Joan d'Alacant, Alicante, Spain
| | - Olga Mínguez
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Lydia Pascual
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Anunciación Cortijo
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Dolores Martínez
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Mireia Dalmases
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Chi-Hang Lee
- Cardiovascular Research Institute, National University of Singapore, Singapore, Singapore
| | - R Doug McEvoy
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Ferran Barbé
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Center for Investigation and Research in Sleep, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Raphael Heinzer
- Center for Investigation and Research in Sleep, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Pulmonary Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Manuel Sánchez-de-la-Torre
- Precision Medicine in Chronic Diseases, Hospital Universitari Arnau de Vilanova-Santa Maria, IRB Lleida, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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Almansa R, Eiros JM, de Gonzalo-Calvo D, Postigo T, Ortega A, Lopez-Izquierdo R, Moncusí-Moix A, Gort-Paniello C, Dominguez-Gil M, Fuente ADL, González-González L, Luis-García T, García-Mateo N, Tedim AP, Rodríguez-Jara F, Jorge N, González J, Torres G, Gutiérrez-Pérez ON, Villegas MJ, Campo S, Ayllon E, Albi TR, de Frutos Arribas J, Domingo AA, Abadia-Otero J, Barquero JG, Trapiello W, Garcia Frade LJ, Inglada L, Campo FD, Bermejo-Martin JF, Barbé F, Torres A. N-antigenemia detection by a rapid lateral flow test predicts 90-day mortality in COVID-19: a prospective cohort study. Clin Microbiol Infect 2022; 28:1391.e1-1391.e5. [PMID: 35654316 PMCID: PMC9150910 DOI: 10.1016/j.cmi.2022.05.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 05/03/2022] [Accepted: 05/14/2022] [Indexed: 11/28/2022]
Abstract
Objectives To evaluate if the detection of N antigen of SARS-CoV-2 in plasma by a rapid lateral flow test predicts 90-day mortality in COVID-19 patients hospitalized at the wards. Methods The presence of N-antigenemia was evaluated in the first 36 hours after hospitalization in 600 unvaccinated COVID-19 patients, by using the Panbio COVID-19 Ag Rapid Test Device from Abbott (Abbott Laboratories Inc., Chicago, IL, USA). The impact of N-antigenemia on 90-day mortality was assessed by multivariable Cox regression analysis. Results Prevalence of N-antigenemia at hospitalization was higher in nonsurvivors (69% (82/118) vs. 52% (250/482); p < 0.001). The patients with N-antigenemia showed more frequently RNAemia (45.7% (148/324) vs. 19.8% (51/257); p < 0.001), absence of anti-SARS-CoV-2 N antibodies (80.7% (264/327) vs. 26.6% (69/259); p < 0.001) and absence of S1 antibodies (73.4% (240/327) vs. 23.6% (61/259); p < 0.001). The patients with antigenemia showed more frequently acute respiratory distress syndrome (30.1% (100/332) vs. 18.7% (50/268); p = 0.001) and nosocomial infections (13.6% (45/331) vs. 7.9% (21/267); p = 0.026). N-antigenemia was a risk factor for increased 90-day mortality in the multivariable analysis (HR, 1.99 (95% CI,1.09–3.61), whereas the presence of anti-SARS-CoV-2 N-antibodies represented a protective factor (HR, 0.47 (95% CI, 0.26–0.85). Discussion The presence of N-antigenemia or the absence of anti-SARS-CoV-2 N-antibodies after hospitalization is associated to increased 90-day mortality in unvaccinated COVID-19 patients. Detection of N-antigenemia by using lateral flow tests is a quick, widely available tool that could contribute to early identify those COVID-19 patients at risk of deterioration.
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Affiliation(s)
- Raquel Almansa
- Group for Biomedical Research in Sepsis (BioSepsis). Instituto de Investigación Biomédica de Salamanca, (IBSAL), Gerencia Regional de Salud de Castilla y León, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain; Department of Cellular Biology, Hystology and Pharmacology. University of Valladolid, Av. Ramón y Cajal, 7, 47005 Valladolid, Spain; Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain
| | - Jose María Eiros
- Microbiology Service, Hospital Universitario Rio Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain
| | - David de Gonzalo-Calvo
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain; Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRB Lleida, Av. Alcalde Rovira Roure, 80, 25198 Lleida Spain
| | - Tamara Postigo
- Group for Biomedical Research in Sepsis (BioSepsis). Instituto de Investigación Biomédica de Salamanca, (IBSAL), Gerencia Regional de Salud de Castilla y León, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain; Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain
| | - Alicia Ortega
- Group for Biomedical Research in Sepsis (BioSepsis). Instituto de Investigación Biomédica de Salamanca, (IBSAL), Gerencia Regional de Salud de Castilla y León, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain; Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain
| | - Raul Lopez-Izquierdo
- Emergency Department, Hospital Universitario Rio Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain
| | - Anna Moncusí-Moix
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain; Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRB Lleida, Av. Alcalde Rovira Roure, 80, 25198 Lleida Spain
| | - Clara Gort-Paniello
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain; Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRB Lleida, Av. Alcalde Rovira Roure, 80, 25198 Lleida Spain
| | - Marta Dominguez-Gil
- Microbiology Service, Hospital Universitario Rio Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain
| | - Amanda de la Fuente
- Group for Biomedical Research in Sepsis (BioSepsis). Instituto de Investigación Biomédica de Salamanca, (IBSAL), Gerencia Regional de Salud de Castilla y León, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain; Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain
| | - Laura González-González
- Group for Biomedical Research in Sepsis (BioSepsis). Instituto de Investigación Biomédica de Salamanca, (IBSAL), Gerencia Regional de Salud de Castilla y León, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain; Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain
| | - Tania Luis-García
- Group for Biomedical Research in Sepsis (BioSepsis). Instituto de Investigación Biomédica de Salamanca, (IBSAL), Gerencia Regional de Salud de Castilla y León, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain; Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain
| | - Nadia García-Mateo
- Group for Biomedical Research in Sepsis (BioSepsis). Instituto de Investigación Biomédica de Salamanca, (IBSAL), Gerencia Regional de Salud de Castilla y León, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain; Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain
| | - Ana P Tedim
- Group for Biomedical Research in Sepsis (BioSepsis). Instituto de Investigación Biomédica de Salamanca, (IBSAL), Gerencia Regional de Salud de Castilla y León, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain; Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain
| | - Fátima Rodríguez-Jara
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain; Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRB Lleida, Av. Alcalde Rovira Roure, 80, 25198 Lleida Spain
| | - Noelia Jorge
- Group for Biomedical Research in Sepsis (BioSepsis). Instituto de Investigación Biomédica de Salamanca, (IBSAL), Gerencia Regional de Salud de Castilla y León, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain; Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain
| | - Jessica González
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRB Lleida, Av. Alcalde Rovira Roure, 80, 25198 Lleida Spain
| | - Gerard Torres
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain; Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRB Lleida, Av. Alcalde Rovira Roure, 80, 25198 Lleida Spain
| | - Oliver Norberto Gutiérrez-Pérez
- Hematology Service. Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain
| | - Maria José Villegas
- Hematology Service. Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain
| | - Sonia Campo
- Hematology Service. Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain
| | - Eva Ayllon
- Hematology Service. Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain
| | - Tomás Ruiz Albi
- Pneumology Service, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain
| | - Julio de Frutos Arribas
- Pneumology Service, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain; Deparment of Medicine, Dermatology and Toxicology, School of Medicine, University of Valladolid, Av. Ramón y Cajal, 7, 47005 Valladolid, Spain
| | - Ainhoa Arroyo Domingo
- Pneumology Service, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain
| | - Jesica Abadia-Otero
- Internal Medicine Service, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain
| | - Julia Gómez Barquero
- Internal Medicine Service, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain
| | - Wysali Trapiello
- Clinical Analysis Service. Hospital Clínico Universitario de Valladolid, Gerencia Regional de Salud de Castilla y León, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain
| | - Luis Javier Garcia Frade
- Hematology Service. Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain
| | - Luis Inglada
- Internal Medicine Service, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain
| | - Felix Del Campo
- Pneumology Service, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain; Deparment of Medicine, Dermatology and Toxicology, School of Medicine, University of Valladolid, Av. Ramón y Cajal, 7, 47005 Valladolid, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain
| | - Jesús F Bermejo-Martin
- Group for Biomedical Research in Sepsis (BioSepsis). Instituto de Investigación Biomédica de Salamanca, (IBSAL), Gerencia Regional de Salud de Castilla y León, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain; Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain; Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León, Calle Dulzaina, 2, 47012 Valladolid, Spain.
