Background: The aim of this study was to analyse the relationship between occupational exposure to asbestos and the severity of SARS-CoV-2 infection. Methods: We evaluated patients who survived admission in our centre for COVID-19 pneumonia. Demographic, analytical, and clinical variables were collected during admission. After discharge, a previously validated occupational exposure to asbestos questionnaire was administered. Spirometry, CO diffusion test, the 6-min walk test, and high-resolution chest CT were performed. Patients who required respiratory support (oxygen, CPAP, or NIV) were considered severe. Results: In total, 293 patients (mean age 54 + 13 years) were included. Occupational exposure to asbestos was detected in 67 (24%). Patients with occupational exposure to asbestos had a higher frequency of COVID-19 pneumonia requiring respiratory support (n = 52, 77.6%) than their unexposed peers (n = 139, 61.5%) (p = 0.015). Asbestos exposure was associated with COVID-19 severity in the univariate but not in the multivariate analysis. No differences were found regarding follow-up variables including spirometry and the DLCO diffusion, the 6-min walk test, and CT alterations. Conclusions: In hospitalised patients with COVID-19 pneumonia, those with occupational exposure to asbestos more frequently needed respiratory support. However, an independent association between asbestos exposure and COVID-19 severity could not be confirmed.

Although short-term CAT score variability has been associated with COPD exacerbations, evidence supporting its integration into virtual assistant-based monitoring remains limited. The aim of this study was to assess the short-term variability in CAT scores using a virtual management tool in patients with COPD and to examine its relationship with the prediction of exacerbations. A prospective observational single-center study was conducted in patients aged >35 with COPD and an exacerbator phenotype (≥2 outpatient exacerbations or ≥1 hospitalization in the previous year). Follow-up was performed weekly, including the CAT questionnaire, through calls were conducted by the virtual assistant Tucuvi Health Manager^® during a period of one year. A total of 106 patients were included; 64.2% were male, with a mean (SD) age of 66.8 (7.9) years and a median FEV₁(%) of 38.8 (30.1–45.0). The mean follow-up was 25 weeks [IQR 20–35], during which 73 (69%) patients experienced ≥1 exacerbation, accounting for 192 episodes (26% of which required hospitalization). A total of 2550 CAT scores were collected. The mean baseline CAT score was 17.9 (7.6), and scores increased significantly during exacerbations compared with non-exacerbation periods and according to exacerbation severity. Each one-point increase in absolute CAT score was associated with an 11.1% increase in the odds of exacerbation (OR: 1.11; 95% CI: 1.08–1.13), while a weekly variation of ≥2 points (MCID) was associated with more than sixfold higher odds (OR: 6.30; 95% CI: 4.28–9.27). The optimal cut-off for CAT change in the prediction of exacerbation risk was 3 points with a ROC curve of 0.773. Weekly deterioration in CAT scores was associated with increased exacerbation risk in patients with COPD. Short-term increases in CAT may serve as clinically useful warning signals for exacerbation.

Obstructive sleep apnea (OSA) is highly prevalent. Elderly patients may have special difficulty initiating CPAP. This results in poor therapy adaptation and an overload on the healthcare system. AI, in constant development, emerges as a tool to optimize healthcare circuits. Objective: To compare the efficency of a natural language processing-based virtual assistant (TUCUVI) to in-person follow-up in the initiation of CPAP for patients aged >=65. Methods: Randomized non-inferiority study of OSA patients aged >=65 eligible for CPAP treatment, comparing in person vs telephonic follow-up with TUCUVI over 6 months (Image 1). Data on OSA diagnosis, symptoms, CPAP adherence, adverse effects and number of in-person visits were collected. erj;64/suppl_68/PA4364/F1 F1 F1 Results: 51 patients were included, 26 followed with TUCUVI and 25 in person, 56.9% male, with a mean age of 73.2 (SD 5.9) and an AHI at diagnosis of 46.2/h (SD 16.3), no differences between groups. Table 1 shows results from 30 patients at 3-month follow-up. erj;64/suppl_68/PA4364/F2 F2 F2 Conclusion: TUCUVI allows a correct adaptation to CPAP similar to in-person control, without significant issues nor additional in-person visits required, based on a partial analysis at 3 months.