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Preprint ARTICLE | doi:10.20944/preprints202305.1916.v1

Improved Arterial Oxygenation by High Flow Nasal Cannula Oxygen Therapy in Older Patients with Severe Respiratory Failure in a Non-intensive Hospital Ward

Filippo Luca Fimognari, Valentina Bambara, Giuseppe Armentaro, Paola Scarpino, Chiara Settino, Marco Filice, Massimo Rizzo, Angela Sciacqua

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: High flow nasal cannula oxygen therapy; acute respiratory failure; geriatrics; acute non-intensive hospital setting

Online: 26 May 2023 (10:22:17 CEST)

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Preprint REVIEW | doi:10.20944/preprints202305.1889.v1

Clinical Applications of Endobronchial Ultrasound: Challenges and Opportunities

Davide Biondini, Mariaenrica Tinè, Umberto Semenzato, Matteo Daverio, Francesca Scalvenzi, Erica Bazzan, Graziella Turato, Marco Damin, Paolo Spagnolo

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Endobronchial ultrasound; Transbronchial needle aspiration; bronchoscopy

Online: 26 May 2023 (08:16:28 CEST)

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Preprint INTERESTING IMAGES | doi:10.20944/preprints202305.1842.v1

Sequence of Rare Diagnoses in a Young Patient: Altitude Barotrauma Hemopneumothorax and Desquamative Interstitial Pneumonia

Iustina Leonte, Karina Ivanov, Angela Stefania Marghescu, Șerban-Radu Matache, Florica Valeria Negru, Ana Luiza Iorga, Silviu Mihail Dumitru, Beatrice Mahler

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: hemopneumothorax; altitude barotrauma; emphysematous lesions; desquamative interstitial pneumonia

Online: 26 May 2023 (05:14:06 CEST)

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Preprint REVIEW | doi:10.20944/preprints202305.1855.v1

Molecular Mechanism in the Development of Pulmonary Fibrosis in Sarcoid Patient

Elisabetta Cocconcelli, Nicol Bernardinello, Gioele Castelli, Simone Petrarulo, Serena Bellani, Marina Saetta, Paolo Spagnolo, Elisabetta Balestro

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: sarcoidosis; advanced pulmonary fibrosis; signaling; molecular pathway

Online: 26 May 2023 (04:55:01 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202305.1684.v1

Reference Values for the Grocery Shelving Test among United Arab Emirates Population: A Cross Sectional Study

Gopala Krishna Alaparthi, Aishwarya Prabhakar Gatty, Huda Isa, Latifa Hassan, Noura Khalid, Abdullah Osman, Sara Mahmoud, May Tamim, Kalyana Chakravarthy Bairapareddy, Arthur De Sa Ferreira

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Arm elevation; Grocery Shelving Test; Functional assessment; Reference values; Upper limb activities

Online: 24 May 2023 (04:13:07 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202305.1200.v1

Extracellular Histone 3.3 and Its Hyper-acetylated Isoform In-duce an Inflammatory Response and Damage Lung Tissue

Mario C. Rico, Oscar Perez-Leal, Mary F. Barbe, Mamta Amin, Dennis J. Colussi, Magda L. Florez, Victor Olusajo, Carlos A. Barrero

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Histones; COPD; HDAC; H3.3; Inflammation; Hyperacetylations; Cytotoxicity; Alveolar damage; Cytokines.

Online: 17 May 2023 (05:46:03 CEST)

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Preprint INTERESTING IMAGES | doi:10.20944/preprints202305.1169.v1

Dynamic and Static ¹⁸F-FDG PET/CT Imaging in SMARCA4-Deficient Non-small Cell Lung Cancer and Response to Therapy: A Case Report

Xieraili Wumener, Xiaoxing Ye, Yarong Zhang, Shi Jin, Ying Liang

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: 18F-FDG; PET/CT; SMARCA 4; NSCLC; Dynamic imaging；Efficacy evaluation

Online: 17 May 2023 (02:37:11 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202305.1120.v1

Comparison of a Wireless Ultrasound Device with a High-End Ultrasound Machine in the Assessment of Pleuro-Pulmonary Diseases

Carla Maria Irene Quarato, Lucia Angela Fiore, Donato Lacedonia, Giulia Scioscia, Michela Salvemini, Anela Hoxhallari, Rosanna Villani, Federica D’Agostino, Giulia Tuccari, Stefano Notarangelo, Antonio Mirijello, Salvatore De Cosmo, Evaristo Maiello, Marco Sperandeo

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Wireless ultrasound scanners; Thoracic Ultrasound; Pleural effusion; Subpleural consolidations; Pleural lesions; Advances in thoracic ultrasound

Online: 16 May 2023 (07:37:14 CEST)

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Abstract: Background. The newer wireless portable scanners seem to permit a quicker bedside ultrasound (US) assessment, shortening the transfer times of the portable US unit and without the hindering of connection cables. However, no substantial evidence is currently available regarding of the clinical effectiveness of such new generation devices. Objective. The aim of the current study was to evaluate the efficacy of a wireless US system with respect to a high-end US unit in a cohort of consecutive respiratory patients. Materials and Methods. This prospective observational study included a total of 72 respiratory patients admitted in the department of Internal Medicine. The US examination were independently performed by two experienced blinded examiners with a high-end Esaote MyLab-Twice scanner and a wireless double-head linear and convex probe OTE-L/C501CD. The findings resulting from the high-end US assessment and the wireless US examination were then compared each other. All the patients had a confirmation chest CT scan. Results. The high-end US machine identified 64 positive cases for pleuro-pulmonary alterations, in comparison to which the wireless US unit resulted in 13 false negative results. The respective overall sensitivity and specificity for the portable wireless US unit were of 79.69% and 100.00%, respectively. The resolution of the portable wireless US device was judged as good in 22 (31%) cases, affected by minor diagnostic limitations in 26 (36%) cases and affected by major diagnostic limitations in 24 (33%). The main diagnostic strength of the wireless probe was in the detection of pleural effusion (sensitivity 100%). The diagnostic sensitivity of the wireless probe in assessing abnormalities of the pleural line (67%), pulmonary subpleural consolidations (65%), pleural lesions (33%) and pericardial effusion (0%) was reduced. Conclusions. The newer wireless US probes may have clinical roles for the detection and management of pleural effusion when used by experienced examiners. However, sensitivity in detecting other pleuro-pulmonary pathologies is not comparable to high-end ultrasound machines.

Preprint REVIEW | doi:10.20944/preprints202305.0865.v1

Prevalence and Burden of Comorbidities in Obstructive Sleep Apnea Syndrome

Victoria Sircu, Silvia Colesnic, Serghei Covantsev, Olga Corlateanu, Anna S Sukhotko, Cristian Popovici, Alexandru Corlateanu

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: OSAS; CPAP; diabetes mellitus; hypertension; ischemic heart disease; stroke; renal failure

Online: 11 May 2023 (13:47:41 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202305.0774.v1

The Role of Erythrocyte Membrane Protein Band 4.1-Like 3 in Idiopathic Pulmonary Fibrosis

Min Kyung Kim, Jong-Uk Lee, Sun Ju Lee, Hun Soo Chang, Jong-Sook Park, Choon-Sik Park

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: EPB41L3; Lung; Fibrosis; Epithelium; Mesenchyme; Fibroblast; Myofibroblast; Transition

Online: 11 May 2023 (03:44:24 CEST)

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Preprint REVIEW | doi:10.20944/preprints202305.0732.v1

Chronic Bacterial Airways disease: the Pernicious Global Health Challenge Hidden in Plain Sight

Mark L. Everard

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: chronic bacterial broncitis; airways disease; biofilms; microbiome; COPD; bronchiectasis

Online: 10 May 2023 (10:13:54 CEST)

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This manuscript is aimed at encouraging those interested in biofilms and their effects on microbial communities to view the study of chronic airways disease as one of the most challenging and potentially rewarding areas to focus on. To do this it is necessary to review how we have reached 2023 having made so little progress. It is more than two hundred years ago since the term bronchitis was proposed to describe diseases affecting the airways rather than the respiratory zone of the lungs. The main histological features were described in Laennec’s text of 1819. By the mid C20th it was recognised that the two great drivers of chronic respiratory symptoms were inhaled toxins and chronic bacterial infections. The widespread availability of antibiotics in subsequent years had a dramatic impact on mortality from pneumonia, greatly reduced the prevalence of chronic symptoms after acute lower respiratory tract infections, transformed the lives of many with bronchiectasis and appeared to play a major role in the dramatic fall in prevalence of bronchiectasis. Unfortunately, during the following 70 years the importance of dealing with a chronic bacterial bronchitis was largely forgotten. While two artificial diseases ‘COPD’ and ‘bronchiectasis’ have been the subject of numerous guidelines, chronic bacterial bronchitis has been out in the cold. Antibiotics have in theory been reserved for those with established damage in the form of bronchiolitis and impaired lung function as defined by an arbitrary FEV1/FVC ratio and even then there is a disconnect with a minimum of 2 weeks being prescribed for exacerbations of bronchiectasis and the use of long term inhaled and oral macrolides frequently being advocated while a 5 day course is reserved for an exacerbation in a patient with COPD. The loss of focus on the role of antibiotics has a number of causes – a desire to ration antibiotic as part of ‘antibiotic stewardship’, the potential cost of treatment, the failure to ‘cure’ patients with chronic bronchitis and the difficulty in dealing with a disease whose morbidity at any given time can range from a mild cough and production of phlegm in the morning with no obvious impact on daily function to troublesome cough, sputum production and significant ill health. This was compounded by the vagaries of culture based diagnosis and the observation that more than one potential pathogen was often present. As a result chronic bacterial bronchitis was relegated to the ‘too hard to deal with’ box and many of the lessons of the past were forgotten. Revisiting the field from the perspective of current understanding of bacterial behaviour in biofilms and how these alter the resident microbiota of the airways should ensure that a chronic bacterial bronchitis returns to centre stage in order to minimise respiratory morbidity and mortality. This review charts the history of our understanding and mis-understanding of the role of chronic bacterial bronchitis in airways disease and the pernicious effect of language in helping to ensure that this common and important condition became the elephant in the room. Focusing on the nature of chronic bacterial bronchitis is essential if we are to find ways of identifying it accurately and treat it effectively – new approaches will be extremely slow unless we recognise its importance and the challenges it poses.