| | - Ferran Barbé
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain; Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRB Lleida, Av. Alcalde Rovira Roure, 80, 25198 Lleida Spain
| | - Antoni Torres
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain; Department of Pulmonology, Hospital Clinic de Barcelona, Universidad de Barcelona, Institut D investigacions August Pi I Sunyer (IDIBAPS), Carrer del Rosselló, 149, 08036 Barcelona, Spain; Catalan Institution for Research and Advanced Studies, Passeig de Lluís Companys, 23, 08010 Barcelona, Spain
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García-Hidalgo MC, González J, Benítez ID, Carmona P, Santisteve S, Moncusí-Moix A, Gort-Paniello C, Rodríguez-Jara F, Molinero M, Perez-Pons M, Torres G, Caballero J, Barberà C, Tedim AP, Almansa R, Ceccato A, Fernández-Barat L, Ferrer R, Garcia-Gasulla D, Menéndez R, Motos A, Peñuelas O, Riera J, Bermejo-Martin JF, Torres A, Barbé F, de Gonzalo-Calvo D. Proteomic profiling of lung diffusion impairment in the recovery stage of SARS-CoV-2-induced ARDS. Clin Transl Med 2022; 12:e838. [PMID: 35538880 PMCID: PMC9091985 DOI: 10.1002/ctm2.838] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/04/2022] [Accepted: 04/08/2022] [Indexed: 12/19/2022] Open
Affiliation(s)
- María C García-Hidalgo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Jessica González
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Iván D Benítez
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Paola Carmona
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Sally Santisteve
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Anna Moncusí-Moix
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Clara Gort-Paniello
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Fátima Rodríguez-Jara
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Marta Molinero
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Manel Perez-Pons
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Gerard Torres
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Jesús Caballero
- Intensive Care Department, University Hospital Arnau de Vilanova, IRBLleida, Lleida, Spain
| | - Carme Barberà
- Intensive Care Department, University Hospital Santa María, IRBLleida, Lleida, Spain
| | - Ana P Tedim
- Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain.,Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Raquel Almansa
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain.,Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Adrián Ceccato
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Laia Fernández-Barat
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Servei de Pneumologia, Hospital Clinic, Universitat de Barcelona, IDIBAPS, Barcelona, Spain
| | - Ricard Ferrer
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Intensive Care Department, Vall d'Hebron Hospital Universitari, SODIR Research Group, Vall d'Hebron Institut de Recerca (VHIR), Spain
| | | | - Rosario Menéndez
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Pulmonology Service, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Ana Motos
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Servei de Pneumologia, Hospital Clinic, Universitat de Barcelona, IDIBAPS, Barcelona, Spain
| | - Oscar Peñuelas
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Hospital Universitario de Getafe, Madrid, Spain
| | - Jordi Riera
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Intensive Care Department, Vall d'Hebron Hospital Universitari, SODIR Research Group, Vall d'Hebron Institut de Recerca (VHIR), Spain
| | - Jesús F Bermejo-Martin
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain.,Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Antoni Torres
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Servei de Pneumologia, Hospital Clinic, Universitat de Barcelona, IDIBAPS, Barcelona, Spain
| | - Ferran Barbé
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - David de Gonzalo-Calvo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
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Aldoma A, Manuel Sanchez-De-La-Torre M, Gracia-Lavedan E, Benitez ID, Zapater A, Torres G, Sanchez-De-La-Torre A, De Batlle J, Targa A, Minguez O, Pascual L, Cortijo A, Martinez D, Dalmases M, Barbe-Illa F. Long-term effect of obstructive sleep apnea and CPAP treatment on blood pressure control in patients after acute coronary syndrome. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Instituto de Salud Carlos III (ISCIII) (PI10/02763, PI10/02745, PI18/00449, PI19/00907), co-funded by FEDER “Una manera de hacer Europa”, SEPAR, Catalonian Cardiology Society, ResMed Ltd. (Australia), EsteveTeijin (Spain), Oxigen Salud (Spain), Associació Lleidatana de Respiratori (ALLER), CIBERES. MS received financial support from a "Ramón y Cajal" grant (RYC2019-027831-I) from the“Ministerio de Ciencia e Innovación - Agencia Estatal de Investigación” co-funded by the European Social Fund (ESF)/“Investing in your future”. AZ held the predoctoral fellowship “Ajuts 2021 de Promoció de la Recerca en Salut-9ª edició” from IRBLleida/Diputació de Lleida. JdB acknowledges receiving financial support from ISCIII (Miguel Servet 2019: CP19/00108), co-funded by the European Social Fund (ESF), “Investing in your future”.
Rationale
Obstructive sleep apnea (OSA) is prevalent in acute coronary syndrome (ACS) patients and is a cause of secondary hypertension.
Objectives
To evaluate the long-term effects of OSA and CPAP treatment on blood pressure (BP) control in patients discharged after an ACS.
Methods
Post hoc analysis of the ISAACC study included 1803 patients admitted for ACS (NCT01335087). Patients with OSA (apnea-hypopnea index ≥15 events/h) were randomly assigned to receive either CPAP or/and usual care and followed up for one to 5 years. Office BP was determined at each visit.
Measurements and Main Results
We included 596 patients without OSA, 605 patients in the CPAP group, and 602 patients in the usual care group. 52% of the patients had a diagnosis of hypertension at baseline. Median age and body mass index were 59 [52.0;67.0] years and 28.2 [25.6;31.2] kg/m2, respectively. After a median [25th;75th percentile] follow-up of 41.2 [18.3;59.6] months, BP changes were similar between OSA and non-OSA groups. However, we observed an increase in BP in the third tertile of the AHI (AHI>40 events/h) with a maximum difference in mean BP of +3.3 mmHg at 30 months. OSA patients with good CPAP adherence (≥4 hours/night) reduced mean BP after 18 months compared to non-OSA and poor CPAP adherence patients, maximum mean difference (95% CI) of -4.7 (-6.7,-2.7) mmHg. In patients with severe OSA we observed a maximum mean difference of -7.1 (-10.3,-3.8) mmHg.
Conclusions
In patients discharged after an ACS, severe OSA is associated with a long-term increase in BP, which is reduced by good CPAP adherence.
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Affiliation(s)
- A Aldoma
- University Hospital Arnau de Vilanova, Cardiology, Lleida, Spain
| | - M Manuel Sanchez-De-La-Torre
- Group of Precision Medicine in Chronic Diseases, Hospital Arnau de Vilanova-Santa Maria, IRBLleida,, Institut de Recerca Biomedica, Lleida, Spain
| | - E Gracia-Lavedan
- Primary Care Centre DE SANTA MARIA, Group of Precision Medicine in Chronic Diseases, Hospital Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - ID Benitez
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, I, Institut de Recerca Biomedica, Lleida, Spain
| | - A Zapater
- Group of Precision Medicine in Chronic Diseases, Hospital Arnau de Vilanova-Santa Maria, IRBLleida,, Institut de Recerca Biomedica, Lleida, Spain
| | - G Torres
- Group of Precision Medicine in Chronic Diseases, Hospital Arnau de Vilanova-Santa Maria, IRBLleida,, Institut de Recerca Biomedica, Lleida, Spain
| | - A Sanchez-De-La-Torre
- Group of Precision Medicine in Chronic Diseases, Hospital Arnau de Vilanova-Santa Maria, IRBLleida,, Institut de Recerca Biomedica, Lleida, Spain
| | - J De Batlle
- Group of Precision Medicine in Chronic Diseases, Hospital Arnau de Vilanova-Santa Maria, IRBLleida,, Institut de Recerca Biomedica, Lleida, Spain
| | - A Targa
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, I, Institut de Recerca Biomedica, Lleida, Spain
| | - O Minguez
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, I, Institut de Recerca Biomedica, Lleida, Spain
| | - L Pascual
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, I, Institut de Recerca Biomedica, Lleida, Spain
| | - A Cortijo
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, I, Institut de Recerca Biomedica, Lleida, Spain
| | - D Martinez
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, I, Institut de Recerca Biomedica, Lleida, Spain
| | - M Dalmases
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, I, Institut de Recerca Biomedica, Lleida, Spain
| | - F Barbe-Illa
- Translation Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, I, Institut de Recerca Biomedica, Lleida, Spain
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Torres G, Diaz F, Okamura Y, Messori S, Hutchison J. The World Organisation for Animal Health - current and potential roles in safe international trade of bees and other insects. REV SCI TECH OIE 2022; 41:211-218. [PMID: 35925621 DOI: 10.20506/rst.41.1.3318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The World Organisation for Animal Health (WOAH, founded as OIE) is the recognised intergovernmental standard-setting organisation for animal health and welfare. The WOAH mandate is to support its members in the prevention of the spread of animal diseases of concern, as listed in the Terrestrial Animal Health Code (Terrestrial Code). Once a disease, infection or infestation is listed, national Veterinary Authorities have the obligation regularly to notify WOAH of the presence or absence of the listed disease. In regard to insects, the scope of the Terrestrial Code limits its recommendations to preserving the health of bees (species of the genus Apis, extended to the genus Bombus and to the stingless bees for one disease). However, it does not include standards to mitigate the potential animal health risks associated with the international trade of other insects. A description of the standard-setting process and a review of the history of the standards for bee health highlight the resources and requirements to expand the scope of the Terrestrial Code to include recommendations for animal health risk mitigation measures for the safety of international trade in insects. Any initiative to develop guidance on insect trade should include WOAH in its role as the sole global standard-setting organisation on animal health and welfare matters. This aligns with the WOAH commitment to a One Health approach.
