The COVID-19 pandemic dramatically changed medical care. Healthcare professionals are faced with new issues. Patients who survived COVID-19 have plenty of different continuing symptoms, of which the most common are fatigue and breathlessness. It is not well known how to care for patients with persistent or worsening respiratory symptoms and changes on chest X-ray following COVID-19 pneumonia. In this article, we talk about a subgroup of patients with organizing pneumonia following COVID-19 pneumonia that could be effectively treated with systemic glucocorticoids. It is important that patients with COVID-19 pneumonia be followed-up at least three weeks after diagnosis, in order to recognize early lung damage. We are providing a management algorithm for early diagnosis of lung diseases after COVID-19 pneumonia.

Background and Objectives: Community-acquired pneumonia (CAP) remains a major health burden worldwide, with high morbidity and mortality, particularly among older adults and those with comorbidities. This study aimed to evaluate the etiological factors of CAP and to investigate systemic inflammatory markers (IL-6, IL-8, IFN-γ, and G-CSF) in blood samples collected from CAP patients to identify which markers could be targets for potential etiological, clinical, and therapeutic interventions. Materials and Methods: A prospective study was conducted in 41 patients with confirmed CAP hospitalised during the winter season of 2024–2025. Clinical, demographic, and laboratory data were collected at admission and seven days later. Serum IL-6, IL-8, IFN-γ, and G-CSF concentrations were measured using a multiplex assay. Results: Aetiology was identified in 87.8% of cases, with typical bacterial pathogens being more prevalent among older, smoking patients, while atypical pathogens were more common among younger, non-smoking patients. Hospitalisation and increased inflammatory markers were associated with older age. After seven days of treatment, significant decreases in IL-6, IFN-γ, and G-CSF concentrations were observed. IFN-γ levels were significantly higher in patients with atypical aetiology. Higher concentrations of IL-8 and G-CSF were associated with hospitalisation. IL-6 levels were positively correlated with age, C-reactive protein (CRP), and pneumonia severity index (PSI) scores. Conclusions: Systemic inflammatory markers, especially IL-6, IL-8, IFN-γ, and G-CSF, may be valuable tools in managing generalised pneumonia. They can help to differentiate etiologically, assess disease severity, and make treatment decisions.

Diffuse pulmonary lymphangiomatosis (DPL), an exceptionally rare disease, mainly occurs in children and young adults of both sexes. Even though DPL is considered to be a benign disease, its prognosis is relatively poor. Because of its rarity, little guidance on diagnosis and treatment is available, which makes working with patients with DPL challenging for clinicians. We present here a case of a young man with DPL in whom treatment with sirolimus and propranolol rapidly achieved positive radiological and clinical effects.

Background and Objectives: Dual bronchodilation in chronic obstructive pulmonary disease (COPD) has demonstrated beneficial effects on health-related quality of life (HRQoL) and exercise-related outcomes. Real-world evidence in treatment-naïve COPD remains limited. Materials and Methods: Forty-six COPD patients and 23 age-, gender-, BMI-, and cardiovascular comorbidity–matched controls underwent spirometry, plethysmography, symptom-limited incremental cardiopulmonary exercise testing (CPET), and the 36-item Short-Form Health Survey (SF-36). Following baseline assessment, COPD patients received tiotropium/olodaterol as part of routine practice. Thirty-two patients underwent repeated examinations at 12 weeks. Baseline differences between the COPD and control groups were assessed, and longitudinal changes in pulmonary function, CPET, and SF-36 were evaluated in COPD patients. Results: Compared with controls, COPD patients had lower peak oxygen uptake (VO₂; 17.4 ± 4.4 vs. 22.8 ± 4.5 mL/kg/min, p < 0.001) and oxygen pulse (11.5 ± 3.5 vs. 14.0 ± 2.4 mL/beat, p = 0.003), failed to reach 80% of predicted values, and exhibited worse ventilatory efficiency (p < 0.001). SF-36 scores in the COPD group were lower across all domains. After 12 weeks of tiotropium/olodaterol, pulmonary function improved significantly. CPET was performed at comparable efforts at both visits. Peak VO₂ increased from 70 ± 15 to 75 ± 16% predicted (p = 0.044), and peak oxygen pulse from 74 ± 16 to 79 ± 16% predicted (p = 0.015). VE/MVV decreased from 0.77 ± 0.23 to 0.69 ± 0.15 (p = 0.03). Higher baseline VE/MVV predicted a larger improvement after treatment (B = 0.71, p < 0.001), while beta-blocker use had no effect on the change of VE/MVV. SF-36 physical functioning and health change scores improved (both p < 0.01). Conclusions: At diagnosis, COPD was associated with impaired exercise physiology and reduced HRQoL. Dual bronchodilation improved exercise responses and perceived physical functioning. Beta-blocker use was not associated with changes in breathing reserve, supporting the use of cardioselective agents when indicated.