Preprint CASE REPORT | doi:10.20944/preprints202305.0675.v1

A Case of De Novo Positional Complex Sleep Apnea Syndrome (CompSAS)

Abdelkarim Khalifa, Marc Spielmanns

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Central sleep apnea; adaptive servo ventilation; oxygen therapy; sleep positional therapy

Online: 10 May 2023 (03:28:11 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202305.0640.v1

Catheter High-Frequency Jet Ventilation and Its Basic Technical and Application Principles

Peter Musil, Stefan Harsanyi, Pavol Torok, Monika Paulikova, Didier Moens, Ladislav Kalas, Peter Kalas

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: catheter; highfrequency jet ventilation; artificial lung ventilation; physical principles

Online: 9 May 2023 (10:34:37 CEST)

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Preprint REVIEW | doi:10.20944/preprints202305.0581.v1

Multiomic Investigations into Lung Health and Disease

Sarah E Blutt, Cristian Coarfa, Josef Neu, Mohan Pammi

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: multiomics; lung, respiratory; models; integration; outcomes

Online: 9 May 2023 (07:38:25 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202305.0533.v1

Micro-Ct Features of Lung Consolidation, Collagen Deposition and Inflammation in Experimental Rsv Infection Are Aggravated in the Absence of Nrf2

Teodora Ivanciuc, Igor Patrikeev, Yue Qu, Massoud Motamedi, Yava Jones-Hall, Antonella Casola, Roberto P. Garofalo

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Respiratory syncytial virus; Nrf2; collagen; micro-CT; airway remodeling

Online: 8 May 2023 (11:21:24 CEST)

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Preprint REVIEW | doi:10.20944/preprints202305.0181.v1

Pathology Outlines of Post-COVID-19 Pulmonary Fibrosis Comparative with Idiopathic Pulmonary Fibrosis

Roxana-Elena Cîrjaliu, Mariana Deacu, Ioana Gherghișan, Angela-Ștefania Marghescu, Manuela Enciu, Gabriela-Izabela Băltățescu, Antonela Anca Nicolau, Doina-Ecaterina Tofolean, Oana Cristina Arghir, Ariadna Petronela Fildan

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Covid-19; idiopathic pulmonary fibrosis; interstitial lung disease; pulmonary fibrosis

Online: 4 May 2023 (04:09:04 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202305.0091.v1

Assessing the Impact of Health Education Intervention on Asthma prevention Knowledge, Attitudes, and Practices: A Cross-Sectional Study in Erbil, Iraq

Karwan Bahram Maulood, Mohammad Khan, Syed Azhar Syed Sulaiman, Amer Hayat Khan

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Asthma; Erbil; Health education; Knowledge; Attitudes; Practice

Online: 3 May 2023 (04:10:18 CEST)

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Preprint REVIEW | doi:10.20944/preprints202304.1130.v1

Two decades of ITALUNG. What we have learned and what is yet to be addressed in lung cancer screening with low dose CT.

Mario Mascalchi, Giulia Picozzi, Donella Puliti, Stefano Diciotti, Annalisa Deliperi, Chiara Romei, Fabio Falaschi, Francesco Pistelli, Michela Grazzini, Letizia Vannucchi, Simonetta Bisanzi, Marco Zappa, Giuseppe Gorini, Francesca Maria Carozzi, Laura Carrozzi, Eugenio Paci

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: biomarkers; coronary artery calcifications; emphysema; low-dose CT; lung cancer; lung nodules; mortality; radiations; screening; smoking

Online: 28 April 2023 (07:17:21 CEST)

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Preprint REVIEW | doi:10.20944/preprints202304.1075.v1

The role of Vitamin D supplementation on Airway Remodeling in Asthma: A Comprehensive Systematic Review

Laila Salameh, Walid Mahmood, Rifat Hamoudi, Khulood Almazrouei, Mahesh Lochanan, Suheyl Seyhoglu, Bassam Mahboub

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Asthma; Vitamin D; Airway Remodeling; inflammation; Smooth muscle cell.

Online: 27 April 2023 (10:37:35 CEST)

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Preprint REVIEW | doi:10.20944/preprints202304.1030.v1

Interrelationship between COVID-19 and coagulopathy: pathophysiological and clinical evidence

Beatrice Ragnoli, Beatrice Da Re, Alessandra Galantino, Stefano Kette, Andrea Salotti, Mario Malerba

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: COVID-19 infection; coagulopathy; endothelial dysfunction; platelet activation; citokine storm; anticoagulant therapy

Online: 27 April 2023 (04:14:52 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202304.1027.v1

Double-pigtail Drainage Catheter: A New Design for Efficient Pleural Drainage

Youngjong Cho, Hyung Nam Lee, Ji Hoon Shin, Sung-Joon Park, Sangjoon Lee, Jae-Seok Song

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Pigtail catheter; pleural drainage; simple pleural effusion

Online: 27 April 2023 (04:06:55 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202304.0971.v1

Diagnostic of Patients With COVID-19 Pneumonia Using Passive Medical Microwave Radiometry (MWR)

Berik Emilov, Aleksander Sorokin, Meder Seiitov, Tulegen Chubakov, Sergey Vesnin, Igor Goryanin

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: 2019-nCoV; COVID-19; RT-PCR; SARS-CoV-2; Community-acquired pneumonia; Chest CT; microwave radiometry; temperature measurement

Online: 26 April 2023 (08:02:32 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202304.0906.v1

CD4+CD31+ and CD4+CD44+ Lymphocytes in Peripheral Blood, CD8+CD31+ and CD8+CD103+ Lymphocytes in Bronchoalveolar Lavage Fluid, and Pulmonary Nodules in Predicting the Course of Pulmonary Sarcoidosis

Edvardas Danila, Regina Aleksonienė, Justinas Besusparis, Vygantas Gruslys, Laimutė Jurgauskienė, Aida Laurinaviciene, Arvydas Laurinavicius, Antanas Mainelis, Rolandas Zablockis, Ingrida Zeleckiene, Edvardas Žurauskas, Radvile Malickaite

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: sarcoidosis; bronchoalveolar lavage; chest computed tomography; biological markers

Online: 25 April 2023 (09:27:52 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202304.0511.v1

Cognitive Impairments, Neuroinflammation and Blood Brain Barrier Permeability in Mice Exposed to Chronic Sleep Fragmentation During the Daylight Period.

Clementine Puech, Mohammad Badran, Alexandra R Runion, Max B Barrow, Kylie Cataldo, David Gozal

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: sleep fragmentation; obstructive sleep apnea; explicit memory; inflammation; blood brain barrier; cognition; microglia

Online: 18 April 2023 (10:18:23 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202304.0186.v1

Prone Position Ventilation in Severe ARDS Due to COVID-19: Comparison Between Prolonged and Intermittent Strategies

George Karlis, Despina Markantonaki, Sotirios Kakavas, Dimitra Bakali, Georgia Katsagani, Theodora Katsarou, Christos Kyritsis, Vasiliki Karaouli, Paraskevi Athanasiou, Mary Daganou

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: ARDS; Prone position; COVID-19; Mechanical ventilation

Online: 11 April 2023 (03:57:11 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202304.0162.v1

Pulmonary Recruitment Prior to One-Stage Multiple Pulmonary Ground Glass Nodule Localization Increases Localization Accuracy

Yu Hsiang Wang, Pei Chin Su, Kenneth Au, Hsu Chih Huang, Frank Cheau-Feng Lin, Chih-Yi Chen, Ming Chih Chou, Jiun Yi Hsia

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Hybrid computer tomography; pulmonary ground glass nodule localization; video-assisted thoracic surgery; pulmonary recruitment

Online: 10 April 2023 (09:30:44 CEST)

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Preprint REVIEW | doi:10.20944/preprints202304.0019.v1

Comparative Analysis on Available Technique for the Detection of Covid-19 through CT-Scan and X-Ray using Machine Learning: A Systematic Review

Vinayak Majhi, Sudip Paul

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Covid-19; Deep Learning; Computerized Tomography; Artificial Intelligence; Machine Learning; X-ray

Online: 3 April 2023 (08:40:11 CEST)

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Preprint REVIEW | doi:10.20944/preprints202303.0524.v1

From Cell to Symptoms: The Role of SARS-CoV-2 Cytopathic Effects in the Pathogenesis of COVID-19 and Long COVID

Pablo Gonzalez-Garcia, Ornella Fiorillo Moreno, Eloina Zarate Peñate, Alejandro Calderón-Villalba, Lisandro Pacheco Lugo, Antonio Acosta Hoyos, Jose Luis Villarreal Camacho, Roberto Navarro Quiroz, Leonardo Pacheco Londoño, Gustavo Aroca Martinez, Noelia Moares, Antonio Gabucio, Cecilia Fernandez-Ponce, Francisco Garcia-Cozar, Elkin Navarro Quiroz

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: COVID-19; SARS-CoV-2; Long COVID; Cytopathy; cytokine storm; sequelae; PASC; coronavirus; angiotensin-converting enzyme 2; cell dysfunction

Online: 30 March 2023 (05:09:50 CEST)

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Preprint COMMUNICATION | doi:10.20944/preprints202303.0515.v1

Key Epidemic Parameters of the SIRV-Model Determined from Past COVID-19 Mutant Waves

Reinhard Schlickeiser, Martin Kröger

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: coronavirus; statistical analysis; extrapolation; parameter estimation; pandemic spreading

Online: 30 March 2023 (02:30:40 CEST)

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Preprint REVIEW | doi:10.20944/preprints202303.0472.v1

Nano-Therapeutic Approaches to Treat COVID Induced Pulmonary Fibrosis

Shrey Kanvinde, Suyash Deodhar, Tanmay A. Kulkarni, Chinmay M. Jogdeo

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: SARS-CoV-2; COVID-19; pulmonary fibrosis; coronavirus; nanoparticles; nanomedicine; pandemic; acute respiratory syndrome

Online: 28 March 2023 (03:59:29 CEST)

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Preprint HYPOTHESIS | doi:10.20944/preprints202303.0441.v1

IgG4 Antibodies Induced by mRNA Vaccines Generate Immune Tolerance to SARS-CoV-2’spike Protein by Suppressing the Immune System

Vladimir N. Uversky, Elrashdy M. Redwan, William Makis, Alberto Rubio-Casillas

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: IgG4 antibodies; mRNA vaccines; immuno-tolerance; auto-immunity; SARS-CoV-2; COVID-19.

Online: 27 March 2023 (03:56:26 CEST)

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Preprint REVIEW | doi:10.20944/preprints202302.0508.v1

Development and Validation of DAFNE: A Web Based Tool for Determining Airway Treatment Options for OSA and Nasal Breathing Disorders

Karen Parker Davidson, William E Harrell, Jr.

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: nasal function; validation; software; nasal resistance; rhinomanometry; acoustic rhinometry; peak nasal inspiratory flow meter; practice patterns; objective measurement outcomes; parameters

Online: 28 February 2023 (06:32:27 CET)

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Abstract: Background: The diagnosis of nasal airway disorders relies on questionnaires, subjective data, and objective data. Interpretation of objective data obtained from measurement technology is not well understood by providers and researchers who use the equipment to test nasal airway function, justifying the need to cre-ate a new clinical tool. The Davidson Airway Function & Nasal Evaluation (DAFNE) Scoring System is a web-based scoring system that allows healthcare providers (MDs, PAs, PTs, APRNs, DMDs, DDSs, SLPs, and DCs) and researchers who treat nasal obstruction and breathing disorders to make more accurate diagnostic decisions, select the appropriate treatment for individualized patient care, monitor treatment progression and outcomes, and show how to approach a collaborative care model with other healthcare professionals. The current technologies, such as 4-phase rhinomanometry, use a simple approach that relies on a measurement tracing intersecting a color-coded y-axis on a four-quadrant graph with diagnostic numeric data output de-scribing nasal airflow and resistance. This is a good source of biofeedback demonstrating abnormal nasal breathing patterns but lacks interpretation guidelines to describe the severity of disease. The more sophisti-cated proprietary DAFNE approach uses multiple parameters which include airflow restriction, speed, vol-ume, and patient characteristics to identify patients’ disease progression much more accurately. Additionally, it explains how to segregate patients into appropriate treatment options which minimizes risks and compli-cations associated with sleep and breathing disorders while improving patient outcomes. Methods: Electronic searches of PubMed, MEDLINE, EMBASE Cochrane Library, and Scopus of publications between 1988-2022 were necessary to identify studies which determined the ranges of nasal function measurement parameters among three airway measurement technologies used in writing the DAFNE Score algorithm. The performance of DAFNE was evaluated compared to the research data and patient demographics used in previous studies. Results: By using primary outcome measurements from the literature, we were able to create a reliable, re-peatable, and validated tool to facilitate patient identification, treatment stratification, and collaboration for sleep and nasal breathing dysfunction. Subsequently, we found DAFNE could be used to identify the appro-priateness of a sleep study. Conclusions: DAFNE Scoring System has demonstrated the ability to detect high risk patients in the pediatric and adult populations susceptible of sleep apnea and breathing dysfunction needing a sleep study and treatment to improve nasal airway function and sleep. DAFNE Scoring System should be used as an adjunct tool in routine clinical practice and research to further understand the technol-ogy data output, identify patients at risk, stratify treatment options, progress, and stabilization after treatment, and how to collaborate with other healthcare providers to improve patient outcomes.

