Background and Objective: Fibrotic interstitial lung disease (ILD) is associated with high morbidity and mortality. Patients often exhibit impaired nutritional status and alterations in body composition, such as dynapenia and sarcopenia, which correlate with poor pulmonary function, reduced exercise tolerance and diminished quality of life. However, the impact of dynapenia and sarcopenia on prognosis has not been examined extensively in ILD patients.We assessed the impact of dynapenia and sarcopenia as risk factors for mortality and their prevalence in ILD.Methods: Prospective cohort study. ILD was classified into idiopathic pulmonary fibrosis (IPF), connective tissue disease‐related ILD (CTD‐ILD) and chronic hypersensitivity pneumonitis (CHP). Patients over 18 years old with a confirmed diagnosis of ILD were included, while those with diagnoses of cancer, human immunodeficiency virus and neurological disease were excluded. Dynapenia and sarcopenia were determined according to EWGSOP2 criteria.Results: Ninety‐eight ILD patients were included; 33.66% had IPF, 47.96% had CTD‐ILD, and 18.37% had CHP. The mean age was 63.89 ± 12.02 years; 37.76% were male.The risk factors associated with mortality included dynapenia (HR: 2.04, 95% CI: 1.10–3.77, p = 0.022), sarcopenia (HR: 1.88, 95% CI; 1.00–3.33, p = 0.049) and exercise tolerance (HR: 0.99, 95% CI; 0.99–0.99, p = 0.023), adjusted for confounding variables.The prevalence of dynapenia was 45% in ILD; 51% in IPF, 35% in CTD‐ILD and 61% in CHP. The prevalence of sarcopenia was 29%; both IPF (39%) and CHP (50%) had a higher prevalence of sarcopenia than CTD‐ILD (14%).Conclusion: Sarcopenia and dynapenia are independent risk factors for mortality in ILD. image

Background: After hospital discharge, post-COVID-19 syndrome has been observed to be associated with impaired diffusing capacity, respiratory muscle strength, and lung imaging abnormalities, in addition to loss of muscle mass/strength, sarcopenia, and obesity impact exercise tolerance, pulmonary functions, and overall prognosis. However, the relationship between lung function and the coexistence of obesity with low muscle strength and sarcopenia in post-COVID-19 patients remains poorly investigated. Therefore, our aim was to evaluate the association between lung function and the coexistence of obesity with dynapenia and sarcopenia in post-COVID-19 syndrome patients. Methods: This cross-sectional study included subjects who were hospitalized due to moderate to severe COVID-19, as confirmed by PCR testing. Subjects who could not be contacted, declined to participate, or died before the follow-up visit were excluded. Results: A total of 711 subjects were evaluated; the mean age was 53.64 ± 13.57 years, 12.4% had normal weight, 12.6% were dynapenic without obesity, 8.3% had sarcopenia, 41.6% had obesity, 21.2% had dynapenic obesity, and 3.8% had sarcopenic obesity. In terms of pulmonary function, the dynapenic subjects showed decreases of −3.45% in FEV₁, −12.61 cmH2O in MIP, and -12.85 cmH2O in MEP. On the other hand, the sarcopenic subjects showed decreases of −6.14 cmH2O in MIP and −11.64 cmH2O in MEP. The dynapenic obesity group displayed a reduction of −12.13% in PEF. Conclusions: In post-COVID-19 syndrome, dynapenia and sarcopenia—both with and without obesity—have been associated with lower lung function.

Patients with biomass exposure-related COPD (BE-COPD) is a prevalent disease in developing countries and requires a detailed study of its clinical and inflammatory characteristics, specifying interventions that may differ from tobacco exposure-related COPD (TE-COPD). The objective was to describe clinical characteristics, biomarkers of inflammation, T-helper cells, and microbiological agents during a COPD exacerbation in BE-COPD in comparison with TE-COPD. A prospective observational study in patients with moderate or severe exacerbation was recruited either in the emergency room or the COPD clinic. At enrollment, nasopharyngeal swabs and sputum were collected to identify viral and bacterial pathogens. Blood samples were also collected to measure inflammatory biomarkers and T-helper cells levels. Days of hospitalization and mechanical ventilation requirement was evaluated. Clinical characteristics, vaccination history, hospitalization, history of exacerbations, and microbiological pattern between BE-COPD and TE-COPD were similar. The Th2 profile was higher in BE-COPD than in TE-COPD (2.10 [range 1.30-3.30] vs. 1.40 [range 1.20-1.80], p = 0.001). The Th2/Th1 ratio was higher in BE-COPD than TE-COPD (1.22 [range 0.58-2.57 ] vs. 0.71 [range 0.40-1.15], p = 0.004). The need of mechanical ventilation (MV) was higher in TE-COPD than BE-COPD (13% vs. 31.1%, p = 0.01). Nonvaccination history and high CRP levels were significantly associated with hospitalization [OR 1.48 (CI 95% 1.30-4.61, p = 0.005) and OR 1.17 (CI 95% 1.10-1.24, p = 0.001), respectively]. Clinical characteristics, inflammatory markers, and microbiological isolates were similar in both groups but BE-COPD show a tendency to present higher inflammatory Th2 cells and low requirement MV compared with TE-COPD.