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Quinlan MM, Mumford JD, Messori S, Enkerlin WR, Shimura J, Smith L, Dass B, Oliva CF, Nelson C, Chand R, Torres G. Issues and gaps in international guidance and national regulatory systems affecting international live insect trade. REV SCI TECH OIE 2022; 41:198-210. [PMID: 35925620 DOI: 10.20506/rst.41.1.3317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
International trade in live insects involves the shipping of many different species, for various purposes, with a variety of handling requirements regulated by numerous authorities with varying objectives. The diversity of factors at play has both created and been subject to a complex regulatory landscape. A review of global production, shipping and use experiences from a range of perspectives has shown gaps and inconsistencies in international guidance and national implementation. Private carriers add another layer of uncertainty that is disproportionate to risks, resulting in variable practices and charges. Many benefits can come from international trade in insects, including pollinator services, control of pests and of disease vectors, and enhanced international scientific research and innovation. These benefits will be better achieved through a more evidence-based and efficient approach to regulating trade. This change in approach will in turn require an improved and widely accepted risk-management landscape for insect trade.
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Oliva CF, Chand R, Prudhomme J, Messori S, Torres G, Mumford JD, Deme I, Quinlan MM. International live insect trade: a survey of stakeholders. REV SCI TECH OIE 2022; 41:29-65. [PMID: 35925637 DOI: 10.20506/rst.41.1.3302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
There are significant numbers of transboundary shipments of live insects for pollination, pest management, industrial processes, research and other uses, but data collection and analysis have proved difficult. The World Organisation for Animal Health and Collectif TIS (Technique de l'Insecte Stérile), a French think tank, carried out a stakeholder survey to understand the nature of the live insect trade and potential challenges to safety and efficiency. Target respondents had experience in the areas of biocontrol, sterile insect technique, entomological research and regulatory affairs. Although the survey was sent globally, the responses were unintentionally biased towards Europe, where interest is high, since this region is developing a comprehensive framework to promote the use of beneficial insects to replace pesticides. The survey also explored respondents' knowledge of several international agreements on the movement and risk management of beneficial or invasive insects. Knowledge of the various regulations was generally poor, and respondents highlighted a perceived lack of clarity regarding live insect shipments in the existing international regulations and guidelines. Almost two-thirds of participants reported reluctance by carriers to accept live insects for shipment, and three-quarters described occasional to systematic delays that resulted in a reduction of quality or viability. Some respondents reported that they instead hand-carry live insects, mostly in small quantities. Participants described being directly involved in trade covering 70 species of live insects and ticks transported among 37 countries, with volumes ranging from fewer than ten insects to over a million per shipment. Of these, 30% were potential vectors of pathogens to humans or animals, 42% were potential plant pest species (including some used for biocontrol), and 17% were classical biocontrol agents. The results of this survey begin to define the current scope, scale and issues for those involved in shipping live insects and ticks across political boundaries. The survey's aim is to persuade regulatory bodies and shipping operators to facilitate safety, efficiency and consistency in this underdeveloped sector.
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Quinlan MM, Mumford JD, Benedict MQ, Wäckers F, Oliva CF, Wohlfarter M, Smagghe G, Vila E, Klapwijk J, Michaelakis A, Collins CM, Prudhomme J, Torres G, Diaz F, Saul-Gershenz L, Cook K, Verghese A, Sreerama Kumar P. Can there be a common, risk-based framework for decisions around live insect trade? REV SCI TECH OIE 2022; 41:219-227. [PMID: 35925619 DOI: 10.20506/rst.41.1.3319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A network of scientists involved in shipment of live insects has met and generated a series of articles on issues related to live insect transport. The network is diverse, covering large-scale commercial interests, government operated areawide control programmes, biomedical research and many smaller applications, in research, education and private uses. Many insect species have a record of safe transport, pose minimal risks and are shipped frequently between countries. The routine shipments of the most frequently used insect model organism for biomedical research, Drosophila melanogaster, is an example. Successful large scale shipments from commercial biocontrol and pollinator suppliers also demonstrate precedents for low-risk shipment categories, delivered in large volumes to high quality standards. Decision makers need access to more information (publications or official papers) that details actual risks from the insects themselves or their possible contaminants, and should propose proportionate levels of management. There may be harm to source environments when insects are collected directly from the wild, and there may be harm to receiving environments. Several risk frameworks include insects and various international coordinating bodies, with experience of guidance on relevant risks, exist. All stakeholders would benefit from an integrated overview of guidance for insect shipping, with reference to types of risk and categories of magnitude, without trying for a single approach requiring universal agreement. Proposals for managing uncertainty and lack of data for smaller or infrequent shipments, for example, must not disrupt trade in large volumes of live insects, which are already supporting strategic objectives in several sectors.
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Sánchez E, Kerkeni M, Hernández M, Gavaldà R, Rius F, Sauret A, Torres G, Bermúdez-López M, Fernández E, Castro-Boqué E, Purroy F, Mauricio D, Farràs-Sallés C, Buti M, Godoy P, Pamplona R, Lecube A. Weak Association between Skin Autofluorescence Levels and Prediabetes with an ILERVAS Cross-Sectional Study. Nutrients 2022; 14:nu14051102. [PMID: 35268075 PMCID: PMC8912766 DOI: 10.3390/nu14051102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/27/2022] [Accepted: 03/03/2022] [Indexed: 02/04/2023] Open
Abstract
A large body of evidence demonstrates a relationship between hyperglycemia and increased concentrations of advanced glycation end-products (AGEs). However, there is little information about subcutaneous AGE accumulation in subjects with prediabetes, and whether or not this measurement could assist in the diagnosis of prediabetes is unclear. A cross-sectional study was conducted in 4181 middle-aged subjects without diabetes. Prediabetes (n = 1444) was defined as a glycosylated hemoglobin (HbA1c) level between 39 and 47 mmol/mol (5.7 to 6.4%), and skin autofluorescence (SAF) measurement was performed to assess AGEs. A multivariable logistic regression model and receiver operating characteristic curve were used. The cohort consisted of 50.1% women with an age of 57 [52;62] years, a BMI of 28.3 [25.4;31.6] kg/m2, and a prevalence of prediabetes of 34.5%. Participants with prediabetes showed higher SAF than control participants (2.0 [1.7;2.2] vs. 1.9 [1.7;2.2], p < 0.001). However, HbA1c was not significantly correlated with SAF levels (r = 0.026, p = 0.090). In addition, the SAF level was not independently associated with prediabetes (OR = 1.12 (0.96 to 1.30)). Finally, there was no good cutoff point for SAF to identify patients with prediabetes (AUC = 0.52 (0.50 to 0.54), sensitivity = 0.61, and 1-specificity = 0.56). Given all of this evidence, we can conclude that although there is an increase in SAF levels in participants with prediabetes, the applicability and clinical relevance of the results is low in this population.
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Affiliation(s)
- Enric Sánchez
- Endocrinology and Nutrition Department, Diabetes and Metabolism (ODIM) Research Group, University Hospital Arnau de Vilanova, Obesity, IRBLleida, University of Lleida, 25198 Lleida, Spain; (E.S.); (M.H.); (F.R.); (A.S.)
| | - Mohsen Kerkeni
- Laboratory of Research on Biologically Compatible Compounds, Faculty of Dental Medicine, University of Monastir, Monastir 5000, Tunisia;
| | - Marta Hernández
- Endocrinology and Nutrition Department, Diabetes and Metabolism (ODIM) Research Group, University Hospital Arnau de Vilanova, Obesity, IRBLleida, University of Lleida, 25198 Lleida, Spain; (E.S.); (M.H.); (F.R.); (A.S.)
| | - Ricard Gavaldà
- Amalfi Analytics, Polytechnic University of Catalonia, 08034 Barcelona, Spain;
| | - Ferran Rius
- Endocrinology and Nutrition Department, Diabetes and Metabolism (ODIM) Research Group, University Hospital Arnau de Vilanova, Obesity, IRBLleida, University of Lleida, 25198 Lleida, Spain; (E.S.); (M.H.); (F.R.); (A.S.)
| | - Ariadna Sauret
- Endocrinology and Nutrition Department, Diabetes and Metabolism (ODIM) Research Group, University Hospital Arnau de Vilanova, Obesity, IRBLleida, University of Lleida, 25198 Lleida, Spain; (E.S.); (M.H.); (F.R.); (A.S.)
| | - Gerard Torres
- Precision Medicine in Chronic Diseases Group, IRBLleida, 25198 Lleida, Spain;
| | - Marcelino Bermúdez-López
- Vascular and Renal Translational Research Group, IRBLleida, 25198 Lleida, Spain; (M.B.-L.); (E.F.); (E.C.-B.)
- Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), 28029 Madrid, Spain
| | - Elvira Fernández
- Vascular and Renal Translational Research Group, IRBLleida, 25198 Lleida, Spain; (M.B.-L.); (E.F.); (E.C.-B.)
- Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), 28029 Madrid, Spain
| | - Eva Castro-Boqué
- Vascular and Renal Translational Research Group, IRBLleida, 25198 Lleida, Spain; (M.B.-L.); (E.F.); (E.C.-B.)
- Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), 28029 Madrid, Spain
| | - Francisco Purroy
- Stroke Unit, Clinical Neurosciences Group, University Hospital Arnau de Vilanova, IRBLleida, University of Lleida, 25198 Lleida, Spain; (F.P.); (P.G.)
| | - Dídac Mauricio
- Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Biomèdica Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain;
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Cristina Farràs-Sallés
- Applied Epidemiology Research Group, IRBLleida. Unitat de Suport a la Recerca Lleida, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 25198 Lleida, Spain; (C.F.-S.); (M.B.)
| | - Miquel Buti
- Applied Epidemiology Research Group, IRBLleida. Unitat de Suport a la Recerca Lleida, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 25198 Lleida, Spain; (C.F.-S.); (M.B.)
| | - Pere Godoy
- Stroke Unit, Clinical Neurosciences Group, University Hospital Arnau de Vilanova, IRBLleida, University of Lleida, 25198 Lleida, Spain; (F.P.); (P.G.)
| | - Reinald Pamplona
- Department of Experimental Medicine, IRBLleida, University of Lleida, 25198 Lleida, Spain;
| | - Albert Lecube
- Endocrinology and Nutrition Department, Diabetes and Metabolism (ODIM) Research Group, University Hospital Arnau de Vilanova, Obesity, IRBLleida, University of Lleida, 25198 Lleida, Spain; (E.S.); (M.H.); (F.R.); (A.S.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-973-70-51-83; Fax: +34-973-70-51-89
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Zapater A, Benítez ID, Santamaria-Martos F, Pinilla L, Targa A, De Gonzalo-Calvo D, Torres G, Mínguez O, Cortijo A, Dalmases M, Barbé F, Sánchez-de-la-Torre M. Endogenous controls and microRNA profile in female patients with obstructive sleep apnea. Sci Rep 2022; 12:1916. [PMID: 35115631 PMCID: PMC8813920 DOI: 10.1038/s41598-022-05782-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 12/03/2021] [Indexed: 01/07/2023] Open
Abstract
Recent studies have evaluated the potential of circulating microRNAs (miRNAs) as valuable biomarkers for characterizing obstructive sleep apnea (OSA) in males. The potential use of miRNAs as clinical indicators in females is unknown. The objective is to identify a set of miRNAs to be used as endogenous controls (ECs) in female patients with OSA. Then, to analyze differences in the miRNA expression profile between patients with and without OSA. This observational, longitudinal study included 85 females with suspected OSA who underwent a polysomnography. OSA was defined as an apnea hypopnea index ≥ 15 events/h. The study population was stratified into 50 OSA patients and 38 non-OSA patients. Exploratory expression profiling of 188 miRNAs consistent and reliable in plasma was performed in a discovery cohort of 21 patients by TaqMan-Low-Density-Array (TLDA). The best ECs were identified by mean centre + standard deviation normalization and concordance correlation restricted normalization. Differentially expressed candidate miRNAs were selected for RT-qPCR validation in a validation cohort of 64 patients. Three circulating miRNAs (miR-30a-5p, miR-93-3p and miR-532-5p) were identified as most stable for use as ECs. Twenty-seven miRNA candidates were identified as potential biomarkers for OSA screening (p value < 0.025) in the TLDA cohort. However, validation cohort showed no differences in the circulating miRNA profile in female patients with and without OSA. We identified a set of ECs in females with OSA that may contribute to result homogeneity in determining circulating miRNAs. Exploratory analysis did not identify a significantly miRNA profile between female patients with and without OSA.
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Affiliation(s)
- Andrea Zapater
- Precision Medicine in Chronic Diseases, Hospital Universitari Arnau de Vilanova-Santa Maria, IRB Lleida, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Iván D Benítez
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Translational Research in Respiratory Medicine, Hospital Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Fernando Santamaria-Martos
- Translational Research in Respiratory Medicine, Hospital Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Lucía Pinilla
- Precision Medicine in Chronic Diseases, Hospital Universitari Arnau de Vilanova-Santa Maria, IRB Lleida, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Adriano Targa
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Translational Research in Respiratory Medicine, Hospital Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - David De Gonzalo-Calvo
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Translational Research in Respiratory Medicine, Hospital Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Gerard Torres
- Precision Medicine in Chronic Diseases, Hospital Universitari Arnau de Vilanova-Santa Maria, IRB Lleida, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Olga Mínguez
- Translational Research in Respiratory Medicine, Hospital Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Anunciación Cortijo
- Translational Research in Respiratory Medicine, Hospital Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Mireia Dalmases
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Translational Research in Respiratory Medicine, Hospital Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Ferrán Barbé
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Translational Research in Respiratory Medicine, Hospital Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Manuel Sánchez-de-la-Torre
- Precision Medicine in Chronic Diseases, Hospital Universitari Arnau de Vilanova-Santa Maria, IRB Lleida, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain. .,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
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Molinero M, Benítez ID, González J, Gort-Paniello C, Moncusí-Moix A, Rodríguez-Jara F, García-Hidalgo MC, Torres G, Vengoechea JJ, Gómez S, Cabo R, Caballero J, Bermejo-Martin JF, Ceccato A, Fernández-Barat L, Ferrer R, Garcia-Gasulla D, Menéndez R, Motos A, Peñuelas O, Riera J, Torres A, Barbé F, de Gonzalo-Calvo D. Bronchial Aspirate-Based Profiling Identifies MicroRNA Signatures Associated With COVID-19 and Fatal Disease in Critically Ill Patients. Front Med (Lausanne) 2022; 8:756517. [PMID: 35186962 PMCID: PMC8850692 DOI: 10.3389/fmed.2021.756517] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/28/2021] [Indexed: 12/22/2022] Open
Abstract
Background The pathophysiology of COVID-19-related critical illness is not completely understood. Here, we analyzed the microRNA (miRNA) profile of bronchial aspirate (BAS) samples from COVID-19 and non-COVID-19 patients admitted to the ICU to identify prognostic biomarkers of fatal outcomes and to define molecular pathways involved in the disease and adverse events. Methods Two patient populations were included (n = 89): (i) a study population composed of critically ill COVID-19 and non-COVID-19 patients; (ii) a prospective study cohort composed of COVID-19 survivors and non-survivors among patients assisted by invasive mechanical ventilation (IMV). BAS samples were obtained by bronchoaspiration during the ICU stay. The miRNA profile was analyzed using RT-qPCR. Detailed biomarker and bioinformatics analyses were performed. Results The deregulation in five miRNA ratios (miR-122-5p/miR-199a-5p, miR-125a-5p/miR-133a-3p, miR-155-5p/miR-486-5p, miR-214-3p/miR-222-3p, and miR-221-3p/miR-27a-3p) was observed when COVID-19 and non-COVID-19 patients were compared. In addition, five miRNA ratios segregated between ICU survivors and nonsurvivors (miR-1-3p/miR-124-3p, miR-125b-5p/miR-34a-5p, miR-126-3p/miR-16-5p, miR-199a-5p/miR-9-5p, and miR-221-3p/miR-491-5p). Through multivariable analysis, we constructed a miRNA ratio-based prediction model for ICU mortality that optimized the best combination of miRNA ratios (miR-125b-5p/miR-34a-5p, miR-199a-5p/miR-9-5p, and miR-221-3p/miR-491-5p). The model (AUC 0.85) and the miR-199a-5p/miR-9-5p ratio (AUC 0.80) showed an optimal discrimination value and outperformed the best clinical predictor for ICU mortality (days from first symptoms to IMV initiation, AUC 0.73). The survival analysis confirmed the usefulness of the miRNA ratio model and the individual ratio to identify patients at high risk of fatal outcomes following IMV initiation. Functional enrichment analyses identified pathological mechanisms implicated in fibrosis, coagulation, viral infections, immune responses and inflammation. Conclusions COVID-19 induces a specific miRNA signature in BAS from critically ill patients. In addition, specific miRNA ratios in BAS samples hold individual and collective potential to improve risk-based patient stratification following IMV initiation in COVID-19-related critical illness. The biological role of the host miRNA profiles may allow a better understanding of the different pathological axes of the disease.