Preprint ARTICLE | doi:10.20944/preprints202302.0342.v1

First Clinical Comparison of STANDARD F TB-Feron FIA and the QIAreachTM QuantiFERON-TB for Tuberculosis Infection in Tertiary Public Hospital in South America

Gustavo Saint-Pierre, Daniel Conei, Patricia Cantillana, Mariella Raijmakers, Andrea Vera, Daniela Gutierrez, Cristopher Kennedy, Paulina Peralta, Paulina Ramonda

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Latent Tuberculoses; Latent Tuberculosis Infections; Koch's Disease; Interferon-gamma Release Assay; Tuberculin Tests; Rapid Diagnostic Test

Online: 20 February 2023 (13:37:31 CET)

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Preprint CONCEPT PAPER | doi:10.20944/preprints202212.0541.v1

Spiral Steroid (SS) Phosphodiesters: Role in Pregnancy

Fred Chasalow

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Ionotropin; Kaleotropin; Galotropin; Pre-eclampsia; Spiral Steroids; Necrotizing Enterocolitis; Cardiotonic glycosides; lactone; digoxin-like materials; DLM

Online: 28 December 2022 (12:24:39 CET)

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Preprint BRIEF REPORT | doi:10.20944/preprints202212.0525.v1

Survival of Inpatients under 5 Years Old with Bronchiolitis by Laboratory-Confirmed Respiratory Syncytial Virus Infection

Oliver Mendoza-Cano, Xóchitl Trujillo, Miguel Huerta, Mónica Ríos-Silva, José Guzmán-Esquivel, Verónica Benites-Godínez, Jaime Alberto Bricio-Barrios, Eder Fernando Ríos-Bracamontes, Agustín Lugo-Radillo, Efrén Murillo-Zamora

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Respiratory Syncytial Virus Infections; Child; Bronchiolitis; Survival.

Online: 28 December 2022 (02:37:39 CET)

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Preprint BRIEF REPORT | doi:10.20944/preprints202212.0469.v1

Vaccination and Younger Age Are Associated with Recurrent Laboratory-Confirmed Symptomatic SARS-Cov-2 Infections

Mónica Ríos-Silva, Xóchitl Trujillo, Miguel Huerta, José Guzmán-Esquivel, Verónica Benites-Godínez, Agustín Lugo-Radillo, Jaime Alberto Bricio-Barrios, Eder Fernando Ríos-Bracamontes, Vannya Marisol Ortega-Macías, Valeria Ruiz-Montes de Oca, Oliver Mendoza-Cano, Efrén Murillo-Zamora

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: COVID-19; SARS-CoV-2; Reinfection

Online: 26 December 2022 (03:53:55 CET)

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Preprint REVIEW | doi:10.20944/preprints202212.0296.v1

Aterosclerosis, Cardiovascular Disorders And Covid-19: Comorbid Pathogenesis

Yulia A Makarova, Varvara A Ryabkova, Vladimir V Salukhov, Boris V Sagun, Aleksandr E Korovin, Leonid P Churilov

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: atherosclerosis; COVID-19; inflammation; cardiovascular system; cytokines; endothelium; lipoproteins; renin-angiotensin system; atheroma; autoimmunity; vasa vasorum.

Online: 16 December 2022 (06:32:21 CET)

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Preprint ARTICLE | doi:10.20944/preprints202212.0061.v1

Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio as a Predictor of Mortality in Severe COVID 19 Cases

Srivatsa R, Supriya P S, Samaga L N

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Covid-19; Neutrophil-Lymphocyte ratio (NLR); severe covid pneumonia

Online: 5 December 2022 (06:26:50 CET)

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Preprint REVIEW | doi:10.20944/preprints202212.0032.v1

S protein, ACE2 and Host Cell Proteases in SARS-CoV2 Cell Entry and Infectivity; Is Soluble ACE2 a Two Blade Sword?

Reza Nejat, Maziar Fayaz Torshizi, David J. Najafi

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: ACE2; Ang II; angiotensin(1-7); AT1R; Cathepsin; cell entry; COVID-19; Endocytosis; ERK1/2; Furin; IL-1β; IL-6; MAPK; MasR; NF-κB; PLC; PKC; RAS; RBD; SARS-CoV2; S protein; TMPRSS2; TNF-α

Online: 2 December 2022 (02:19:48 CET)

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Preprint REVIEW | doi:10.20944/preprints202211.0448.v1

COVID-19 Pathology Sheds New Light on Balance between Neutrophil Proteases and Their Inhibitors

Marko Radic, Vasuki Vindiya Silva

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: alpha-1-antitrypsin (AAT); neutrophil elastase (NE); NETosis, PAD4, ARDS, COPD; neutrophils; COVID-19; TMPRSS2.

Online: 24 November 2022 (02:50:25 CET)

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Preprint ARTICLE | doi:10.20944/preprints202211.0417.v1

Relation between Cytokines Expression and Pulmonary Dysfunction among a Cohort of COVID-19 Patients

Salma A. El Kazafy, Yasser Fouad, Azza F. Said, Hebatallah H. Assal, Amr E. Ahmed, Osama M. Ahmed

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: cytokines; pulmonary; COVID-19; CORADS; moderate; severe

Online: 22 November 2022 (09:56:04 CET)

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Aim: In individuals with COVID-19, the study assessed the relationship between cytokine expression and pulmonary dysfunction. These correlations may help to suggest strategies for prevention and therapies of coronavirus disease outbreak. Patients and methods: 50 healthy participants and 100 COVID-19 patients participated in this study. COVID-19 participants were subdivided into moderate and severe groups based on the severity of their symptoms. In both patients and controls, measurements of white blood cells (WBCs), lymphocytes, C-reactive protein (CRP), interleukin (IL)-1, IL-4, IL-6, IL-18, and IL-35 were estimated. All the patients performed chest CT and CO-RADS score was assessed. Results: All patients had increased WBCs count and CRP, IL-1, IL-4, IL-6, IL-18, and IL-35 levels than healthy controls. While WBCs, CRP, and cytokines like IL-1β and IL-6 showed significantly higher levels in the severe group as compared to moderate patients, IL-4, IL-35, and IL-18 showed comparable levels in both disease groups. Furthermore, CO-RADS score was positively connected with WBCs, CRP, and cytokine levels (IL-35, IL-18, IL-6, IL-4 and IL-1β) in both groups, and lymphocyte levels in all patient groups considerably decreased as compared to the controls. CO-RADS score, also demonstrated a positive correlation with lymphocytes in the moderate COVID-19 patients, whereas in the severe patients, it demonstrated a negative correlation with lymphocytes. Conclusion: Severe COVID-19 patients, compared to individuals with moderate illness and healthy controls, patients had lower lymphocyte counts and increased CRP with greater WBCs counts. In contrast to moderate COVID-19 patients, severe COVID-19 patients had higher levels of IL-1β and IL-6, but IL-4, IL-18, and IL-35 between both illness categories at close levels. CO-RADS 5 was the most frequent category in both moderate and severe cases. Patients with a typical CO-RADS involvement had a higher CRP and white blood cell count with a lower lymphocyte count than the others. Cytokine levels were considered a surrogate markers of severe lung affection in COVID 19 patients.

Preprint ARTICLE | doi:10.20944/preprints202211.0285.v1

Inter-rater Variability in the Evaluation of Lung Ultrasound on Videos Acquired from COVID-19 Patients

Joaquin L. Herraiz, Clara Freijo, Jorge Camacho, Mario Muñoz, Ricardo González, Rafael Alonso-Roca, Jorge Álvarez-Troncoso, Luis Matías Beltrán-Romero, Máximo Bernabeu-Wittel, Rafael Blancas, Antonio Calvo-Cebrián, Ricardo Campo-Linares, Jaldún Chehayeb-Morán, Jose Chorda-Ribelles, Samuel García-Rubio, Gonzalo García-de-Casasola, Adriana Gil-Rodrigo, César Henríquez-Camacho, Alba Hernandez-Píriz, Carlos Hernandez-Quiles, Rafael Llamas-Fuentes, Davide Luordo, Raquel Marín-Baselga, María Cristina Martínez-Díaz, María Mateos-González, Manuel Mendez-Bailon, Francisco Miralles-Aguiar, Ramón Nogue, Marta Nogué, Borja Ortiz de Urbina-Antia, Alberto Ángel Oviedo-García, José M. Porcel, Santiago Rodriguez, Diego Aníbal Rodríguez-Serrano, Talía Sainz, Ignacio Manuel Sánchez-Barrancos, Marta Torres-Arrese, Juan Torres-Macho, Ángela Trueba-Vicente, Tomas Villen-Villegas, Juan José Zafra-Sánchez, Yale Tung-Chen

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Coronavirus disease 2019; interobserver agreement; interrater reliability; lung ultrasound; point-of-care ultrasound; reliability; severe acute respiratory syndrome; ultrasound

Online: 15 November 2022 (09:57:17 CET)

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Preprint ARTICLE | doi:10.20944/preprints202211.0236.v1

Platelet-to-Lymphocyte Ratio (PLR), Neutrophil-to-Lymphocyte Ratio (NLR), and Monocyte-to-Lymphocyte Ratio (MLR), and Eosinophil-to-Lymphocyte Ratio (ELR) as Biomarkers in Patients with Acute Exacerbation Chronic Obstructive Pulmonary Disease.

Qian-Qian Liao, Yan-Ju Mo, Ke-Wei Zhu, Feng Gao, Bin Huang, Peng Chen, Feng-Tian Jing, Xuan Jiang, Hong-Zhen Xu, Yan-Feng Tang, Li-Wei Chu, Hai-Ling Huang, Wen-Li Wang, Fang-Ning Wei, Dan-Dan Huang, Bin-Jing Zhao, Jia Chen, Hao Zhang

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Acute exacerbation chronic obstructive pulmonary disease (AECOPD); platelet-to-lymphocyte ratio (PLR); neutrophil-to-lymphocyte ratio (NLR); monocyte-to-lymphocyte ratio (MLR); baso-phil-to-lymphocyte ratio (BLR); eosinophil-to-lymphocyte ratio (ELR); in-hospital mortality; nom-ogram; decision curve analysis (DCA); clinical impact curve (CIC)

Online: 14 November 2022 (04:42:59 CET)

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Preprint REVIEW | doi:10.20944/preprints202211.0184.v1

Etiology of Pneumoparotid: A Systematic Review

Kazuya Yoshida

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: pneumoparotid; systematic review; pneumoparotitis; parotid gland; etiology; intraoral pressure; Stensen’s duct

Online: 10 November 2022 (02:56:35 CET)

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Preprint BRIEF REPORT | doi:10.20944/preprints202211.0033.v1

Long COVID Classification: Findings from a Clustering Analysis in the Predi-COVID Cohort Study

Aurélie Fischer, Nolwenn Badier, Lu Zhang, Abir Elbeji, Paul Wilmes, Pauline Oustric, Charles Benoy, Markus Ollert, Guy Fagherazzi

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Clustering; COVID-19; Long COVID; disease severity

Online: 2 November 2022 (01:02:16 CET)

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Preprint REVIEW | doi:10.20944/preprints202210.0292.v1

SARS-CoV-2 Omicron (B.1.1.529) Variant: A Challenge with Covid-19

Zeinab Mohseni Afshar, Ali Tavakoli Pirzaman, Bardia Karim, Rezvan Hosseinzadeh, Arefeh Babazadeh, Dariush Hosseinzadeh, Seyed Rouhollah Miri, Terence T. Sio, Mark J. M. Sullman, Mohammad Barary, Soheil Ebrahimpour

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Omicron; Covid-19; SARS-CoV-2; Variants of concern

Online: 20 October 2022 (02:16:05 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202210.0057.v1

A New Set-up of Vanishing Antibodies: A Biennial Follow-up of Three Different Clients’ Humoral Responses Against Sars-Cov-2 After Systemic Vaccination in an Oncology Hospital in Poland

Piotr Kosiorek, Samuel Stróż, Anna Hryniewicz, Robert Milewski, Klaudia Bartoszewicz, Anna Stasiak-Barmuta

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: COVID-19; BNT162b2; vaccination; S-RBD; SARS-CoV-2; seroconversion

Online: 6 October 2022 (08:42:11 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202209.0383.v1

Associations Between Obstructive Sleep Apnea (OSA) and COVID-19 Infection and Hospitalization Among U.S. Adults

Stuart F. Quan, Matthew Weaver, Mark Czeisler, Laura Barger, Lauren Booker, Mark Howard, Melinda Jackson, Rashon Lane, Christine McDonald, Anna Ridgers, Rebecca Robbins, Prerna Varma, Shantha Rajaratnam, Charles Czeisler

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Obstructive Sleep Apnea; COVID-19; Hospitalization; Infection; Epidemiology

Online: 26 September 2022 (08:02:12 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202209.0328.v1

SARS-Cov-2 in Asymptomatic and Mild Infections in a Hungarian Outpatient Cohort in the First Year of the Pandemic

István Jankovics, Cecília Müller, Éva Gönczöl, Ildikó Visontai, István Varga, Márta Lőrincz, Dávid Kuti, Ágnes Hasitz, Péter Malik, Krisztina Ursu, Borbála Bányász, Júlia Sarkadi, Béla Dénes

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: SARS-CoV-2; COVID-19; outpatient cohort; seroprevalence; mild infections; asymptomatic cases; COVID-19 contacts; PCR-positivity and symptoms; first year of the pandemic; Hungary

Online: 22 September 2022 (02:08:09 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202209.0297.v1

Effectiveness and Tolerability of Early Treatment with Monoclonal Antibodies against SARS-Cov-2: Results from A Real-Life Study before Omicron Surge

Riccardo Scotto, Antonio Riccardo Buonomo, Giulia Zumbo, Antonio Di Fusco, Nunzia Esposito, Isabella Di Filippo, Mariano Nobile, Biagio Pinchera, Nicola Schiano Moriello, Riccardo Villari, Ivan Gentile

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Mabs; VoC; COVID-19; real-life

Online: 20 September 2022 (07:15:52 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202209.0134.v1

Validation of a Novel User Interface and Calculation Method for Determining Nasal Resistance and Patency

Karen Parker Davidson, William E Harrell, Jr.

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: nasal function; validation; software; nasal resistance; rhinomanometry; acoustic rhinometry; peak nasal inspiratory flow meter; practice patterns; objective measurement outcomes; parameters

Online: 9 September 2022 (09:41:14 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202208.0499.v1

Variables Influencing the Pressure and Volume of the Pulmonary Circulation as Risk Factors for Developing High Altitude Pulmonary Edema (HAPE)

Thomas Küpper, Christian Apel, Daniela Bertsch, Michael Van der Giet, Simone Van der Giet, Maren Graß, Carina Gschwandtl, Nikole Heussen, Christian Kühn, Miriam Hundt, Julia Risse, Sonja Schmitz, Lisa Timmermann, Knut Wernitz, Ulf Gieseler, Audry Morrison, Nina Hundt

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: HAPE; risk factors; echocardiography; pulmonary pressure; workload

Online: 30 August 2022 (03:18:35 CEST)

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Background: At altitudes beyond 2500 m the risk of developing high altitude pulmonary edema (HAPE) grows with the increases in pulmonary arterial pressure. HAPE is characterized by severe pulmonary hypertension, though the incidence and relevance of individual risk factors are not yet predictable. However, the systolic pulmonary pressure (SPAP) and peak in tricuspid regurgitation velocity (TVR) are crucial factors when diagnosing pulmonary hypertension by echocardiography. Methods: The SPAP and TVR of 27 trekkers aged 20-65 years en route in the Solu Khumbu region of Nepal was assessed. Echocardiograph measurements were performed at Lukla (2,860 m), Gorak Shep (5170 m), and the summit of Kala Patthar (5,675 m). The altitude profile and the participant’s characteristics were also compiled for correlation with the measured data. Results: The results showed a highly significant increase of SPAP and TVR after ascending Kala Patthar. The study revealed a lower increase of SPAP and TVR in the group of older participants, although the initial respective measurements in Gorak Shep were significantly higher for this group. A similar finding occurred in those using Diamox® as prophylaxis. There was an inverse relationship between TVR and SPAP, the peripheral capillary oxygen saturation and heart rate. Conclusions: The echocardiograph results indicate that older people are a risk group for developing a HAPE. The prophylactic use of acetazolamid led to higher initial SPAP values in Gorak Shep, and a lower increase of SPAP as well as TRV after ascending Kala Patthar. Arterial oxygen saturation measurements can provide an indicator for the self-assessment for the risk of developing HAPE and provide a rule of thumb for the altitude profile but does not replace a HAPE diagnosis. The collected data variables concerning backpack weight, sex, workload (actual ascent speed), and pre-existing diseases were not statistically significant factors related to SPAP and TVR (p=<0.05).

Preprint ARTICLE | doi:10.20944/preprints202208.0376.v1

Long COVID at Low and High Altitude: A Countrywide Epidemiological Analysis of Self-Reported Long-Term Persisting Symptoms in Ecuador

Juan S. Izquiero-Condoy, Raul Fernandez-Naranjo, Jorge Vásconez-González, Simone Cordovez, Andrea Tello-De-la-Torre, Clara Paz, Karen Delgado-Moreira, Sarah Carrington, Ginés Viscor, Esteban Ortiz-Prado

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: COVID-19; SARS-CoV-2; long-COVID; sequalae; symptoms; Latin America; high altitude

Online: 22 August 2022 (06:04:53 CEST)

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Preprint REVIEW | doi:10.20944/preprints202208.0278.v1

Modulation of the Central Stress Response System to Prevent Complications of COVID-19 ‘Dam and Wall Concept’

Sanjiv K. Hyoju

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: central stress response system; sympathetic activity; HPA axis; SAR-CoV-2; catecholamine; corti-costeriods; clonidine; dexamethasone

Online: 16 August 2022 (05:07:18 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202208.0099.v1

Enhancing Imagistic Interstitial Lung Disease Diagnosis by Using Complex Networks

Ana Adriana Trușculescu, Diana Luminița Manolescu, Laura Broască, Versavia Maria Ancușa, Horia Ciocârlie, Corina Camelia Pescaru, Emanuela Vaștag, Cristian Iulian Oancea

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Interstitial lung disease; Diffuse interstitial lung disease; Idiopathic pulmonary fibrosis; High-resolution computed tomography; Complex Networks; Computer aided diagnosis

Online: 4 August 2022 (04:14:44 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202208.0014.v2

Estimation of the Odds Ratio in Vaccinated Individuals and Determination of Vaccine Efficacy against Sars-CoV-2 Infection in Angola – Part I

Santland Sebastião Alberto De Lemos, José Belchior Da Silva, Carlos Alberto Pinto De Sousa

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Odds ratio; vaccine efficacy; SARS-CoV-2; Angola

Online: 2 August 2022 (12:25:20 CEST)

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Introduction: Studies conducted in real-life scenarios on vaccine protection against COVID-19 constitute an important global priority, but one that is currently mostly neglected in low- and middle-income countries such as Angola. Here, we analyze for the first-time vaccine protection against COVID-19 in a real-life scenario after 6 months of implementing a multi-vaccination plan in Angola, providing estimation of odds ratios in vaccinated individuals and vaccine efficacy against infection by SARS-CoV-2 in a period that coincided with the identification of the Omicron variant in the country. Methods: We used a negative test case-control design to assess the effectiveness of vaccination against confirmed SARS-CoV-2 infection. A total of 4.232 vaccinated and unvaccinated individuals with the result of a rapid antigen diagnostic test against SARS-CoV-2 performed from December 27 to 28, 2021 were included in the study. Data were extracted from the Digital Vaccination Record Platform (Rediv) of the Ministry of Health of Angola. All ethical procedures related to the authorization necessary to carry out the study were followed. Statistical analyzes were performed using version 7.5.2.0 of CDC's Epi Info. Frequency distributions and measures of central tendency were used to characterize the study universe. The general and sex-adjusted and age-adjusted odds ratios, were evaluated by comparing the chances of vaccination between cases and controls, and their associated 95% CI, which were calculated using the Mantel-Haenszel stratification method. The risk classification of Axel Kroeger, Piscoya and Alarcon was used to interpret the odds ratio. The Breslow-Day statistic was used to assess the homogeneity of the odds ratios. Vaccine efficacy was calculated using the odds ratio applying the accepted statistical vaccine efficacy formula:(1 − odds ratio) × 100. For all estimates, a P value < 0.05 was considered statistically significant. Results: The population consisted of 63.63% male and 36.37% female. The mean age was 36 years with a standard deviation of 13. 83. Regarding vaccination status, 83.27% of individuals were vaccinated and 16.73% were unvaccinated, with 21.81% positive and 78.19% negative for SARS -CoV-2. The odds of SARS-CoV-2 infection were 0.85 (95% CI 0.70 – 1.03) times lower in vaccinated compared to unvaccinated individuals, with P=0.09. The overall vaccine efficacy (VE) was 15% (95% CI -3 – 30). Conclusion: There was no statistically significant decrease in the chances of SARS-CoV-2 infection in vaccinated versus unvaccinated individuals. However, the overall vaccine efficacy was 15%.

Preprint ARTICLE | doi:10.20944/preprints202208.0014.v1

Estimation of the Odds Ratio in Vaccinated Individuals and Determination of Vaccine Efficacy against Sars-Cov-2 Infection in Angola – Part I

Santland Sebastião Alberto De Lemos, José Belchior Da Silva, Carlos Alberto Pinto De Sousa

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Odds ratio; vaccine efficacy; SARS-CoV-2; Angola

Online: 1 August 2022 (08:54:29 CEST)

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Introduction: Studies conducted in real-life scenarios on vaccine protection against COVID-19 constitute an important global priority, but one that is currently mostly neglected in low- and middle-income countries such as Angola. Here, we analyze for the first-time vaccine protection against COVID-19 in a real-life scenario after 6 months of implementing a multi-vaccination plan in Angola, providing estimation of odds ratios in vaccinated individuals and vaccine efficacy against infection by SARS-CoV-2 in a period that coincided with the identification of the Omicron variant in the country. Methods: We used a negative test case-control design to assess the effectiveness of vaccination against confirmed SARS-CoV-2 infection. A total of 4.232 vaccinated and unvaccinated individuals with the result of a rapid antigen diagnostic test against SARS-CoV-2 performed from December 27 to 28, 2021 were included in the study. Data were extracted from the Digital Vaccination Record Platform (Rediv) of the Ministry of Health of Angola. All ethical procedures related to the authorization necessary to carry out the study were followed. Statistical analyzes were performed using version 7.5.2.0 of CDC's Epi Info. Frequency distributions and measures of central tendency were used to characterize the study universe. The general and sex-adjusted and age-adjusted odds ratios, were evaluated by comparing the chances of vaccination between cases and controls, and their associated 95% CI, which were calculated using the Mantel-Haenszel stratification method. The risk classification of Axel Kroeger, Piscoya and Alarcon was used to interpret the odds ratio. The Breslow-Day statistic was used to assess the homogeneity of the odds ratios. Vaccine efficacy was calculated using the odds ratio applying the accepted statistical vaccine efficacy formula:(1 − odds ratio) × 100. For all estimates, a P value < 0.05 was considered statistically significant. Results: The population consisted of 63.63% male and 36.37% female. The mean age was 36 years with a standard deviation of 13. 83. Regarding vaccination status, 83.27% of individuals were vaccinated and 16.73% were unvaccinated, with 21.81% positive and 78.19% negative for SARS -CoV-2. The odds of SARS-CoV-2 infection were 0.85 (95% CI 0.70 – 1.03) times lower in vaccinated compared to unvaccinated individuals, with P=0.09. The overall vaccine efficacy (VE) was 15% (95% CI -3 – 30). Conclusion: There was no statistically significant decrease in the chances of SARS-CoV-2 infection in vaccinated versus unvaccinated individuals. However, the overall vaccine efficacy was 15%.

Preprint ARTICLE | doi:10.20944/preprints202207.0351.v1

Almamy Amara Touré, Aboubacar Sidiki Magassouba, Gnoume Camara, Abdoulaye Doumbouya, Diao Cissé, Ibrahima Barry, Lansana Mady Camara, Abdoul Habib Béavogui, Alexandre Delamou, Vanessa Veronese, Corinne Simone Merle, Hugues Asken Traoré, Adama Marie Bangoura

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Tuberculosis; Health-related quality of life; COVID-19; Guinea

Online: 25 July 2022 (05:37:10 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202207.0331.v1

Impact of COVID-19 on Diagnosis of Respiratory Diseases in the Northern Metropolitan Area in Barcelona (Spain)

Ignasi García Olivé, Zoran Stojanovic, Carlos Martínez Rivera, Francesc López Seguí, Guillem Hernández Guillamet, Josep Vidal Alaball, Jorge Abad Capa, Antoni Rosell Gratacós

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: COVID-19; diagnose; primary care; respiratory disease

Online: 22 July 2022 (03:12:31 CEST)

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Preprint REVIEW | doi:10.20944/preprints202207.0051.v1

SARS-CoV-2 Intermittent Virulence as A Result of Natural Selection

Alberto Rubio-Casillas, Elrashdy M. Redwan, Vladimir N. Uversky

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: SARS-CoV-2; Omicron; variant of concern

Online: 4 July 2022 (10:28:04 CEST)

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Preprint REVIEW | doi:10.20944/preprints202104.0633.v2

A Hierarchical Framework for Assessing Transmission Causality of Respiratory Viruses

Tom Jefferson, Carl J. Heneghan, Elizabeth Spencer, Annette Pluddemann, Igho Onakpoya, Jon Brassey, David Evans, John Conly

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: viral transmission; causation; evidence hierarchy; SARS-CoV-2; respiratory pathogens

Online: 30 June 2022 (03:33:13 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202206.0272.v1

The Combination of Molnupiravir with Nirmatrelvir or GC376 has a Synergic role in the Inhibition of SARS-CoV-2 Replication in Vitro

Anna Gidari, Samuele Sabbatini, Elisabetta Schiaroli, Sabrina Bastianelli, Sara Pierucci, Chiara Busti, Lucia Comez, Valeria Libera, Antonio Macchiarulo, Alessandro Paciaroni, Ilaria Vicenti, Maurizio Zazzi, Daniela Francisci

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: COVID-19; SARS-CoV-2; molnupiravir; nirmatrelvir; GC376; PF-07321332; variant; synergy; an-tiviral

Online: 20 June 2022 (10:57:26 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202206.0235.v1

Measurement of Serum Paraoxonase-1 Arylesterase Activity as a Screening Test for the Diagnosis of COVID-19

Xavier Gabaldó, Màrius Juanpere, Helena Castañé, Elisabet Rodríguez-Tomàs, Ana Felisa López-Azcona, Gerard Baiges-Gaya, Lourdes Castro, Enrique Valverde-Díaz, Aida Muñoz-Blázquez, Laura Giménez-Cuenca, Laura Felipo-Balada, Frederic Ballester, Isabel Pujol, Josep M Simó, Antoni Castro, Simona Iftimie, Jordi Camps, Jorge Joven

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: biomarkers; COVID-19; paraoxonase-1; SARS-CoV-2

Online: 16 June 2022 (09:13:11 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202206.0149.v1

Early Prediction of Ventilator-Associated Pneumonia in ICU Patients Using An Interpretable Machine Learning Algorithm

Maxime Faucher, Satish Casie Chetty, Sepideh Shokouhi, Gina Barnes, Keyvan Rahmani, Jacob Calvert, Qingqing Mao

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: critical care; artificial intelligence; predictive analytics; VAP; interpretable models

Online: 10 June 2022 (04:43:07 CEST)

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Preprint COMMUNICATION | doi:10.20944/preprints202206.0137.v1

FAIR Sharing of Reproducible Models of Epidemic and Pandemic Forecast

Kausthubh Ramachandran, Matthias König, Martin Scharm, Tung V. N. Nguyen, Henning Hermjakob, Dagmar Waltemath, Rahuman S. Malik Sheriff

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: FAIR; epidemiology; models; pandemic forecast; SIR modelling; standards

Online: 9 June 2022 (07:55:55 CEST)

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Preprint REVIEW | doi:10.20944/preprints202206.0121.v1

Factors Modulating COVID-19: A Mechanistic Understanding Based on the Adverse Outcome Pathway Framework

Laure-Alix Clerbaux, Maria Cristina Albertini, Núria Amigó, Anna Beronius, Gillina F.G. Bezemer, Sandra Coecke, Evangelos P. Daskalopoulos, Giusy Del Giudice, Dario Greco, Lucia Grenga, Alberto Mantovani, Amalia Muñoz, Elma Omeragic, Nikolaos Parissis, Mauro Petrillo, Laura A. Saarimäki, Helena Soares, Kristie Sullivan, Brigitte Landesmann

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: SARS-CoV-2 infection; COVID-19; modulating factors; Adverse Outcome Pathway; sex; age; co-morbidities; lifestyle; environment; pre-existing conditions

Online: 8 June 2022 (09:47:23 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202206.0116.v1

Protectivity of Covid-19 Vaccines and Its Relationship with Immune Response and Vaccination Strategy: a One-Year Cohort Study

Ferdi Tanir, Burak Mete, Hakan Demirhindi, Ertan Kara, Ersin Nazlıcan, Gülçin Dağlıoglu, Filiz Kibar, Salih Cetiner, Ceren Kanat

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: SARS-CoV2; inactivated vaccine; mRNA vaccine; COVID-19; homologous vaccination; heterolo-gous vaccination; protectivity

Online: 8 June 2022 (05:39:30 CEST)

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Preprint REVIEW | doi:10.20944/preprints202206.0054.v1

Impacts of COVID-19 on Accessibility of Sexual and Reproductive Health Services: Scoping Review

Josphat Nkole, Muyembe Chisotwa, Rachael Chikumbi, Francis Bota, Mainga Mulemwa, Margareta Kasonde, Chofwe Musele, Nkisu Kasapatu, Brian Chanda Chiluba

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: family planning service and COVID-19; maternal; Neonatal and child health service and COVID-19; sexual behaviour and COVID-19; SARSCOVID-2 and family planning

Online: 6 June 2022 (03:39:05 CEST)

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Introduction: Since its discovery in late 2019, the novel coronavirus (SARSCOVID-2) that causes COVID-19 has spread fast, prompting the World Health Organization (WHO) to designate the disease a worldwide pandemic on March 11, 2020.The epidemic has profoundly altered the preexisting global sexual and reproductive health landscape .The virus’s load has put ordinary services in jeopardy and harmed other health priorities. This encompasses both the provision and the supply of contraceptives, sexual health, new born and maternal health services. This Scoping review therefore mapped the availability evidence on the impact and effects of the COVID-19 disease outbreak on sexual and reproductive health. Methods: The methodological framework by Arksey and O’Malley guided this scoping review. A literature search was conducted from the following databases: Embase, PubMed, CINAHL, Scopus, WOS, and AJOL. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) flow diagram and the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) checklist were used to document the review process. The Strobe critical review checklist was used to determine the quality of the included studies. Results:19 studies were reviewed, out of which 4 were cross sectional studies, 1 was an observational study, 1 was a descriptive analytical study and the rest were qualitative studies .Majority of the studies showed evidence on the impact of COVID-19 and family planning service, maternal and child services, and three studies reported on COVID-19 and sexual behaviour. Five of the nineteen included studies reported on the impact of COVID-19 and family planning service. Conclusion: This scoping review has granted the assessment of the impact of novel SARS-CoV-2 on Sexual and reproductive health services with regards to sexual behaviour, family planning and maternal, neonatal and child health. From the 18 articles identified and reviewed, the overall responses stipulated a significant reduction in client’s utilization of services due to challenges experiences in service implementation such as stock outs. In addition, low demand for reproductive health services by clients due to restrictions imposed on the movements of people to curb the spread of the virus. It is therefore important that Governments and relevant stakeholders in Maternal and Sexual Reproductive Health prioritize development of policies and practices that protect women from the impacts of the pandemic. Furthermore, regular audits to detect trends in MSRH are necessary to inform on going mitigation efforts.

Preprint ARTICLE | doi:10.20944/preprints202205.0069.v1

Sampling and Analysis of Low Molecular Weight Volatile Metabolites in Cellular Headspace and Mouse Breath

Theo Issitt, Sean T Sweeney, William J. Brackenbury, Kelly Redeker

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Volatile organic compound; VOC; headspace; breath; breath biomarker; volatile metabolite; breath diagnosis

Online: 6 May 2022 (09:27:04 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202204.0313.v1

Is There Any Importance of Brain Tomography and Diffusion Magnetic Resonance Imaging in COVID-19 Patients?

Figen Tunalı Türkdoğan, Abuzer Coskun

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Emergency department; COVID-19; lung radiography; computed tomography; diffusion magnetic resonance

Online: 30 April 2022 (08:21:41 CEST)

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Background: As coronavirus (COVID-19) continues to pose a threat to the entire world, it is critical to developing strategies for containing its spread. The purpose of this study was to assess the demographic characteristics, brain tomography characteristics, and diffusion magnetic resonance findings of COVID-19 positive individuals. Material and Method: Between January 1 and December 31, 2021, 317 patients over the age of 18 were admitted to the emergency department with symptoms consistent with COVID-19. Three groups were formed based on clinical findings in patients, divided into light, medium, and severe, and four groups were formed based on radiological imaging findings. Results: The mean age of the 317 patients included in the study was 67.28±12.06 years, with a range of 28-91 years. The clinical classification of the patients was based on laboratory parameters and radiological imaging, not on their age or gender. Mild cases were classified as CO-RADS 0-4; moderate and severe cases were classified as CO-RADS 5-6 (p=0.001). While 60 (18.9%) of patients were followed outpatient, 144 (45.4%) were admitted to the hospital, 73 (23%) were admitted to the intensive care unit, and 40 (12.7%) died (p=0.001). Direct radiographs revealed bilateral involvement in 224 (70.7%) cases, peripheral involvement in 259 (81.7%) cases, and mid-lower lobe lung involvement in 194 (61.2%) cases (p=0.001). Brain tomography revealed infarction in 42 (13.2%) of the patients who were followed and hospitalized and hemorrhage in 22 (6.9%) of the patients. Magnetic resonance imaging revealed diffusion involvement in 68 (21.5%) of the cases (p=0.001). Conclusion: A standardized reporting system for COVID-19 data is required, and it must be simple to use, quick to understand, and focused on determining the risk of pneumonia. Additionally, the diagnostic role of radiological imaging, prognosis prediction, and severity scoring of lung involvement should be included.

Preprint ARTICLE | doi:10.20944/preprints202204.0225.v1

Efficacy and Safety Evaluation of Arbidol in Patients with COVID-19

Yujiao Bai, Xianqin Zhang, Meng Yang, Lin Zhang, Xu Jia

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: COVID-19; SARS-Cov-2; arbidol; treatment

Online: 26 April 2022 (04:07:48 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202204.0165.v1

Longitudinal Randomized Cohort Study of SARS-CoV-2 Antibody Seroprevalence in the St. Petersburg Population

Viacheslav S. Smirnov, Liudmila V. Lyalina, Andzhelica M. Milichkina, Irina V. Khamitova, Elena V. Zueva, Valery A. Ivanov, Vitaly S. Zaguzov, Areg Artemovich Totolian

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Coronavirus SARS-CoV-2; seroprevalence; antibodies; nucleocapsid antigen; antigen receptor binding domain; seropositivity; St. Petersburg; volunteers; vaccination

Online: 18 April 2022 (10:42:54 CEST)

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Since the detection of the first COVID-19 patient, 2 years have passed, during which more than 287,862,000 people fell ill globally, of which about 1.9% died. Implementation of SARS-CoV-2 control programs required efforts from almost all countries. An important direction in the fight against COVID-19 was the formation of herd immunity, the main tool for managing the pandemic. Study goal: to assess the seroprevalence of antibodies (Abs) to SARS-CoV-2 nucleocapsid (Nc) and receptor binding domain (RBD) in the St. Petersburg population during the COVID-19 pandemic. Materials and methods. A longitudinal cohort randomized monitoring study of Ab seroprevalence (SARS-CoV-2 Nc, RBD) was organized and conducted according to a unified methodology developed by Rospotrebnadzor with the participation of the St. Petersburg Pasteur Institute. For this purpose, a cohort of 1000 volunteers was formed who participated in all five stages of seromonitoring. The cohort was divided into 7 age groups: 1-17; 18-29; 30-39; 40-49; 50-59; 60-69; 70; and older (70+) years. Seropositivity levels (Nc, RBD) were assessed by quantitative and qualitative enzyme immunoassays. During the 2nd year of monitoring, some volunteers were vaccinated with the GamCOVIDVac (84%) or EpiVacCorona (11.6%) vaccines approved in Russia. Statistical processing was carried out using the Excel 2010 software package. Confidence intervals for shares and percentages (95% CI) were calculated using the method of A. Wald and J. Wolfowitz with adjustment (A. Agresti, B.A. Coull). The statistical significance of differences was calculated by z-test, using the appropriate online calculator (p<0.05), unless indicated. Results. There was a trend towards: an increase in Nc seropositivity in stages 1-3 of seromonitoring, with a decrease in stages 4-5 among children and adults. The share of RBD seropositive steadily increased during all 5 stages of seromonitoring. The most frequently found were low anti-RBD Abs levels (22.6-220 BAU/ml). High Ab levels were recorded statistically significantly less frequently. Asymptomatic forms were observed in 84-88% of SARS-CoV-2 seropositive volunteers. By the 5th stage of monitoring, this indicator significantly decreased to 69.8% (95% CI: 66.1-73.4). The monitoring revealed a statistically significant increase in anti-RBD Abs, alongside a statistically significant decrease in the proportion of Nc seropositive. This dynamic was especially characteristic of persons vaccinated with GamCOVIDVac. Conclusion. Prior to the use of specific vaccines, a seroprevalence of anti-Nc Abs was noted. After the introduction of the GamCOVIDVac vaccine in adults, a decrease in the level of anti-Nc Abs was noted due to an increase in the proportion of RBD seropositive persons.

Preprint REVIEW | doi:10.20944/preprints202203.0293.v1

Advances in Non-invasive Biosensing Measures to Monitor Wound Healing Progression

Walker Short, Oluyinka Olutoye, Benjamin Padon, Umang Parikh, Daniel Colchado, Hima Vangapandu, Shayan Shams, Taiyun Chi, Jangwook Jung, Swathi Balaji

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: extracellular matrix; biosensing; machine learning; wound healing

Online: 22 March 2022 (03:50:47 CET)

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Preprint ARTICLE | doi:10.20944/preprints202203.0277.v1

Collaborative Research for Long COVID Haulers in Greece (Characteristics, Clinical Assessment and Rehabilitation). Non-hospitalized and Hospitalized Long COVID Patients Share Similar Symptom Patterns

Martha Spyridoula Katsarou, Eleni Iasonidou, Alexander Osarogue, Efthymios Kalafatis, Stylianos Gatzonis, Sofia Pappa, Athanasia Verentzioti, Maria Stefanatou, Pantelis Gounopoulos, Christos Demponeras, Eleni Konstantinidou, Nikolaos Drakoulis, Andreas Asimakos, Archontoula Antonoglou, Aspasia Mavronasou, Stavroula Spetsioti, Anastasia Kotanidou, Paraskevi Katsaounou

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Long Covid; post Covid; Post-acute COVID

Online: 21 March 2022 (08:25:20 CET)

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Preprint ARTICLE | doi:10.20944/preprints202203.0272.v1

Multicentric Study on the Effect of Rectal Ozone on COVID-19: the Spanish and Slovakian Experience.

Marcos Fernandez-Cuadros, Maria Jesus Albaladejo-Florin, Olga Pérez-Moro, Javier Rodríguez-de-Cía, Alberto Hernández, Sandra Alava-Rabasa, Darraj Mohammed, Alzbeta Gondzurova, Martin Molnar, Monika Kulinova, Juraj Vyletelka

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Ozone; Ozone therapy; pneumonia; COVID-19; SARS-CoV-2; rectal insufflation

Online: 19 March 2022 (03:35:45 CET)

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Objective: To evaluate the effect of rectal Ozone (O3) in severe COVID-19 pneumonia in two different cohorts differing in location (Madrid vs Zilina), ethnicity (Slovakian vs Spanish cohorts) and age. Material and Methods: In a multicenter-study, 32 severe bilateral-COVID-19-pneumonia patients and (+) RT-PCR (reverse transcriptase polymerase chain reaction) SARS-CoV-2 were evaluated (16 from each cohort). Primary outcomes: a) clinical (O2-saturation); b) biochemical (Lymphocyte-count, Fibrinogen, D-Dimer, Urea, Ferritin, LDH [lactate dehydrigenase], IL-6 and CRP [c-reactive protein]); and c) radiological improvement. Secondary outcomes: a) days-of-hospitalization, b) mortality-rate before discharge. The Ozone-protocol consisted of 10 sessions of intra-rectal Ozone, total dose 5.25 mg (150 mL volume, 35 g/ml concentration). The Standard-of-care protocol included O2 supply, antivirals (Remdesivir / Isoprinosine), corticosteroids (Dexamethasone / Metilprednisolone), monoclonal antibodies (Anakinra / Tocilizumab), antibiotics (Azytromicine), anticoagulants (Enoxaparine / Fraxiparine). Protocol was approved by Health Care Ethics Committee (Report 15/4/2020) of our Hospital and by Ethics Committee for Medical Investigation of La Princesa’s Hospital (ACTA CEIm 12/20, 28/5/20, Registry 4146). Results: Patients in Slovakian cohort were younger (53.38 vs 84.69 years). Grade of severity was worse in Spanish-cohort (4.78 vs 3.30 points). Length of stay was superior in Spanish-cohort (27.38 vs 10.07 days). Both cohorts improved O2-saturation and Lymphocyte-count. Inflammation biomarkers (Fibrinogen, D-Dimer, Urea, Ferritin, LDH, CRP and IL-6) decreased in both cohorts. In Spanish-cohort, Urea and Ferritin improvement was not significant (p>0.05), while in Slovakian-cohort, Urea, Fibrinogen and LDH were not significant (p>0.05) Radiological signs of bilateral pneumonitis decreased on both cohorts. Mortality was similar (12.5%). Conclusion: After Standard of care protocol, Rectal Ozone improved O2-saturation, decreased inflammation biomarkers and improved Taylor’s radiological scale in both cohorts. Although age, grade of severity and days of hospitalization were inferior in Slovakian cohort, mortality was similar in both cohorts, but inferior if compared to an external control cohort.

Preprint ARTICLE | doi:10.20944/preprints202203.0227.v1

[¹⁸F]FDG PET/CT in Short-Term Complications of COVID-19: Metabolic Markers of Persistent Inflammation and Impaired Respiratory Function

Eva María Triviño-Ibáñez, Beatriz María Jiménez-Rodríguez, Teodoro Rudolphi-Solero, Encarnación Yolanda García-Rivero, Antonio Rodríguez-Fernández, Jose Manuel Llamas-Elvira, Manuel Gómez-Río, Concepción Morales-García

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: COVID-19; FDG-PET/CT; respiratory function test; complications; inflammatory; SARS-CoV-2

Online: 16 March 2022 (09:26:16 CET)

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Preprint COMMUNICATION | doi:10.20944/preprints202203.0185.v1

Would New SARS-CoV-2 Variants Change the War Against COVID-19?

Elrashdy M. Redwan, Fatma Elrashdy, Alaa A. A. Aljabali, Wagner Baetas-da-Cruz, Debmalya Barh, Adam M. Brufsky, Sk. Sarif Hassan, Kenneth Lundstrom, Ángel Serrano-Aroca, Kazuo Takayama, Murtaza M. Tambuwala, Bruce D. Uhal, Vladimir N Uversky

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: SARS-CoV-2; COVID-19; variant; sublineage; transmission; immunity; infection; vaccination; non-pharmaceutical interventions

Online: 14 March 2022 (11:19:04 CET)

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Preprint ARTICLE | doi:10.20944/preprints202203.0072.v1

Microbial Pattern and Antibiotic Resistance of Severe Pneumonia in A National Referral Hospital in Indonesia

Gurmeet Singh, Nova Bornida Fauzi, Sudirman Fakhruddin Masse, Dita Aditianingsih, Adhrie Sugiarto, Tonny Loho, Dewi Wulandari

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: antibiotic resistance; Acinetobacter baumannii; severe pneumonia

Online: 4 March 2022 (03:15:35 CET)

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Preprint ARTICLE | doi:10.20944/preprints202202.0194.v1

Experience of Isavuconazole as Salvage Therapy in Chronic Pulmonary Fungal Disease

Lisa Nwankwo, Desmond Gilmartin, Sheila Matharu, Ali Nuh, Jackie Donovan, Darius Armstrong-James, Anand Shah

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: antifungal resistance; isavuconazole; cystic fibrosis; pulmonary disease; Aspergillus fumigatus; pulmonary aspergillosis; respiratory disease; antifungal stewardship; therapeutic drug monitoring; minimum inhibitory concentration (MIC)

Online: 16 February 2022 (05:12:39 CET)

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Background: The burden of resistant fungal infection is rising in patients with pulmonary disease. Options for antifungal therapy are limited, and the only orally-available antifungals, the triazoles, demonstrate inter and intra-patient variability, non-linear kinetics, toxicity, drug interactions and increasing antifungal resistance. Therapeutic drug monitoring (TDM) of itraconazole, voriconazole and posaconazole has been necessary to ensure their safety and efficacy, but is considered unnecessary for the newest triazole isavuconazole, use of which is increasing. Aims: To characterise isavuconazole susceptibility of Aspergillus fumigatus isolates in a tertiary respiratory referral centre to understand prevalence of isavuconazole antimicrobial resistance. To retrospectively review experience of isavuconazole use in this setting, assessing tolerability and therapeutic drug monitoring. Methods: A retrospective observational analysis of adult patients with respiratory disease in a tertiary hospital setting between Sept 2016 and Aug 2021. Clinical cultures were collected and triazole Minimum inhibitory concentration (MIC) were recorded (based on Clinical & Laboratory Standards Institute (CLSI method)). Isavuconazole trough drug levels were carried out as part of the standard of care. Clinical outcomes of treatment were evaluated, along with drug tolerance and TDM. Results: During the study period, isavuconazole susceptibility testing was performed on 26 Aspergillus spp isolates. 80.8% of Aspergillus fumigatus isolates were non-wild type and had isavuconazole MIC > 1mg/L, and 73.0% had MIC above the EUCAST (European Committee on Antimicrobial Susceptibility Testing) epidemiological cut-off (ECOFF) of 2mg/L. There was good correlation between isavuconazole MIC and voriconazole MIC (r =0.7, p=0.0002). 54 patients had isavuconazole therapy over the study period with a median duration of 7.7 months (IQR 0.79 - 16.42). 67% of patients were able to tolerate isavuconazole, despite toxicity with prior azole treatment being the primary indication for use (in 61.8%). Increased age (r=0.29; p=0.03 (95%CI 0.02,0.52)) and gender (r for female sex=-0.31; p=0.027 (95%CI -0.52,0.036) were associated risk factors for development of adverse events (AEs). 127 Isavuconazole TDM levels were performed over the study period with 90% >1mg/L and 72% >2mg/L. Dose change from manufacturer’s dose recommendation, however, was required in 15% of patients to achieve a serum drug concentration above the EUCAST ECOFF or Area of technical uncertainty (ATU) value of 2mg/L. Conclusion: In our study, we show use of Isavuconazole as salvage therapy in chronic pulmonary fungal disease setting with high prevalence of azole resistance. Isavuconazole MICs demonstrated good correlation with voriconazole MICs suggesting the latter could be a useful surrogate marker for isavuconazole susceptibility. Although Isavuconazole achieved excellent serum drug concentrations at standard dose compared to other azole drugs, we highlight the importance of antifungal stewardship and TDM monitoring to optimise therapy in this setting.

Preprint ARTICLE | doi:10.20944/preprints202112.0446.v1

Usefulness of a Titratable Mandibular Positioner During Sleep Endoscopy as a Prediction Tool for Treatment Outcome with Mandibular Advancement Devices: DISE-SAM Protocol

Patricia Fernández-Sanjuán, Juan José Arrieta, Jaime Sanabria, Marta Alcaraz, Gabriela Bosco, Nuria Pérez-Martín, Adriana Pérez, Marina Carrasco-Llatas, Isabel Moreno-Hay, Rodolfo Lugo, Marcos Ríos-Lago, Carlos O'Connor-Reina, Peter Baptista, Guillermo Plaza

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: sleep breathing disorders; mandibular advancement; MAD; titratable positioner; drug-induced sleep endoscopy; patient selection.

Online: 28 December 2021 (11:03:45 CET)

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Preprint ARTICLE | doi:10.20944/preprints202111.0195.v2

Experimental Evaluation of Dry Powder Inhalers During In- and Exhalation Using a Model of the Human Respiratory System (xPULM™)

Richard Pasteka, Lara Schöllbauer, Joao Pedro Santos da Costa, Radim Kolar, Mathias Forjan

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: airway model; DPI; inhalation; aerosol testing; drug delivery; porcine lung

Online: 22 December 2021 (12:09:20 CET)

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Preprint ARTICLE | doi:10.20944/preprints202112.0284.v1

Assessment of the Effectiveness of Obstructive Sleep Apnea Treatment Using Optical Coherence Tomography to Evaluate Retinal Findings

Gloria Tejero-Garcés, Francisco J Ascaso, Paula Casas, Maria I Adiego, Peter Baptista, Carlos O'Connor-Reina, Eugenio Vicente, Guillermo Plaza

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Retina; Retinal nerve fiber layer; Obstructive sleep apnea syndrome; Optical coherence tomography; OCT; CPAP; Upper airway surgery.

Online: 17 December 2021 (08:47:15 CET)

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Preprint ARTICLE | doi:10.20944/preprints202112.0133.v1

Significance of Peripheral Blood Morphology With Granulocyte Distribution and Spirometry in Evaluation of Asthma and COPD Treatment

Grzegorz Kardas, Alicja Zielińska, Adam Pancer, Piotr Kuna, Michał Panek

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: COPD; asthma; bmi; eosinophils; blood morphology

Online: 8 December 2021 (14:28:32 CET)

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The two main chronic obstructive diseases are asthma – affecting 1-18% of adult population – and chronic obstructive pulmonary disease (COPD) prevalent in up to 6% of adults. In both cases the treatment depends on diseases’ severity. In management of these conditions, spirometry and complete blood count are two major monitoring tests. Our aim was to compare blood morphology results and spirometry values between patients in groups of different treatment intensity in asthma and COPD. By measuring that, we expected to study whether asthma/COPD patients have a need of stepping-up their treatment steps. Methods A retrospective analysis of patients admitted in 2013-2019 to an outpatient pulmonology clinic in Łódź (Poland). Spirometry values, complete blood count and information on pharmacological treatment were obtained from archival data. Patients were assigned with disease severity according to present GINA/GOLD recommendations. The study included 125 patients – 47 with COPD (22 females) and 78 with asthma (57 females). Results Among patients with asthma, a positive correlation in white blood cell count (WBC) (r=0,236, p=0.038) and ascending GINA treatment steps was found. Significant negative correlations were shown between ascending GINA treatment steps and FEV1, FEV1%, FVC%, MEF50, MEF50, PEF%. In COPD patients, positive correlations between ascending GOLD treatment groups and white blood cell count, neutrophil count, basophil percentage, platelet count (r=0.346; 0.309; 0.321; 0.401 respectively) were found. Negative correlations were shown between ascending GOLD treatment groups and FEV1, FEV1%, FVC, FVC%, MEF50, MEF50%, PEF, PEF% (r=-0.732; -0.575; -0.705; -0.498; -0.632; -0.558; -0.688; -0.597 respectively). Conclusions Negative correlations between ascending GINA and GOLD treatment steps and spirometry values may suggest that asthma and COPD patients may benefit from stepping-up the treatment steps earlier. Potential advantages of that more intensive treatment needs to be examined in the future

Preprint ARTICLE | doi:10.20944/preprints202111.0195.v1

Experimental Evaluation of Dry Powder Inhalers During In- and Exhalation Using a Model of the Human Respiratory System (xPULM™)

Richard Pasteka, Joao Pedro Santos da Costa, Mathias Forjan

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: airway model; DPI; inhalation; aerosol testing; drug delivery; porcine lung

Online: 10 November 2021 (08:39:55 CET)

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Preprint ARTICLE | doi:10.20944/preprints202110.0195.v1

Targeting of Inhaled Therapeutics to the Small Airways: Nanoleucine Carrier Formulations

Danforth P. Miller, Thomas E. Tarara, Jeffry G. Weers

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: respirable agglomerates; inhaled corticosteroids; ciclesonide; particle engineering; dry powder inhaler; extrafine; total lung dose; Alberta Idealized Throat; Idealized Child Throat

Online: 13 October 2021 (10:52:57 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202105.0116.v1

Forecasted Incidence, Intensive Care Unit Admissions and Projected Mortality Attributable to Covid-19 in Portugal, UK, Germany, Italy and France – 4 Weeks Ahead

Kathleen Carvalho, João Paulo Vicente, Mihajlo Jakovljevic, João Paulo Teixeira

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Time Series Prediction; ANN forecasting; New Coronavirus; COVID19 prediction cases; COVID19 prediction deaths; COVID19 prediction ICU, COVID19 Vaccination; COVID19 in Europe; COVID19 in Israel; COVID19 use of face mask.

Online: 6 May 2021 (16:58:01 CEST)

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Working Paper REVIEW

Computational, Experimental, and Clinical Evidence for a Specific but Peculiar Evolutionary Nature of (COVID-19) SARS-CoV-2

Gerard Goh, James Foster, A. Keith Dunker, Vladimir Uversky

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Pangolin; Intrinsic; Disorder; Protein; Nucleocapsid; Virulence; Shell; Covid; Coronavirus; Vaccine; Immune; Antibody; Shell; Nucleoprotein; Matrix; Attenuate; Severe Acute Respiratory

Online: 4 May 2021 (16:24:51 CEST)

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SARS-CoV-2 was empirically and computationally found to be of a specific but peculiar evolution. Shell disorder models found that the outer shell (M protein) of SARS-CoV-2 to be among the hardest in its CoV family. The hard outer shell (low M percentage of disorder (PID)) is likely to be related to the SARS-CoV-2 resistance to the antimicrobial enzymes in saliva and mucus, and be responsible for the high-level of viral shedding which has been observed clinically. Experimental studies have also shown that SARS-CoV-2 is more resilient in the environment than many other CoVs, including SARS-CoV-1. Another aspect of the shell disorder models predicts that SARS-CoV-1 is more virulent than SARS-CoV-2 because of higher inner shell disorder (N PID) that helps SARS-CoV-1 replicate faster in vital organs despite being of lesser viral loads in the saliva and mucus, unlike SARS-CoV-2. This has been reaffirmed experimentally, where higher levels (50 folds) of infectious particles were detected in the SARS-CoV-1 samples in comparison with those of SARS-CoV-2. The hard outer shell of SARS-CoV-2 has been found to be associated with burrowing animals, particularly pangolins, which are often in contact with buried feces. For these reasons, the M protein is highly conserved among close relatives of SARS-CoV-2. The phylogenetic tree using M, unlike the genome-wide one, shows that pangolin-CoVs are more closely related to SARS-CoV-2 than bat-RaTG13. Previous phylogenetic studies may have been confused by recombinations that are usually poorly handled. According to the shell disorder models based on the N PID, an attenuated COVID-19 strain is likely to have entered humans via pangolins in 2017 or before, which provides the virus enough time to adapt to humans. This could explain why the SARS-CoV-2 S protein is highly adapted to the human ACE-2. The specific but peculiar evolution has a wide range of clinical, immunological, and epidemiological implications.

Working Paper ARTICLE

Identifying COVID-19 by Using Spectral analysis of Cough Recordings: A Distinctive Classification Study

Negin Manshouri

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: COVID-19; Cough; Signal processing; STFT; MFCC; SVM

Online: 13 January 2021 (11:09:03 CET)

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Sound signals from the respiratory system are largely the harbingers of human health. Early diagnosis of respiratory tract diseases is of great importance as it creates irreversible effects on human health when delayed. This diagnostic in the medical world has been made possible thanks to machine learning and signal processing analysis. The coronavirus epidemic, which is in question today and deeply shakes the whole world, has been revealed the importance of this issue even more. In terms of the coronavirus pandemic, it has become the focus of researchers to differentiate symptoms from similar diseases such as normal flu or influenza. Among these symptoms, the difference in cough sound has played a distinctive role in the proposed study. Several pioneering studies have proven that almost two-thirds of people who get corona have a dry cough. At this stage, the information of studies based on cough constitutes the main framework of our study. On the other hand, the basis of this study is based on machine learning algorithms. Clinical data collected under the supervision of doctors in a reliable environment was used as dataset. This dataset consists of 16 subjects suspected of the coronavirus with a specific patient demographic. In this study, using the polymerase chain reaction (PCR) test, suspected subjects were divided into two groups as negative and positive. The negative and positive labels represent the patient with non-COVID and with a COVID-19 cough respectively. Using the 3D plot or waterfall representation of the signal frequency spectrum, the salient features of the cough data are revealed. In this way, COVID-19 can be differentiated from other coughs by applying effective feature extraction and classification techniques. Power Spectral Density (PSD) based on Short Time Fourier Transform (STFT) and Mel Frequency Cepstral Coefficients (MFCC) were chosen as the efficient feature extraction method. Finally, among the classification techniques the Support Vector Machine (SVM) algorithm, was applied to the processed signals in order to identify and classify COVID-19 cough. In terms of results evaluation, the cough of subjects with COVID-19 has obtained with 95.86% classification accuracy thanks to the RBF kernel function of SVM and the MFCC method. In other words, the diagnosis of COVID-19 coughs was obtained with 98.6% and 91.7% sensitivity and specificity measures respectively.

Preprint REVIEW | doi:10.20944/preprints202010.0041.v1

The Human Coronaviruses (HCoVs) and the Molecular Mechanisms of SARS-CoV-2 Infection

Luigi Santacroce, Ioannis A. Charitos, Domenico M. Carretta, Emanuele De Nitto, Roberto Lovero

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Coronavirus, SARS-CoV-2, Pandemics, Molecular biology, Immunity, Pathology

Online: 2 October 2020 (13:24:16 CEST)

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Preprint CONCEPT PAPER | doi:10.20944/preprints202009.0320.v1

Reciprocal Personal/Public Protection for COVID-19 with Mask Discriminating Mouth and Nose

Yijun Yuan

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: reciprocal personal/public protection; mask discriminating mouth and nose; mouth cover; mask; face covering; source control; source classification; Covid-19; active source; liquid droplets

Online: 14 September 2020 (11:45:27 CEST)

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Working Paper ARTICLE

Lung Damage Mechanisms For COVID-19 and Other Lung Infections, and Driving Force in Leukecyte Recruitment and Migration

Jianqing Wu, Ping Zha

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: SARS-CoV-2 COVID-19; lung damage mechanisms; leukecyte recruitment; viral infection; immune response; temperature and humidity; interstitial pressure change

Online: 9 September 2020 (11:32:55 CEST)

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To understand lung damage caused by COVID-19, we deduced two-phase lung damage mechanisms. After the lungs are infected with SARS-CoV-2 virus, the affected lung tissue swells and surface properties of pulmonary capillaries change, resulting in an increased flow resistance of affected capillaries. If a sufficient number of capillaries are affected by the infection, the swelling and increased cell wall adhesion collectively raise pulmonary vascular resistance. The increased vascular resistance further increases the dwell times of WBCs in affected capillaries and nearly capillaries. When pulmonary pressure is sufficiently higher, WBCs are forced to squeeze into interstitial spaces or alveolar spaces when local pressures are higher than what the capillaries can withstand. When more and more WBCs are dynamically retained, the flow resistance of more capillaries rises, pulmonary vascular resistance rises, and pulmonary pressure rises. The rise in the pulmonary pressure in turn results in elevated capillary pressures. When capillary pressures around the alveoli are sufficiently high, they cause interstitial pressures to change from normally negative values to positive values. The positive pressures cause fluid leakage to the alveolar space and thus degrade lung function. Tissue swelling, and occupation of WBCs in interstitial spaces and alveolar spaces further reduce compressible volume, and thus cause further rise in the pulmonary vascular resistance and pulmonary pressure. When the pulmonary pressure has reached a critical point as in the second phase, the blood breaks capillary walls and squeezes through interstitial spaces to reach alveolar spaces, resulting in irreversible lung damages. The available free volume in the thorax cage, organ usable capacities, temperature and humid are expected to have great impacts on degree of lung damages. The free volume in the thorax cage, lung usable surplus capacity, and other organ usable capacities determine the arrival time of last-phase irreversible damage. The mechanisms imply that the top priority for protecting lungs is maintaining pulmonary micro-circulation and preserving organ functions in the entire disease course while controlling viral reproduction should be stressed in the earliest time possible. The mechanisms also explain leukecytes are recruited and migrated into inflamed tissues by increasing their dwell times caused by increased local flow resistance.

Preprint ARTICLE | doi:10.20944/preprints202008.0267.v2

Trends in Intensive Care for Patients with COVID-19 in England, Wales and Northern Ireland

James C Doidge, Paul R Mouncey, Karen Thomas, Doug W Gould, Paloma Ferrando-Vivas, Manu Shankar-Hari, David A Harrison, Kathryn M Rowan

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: COVID-19; intensive care; trends; United Kingdom; mortality; mechanical ventilation

Online: 9 September 2020 (09:28:49 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202009.0008.v1

Implementation of a Delayed Prescribing Model to Reduce Antibiotic Prescribing for Suspected Upper Respiratory Tract Infections in a Hospital Outpatient Department, Ghana

Sam Ghebrehewet, Wendi Shepherd, Edwin Panford-Quainoo, Saran Shantikumar, Valerie Decraene, Rajesh Rajendran, Menaal Kushal, Afua Akuffo, Dinah Ayerh, George Amofah

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Antimicrobial Resistance (AMR); Antimicrobial Stewardship (AMS); delayed/back-up prescribing; upper respiratory tract infections; developing countries; LMICs; Ghana

Online: 1 September 2020 (11:29:47 CEST)

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Preprint SHORT NOTE | doi:10.20944/preprints202008.0663.v1

At “Half Mask” or “Nose Commando:” A Note Demonstrating Nasal Breaths Can Spread Microorganisms When Improperly Wearing a Mask During COVID-19

Robert Wolff

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: Mask; PPE; Bacteria; Nasal; Breath; Bacterial Culture; bioaerosols; COVID-19; SARS-CoV-2; hygiene behavior; face mask

Online: 30 August 2020 (11:41:33 CEST)

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Preprint CASE REPORT | doi:10.20944/preprints202008.0640.v1

Rapid Recovery in Six Patients with COVID-19 Respiratory Failure after Treatment with Vasoactive Intestinal Peptide

Jonathan Javitt, Jihad Youssef

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: VIP; COVID-19; respiratory failure; vasoactive intestinal peptide; aviptadil; ARDS

Online: 28 August 2020 (11:38:23 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202008.0267.v1

Trends in Intensive Care for Patients with COVID-19 in England, Wales and Northern Ireland

James C Doidge, Paul R Mouncey, Karen Thomas, Doug W Gould, Paloma Ferrando-Vivas, Manu Shankar-Hari, David A Harrison, Kathryn M Rowan

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: COVID-19; intensive care; trends; United Kingdom; mortality; mechanical ventilation

Online: 11 August 2020 (13:45:43 CEST)

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Preprint COMMUNICATION | doi:10.20944/preprints202004.0445.v2

Meta-Analysis: COVID-19 Disease Severity Correlates with Smoking Status

Edouard Lansiaux, Pierre-Philippe Pébaÿ, Jean-Laurent Picard, Joachim Son-Forget

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: COVID-19; Coronavirus; Respiratory Distress; Tobacco Smoking; Correlation Statistics; Conditional Probability; Regression; China; U.S.A.

Online: 27 July 2020 (05:59:51 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202007.0453.v1

Treatment of Acute Respiratory Distress Syndrome with Vasoactive Intestinal Peptide

Jihad Georges Youssef, Sami Said, George Youssef, Matthew J. Javitt, Jonathan C. Javitt

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: ARDS; VIP; Aviptadil; RLF-100; Acute Respiratory Distress Syndrome; Sepsis

Online: 20 July 2020 (03:46:11 CEST)

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Preprint CONCEPT PAPER | doi:10.20944/preprints202007.0259.v1

MARS Glass: A Smart Personal Protective Wearable

Muthucumaru Maheswaran, Maiuri Maheswaran

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: COVID-19; Smart wearable; personal protective equipment; augmented reality

Online: 12 July 2020 (14:48:50 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202007.0124.v1

Data-driven Analytical Models of COVID-2019 for Epidemic Prediction, Clinical Diagnosis, Policy Effectiveness and Contact Tracing: A Survey

Ying Mao, Susiyan Jiang, Daniel Nametz

Subject: Medicine And Pharmacology, Pulmonary And Respiratory Medicine Keywords: COVID-19; Epidemic Prediction; Clinical Diagnosis; Policy Effectiveness; Contact Tracing

Online: 7 July 2020 (10:06:05 CEST)

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