RATIONALE: Persistent respiratory symptoms following Coronavirus Disease 2019 (COVID-19) are associated with residual radiological changes in lung parenchyma, with a risk of development into lung fibrosis, and with impaired pulmonary function. Previous studies hinted at the possible efficacy of corticosteroids (CS) in facilitating the resolution of post-COVID residual changes in the lungs, but the available data is limited. AIM: To evaluate the effects of CS treatment in post-COVID respiratory syndrome patients. PATIENTS AND METHODS: Post-COVID patients were recruited into a prospective single-center observational study and scheduled for an initial (V1) and follow-up visit (V2) at the Department of Respiratory Medicine and Tuberculosis, University Hospital Olomouc, comprising of pulmonary function testing, chest x-ray, and complex clinical examination. The decision to administer CS or maintain watchful waiting (WW) was in line with Czech national guidelines. RESULTS: The study involved 2729 COVID-19 survivors (45.7% male; mean age: 54.6). From 2026 patients with complete V1 data, 131 patients were indicated for CS therapy. These patients showed significantly worse radiological and functional impairment at V1. Mean initial dose was 27.6 mg (SD ± 10,64), and the mean duration of CS therapy was 13.3 weeks (SD ± 10,06). Following therapy, significantly better improvement of static lung volumes and transfer factor for carbon monoxide (DLCO), and significantly better rates of good or complete radiological and subjective improvement were observed in the CS group compared to controls with available follow-up data (n = 894). CONCLUSION: Better improvement of pulmonary function, radiological findings and subjective symptoms were observed in patients CS compared to watchful waiting. Our findings suggest that glucocorticoid therapy could benefit selected patients with persistent dyspnea, significant radiological changes, and decreased DLCO.

• Klíčová slova
• Corticosteroids, Post-covid syndrome, Pulmonary fibrosis, Pulmonary function, Watchful waiting,
• Publikační typ
• časopisecké články MeSH

Excessive daytime sleepiness (EDS) is a common symptom of sleep disorders such as narcolepsy, obstructive sleep apnea, and hypersomnia. The most common tools for assessing EDS are various specialized questionnaires such as Epworth Sleepiness Scale (ESS) and Stanford Sleepiness Scale (SSS). However, the scores obtained from self-rating questionnaires do not seem to measure physiological sleepiness but rather a more complex phenomenon of subjective sleepiness modulated by other factors such as motivation, expectation, and capability of self-perception. The golden standard for measuring physiological sleepiness and assessing EDS is the Multiple Sleep Latency Test (MSLT). However, MSLT is very time consuming and requires trained personnel and expensive equipment. Different method modifications are employed in various medical and industrial fields for different purposes. The infrared pupillography in darkness has the potential to measure objective physiological sleepiness, especially the Pupillographic Sleepiness Test (PST), which is the method of choice for pupillographic measurement of daytime sleepiness. The method has also been employed in several specific sleep disorders, outlining possible future usage. This narrative review summarizes the current state of knowledge on the relevance and usefulness of pupillography in sleep medicine.

• Publikační typ
• časopisecké články MeSH

AIMS: The study analysed post-acute COVID-19 symptoms and the pulmonary function test (PFT) results in patients surviving the native strain of the virus. METHODS: The study was prospective; the inclusion criteria were positive PCR test for SARS-CoV-2 and age 18-100. Exclusion criteria were active respiratory infection, known or suspicious pre-existing pulmonary disease, cardiac failure, recent or acute pulmonary embolism, anaemia, and neuromuscular diseases. The recruitment period was 1st March 2020 - 25th December 2020. The initial examination was performed 4-12 weeks after the disease onset. All subjects underwent physical examination, anamnesis, chest x-ray and PFT. RESULTS: The study involved 785 subjects (345 male) mean age 53.8 (SD 14.6). The disease severity groups were: mild (G1), moderate (G2) and severe/critical (G3). Anosmia was present in the acute disease phase in 45.2% of G1 patients, but only in 4.5% of G3 patients. Dyspnoea occurred frequently in more severe groups (40%, 51.8% and 63.7% for G1, G2 and G3 respectively), while cough and fatigue showed no relationship to disease severity. Females were more likely to experience persistent symptoms. PFT results were significantly decreased in more severe groups compared to the mild COVID-19 patients, diffusing capacity was 86.3%, 79% and 68% of predicted values in G1, G2 and G3 respectively. CONCLUSION: Anosmia during the acute phase was associated with mild disease, persisting dyspnoea was more frequent after more severe COVID-19. Females tended to have persisting symptoms in post-acute phase more frequently. PFT results showed decrease with disease severity.

