Respiratory disorders can get critical if not diagnosed at the right time. An early COPD treatment can be a saviour for an individual's functional status, quality of life, and prevention of future exacerbations. This article presents excerpts from studies about COPD from famous peer-reviewed journals for primary care physicians.

1. COPD is getting an early start

ERJ Open Research 2020- A study found that early COPD is correlated with a significant disease burden and the use of healthcare services due to significant structural and functional disorders that often go unreported and therefore untreated. A family history of respiratory disorders or prior early-life respiratory incidents has been documented by many patients, reinforcing the perception that COPD can occur very early age and providing new possibilities for prevention, diagnosis and management.

2. COVID-19 may be distinguished by a breath test

Lancet 2020- In a feasibility review, near-patient gas chromatography-ion mobility spectrometry was used to easily differentiate patients with COVID-19 from patients with COPD, asthma, flu, or bacterial pneumonia during the first interaction with healthcare. It was possible to distinguish between patients with a definite diagnosis of COVID-19 and non-COVID-19 with ~80% precision. In the endemic flu seasons, the use of the approach may enable rapid detection of COVID-19.

3. Education and training eliminate geriatric inhalation errors and symptoms

BMC Geriatrics 2020- In a prospective intervention study, extensive training for 8 days enhanced their handling of inhalers and decreased clinical symptoms for patients aged 65 years and over with COPD. Those with cognitive abnormalities have gained as well. Errors in handling per patient decreased from 3.0 to 0.5. COPD assessment test scores decreased from 19.5 to 14.5, reflecting a major reduction in clinical symptoms. Forced expiration volume in 1 s and forced vital capability increased just marginally.

4. The question is still out on nocturnal oxygen

New England Journal of Medicine 2020- In a review of whether nocturnal oxygen given for 3 to 4 years reduces the mortality or deterioration of the disease in COPD patients in such a way that they fulfil the current requirements for long-term oxygen therapy, the results did not suggest that nocturnal oxygen had a positive or negative impact. At three years of follow-up, 39 per cent of the nocturnal oxygen patients and 42 per cent of those assigned to placebo fulfilled requirements for Nocturnal Oxygen Therapy Trial criteria for chronic oxygen therapy or died.

5. A boost is created by pulmonary rehab

Chest 2020- For patients with COPD, an 8-week pulmonary rehabilitation programme led to significant improvements across 2 years in anxiety and quality of life (QoL). Dyspnoea measured by the updated Medical Research Council questionnaire, QoL assessed by the Saint George Respiratory Questionnaire, and anxiety measured by the Anxiety Inventory for Respiratory Disease and Depression Anxiety Stress Scale were statistically substantial improvements at 8 weeks. Short-term changes in symptoms of dyspnoea, depression and stress were not sustained after 2 years.

6. Non-invasive ventilation late failure is explained

Canadian Respiratory Journal 2020- In a recent report, nosocomial pneumonia; heart rate at the start of NIV; and consciousness, acidosis, and oxygenation at 1–2 hours of NIV were the risk factors for non-invasive ventilation (NIV) failure after initial progress in patients with acute exacerbation of COPD. Late NIV failure (patients needing intubation or dying after initial success during NIV) was linked with prolonged stays in the ICU and greater hospital mortality.

7. Elderly adults are unable to use cannabinoids

Thorax 2020- In older adults with COPD, the new use of oral synthetic cannabinoids (nabilone, dronabinol) has been shown to be correlated with high levels of adverse effects. Their hospitalisation rate for COPD was not substantially different from that of the controls, but there were considerably higher all-cause mortality rates. Those who received higher-dose cannabinoids had higher hospitalisation rates and mortality rates for all reasons.

Disclaimer- The views and opinions expressed in this article are those of the author's and do not necessarily reflect the official policy or position of M3 India.

The author is a practising super specialist from New Delhi.