Patients with COPD (chronic obstructive pulmonary disease) are at a higher risk of comorbid conditions such as anxiety and/or depression, which in turn increase their symptom burden and rehospitalizations compared to the general population. It is important to investigate the pathophysiology and clinical implications of mental health on patients with COPD. This review article finds that COPD patients with anxiety and/or depression have a higher rehospitalization incidence. It reviews the current screening and diagnosis methods available. There are pharmacological and non-pharmacologic interventions available for treatment of COPD patients with depression based on severity. COPD patients with mild depression benefit from pulmonary rehabilitation and cognitive behavioral therapy, whereas patients with severe or persistent depression can be treated with pharmacologic interventions.

Diffuse alveolar hemorrhage (DAH), a catastrophic complication of connective tissue disorders (CTDs), manifests as rapid-onset hypoxemia, alveolar infiltrates, and progressive bleeding into the airways. While immune-mediated alveolar–endothelial injury primarily drives its pathophysiology, diagnosis is based on bronchoscopy and chest imaging. The clinical urgency lies in securing the compromised airway and stabilizing respiratory failure, a challenge increased by CTD-specific anatomical alterations such as cervical spine instability, cricoarytenoid arthritis, and subglottic stenosis. High-dose corticosteroids and immunosuppression are essential, while severe cases require extracorporeal membrane oxygenation or plasmapheresis. This comprehensive review introduces two novel approaches to address fundamental gaps in the management of CTD-induced DAH: a structured algorithm for a CTD-specific airway risk stratification tool, integrating anatomical screening and the application of lung ultrasounds (LUSs) for post-intubation CTD-induced DAH ventilation management. The need for a multidisciplinary team approach is also discussed. Despite aggressive care, mortality remains high (25–50%), underscoring the necessity for improved early recognition and intervention strategies for these high-risk patients.

Background/Objectives: Respiratory syncytial virus (RSV) infection can lead to significant complications, particularly among those with underlying cardiovascular and pulmonary complications. Patients with pulmonary hypertension (PH) are susceptible to clinical deterioration triggered by respiratory infections due to their limited cardiopulmonary reserve. This study aimed to assess the risk of hospitalization in RSV-infected adults with and without PH. Methods: We conducted a retrospective cohort study using the research network TriNetX to assess the risk of hospitalization in a cohort of patients with RSV infection, comparing those with and without PH. Propensity score matching was performed for demographic variables and RSV risk factors between the two cohorts. The risk of hospitalization was expressed as an adjusted odds ratio (aOR) with a 95% confidence interval (CI). Results: There were 193,256 patients in the RSV with PH cohort and 2,843,714 in the RSV without PH cohort (all aged >18 years). The mean age of the RSV with PH cohort was 68.2 ± 15.3 years, 50.6% were females, 64% were white, and 64.2% were group 2 PH. The RSV with PH cohort was at an increased risk of hospitalization (aOR 1.89, 95% CI 1.87–1.92, p-value 0.02). There was a significant risk (aOR 1.29, 95% CI 1.27–1.32) for the composite outcome of hospitalization-related complications between the two cohorts. Comorbid conditions (diabetes, cardiovascular disease, chronic lung disease, and chronic kidney disease) increased the risk of hospitalization in the RSV with PH group, with the biggest effect noted with underlying cardiovascular disease. Similarly, those with group 2 PH had a higher risk of hospitalization compared to the other PH groups. Remarkably, all PH groups demonstrated increased hospitalization risk compared to the RSV without PH cohort. Conclusions: We found that patients >18 years of age with PH and RSV infection were at an increased risk of hospitalization, with subsequently higher rates of RSV-infection-related complications. All PH groups had a higher hospitalization risk compared to the RSV without PH cohort, likely denoting PH as an independent risk factor for worse RSV-infection-related outcomes. RSV vaccination, therefore, may benefit all age groups of patients with PH.

Background/Objectives: RSV infection can lead to significant complications, particularly among those with underlying cardiovascular and pulmonary complications. Patients with pulmonary hypertension (PH) are susceptible to clinical deterioration triggered by respiratory infections due to their limited cardiopulmonary reserve. This study aimed to assess the risk of hospitalization in RSV-infected adults with and without PH. Methods: : We conducted a retrospective cohort study using the research network TriNetX to assess the risk of hospitalization in a cohort of patients with RSV infection compared with and without PH. Propensity score matching was performed for demographic variables and RSV risk factors between the two cohorts. Risk of hospitalization was expressed as adjusted odds ratio (aOR) with 95% confidence interval(CI). Results: There were 193,256 patients in the RSV with PH cohort and 2,843,714 in the RSV without PH cohort (all aged >18 years). The mean age of the RSV with PH cohort was 68.2+/-15.3 years, 50.6% were females, 64% were white, and 64.2% were group 2 PH. The RSV with PH cohort was at an increased risk of hospitalization (aOR 1.89, 95% CI 1.87–1.92, p value 0.02). There was a significant risk (aOR 1.29, 95% CI 1.27–1.32) for the 32 composite outcome of hospitalization-related complications between the 2 cohorts. Comorbid conditions (diabetes, cardiovascular disease, chronic lung disease, and chronic kidney disease) increased the risk of hospitalization in the RSV with PH group, with the most effect noted with underlying cardiovascular disease. Similarly, Group 2 PH noted a higher risk of hospitalization compared to the other PH groups. Remarkably, all PH groups noted increased hospitalization risk compared to the RSV without PH cohort. Conclusions: We found that patients > 18 years of age with PH and RSV infection are at an increased risk of hospitalization with subsequently higher RSV infection-related complications. All PH groups noted higher hospitalization risk compared to RSV without PH, likely denoting PH as an independent risk factor for worse RSV infection-related outcomes. RSV vaccination, therefore, may benefit all age groups in patients with PH. Our study also reiterates the current RSV vaccination recommendation for patients with underlying cardiovascular disease.

Background: Post-procedural respiratory disorders (PPRDs), including tracheostomy complications and post-surgical pulmonary insufficiency, are serious peri-operative complications among older adults. Despite their clinical importance, national mortality trends related to PPRDs have not been comprehensively characterized. Methods: We analyzed data from the CDC WONDER Multiple Cause of Death database from 1999 to 2020, focusing on decedents aged ≥65 years with ICD-10 codes J95.0–J95.9. Age-adjusted mortality rates (AAMRs) per 100 000 were calculated using the 2000 U.S. standard population. Joinpoint regression was used to assess temporal trends and estimate average annual percent change (AAPC) with 95% confidence intervals (CIs). Results: From 1999 to 2020, there were 34 722 deaths due to PPRDs among older adults. The overall AAMR declined from 6.47 to 1.78 per 100,000, with an AAPC of −5.81% (95% CI: −6.71 to −5.14). AAMRs declined across all subgroups. By sex, AAPCs were −6.71% for males and −6.11% for females. By race/ethnicity, the steepest declines occurred among Asian or Pacific Islanders (–6.99%), followed by Black individuals (–6.59%), White individuals (–6.26%), and Hispanic individuals (–5.65%). By age, the greatest decline was observed in those ≥85 years (–6.73%), followed by those aged 65–74 (–6.51%) and 75–84 (–5.80%). Geographic differences were noted: metropolitan areas showed a steeper decline (–6.37%) compared to non-metropolitan areas (–5.81%). Conclusion: PPRD-related mortality in older U.S. adults declined substantially over the past two decades. The observed decline may reflect advances in perioperative respiratory care, anesthesia practices, and critical care delivery over time. However, persistent disparities by race, age, and geography suggest targeted interventions to reduce preventable postoperative mortality and improve equity in surgical outcomes.