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Affiliation(s)
- Marta Molinero
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Iván D. Benítez
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Jessica González
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Clara Gort-Paniello
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Anna Moncusí-Moix
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Fátima Rodríguez-Jara
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - María C. García-Hidalgo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Gerard Torres
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - J. J. Vengoechea
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Silvia Gómez
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Ramón Cabo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Jesús Caballero
- Intensive Care Department, University Hospital Arnau de Vilanova, IRBLleida, Lleida, Spain
| | - Jesús F. Bermejo-Martin
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain
- Group for Biomedical Research in Sepsis (BioSepsis), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Adrián Ceccato
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Laia Fernández-Barat
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Servei de Pneumologia, Hospital Clinic, Universitat de Barcelona, IDIBAPS, Barcelona, Spain
| | - Ricard Ferrer
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Intensive Care Department, Vall d'Hebron Hospital Universitari, SODIR Research Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | | | - Rosario Menéndez
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Pulmonology Service, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Ana Motos
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Servei de Pneumologia, Hospital Clinic, Universitat de Barcelona, IDIBAPS, Barcelona, Spain
| | - Oscar Peñuelas
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Hospital Universitario de Getafe, Madrid, Spain
| | - Jordi Riera
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Intensive Care Department, Vall d'Hebron Hospital Universitari, SODIR Research Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Antoni Torres
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Servei de Pneumologia, Hospital Clinic, Universitat de Barcelona, IDIBAPS, Barcelona, Spain
| | - Ferran Barbé
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - David de Gonzalo-Calvo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- *Correspondence: David de Gonzalo-Calvo
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González J, Benítez ID, de Gonzalo-Calvo D, Torres G, de Batlle J, Gómez S, Moncusí-Moix A, Carmona P, Santisteve S, Monge A, Gort-Paniello C, Zuil M, Cabo-Gambín R, Manzano Senra C, Vengoechea Aragoncillo JJ, Vaca R, Minguez O, Aguilar M, Ferrer R, Ceccato A, Fernández L, Motos A, Riera J, Menéndez R, Garcia-Gasulla D, Peñuelas O, Labarca G, Caballero J, Barberà C, Torres A, Barbé F. Impact of time to intubation on mortality and pulmonary sequelae in critically ill patients with COVID-19: a prospective cohort study. Crit Care 2022; 26:18. [PMID: 35012662 PMCID: PMC8744383 DOI: 10.1186/s13054-021-03882-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 12/23/2021] [Indexed: 01/08/2023]
Abstract
Question We evaluated whether the time between first respiratory support and intubation of patients receiving invasive mechanical ventilation (IMV) due to COVID-19 was associated with mortality or pulmonary sequelae.
Materials and methods Prospective cohort of critical COVID-19 patients on IMV. Patients were classified as early intubation if they were intubated within the first 48 h from the first respiratory support or delayed intubation if they were intubated later. Surviving patients were evaluated after hospital discharge.
Results We included 205 patients (140 with early IMV and 65 with delayed IMV). The median [p25;p75] age was 63 [56.0; 70.0] years, and 74.1% were male. The survival analysis showed a significant increase in the risk of mortality in the delayed group with an adjusted hazard ratio (HR) of 2.45 (95% CI 1.29–4.65). The continuous predictor time to IMV showed a nonlinear association with the risk of in-hospital mortality. A multivariate mortality model showed that delay of IMV was a factor associated with mortality (HR of 2.40; 95% CI 1.42–4.1). During follow-up, patients in the delayed group showed a worse DLCO (mean difference of − 10.77 (95% CI − 18.40 to − 3.15), with a greater number of affected lobes (+ 1.51 [95% CI 0.89–2.13]) and a greater TSS (+ 4.35 [95% CI 2.41–6.27]) in the chest CT scan. Conclusions Among critically ill patients with COVID-19 who required IMV, the delay in intubation from the first respiratory support was associated with an increase in hospital mortality and worse pulmonary sequelae during follow-up. Supplementary Information The online version contains supplementary material available at 10.1186/s13054-021-03882-1.
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Affiliation(s)
- Jessica González
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain.,Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain.,Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Iván D Benítez
- Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain.,Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - David de Gonzalo-Calvo
- Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain.,Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Gerard Torres
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain.,Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain.,Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Jordi de Batlle
- Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain.,Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Silvia Gómez
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain.,Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain.,Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Anna Moncusí-Moix
- Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain.,Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Paola Carmona
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain.,Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain.,Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Sally Santisteve
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain.,Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain.,Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Aida Monge
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain.,Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain.,Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Clara Gort-Paniello
- Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain.,Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - María Zuil
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain.,Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain.,Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Ramón Cabo-Gambín
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain.,Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain.,Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Carlos Manzano Senra
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain.,Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain.,Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - José Javier Vengoechea Aragoncillo
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain.,Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain.,Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Rafaela Vaca
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain.,Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain
| | - Olga Minguez
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain.,Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain
| | - María Aguilar
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain.,Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain
| | - Ricard Ferrer
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Intensive Care Department, Vall d'Hebron Hospital Universitari, Barcelona, Spain.,SODIR Research Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Adrián Ceccato
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Laia Fernández
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Pulmonary Department, Hospital Clinic, Universitat de Barcelona. IDIBAPS. ICREA, Barcelona, Spain
| | - Ana Motos
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Pulmonary Department, Hospital Clinic, Universitat de Barcelona. IDIBAPS. ICREA, Barcelona, Spain
| | - Jordi Riera
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Intensive Care Department, Vall d'Hebron Hospital Universitari, Barcelona, Spain.,SODIR Research Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Rosario Menéndez
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,University and Polytechnic Hospital La Fe, Valencia, Spain
| | | | - Oscar Peñuelas
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Hospital Universitario de Getafe, Madrid, Spain
| | - Gonzalo Labarca
- Faculty of Medicine, University of Concepcion, Concepción, Chile.,Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, University of Concepcion, Concepción, Chile
| | - Jesús Caballero
- Intensive Care Department, Hospital Universitari Arnau de Vilanova de Lleida, IRBLleida, Lleida, Spain
| | - Carme Barberà
- Intensive Care Department, Hospital Universitari Santa Maria de Lleida, Lleida, Spain
| | - Antoni Torres
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.,Pulmonary Department, Hospital Clinic, Universitat de Barcelona. IDIBAPS. ICREA, Barcelona, Spain
| | - Ferran Barbé
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain. .,Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain. .,Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain. .,CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.
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Dakterzada F, Targa A, Benitez ID, Torres G, ElKhayat LR, Moncusi A, Huerto R, Barbe F, Piñol‐Ripoll G. Endogenous control miRNAs for normalization in plasma samples of Alzheimer’s disease patients from a discovery and validation cohort. Alzheimers Dement 2021. [DOI: 10.1002/alz.053025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Faride Dakterzada
- Hospital Universitari Santa Maria Lleida, Cognitive Impairment Unit Lleida Spain
| | - Adriano Targa
- IRB Lleida, Group of Translational Research in Respiratory Medicine Lleida Spain
| | - Ivan David Benitez
- IRB Lleida, Group of Translational Research in Respiratory Medicine Lleida Spain
| | - Gerard Torres
- Hospital Universitari Santa Maria Lleida Lleida Spain
| | | | - Anna Moncusi
- Group of Translational Research in Respiratory Medicine Lleida Spain
| | - Raquel Huerto
- Cognitive Disorder Unit, Hospital Universitari Santa Maria Lleida Spain
| | - Ferran Barbe
- Hospital Universitari Santa Maria Lleida, Lleida Spain
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42
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Zuil M, Benítez ID, Cabo-Gambín R, Manzano Senra C, Moncusí-Moix A, Gort-Paniello C, de Gonzalo-Calvo D, Molinero M, Vengoechea Aragoncillo JJ, Comella T, de Batlle J, Torres G, Torres A, Barbé F, González J. Clinical management and outcome differences between first and second waves among COVID-19 hospitalized patients: A regional prospective observational cohort. PLoS One 2021; 16:e0258918. [PMID: 34710120 PMCID: PMC8553128 DOI: 10.1371/journal.pone.0258918] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/07/2021] [Indexed: 01/08/2023] Open
Abstract
The objective was to describe the clinical characteristics and outcomes of hospitalized COVID-19 patients during the two different epidemic periods. Prospective, observational, cohort study of hospitalized COVID-19. A total of 421 consecutive patients were included, 188 during the first period (March-May 2020) and 233 in the second wave (July-December 2020). Clinical, epidemiological, prognostic and therapeutic data were compared. Patients of the first outbreak were older and more comorbid, presented worse PaO2/FiO2 ratio and an increased creatinine and D-dimer levels at hospital admission. The hospital stay was shorter (14.5[8;29] vs 8[6;14] days, p<0.001), ICU admissions (31.9% vs 13.3%, p<0.001) and the number of patients who required mechanical ventilation (OR = 0.12 [0.05-10.26]; p<0.001) were reduced. There were no significant differences in hospital and 30-day after discharge mortality (adjusted HR = 1.56; p = 0.1056) or hospital readmissions. New treatments and clinical strategies appear to improve hospital length, ICU admissions and the requirement for mechanical ventilation. However, we did not observe differences in mortality or readmissions.
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Affiliation(s)
- María Zuil
- Group of Translational Research in Respiratory Medicine, IRBLleida, Hospital Universitari Arnau de Vilanova and Santa Maria, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Lleida, Spain
| | - Iván D. Benítez
- Group of Translational Research in Respiratory Medicine, IRBLleida, Hospital Universitari Arnau de Vilanova and Santa Maria, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Ramón Cabo-Gambín
- Group of Translational Research in Respiratory Medicine, IRBLleida, Hospital Universitari Arnau de Vilanova and Santa Maria, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Lleida, Spain
| | - Carlos Manzano Senra
- Group of Translational Research in Respiratory Medicine, IRBLleida, Hospital Universitari Arnau de Vilanova and Santa Maria, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Lleida, Spain
| | - Anna Moncusí-Moix
- Group of Translational Research in Respiratory Medicine, IRBLleida, Hospital Universitari Arnau de Vilanova and Santa Maria, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Clara Gort-Paniello
- Group of Translational Research in Respiratory Medicine, IRBLleida, Hospital Universitari Arnau de Vilanova and Santa Maria, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - David de Gonzalo-Calvo
- Group of Translational Research in Respiratory Medicine, IRBLleida, Hospital Universitari Arnau de Vilanova and Santa Maria, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Marta Molinero
- Group of Translational Research in Respiratory Medicine, IRBLleida, Hospital Universitari Arnau de Vilanova and Santa Maria, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Jose Javier Vengoechea Aragoncillo
- Group of Translational Research in Respiratory Medicine, IRBLleida, Hospital Universitari Arnau de Vilanova and Santa Maria, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Lleida, Spain
| | - Thais Comella
- Group of Translational Research in Respiratory Medicine, IRBLleida, Hospital Universitari Arnau de Vilanova and Santa Maria, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Lleida, Spain
| | - Jordi de Batlle
- Group of Translational Research in Respiratory Medicine, IRBLleida, Hospital Universitari Arnau de Vilanova and Santa Maria, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Gerard Torres
- Group of Translational Research in Respiratory Medicine, IRBLleida, Hospital Universitari Arnau de Vilanova and Santa Maria, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Antoni Torres
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Pulmonary Department, Hospital Clinic, Universitat de Barcelona, IDIBAPS, ICREA, Barcelona, Spain
| | - Ferrán Barbé
- Group of Translational Research in Respiratory Medicine, IRBLleida, Hospital Universitari Arnau de Vilanova and Santa Maria, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Jessica González
- Group of Translational Research in Respiratory Medicine, IRBLleida, Hospital Universitari Arnau de Vilanova and Santa Maria, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
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de Gonzalo-Calvo D, Benítez ID, Pinilla L, Carratalá A, Moncusí-Moix A, Gort-Paniello C, Molinero M, González J, Torres G, Bernal M, Pico S, Almansa R, Jorge N, Ortega A, Bustamante-Munguira E, Gómez JM, González-Rivera M, Micheloud D, Ryan P, Martinez A, Tamayo L, Aldecoa C, Ferrer R, Ceccato A, Fernández-Barat L, Motos A, Riera J, Menéndez R, Garcia-Gasulla D, Peñuelas O, Torres A, Bermejo-Martin JF, Barbé F. Circulating microRNA profiles predict the severity of COVID-19 in hospitalized patients. Transl Res 2021; 236:147-159. [PMID: 34048985 PMCID: PMC8149473 DOI: 10.1016/j.trsl.2021.05.004] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/04/2021] [Accepted: 05/20/2021] [Indexed: 12/13/2022]
Abstract
We aimed to examine the circulating microRNA (miRNA) profile of hospitalized COVID-19 patients and evaluate its potential as a source of biomarkers for the management of the disease. This was an observational and multicenter study that included 84 patients with a positive nasopharyngeal swab Polymerase chain reaction (PCR) test for SARS-CoV-2 recruited during the first pandemic wave in Spain (March-June 2020). Patients were stratified according to disease severity: hospitalized patients admitted to the clinical wards without requiring critical care and patients admitted to the intensive care unit (ICU). An additional study was completed including ICU nonsurvivors and survivors. Plasma miRNA profiling was performed using reverse transcription polymerase quantitative chain reaction (RT-qPCR). Predictive models were constructed using least absolute shrinkage and selection operator (LASSO) regression. Ten circulating miRNAs were dysregulated in ICU patients compared to ward patients. LASSO analysis identified a signature of three miRNAs (miR-148a-3p, miR-451a and miR-486-5p) that distinguishes between ICU and ward patients [AUC (95% CI) = 0.89 (0.81-0.97)]. Among critically ill patients, six miRNAs were downregulated between nonsurvivors and survivors. A signature based on two miRNAs (miR-192-5p and miR-323a-3p) differentiated ICU nonsurvivors from survivors [AUC (95% CI) = 0.80 (0.64-0.96)]. The discriminatory potential of the signature was higher than that observed for laboratory parameters such as leukocyte counts, C-reactive protein (CRP) or D-dimer [maximum AUC (95% CI) for these variables = 0.73 (0.55-0.92)]. miRNA levels were correlated with the duration of ICU stay. Specific circulating miRNA profiles are associated with the severity of COVID-19. Plasma miRNA signatures emerge as a novel tool to assist in the early prediction of vital status deterioration among ICU patients.
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Key Words
- auc, area under the roc curve
- crp, c-reactive protein
- cq, quantification cycle
- icu, intensive care unit
- lasso, least absolute shrinkage and selection operator
- ldh, lactate dehydrogenase
- mirna, microrna
- mse, mean square error
- ncrna, noncoding rna
- pca, principal component analysis
- roc, receiver operating characteristic
- rt, reverse transcription
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Affiliation(s)
- David de Gonzalo-Calvo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Iván D Benítez
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Lucía Pinilla
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Amara Carratalá
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Anna Moncusí-Moix
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Clara Gort-Paniello
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Marta Molinero
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Jessica González
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain
| | - Gerard Torres
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - María Bernal
- Laboratory Medicine Department, University Hospital Arnau de Vilanova, Lleida, Spain
| | - Silvia Pico
- Laboratory Medicine Department, University Hospital Arnau de Vilanova, Lleida, Spain
| | - Raquel Almansa
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Noelia Jorge
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Alicia Ortega
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | | | | | | | | | - Pablo Ryan
- Hospital Universitario Infanta Leonor, Madrid, Spain
| | | | - Luis Tamayo
- Hospital Universitario Río Hortega, Valladolid, Spain
| | - César Aldecoa
- Hospital Universitario Río Hortega, Valladolid, Spain
| | - Ricard Ferrer
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Intensive Care Department, Vall d'Hebron Hospital Universitari. SODIR Research Group, Vall d'Hebron Institut de Recerca (VHIR), Spain
| | - Adrián Ceccato
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Laia Fernández-Barat
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Servei de Pneumologia, Hospital Clinic. Universitat de Barcelona. IDIBAPS, Barcelona, Spain
| | - Ana Motos
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Servei de Pneumologia, Hospital Clinic. Universitat de Barcelona. IDIBAPS, Barcelona, Spain
| | - Jordi Riera
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Intensive Care Department, Vall d'Hebron Hospital Universitari. SODIR Research Group, Vall d'Hebron Institut de Recerca (VHIR), Spain
| | - Rosario Menéndez
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Pulmonology Service, University and Polytechnic Hospital La Fe, Valencia, Spain
| | | | - Oscar Peñuelas
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Hospital Universitario de Getafe, Madrid, Spain
| | - Antoni Torres
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Servei de Pneumologia, Hospital Clinic. Universitat de Barcelona. IDIBAPS, Barcelona, Spain
| | - Jesús F Bermejo-Martin
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Ferran Barbé
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.
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Dakterzada F, David Benítez I, Targa A, Lladó A, Torres G, Romero L, de Gonzalo-Calvo D, Moncusí-Moix A, Tort-Merino A, Huerto R, Sánchez-de-la-Torre M, Barbé F, Piñol-Ripoll G. Reduced Levels of miR-342-5p in Plasma Are Associated With Worse Cognitive Evolution in Patients With Mild Alzheimer's Disease. Front Aging Neurosci 2021; 13:705989. [PMID: 34497505 PMCID: PMC8421031 DOI: 10.3389/fnagi.2021.705989] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/26/2021] [Indexed: 12/28/2022] Open
Abstract
Background Progressive cognitive decline is the most relevant clinical symptom of Alzheimer’s disease (AD). However, the rate of cognitive decline is highly variable between patients. Synaptic deficits are the neuropathological event most correlated with cognitive impairment in AD. Considering the important role of microRNAs (miRNAs) in regulating synaptic plasticity, our objective was to identify the plasma miRNAs associated with the rate of cognitive decline in patients with mild AD. Methods We analyzed 754 plasma miRNAs from 19 women diagnosed with mild AD using TaqMan low-density array cards. The patients were grouped based on the rate of decline in the MMSE score after 2 years [<4 points (N = 11) and ≥4 points (N = 8)]. The differentially expressed miRNAs between the two groups were validated in an independent cohort of men and women (N = 53) with mild AD using RT-qPCR. Results In the discovery cohort, 17 miRNAs were differentially expressed according to the fold change between patients with faster declines in cognition and those with slower declines. miR-342-5p demonstrated differential expression between the groups and a good correlation with the rate of cognitive decline in the validation cohort (r = −0.28; p = 0.026). This miRNA had a lower expression level in patients who suffered from more severe decline than in those who were cognitively more stable after 2 years (p = 0.049). Conclusion Lower levels of miR-342-5p in plasma were associated with faster cognitive decline in patients with mild AD after 2 years of follow-up.
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Affiliation(s)
- Farida Dakterzada
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, Santa Maria University Hospital, IRBLleida, Lleida, Spain
| | - Iván David Benítez
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Adriano Targa
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Albert Lladó
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Department, Hospital Clínic, Institut D'Investigacion Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Gerard Torres
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Leila Romero
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, Santa Maria University Hospital, IRBLleida, Lleida, Spain
| | - David de Gonzalo-Calvo
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Anna Moncusí-Moix
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Adria Tort-Merino
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Department, Hospital Clínic, Institut D'Investigacion Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Raquel Huerto
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, Santa Maria University Hospital, IRBLleida, Lleida, Spain
| | - Manuel Sánchez-de-la-Torre
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain.,Group of Precision Medicine in Chronic Diseases, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - Ferran Barbé
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Gerard Piñol-Ripoll
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, Santa Maria University Hospital, IRBLleida, Lleida, Spain
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Colomina J, Drudis R, Torra M, Pallisó F, Massip M, Vargiu E, Nadal N, Fuentes A, Ortega Bravo M, Miralles F, Barbé F, Torres G, de Batlle J. Implementing mHealth-Enabled Integrated Care for Complex Chronic Patients With Osteoarthritis Undergoing Primary Hip or Knee Arthroplasty: Prospective, Two-Arm, Parallel Trial. J Med Internet Res 2021; 23:e28320. [PMID: 34473068 PMCID: PMC8446839 DOI: 10.2196/28320] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/17/2021] [Accepted: 06/14/2021] [Indexed: 01/19/2023] Open
Abstract
Background Osteoarthritis is a disabling condition that is often associated with other comorbidities. Total hip or knee arthroplasty is an effective surgical treatment for osteoarthritis when indicated, but comorbidities can impair their results by increasing complications and social and economic costs. Integrated care (IC) models supported by eHealth can increase efficiency through defragmentation of care and promote patient-centeredness. Objective This study aims to assess the effectiveness and cost-effectiveness of implementing a mobile health (mHealth)–enabled IC model for complex chronic patients undergoing primary total hip or knee arthroplasty. Methods As part of the Horizon 2020 Personalized Connected Care for Complex Chronic Patients (CONNECARE) project, a prospective, pragmatic, two-arm, parallel implementation trial was conducted in the rural region of Lleida, Catalonia, Spain. For 3 months, complex chronic patients undergoing total hip or knee arthroplasty and their caregivers received the combined benefits of the CONNECARE organizational IC model and the eHealth platform supporting it, consisting of a patient self-management app, a set of integrated sensors, and a web-based platform connecting professionals from different settings, or usual care (UC). We assessed changes in health status (12-item short-form survey [SF-12]), unplanned visits and admissions during a 6-month follow-up, and the incremental cost-effectiveness ratio. Results A total of 29 patients were recruited for the mHealth-enabled IC arm, and 30 patients were recruited for the UC arm. Both groups were statistically comparable for baseline characteristics, such as age; sex; type of arthroplasty; and Charlson index, American Society of Anesthesiologists classification, Barthel index, Hospital Anxiety and Depression scale, Western Ontario and McMaster Universities Osteoarthritis Index, and Pfeiffer mental status questionnaire scores. Patients in both groups had significant increases in the SF-12 physical domain and total SF-12 score, but differences in differences between the groups were not statistically significant. IC patients had 50% fewer unplanned visits (P=.006). Only 1 hospital admission was recorded during the follow-up (UC arm). The IC program generated savings in different cost scenarios, and the incremental cost-effectiveness ratio demonstrated cost-effectiveness. Conclusions Chronic patients undergoing hip or knee arthroplasty can benefit from the implementation of patient-centered mHealth-enabled IC models aimed at empowering patients and facilitating transitions from specialized hospital care to primary care. Such models can reduce unplanned contacts with the health system and reduce overall health costs, proving to be cost-effective. Overall, our findings support the notion of system-wide cross-organizational care pathways supported by mHealth as a successful way to implement IC for patients undergoing elective surgery.
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Affiliation(s)
- Jordi Colomina
- Servei de Cirurgia Ortopèdica i Traumatologia, Hospital Universitari de Santa Maria de Lleida, Universitat de Lleida, Lleida, Spain
| | - Reis Drudis
- Servei Anestesiologia Reanimació i Clínica del Dolor, Hospital Universitari de Santa Maria de Lleida, Universitat de Lleida, Lleida, Spain
| | - Montserrat Torra
- Servei Anestesiologia Reanimació i Clínica del Dolor, Hospital Universitari de Santa Maria de Lleida, Universitat de Lleida, Lleida, Spain
| | - Francesc Pallisó
- Servei de Cirurgia Ortopèdica i Traumatologia, Hospital Universitari de Santa Maria de Lleida, Universitat de Lleida, Lleida, Spain
| | - Mireia Massip
- Group of Translational Research in Respiratory Medicine, Institut de Recerca Biomedica de Lleida (IRBLleida), Lleida, Spain
| | - Eloisa Vargiu
- eHealth Unit, Eurecat Centre Tecnòlogic de Catalunya, Barcelona, Spain
| | - Nuria Nadal
- Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain
| | - Araceli Fuentes
- Atenció Primària Àmbit Lleida, Institut Català de la Salut, Lleida, Spain
| | - Marta Ortega Bravo
- Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Lleida, Spain.,Centre d'Atenció Primària Cappont, Gerència Territorial de Lleida, Institut Català de la Salut, Barcelona, Spain.,Universitat de Lleida, Lleida, Spain
| | - Felip Miralles
- eHealth Unit, Eurecat Centre Tecnòlogic de Catalunya, Barcelona, Spain
| | - Ferran Barbé
- Group of Translational Research in Respiratory Medicine, Institut de Recerca Biomedica de Lleida (IRBLleida), Lleida, Spain.,Center for Biomedical Network Research in Respiratory Diseases (CIBERES), Madrid, Spain
| | - Gerard Torres
- Group of Translational Research in Respiratory Medicine, Institut de Recerca Biomedica de Lleida (IRBLleida), Lleida, Spain.,Center for Biomedical Network Research in Respiratory Diseases (CIBERES), Madrid, Spain
| | - Jordi de Batlle
- Group of Translational Research in Respiratory Medicine, Institut de Recerca Biomedica de Lleida (IRBLleida), Lleida, Spain.,Center for Biomedical Network Research in Respiratory Diseases (CIBERES), Madrid, Spain
| | -
- see Authors' Contributions,
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Abstract
Background The relationship between acute:chronic workload ratios (ACWR) and the incidence of injury, as well as the relationship between subjective wellness scores and training load, is unclear in hockey players. Objectives This study investigated these relationships to determine if the ACWR is a useful workload management tool for field hockey players. In addition, the study investigated the association between specific subjective wellness scores (fatigue, sleep quality, general muscle soreness, mood and stress level) and the acute:chronic workload ratio and training load. The study also assessed the association between individual players' training loads with the self-reported wellness scores. Methods Fourteen male field hockey players from the men's first team at the University of the Witwatersrand participated in the study over ten weeks during a premier league competition phase. A Google form was completed within thirty minutes of every training session/match. This form consisted of questions that allowed for the calculation of the ACWR. Results No incidence of injury was reported during the ten-week period. ACWR scores ranged between 0.67 and 1.87. The ACWR was associated with general muscle soreness (p = 0.010) and training load was associated with fatigue (p = 0.002), sleep quality (p = 0.05), general muscle soreness (p = 0.004), and mood (p=0.025). Conclusion There may be some merit in the use of subjective wellness measures as workload management tools in field hockey. Further research is required to determine if there is an optimal ACWR for this sport.
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Affiliation(s)
- GN Veiga
- Centre for Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - G Torres
- Centre for Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - I Maposa
- Division of Epidemiology and Biostatistics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Cabo-Gambin R, Benítez ID, Carmona P, Santiesteve S, Mínguez O, Vaca R, Moncusí-Moix A, Gort-Paniello C, García-Hidalgo MC, de Gonzalo-Calvo D, de Batlle J, Torres G, Torres A, Barbé F, González J. Three to Six Months Evolution of Pulmonary Function and Radiological Features in Critical COVID-19 Patients: A Prospective Cohort. Arch Bronconeumol 2021; 58:S0300-2896(21)00208-8. [PMID: 35312604 PMCID: PMC8313896 DOI: 10.1016/j.arbres.2021.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 01/12/2023]
Key Words
- ards, acute respiratory distress syndrome
- covid-19, coronavirus disease 2019
- ct, computed tomography
- dlco, diffusing capacity for carbon monoxide
- fev1, forced expiratory volume during the first second of the forced breath
- fvc, forced vital capacity
- ggo, ground-glass opacities
- icu, intensive care unit
- imv, invasive mechanical ventilation
- sars-cov-2, severe acute respiratory syndrome coronavirus 2
- tlc, total lung capacity
- tss, total severity score
- 6mwt, 6 minutes walking test
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Affiliation(s)
- Ramón Cabo-Gambin
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain; Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Iván D Benítez
- Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Paola Carmona
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain; Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Sally Santiesteve
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain; Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Olga Mínguez
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain; Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Rafaela Vaca
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain; Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Anna Moncusí-Moix
- Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Clara Gort-Paniello
- Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - María C García-Hidalgo
- Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain
| | - David de Gonzalo-Calvo
- Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Jordi de Batlle
- Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Gerard Torres
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain; Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Antoni Torres
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Pulmonary Department, Hospital Clínic, Universitat de Barcelona, IDIBAPS, ICREA, Barcelona, Spain
| | - Ferran Barbé
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain; Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Jessica González
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain; Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.
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48
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Sánchez-de-la-Torre M, Benítez ID, Zapater A, Torres G, Sánchez-de-la-Torre A, Barbé F. Reply to Sankari: Does Heart Rate Play a Role in Cardiovascular Outcome in Patients with Obstructive Sleep Apnea? Am J Respir Crit Care Med 2021; 203:1202-1203. [PMID: 33606961 PMCID: PMC8314898 DOI: 10.1164/rccm.202101-0188le] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Manuel Sánchez-de-la-Torre
- IRBLleida Lleida, Spain and.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES) Madrid, Spain
| | - Ivan David Benítez
- IRBLleida Lleida, Spain and.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES) Madrid, Spain
| | - Andrea Zapater
- IRBLleida Lleida, Spain and.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES) Madrid, Spain
| | - Gerard Torres
- IRBLleida Lleida, Spain and.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES) Madrid, Spain
| | - Alicia Sánchez-de-la-Torre
- IRBLleida Lleida, Spain and.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES) Madrid, Spain
| | - Ferran Barbé
- IRBLleida Lleida, Spain and.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES) Madrid, Spain
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Dutra EC, Cowan J, Cunningham T, Durand AM, Emig J, Heeter RF, Knauer J, Knight RA, Lara R, Perry TS, Rodriguez Z, Torres G, Wallace MS. Characterization of Agfa Structurix series D4 and D3sc x-ray films in the 0.7-4.6 keV energy range. Rev Sci Instrum 2021; 92:075103. [PMID: 34340426 DOI: 10.1063/5.0043814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/08/2021] [Indexed: 06/13/2023]
Abstract
X-ray films remain a key asset for high-resolution x-ray spectral imaging in high-energy-density experiments conducted at the National Ignition Facility (NIF). The soft x-ray Opacity Spectrometer (OpSpec) fielded at the NIF has an elliptically shaped crystal design that measures x rays in the 900-2100 eV range and currently uses an image plate as the detecting medium. However, Agfa D4 and D3sc x-ray films' higher spatial resolution provides increased spectral resolution to the data over the IP-TR image plates, driving the desire for regular use of x-ray film as a detecting medium. The calibration of Agfa D4 x-ray film for use in the OpSpec is communicated here. These calibration efforts are vital to the accuracy of the NIF opacity measurements and are conducted in a previously un-studied x-ray energy range under a new film development protocol required by NIF. The absolute response of Agfa D4 x-ray film from 705 to 4620 eV has been measured using the Nevada National Security Site Manson x-ray source. A broader range of energies was selected to compare results with previously published data. The measurements were taken using selected anodes, filters, and applied voltages to produce well-defined energy lines.
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Affiliation(s)
- E C Dutra
- Nevada National Security Site, Livermore Operations, Livermore, California 94550, USA
| | - J Cowan
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - T Cunningham
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - A M Durand
- Nevada National Security Site, Livermore Operations, Livermore, California 94550, USA
| | - J Emig
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R F Heeter
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Knauer
- University of Rochester, Rochester, New York 14623, USA
| | - R A Knight
- Nevada National Security Site, Livermore Operations, Livermore, California 94550, USA
| | - R Lara
- Nevada National Security Site, Livermore Operations, Livermore, California 94550, USA
| | - T S Perry
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - Z Rodriguez
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - G Torres
- Nevada National Security Site, Livermore Operations, Livermore, California 94550, USA
| | - M S Wallace
- Nevada National Security Site, Livermore Operations, Livermore, California 94550, USA
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50
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Pinilla L, Benitez ID, González J, Torres G, Barbé F, de Gonzalo-Calvo D. Peripheral blood microRNAs and the COVID-19 patient: methodological considerations, technical challenges and practice points. RNA Biol 2021; 18:688-695. [PMID: 33530819 PMCID: PMC8078525 DOI: 10.1080/15476286.2021.1885188] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 01/30/2021] [Indexed: 02/06/2023] Open
Abstract
The COVID-19 emergency pandemic resulting from infection with SARS-CoV-2 represents a major threat to public health worldwide. There is an urgent clinical demand for easily accessible tools to address weaknesses and gaps in the management of COVID-19 patients. In this context, transcriptomic profiling of liquid biopsies, especially microRNAs (miRNAs), has recently emerged as a robust source of potential clinical indicators for medical decision-making. Nevertheless, the analysis of the circulating miRNA signature and its translation to clinical practice requires strict control of a wide array of methodological details. In this review, we indicate the main methodological aspects that should be addressed when evaluating the circulating miRNA profiles in COVID-19 patients, from preanalytical and analytical variables to the experimental design, impact of confounding, analysis of the data and interpretation of the findings, among others. Additionally, we provide practice points to ensure the rigour and reproducibility of miRNA-based biomarker investigations of this condition.Abbreviations: ACE: angiotensin-converting enzyme; ARDS: acute respiratory distress syndrome; COVID-19: coronavirus disease 2019; ERDN: early Detection Research Network; LMWH: low molecular weight heparin; miRNA: microRNA; ncRNA: noncoding RNA; SARS-CoV-2: severe acute respiratory syndrome coronavirus-2; SOP: standard operating procedure.
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Affiliation(s)
- Lucía Pinilla
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Ivan D. Benitez
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Jessica González
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Respiratory Department, University Hospital Arnau de Vilanova-Santa María, Translational Research in Respiratory Medicine, IRBLleida, University of Lleida, Lleida, Spain
| | - Gerard Torres
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- Respiratory Department, University Hospital Arnau de Vilanova-Santa María, Translational Research in Respiratory Medicine, IRBLleida, University of Lleida, Lleida, Spain
| | - Ferran Barbé
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
- Respiratory Department, University Hospital Arnau de Vilanova-Santa María, Translational Research in Respiratory Medicine, IRBLleida, University of Lleida, Lleida, Spain
| | - David de Gonzalo-Calvo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
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