During the first year of the COVID-19 pandemic, various authors reported that acute exacerbations of COPD (AECOPD) were reduced [1–4]. In Mexico City, during the beginning of the pandemic, a voluntary lockdown was declared and therefore the adherence to health measures was more flexible and less stringent in the general population than in other countries [5]. However, because there was a reduction of exposure to air pollutants such as particulate matter with a diameter <10 μm (PM₁₀) and <2.5 µm (PM_2.5), as well as total suspended particles levels during the first year of the pandemic, especially among patients living in urban areas like Mexico City, AECOPD could be diminished as other countries have reported [1–4].

Background: COPD due to biomass exposure (COPD-B) is highly prevalent in low- and middle-income countries, and there are no clinical trials designed to evaluate the effectiveness of the treatments currently recommended for patients with COPD due to cigarette smoking (COPD-C). The purpose of the study was to compare the efficacy of fluticasone furoate/vilanterol (FF/V) 100/25 μg and umeclidinium/vilanterol (UMEC/VI) 62.5/25 μg on the rate of exacerbations, the time to first exacerbation, on dyspnoea, health-related quality of life (HRQL), forced expiratory volume in 1 s (FEV₁) and inspiratory capacity (IC) during a period of 6 months in patients with COPD-B and COPD-C, at a third level referral centre in Mexico City.Methods: A pilot, single-centre, open-label, parallel-group study included 132 patients with a history of at least two exacerbations. They were randomised to receive one of four treatment groups: 33 COPD-B patients received FF/VI 100/25 μg, 31 COPD-B patients received UMEC/VI 62.5/25 μg, 34 COPD-C patients received FF/V and 34 COPD-C patients received UMEC/VI.Results: There were no differences in exacerbation rates between patients receiving FF/VI or UMEC/VI in either the COPD-B (0.07 (95% CI 0.03–0.13), 0.06 (95% CI 0.03–0.12)) or COPD-C group (0.06 (95% CI 0.04–0.11), 0.08 (95% CI 0.05–0.13)), nor in the time of first exacerbation, nor FEV₁and IC. All groups showed improvement in dyspnoea and HRQL, independently of medication used.Conclusions: Among patients with COPD-B and COPD-C with a history of exacerbation, FF/VI was equally effective as UMEC/VI in preventing exacerbations and improving dyspnoea and HRQL.

Background: Chronic Obstructive Pulmonary Disease (COPD) exhibits some phenotypic differences between patients with biomass smoke inhalation (COPD-B) and tobacco smoking (COPD-T). COPD-B is characterized by less emphysema but more airway disease and vascular pulmonary remodeling, which are related to mast cells in lung tissues in COPD-T. Our objective was to describe the differences between the number of mast cells in COPD-B and COPD-T patients. Methods: A cross-sectional study was conducted on lung tissue resections for suspected cancer obtained between 2014 and 2021 from patients with documented COPD due to wood smoke or tobacco exposure. Histological samples were analyzed for mast cell count, CD34+ expression, and structural changes in lung tissue and pulmonary circulation. Results: A total of 20 histological samples were analyzed, with significant differences found in mast cell count [median 8 (p25-75, 5–11) vs. 2 (p75-25, 0–6), p = 0.016] and severe peribronchiolar fibrosis (60% vs. 10%, p = 0.04) between COPD-B and COPD-T patients. A positive correlation [Spearman rho = 0.879 (95% CI 0.71–0.96), p < 0.001] was observed between mast cell count and a gradual increase in pulmonary artery diameter. Conclusions: These preliminary findings suggest histological differences and the presence of mast cells between COPD-B and COPD-T, which should be confirmed in a larger number of samples and patients.