• Klíčová slova
• COVID-19, clinical presentation, post-acute phase, pulmonary function tests,
• MeSH
• anosmie MeSH
• COVID-19 * komplikace   diagnóza   MeSH
• dospělí MeSH
• dyspnoe etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• prospektivní studie MeSH
• respirační funkční testy MeSH
• SARS-CoV-2 MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

This review summarizes the issue of acute hypercapnic respiratory failure. Acute respiratory failure is a condition in which the respiratory system is unable to fulfill its basic function, i.e. enriching the blood with oxygen and excreting carbon dioxide. Chronologically, we divide it into acute and chronic, and according to the manifestation into hypoxemic or hypoxemic with hypercapnia. Multiple factors, such as reduced ventilation and increased dead space, contribute to the development of hypoxemic-hypercapnic (global) respiratory failure. Both the patient's clinical presentation and laboratory examination of blood gases and acid-base balance (preferably from arterial blood) are used for diagnosis. In the absence of contraindications, non-invasive ventilation is used to establish normocapnia.

• Klíčová slova
• Respiratory failure, hypercapnia, non-invasive ventilation, noninvasive ventilation, respiratory insufficiency,
• MeSH
• chronická obstrukční plicní nemoc * MeSH
• hyperkapnie komplikace   MeSH
• lidé MeSH
• plíce MeSH
• respirační insuficience * etiologie   terapie   MeSH
• umělé dýchání MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

OBJECTIVE: Both panic disorder (PD) and obstructive sleep apnea (OSA) are frequent conditions that can be comorbid. This article reviews the current state of knowledge about the comorbidity of PD and OSA and the effectiveness of therapy in patients with this comorbidity. METHOD: Articles obtained via PubMed and Web of Science search were selected; the publishing date was between January 1990 and December 2022. The applied search terms were: obstructive sleep apnea; panic disorder; CPAP; antidepressants; anxiolytics; antipsychotics. Eighty-one articles were chosen by primary search via keywords. After a complete assessment of the full texts, 60 papers were chosen. Secondary papers from the references of the primary documents were investigated, evaluated for suitability, and included in the list of documents (n = 18). Thus, seventy-eight papers were incorporated into the review article. RESULTS: Studies describe a greater prevalence of panic disorder in OSA patients. So far, there is no data on the prevalence of OSA in PD patients. Limited evidence is found regarding the influence of CPAP treatment on PD, and this evidence suggests that CPAP can partially alleviate PD symptoms. Medication used in PD treatment can significantly impact comorbid OSA, as explored in several studies. CONCLUSIONS: The relationship between the two conditions seems bidirectional, and it is necessary to assess OSA patients for comorbid panic disorder and vice versa. Both disorders can worsen the other and must be treated with a complex approach to ensure improvement in patients' physical health and psychological well-being.

• MeSH
• anxiolytika * MeSH
• komorbidita MeSH
• lidé MeSH
• obstrukční spánková apnoe * epidemiologie   terapie   diagnóza   MeSH
• panická porucha * komplikace   epidemiologie   terapie   MeSH
• trvalý přetlak v dýchacích cestách MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• anxiolytika * MeSH

