Air pollution is the most significant environmental risk factor for all-cause mortality, and it has caused substantial disability-adjusted life-years and economic loss. Air pollution intensified the mortality during past pandemics, Spanish flu in 1918 and SARS-CoV-1 in 2003. It increases host susceptibility and virulence of respiratory infections and reduces viral clearance. Thus, a question arises whether there will be any impact of air pollution on the current pandemic coronavirus disease 2019 (COVID-19)? Thus far, history and science are directing towards an immense potential impact of air pollution on the COVID-19 pandemic. Some of the devastated countries with the current pandemic are those with a poor air quality index. Further epidemiological and ecological studies are necessary to confirm this association. Also, countries must mobilize funding for mitigation of air pollution to benefit environmental health and ameliorate its potential effects on pandemics of the future.

Turkthoracj, Turkish Thoracic Journal

The aim of this study was to describe the level and perception of control in severe asthma in Trinidad after the introduction of revised guidelines for asthma management. Adult asthmatics ( N = 329) at Trinidad’s chest clinics were cross-sectionally examined for guideline-defined disease control. Patients’ mean (SD) age was 54.36 (14.9) years, with body mass index = 28.54 (7.4) kg/meter², and females were proportionally more (246, 74.74%). Measured (45.29%) and perceived (18.96%) uncontrolled disease were poorly concordant (κ statistic = 0.197). Co-morbidity (≥2 conditions) correlated with uncontrolled disease in 55.80% of patients (Spearman correlation p = 0.03). Absolute peak expiratory flow was higher ( p < 0.001) in controlled and/or partially controlled disease than in uncontrolled asthma. Routine work limitation, night-time disturbances, work absenteeism, exacerbations, rescue inhalation and perceived control correlated with uncontrolled asthma ( p < 0.001). Few patients self-monitored lung function (9.73%) or kept an asthma diary (6.69%), but 65.1% believed they had to live with their symptoms. The asthma burden was at least one hospitalization (53.80%) and emergency department visit (66.36%) in the past year, cough (74.49%), dyspnoea (84.50%), wheezing (80.55%) and chest tightness (66.87%). After the revised guidelines, uncontrolled asthma and related morbidity remain suboptimal, with disagreeing actual and perceived control. Efforts to transform guidelines into patient care with realistic interpretation of control are recommended.

The primary purpose of spirometry is to identify the obstructive ventilatory defect, indicated by diminished forced expiratory volume in 1 s to forced vital capacity ratio (FEV₁/FVC). However, it also has several screening and prognostic applications by detecting nonobstructive abnormal spirometry (NOAS), a condition where either FEV₁ or FVC or both are reduced while the ratio remains normal. Both FVC and FEV₁ are known to be related to all-cause mortality and morbidity even in the general population [1]. Studies indicate that NOAS is prevalent in up to 30% of the general population [2] and an even greater proportion of those experiencing symptoms. However, there is substantial variation in how NOAS is interpreted. Additionally, it is worth noting that NOAS differs from the nonspecific pattern (NSP) described by Hyatt et al. [3], around 15 years ago. NSP is characterised by an abnormally low FEV₁ with normal FEV₁/FVC ratio and normal total lung capacity.