Severe asthma imposes a substantial burden on individuals' health-related quality of life (HRQoL), which might not be fully captured by generic instruments. The Severe Asthma Questionnaire (SAQ) is a validated disease-specific HRQoL instrument capturing the unique lived experience of people with severe asthma. However, the SAQ does not generate preference-based utility values required for health economic evaluations. This study aimed to develop and validate mapping algorithms from the SAQ to the EuroQol (EQ)-5D-5L, enabling estimation of utility values when EQ-5D data are unavailable. We used baseline and 6-month data from the longitudinal, multicentre SHARP Burden of Asthma study, including adults with severe asthma across 7 European countries. Direct mapping (ordinary least squares and beta-mixture regression models) using the UK value set and indirect mapping (ordered probit regression models) were developed with baseline data to predict EQ-5D-5L utility values from SAQ scores. Performance was assessed via mean absolute error (MAE), root mean square error (RMSE), and R², with 6-month data used for validation. Data from 327 patients were included. The beta-mixture model using SAQ subscales marginally outperformed the other models in the development set (MAE = 0.090, RMSE = 0.129, R² = 0.704), whereas in the validation set the ordered probit regression model showed the best predictive performance (MAE = 0.106, RMSE = 0.151, R² = 0.589). Direct mapping with beta-mixture regression showed good overall performance, aligning with prior studies. Indirect mapping may be advantageous in settings requiring flexibility across EQ-5D-5L value sets. These findings demonstrate that EQ-5D-5L utility values can be reliably estimated from the SAQ, supporting use of the instrument in health-economic analyses.

Background/Objectives: Quantitative computed tomography (CT) can be used to characterize airway responses to therapies for chronic obstructive pulmonary disease (COPD), but prospective real-world data in treatment-naïve patients remain limited, and the role of inflammatory markers as potential predictors of structural airway response is poorly understood. Methods: We conducted a prospective real-world study in treatment-naïve patients with moderate-to-severe COPD (n = 47). Lung function and chest CT were assessed at baseline and after 12 weeks of tiotropium/olodaterol (n = 34). Blood eosinophil count and high-sensitivity C-reactive protein (hs-CRP) were measured at baseline. Results: Lung function improved after 12 weeks (p < 0.05). Airway lumen area normalized to body surface area (Ai/BSA) increased from 10.2 ± 2.6 to 12.2 ± 2.7 mm²/m², whereas relative wall area (WA%) decreased from 58.3 (56.6–61.5) to 55.9 (54.4–57.9)% (both p < 0.001). Improvement in Ai/BSA did not differ between upper and lower lobes (p > 0.05). Higher baseline hs-CRP was associated with a smaller Ai/BSA increase (r = −0.454, p = 0.01). No statistically significant associations were detected between ΔAi/BSA and the evaluated baseline variables, including blood eosinophil count, Ai/BSA, age, smoking history and lung function measurements (all p > 0.05), or between blood eosinophil count and baseline Ai/BSA or WA% (both p > 0.05). Conclusions: Initial dual bronchodilator therapy improved lung function and CT-derived airway measurements. In this cohort, no statistically significant association was detected between blood eosinophil count and airway response, whereas higher hs-CRP was associated with a smaller Ai/BSA increase.