INTRODUCTION: Severe respiratory failure is one of the most serious complications of coronavirus disease 2019 (COVID-19). In a small proportion of patients, mechanical ventilation fails to provide adequate oxygenation and extracorporeal membrane oxygenation (ECMO) is needed. The surviving individuals need long-term follow-up as it is not clear what their prognosis is. AIM: To provide a complex clinical picture of patients during follow-up exceeding one year after the ECMO therapy due to severe COVID-19. METHODS: All subjects involved in the study required ECMO in the acute stage of COVID-19. The survivors were followed-up for over one year at a specialized respiratory medical center. RESULTS: Of the 41 patients indicated for ECMO, 17 patients (64.7% males) survived. The average age of survivors was 47.8 years, and the average BMI was 34.7 kg·m-2. The duration of ECMO support was 9.4 days. A mild decrease in vital capacity (VC) and transfer factor (DLCO) was observed on the initial follow-up visit (82.1% and 60%, respectively). VC improved by 6.2% and by an additional 7.5% after 6 months and 1 year, respectively. DLCO improved by 21.1% after 6 months and remained stable after 1 year. Post-intensive care consequences included psychological problems and neurological impairment in 29% of patients; 64.7% of the survivors got vaccinated against SARS-CoV-2 within 12 months of hospitalization and 17.6% experienced reinfection with a mild course. CONCLUSION: The COVID-19 pandemic has significantly increased the need for ECMO. Patients' quality of life after ECMO is temporarily significantly reduced but most patients do not experience permanent disability.

• Klíčová slova
• COVID-19, ECMO, long-term outcome,
• Publikační typ
• časopisecké články MeSH

The overarching importance of sleep was further emphasized during the pandemic of COVID-19. The subjects infected by COVID-19 frequently experience sleep disturbances; some are long-lasting problems and decrease the quality of life. Insomnia is the most studied sleep disorder associated with COVID-19. Insomnia affects patients who have experienced an infection and the general population. Good sleep is important in maintaining mental and physical health, including immune system functions. The interconnections between insomnia, the immune system, and COVID-19 are complex. Insomnia triggers numerous immune system dysregulations and makes individuals more vulnerable to respiratory infections. This narrative review overviews the influence of the COVID-19 pandemic on the immune system through sleep disorders.

• Klíčová slova
• COVID-19, circadian rhythms, immunity, insomnia, mental disorders, sleep deprivation,
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Extracorporeal membrane oxygenation is the highest form of resuscitation care in management of patients with respiratory failure. In the case of acute respiratory distress syndrome, the veno-venous setting is more often used. ECMO support enables, in case of lung function failure, to obtain the necessary time for the onset of the causal treatment effect or is used as a bridge to transplantation Mortality of the patients varies according to the underlying cause and presence of risk factors (e.g., age, complications or comorbid diseases). The onset of the COVID-19 pandemic has led to a significant increase in the need for ECMO. The quality of life of patients after ECMO is significantly reduced, but most patients do not experience permanent disability.

• Klíčová slova
• COVID-19, ECMO, corticosteroid, long-term outcome, long-term results,
• MeSH
• COVID-19 * MeSH
• kvalita života MeSH
• lidé MeSH
• mimotělní membránová oxygenace * MeSH
• pandemie MeSH
• pneumonie * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Overcoming infection with coronavirus disease 2019 (COVID-19) can lead to the persistence of various symptoms in some patients. The complex of symptoms causally related to severe acute respiratory coronavirus 2 infection is called post-COVID syndrome. One of the most common respiratory complications is pulmonary fibrosis, especially after critical course of the disease. In some patients, however, only the peripheral airways are affected by the air-trapping seen on high-resolution computed tomography scans. Less common respiratory complications include sarcoidosis and pneumatoceles. This narrative review summarizes current knowledge about pulmonary involvement as part of post-COVID syndrome.

• MeSH
• COVID-19 * komplikace   MeSH
• lidé MeSH
• SARS-CoV-2 MeSH
• syndrom MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH

A 33-year-old man with obesity, systemic arterial hypertension, and psoriasis who had been treated previously with little success by a pulmonologist for chronic unproductive irritant cough came to the outpatient pulmonary department because of profuse cough and short syncope (probably cough-induced). Chest radiography revealed widened mediastinum with lobular, polycyclic contours that was suspected to be a large mediastinal lymphadenopathy or mediastinal mass.

• MeSH
• dospělí MeSH
• kašel etiologie   MeSH
• lidé MeSH
• lymfadenopatie * diagnostické zobrazování   etiologie   MeSH
• mediastinum MeSH
• mnohočetné plicní uzly * komplikace   diagnostické zobrazování   MeSH
• nemoci mediastina * komplikace   MeSH
• plíce MeSH
• rentgendiagnostika hrudníku MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH