Let’s read an article a month – October 2021

The cropped screenshot of the first page of the article. It also includes the URL or link to the article.

Every month I try to read an open-access article. After reading the article, I share the title and associated link with my followers. This is to encourage clinicians to read articles, stay up to date, and continue to grow.

The objective of this paper is to “evaluate respiratory function 4 months after diagnosis in patients who survive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the difference between patients with or without initial lung involvement” (p1).


Medium-term impact of COVID-19 on pulmonary function, functional capacity and quality of life

By: Fabio Anastasio, Sarah Barbuto, Elisa Scarnecchia, Paolo Cosma, Alessandro Fugagnoli, Giulio Rossi, Mirco Parravicini, and Pierpaolo Parravicini.

European Respiratory Journal 2021 58: 2004015; DOI: 10.1183/13993003.04015-2020

Link to the article: https://erj.ersjournals.com/content/58/3/2004015?etoc


Reasons I liked this article

  • The age range for this study was 18 to 80 years old (p2).  Also, a detailed assessment was attained from the subjects, of course post infection, which included SF-12 and IPAQ questionnaires, 6MWT,  and a comprehensive PFT (p2).
  • This study shows “a reduction of respiratory function and exercise capacity secondary to SARS-CoV-2 pneumonia, mostly in patients who developed ARDS during the acute phase” (p9). 
  • The authors suggest that the data may indicate that “respiratory evaluation does not appear to be necessary in patients without pneumonia and without symptoms. DLCO, 6MWT and plethysmography could be avoided in patients without pneumonia, performing only spirometry with bronchodilator responsiveness testing…In contrast, in patients who developed ARDS, DLCO, 6MWT and complete spirometry could uncover presence of residual pulmonary and functional impairment, with need for respiratory rehabilitation and gradual physical activity “ (p10). 

As always, take the time to read this study. There is a lot of information and data covered in the study which I cannot cover here.  As a disclaimer, continue to follow guidelines for ordering PFTs and providing patient care as recommended by your employer and regulatory body.

Happy reading and learning,

Farzad Refahi

October 6th, 2021

https://respiratory.blog/lets-read-an-article-a-month-october-2021/

Let’s read an article a month – September 2021

The cropped screenshot of the first page of the article. It also includes the URL or link to the article.

Every month I try to read an open-access article. After reading the article, I share the title and associated link with my followers. This is to encourage clinicians to read articles, stay up to date, and continue to grow.

This month I found a piece on cardiopulmonary exercise capacity and COVID19 recovery. The objective of this paper is to “determine cardiopulmonary function during exercise 3–4 months after hospital discharge for COVID-19 compared with a reference population and to describe the characteristics of participants with exercise limitations. ” p2.


Cardiopulmonary exercise capacity and limitations 3 months after COVID-19 hospitalisation

By: Ingunn Skjørten, Odd Andre Wathne Ankerstjerne, Divna Trebinjac, Eivind Brønstad, Øystein Rasch-Halvorsen, Gunnar Einvik, Tøri Vigeland Lerum, Knut Stavem, Anne Edvardsen, and Charlotte Björk Ingul

European Respiratory Journal 2021 58: 2100996; DOI: 10.1183/13993003.00996-2021

Link to the article: https://erj.ersjournals.com/content/58/2/2100996?etoc


The reasons I found this article interesting 

  • Regaining exercise capacity after COVID-19 is an important finding (p7).
  • Brings more weight to self-reported dyspnea as it was “associated with lower ventilatory efficiency and lower V′O2peak·kg−1 due to higher BMI” (p7).
  • In order of relevance: deconditioning, circulatory factors, and ventilatory limitation were the top three exercise limitations (p7).

This is a great article so I encourage you to take the time to read it.  

Happy learning and reading!

Farzad Refahi

September 30, 2021

https://respiratory.blog/lets-read-an-article-a-month-september-2021/

Let’s read an article a month – May 2021

The cropped screenshot of the first page of the article. It also includes the URL or link to the article.

