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.Respiratory system infections and chronic lung disease

Respiratory system infections and chronic lung disease

.Respiratory system infections and chronic lung disease


The two most common chronic inflammatory lung diseases are asthma and chronic obstructive disease (COPD). Respiratory infections are most commonly caused by serious acute respiratory conditions in patients with these chronic lung diseases, which often result in prolonged hospitalizations, worse treatment outcomes, and higher mortality.

Respiratory system infections and chronic lung disease

Asthma and its triggers

Respiratory infections in asthma patients

Chronic obstructive pulmonary disease (COPD)

Pneumonia and other infections in COPD

What is the risk of respiratory infections?

Conclusion

Asthma and its triggers

The most common types of asthma are allergic, non-allergic, aspirin and asthma exertion with various inflammatory processes in the lining.

Asthma is a chronic inflammatory respiratory disease involving many cells and cellular elements. Chronic inflammation is associated with airway hypersensitivity and leads to recurrent episodes of chest pains, shortness of breath, chest pressure and coughing, which are symptoms that are especially present at night or early in the morning. These episodes are caused by narrowing, i.e. airway obstruction, which is usually reversible (either spontaneously or with medication).

 

Asthma is the most common chronic childhood illness; nevertheless, 7-9 percent of the adult population has asthma, and about 235 million suffer from asthma. The most common types of asthma are allergic, non-allergic, aspirin and asthma exertion with various inflammatory processes in the lining. Exacerbation of asthma can be caused by various respiratory infections (most often viral), inhalation allergens (dust, mites, pollen, church, ambrosia, animal hair, etc.), exercise or physical exertion, strong irritants, strong emotions (laughing, crying / upset). changes in weather like cold air.

 

Respiratory infections in asthma patients

The most common viruses associated with asthma episodes are rhinoviruses, influenza virus, and respiratory syncytial virus (RSV).

In patients with asthma, clinical evidence points to the important role of respiratory infections in the development of asthma attacks and is an important factor in severe exacerbations. In the younger population, viral upper respiratory infections are the most common and are associated with 80 percent of asthma exacerbations in children and 50 percent of all adult asthma episodes.

 

The most common viruses associated with asthma episodes are rhinoviruses, influenza virus, and respiratory syncytial virus (RSV). Likewise, some atypical bacteria such as Chlamydophila pneumoniae and Mycoplasma pneumoniae can exacerbate asthma symptoms.

 

For people with asthma, even a common cold is very often not common but can provoke a worsening of the clinical picture with typical symptoms of an asthmatic attack. Symptoms of an asthmatic attack include significant shortness of breath, suffocation and shortness of breath. Furthermore, in the most severe cases, the development of asthmatic status or a prolonged, severe asthma attack can occur which can sometimes endanger the life of the affected person.

 

One of the reasons is that asthmatics have an exaggerated and unusual reaction of the immune system and, accordingly, the symptoms of colds, flu and other respiratory infections are significantly more pronounced than their manifestation in people who do not have asthma. Any exacerbation of asthma also means increased costs of treatment - especially if it requires hospitalization. As it is a younger population that is active, it means not only an increase in the direct costs of treatment but also the cost of sick leave, which puts a heavy burden on the health system.

 

Chronic obstructive pulmonary disease (COPD)

People with COPD are at increased risk for a wide variety of diseases, including respiratory infections.

Chronic obstructive pulmonary disease (COPD) is a disease characterized by a decrease in air flow through the airways that is not completely reversible, usually progressive, and is associated with an increased inflammatory response of the lungs to long-term exposure to harmful particles or gases (most commonly smoking). Exacerbation rates and comorbidities contribute to the overall severity of the disease.

 

Despite advances in diagnosis and treatment, the prevalence and mortality of COPD are still increasing. According to the latest data, COPD is the fourth leading cause of death in the world, just behind cardiovascular and malignancies and stroke. About 328 million people suffer from COPD worldwide, which is a major economic burden for the global health system. COPD patients are at increased risk for cardiovascular disease, respiratory infections, lung cancer, anxiety and depression, diabetes, and osteoporosis.

 

Pneumonia and other infections in COPD

Unlike asthma, where viral infections predominantly cause acute exacerbations of the disease, in COPD patients the causes of respiratory infections are numerous and diverse and can be from all relevant groups of microorganisms. They are most commonly caused by bacteria and less commonly by viruses and atypical microorganisms such as Mycoplasma pneumoniae, chlamydia and rickettsiae. Pneumonia or pneumonia is a common associated disease in COPD that contributes to a more severe clinical course of the disease, prolongs hospitalization and intensive care, and affects mortality.

 

The risk of developing pneumonia in patients with COPD is nearly ten times higher than in the general population and often the onset of pneumonia leads to a diagnosis of COPD. According to the results of a relatively small number of epidemiological studies available, the incidence of pneumonia in COPD patients ranges from 8 to 12.5 percent. As there are some differences in the prevalence of the most common causes of pneumonia between COPD patients and the general population, care should be taken when choosing empirical antimicrobial therapy.

 

Streptococcus pneumoniae (pneumococcus) is the most common cause of pneumonia in patients with COPD, responsible for 80-95 percent of all bacterial pneumonias in these patients. Other, less common bacterial agents are Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, Klebsiella pneumoniae, Proteus spp. and especially Pseudomonas aeruginosa. Each new respiratory infection contributes to the severity of the underlying disease and further impairs pulmonary function.

 

What is the risk of respiratory infections?

Patients with COPD and pneumonia are more likely to require hospitalization and longer hospital treatment compared to the general population.

One of the possible reasons for more frequent respiratory infections is that in patients with COPD there is a gradual pathohistological change in the bronchial mucosa and destruction of the ciliary apparatus of the "scavenger" of the lung, thus creating the preconditions for accelerated colonization of the lung by potentially pathogenic microorganisms. This also increases the risk of respiratory infection.

 

Some clinical trials have also shown that administration of inhaled corticosteroids in patients with COPD significantly increases the risk of pneumonia, by about 30 percent. Inhaled corticosteroids in fixed combination with long-acting bronchodilators are the basis for the treatment of more severe forms of the disease, but are unfortunately often uncritically prescribed beyond the prescribed guidelines.

 

Other risk factors for the development of pneumonia in patients with COPD are age, smoking, male gender, body weight, and comorbidities. associated diseases (diabetes, cardiovascular disease, bronchiectasis, malignancies). Older age and severe COPD with poor pulmonary function are the most important risk factors for respiratory infections. In relation to the general population, patients with COPD and pneumonia are more likely to need hospitalization and longer hospital treatment, which is often accompanied by worse outcomes.

 

Conclusion

Acute respiratory conditions are the most common reason for visits to GPs and are the leading cause of hospitalization of patients with chronic pulmonary diseases that cause prolonged stay, worse treatment outcomes, and increased direct and indirect treatment costs. Accordingly, any respiratory infection in these patients should be promptly and vigorously treated in accordance with the applicable guidelines.



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