Every month I try to read an open-access article. After reading the article, I share the title and associated link with my followers. This is to encourage clinicians to read articles, stay up to date, and continue to grow.

This month I found a great piece to share with you.  This one falls under the infection and lung function categories. The objective of this paper is to “ [assess] patient-reported dyspnoea, lung function, quality of life (QoL) and parenchymal opacities in chest CT scans 3 months after hospital admission for COVID-19 in a prospective, consecutive Norwegian cohort of patients with or without ICU treatment. ” [p2]. 


Dyspnoea, lung function and CT findings 3 months after hospital admission for COVID-19

By: Tøri Vigeland Lerum, Trond Mogens Aaløkken, Eivind Brønstad, Bernt Aarli, Eirik Ikdahl , Kristine Marie Aarberg Lund , Michael T. Durheim, Jezabel Rivero Rodriguez , Carin Meltzer , Kristian Tonby, Knut Stavem, Ole Henning Skjønsberg, Haseem Ashraf and Gunnar Einvik. 

Eur Respir J 2021; 57: 2003448

Link to the pdf/article: https://erj.ersjournals.com/content/erj/57/4/2003448.full.pdf


Why this article caught my attention:

  • It helped me have a better understanding of the recovery process of individuals with COVID19.  There will be a lot of focus on the recovery and rehab of patients once we are done with the peak of this pandemic.  
  • Includes valuable information as it focuses on symptoms and various diagnostic data which includes PFT and CT scans! Check out page 3 and also Table 2 on page 5 for more information

I really hope that more studies like this will be conducted on our COVID19 patients.

How are you preparing for COVID19 Rehab? Which set of data and recommendations are you using?

Happy learning and reading!

Farzad Refahi

May 31st, 2021

Unsure? Get Tested!

A nasopharyngeal swab this past Friday followed the end of my deployment in acute care. A phone call from Markham-Stouffville Hospital confirmed a negative COVID-19 result. I endured 15 seconds of discomfort for a comfortable return to the PFT lab. It was a happy ending to being upfront.

Almost 4 months ago we stopped our pulmonary function testing. I was deployed to the acute care side of the respiratory therapy department. Helping in ICU, Emerg and wards. It was a quick refresher and a dive back to a side of respiratory care that I had not been involved with for almost 6 years.

While my exposure to COVID-19 patients and equipment were with proper PPE utilization, one could never be too sure. At the end of my rotations, and before seeing vulnerable patients in the PFT lab, I decided to get tested.
This is not the first time I have been tested over the last 3 months. With the start of spring, my seasonal allergies became evident. Mornings with red eyes and a runny nose were becoming the new norm for me. At the start of all this, and with these new symptoms, screeners and the occupational health department sent me for testing.

While I was relaxed, comfortable and calm about my recent, second test, the feeling about my first test was not the same. With my first test, I felt almost embarrassed and annoyed. Calling my manager and wondering what my colleagues would think about me being off due to COVID-19 was at the back of my mind. I didn’t want to be known as the person who didn’t use his PPE correctly or be known as the person who got deployed to be helping but now has become a vector. The only reason I am sharing my past false perception and beliefs is to share two points with you. Firstly, of course, you should do your best to follow proper hand hygiene, PPE, social distancing and other recommendations. Even if you have done all of the above correctly, it doesn’t mean that you are 100% protected. Secondly, there is no shame in getting COVID-19. Testing is becoming more readily available, so if you have any concerns that you might have contracted COVID-19, please get tested. It is important not only to look after yourself but also to protect others.

While I work in the healthcare field in Canada, this recommendation extends to all the frontline workers in the world. Thank you for your dedication and service. To those who have followed the recommendations and remained at home, thank you for your team effort. To those who have lost their jobs, became ill with this disease, or lost someone because of it, my heart goes out to you. 2019 and 2020 have been difficult but has shown me that we do great things when we come together. #StrongerTogether.

Farzad Refahi
June 13, 2020
www.respiratory.blog/unsure?-get-tested!/

Right After Getting The Swab