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After multiple waves of the COVID-19 pandemic, it has become clear that the impact of SARS-CoV-2 will carry on for years to come. Acutely infected patients show a broad range of disease severity, depending on virus variant, vaccination status, age and the presence of underlying medical and physical conditions, including obesity. Additionally, a large number of patients who have been infected with the virus present with post-COVID syndrome. In September 2020, the International Society for the Advancement of Respiratory Psychophysiology organized a virtual interest meeting on ‘Respiratory research in the age of COVID-19’, which aimed to discuss how research in respiratory psychophysiology could contribute to a better understanding of psychophysiological interactions in COVID-19. In the resulting current paper, we propose an interdisciplinary research agenda discussing selected research questions on acute and long-term neurobiological, physiological and psychological outcomes and mechanisms related to respiration and the airways in COVID-19, as well as research questions on comorbidity and potential treatment options, such as physical rehabilitation.

BACKGROUND: Reduced physical activity is common in COPD and is associated with poor outcomes. Physical activity is therefore a worthy target for intervention in clinical trials; however, trials evaluating physical activity have used heterogeneous methods. RESEARCH QUESTION: What is the available evidence on the efficacy and/or effectiveness of various interventions to enhance objectively measured physical activity in patients with COPD, taking into account the minimal preferred methodologic quality of physical activity assessment? STUDY DESIGN AND METHODS: In this narrative review, the COPD Biomarker Qualification Consortium (CBQC) task force searched three scientific databases for articles that reported the effect of an intervention on objectively measured physical activity in COPD. Based on scientific literature and expert consensus, only studies with ≥ 7 measurement days and ≥ 4 valid days of ≥ 8 h of monitoring were included in the primary analysis. RESULTS: Thirty-seven of 110 (34%) identified studies fulfilled the criteria, investigating the efficacy and/or effectiveness of physical activity behavior change programs (n = 7), mobile or electronic-health interventions (n = 9), rehabilitative exercise (n = 9), bronchodilation (n = 6), lung volume reduction procedures (n = 3), and other interventions (n = 3). Results are generally variable, reflecting the large differences in study characteristics and outcomes. Few studies show an increase beyond the proposed minimal important change of 600 to 1100 daily steps, indicating that enhancing physical activity levels is a challenge. INTERPRETATION: Only one-third of clinical trials measuring objective physical activity in people with COPD fulfilled the preset criteria regarding physical activity assessment. Studies showed variable effects on physical activity even when investigating similar interventions. ispartof: CHEST vol:160 issue:6 pages:2080-2100 ispartof: location:United States status: published

Chronic Obstructive Pulmonary Disease (COPD) is usually characterized by a progressive decline of lung function. We reported the 10 years follow-up of an elderly man, a heavy smoker with severe COPD and apical bullous emphysema. During 6 months pulmonary rehabilitation program the patient's clinical state improved significantly and it associated with a steep increase in forced expiratory volume in one second (FEV1). This case report elaborates on the unexpected gain of FEV1 in the follow-up of a COPD patient. publisher: Elsevier articletitle: Unexpected improvements of lung function in chronic obstructive pulmonary disease journaltitle: Respiratory Medicine Case Reports articlelink: http://dx.doi.org/10.1016/j.rmcr.2016.05.004 content_type: article copyright: © 2016 The Authors. Published by Elsevier Ltd. ispartof: Respiratory Medicine Case Reports vol:18 pages:81-84 ispartof: location:England status: published

Publisher Summary Pulmonary rehabilitation is nowadays a recognized evidence-based therapy, which can be applied to patients with lung diseases who are symptomatic and have reduced activities of daily living, despite optimal medical therapy. Unlike most drugs, pulmonary rehabilitation does not target the lungs directly, but aims at reversing or stabilizing the extra-pulmonary effects of lung diseases. To be successful, pulmonary rehabilitation is typically designed as a comprehensive intervention offered by a team of health-care providers over a substantial period of time. Typically, rehabilitation programs are carried out for 6 weeks to 6 months, with longer programs yielding more substantial effects. Several other interventions may complement the program to maximize its effectiveness. Pulmonary rehabilitation may serve many goals, which depend on the perspective one takes. It is important to realize that patients suffering from other respiratory diseases, such as pulmonary sarcoidosis, cystic fibrosis, or after lung transplantation, equally present systemic consequences of their disease. Consequently, pulmonary rehabilitation programs should not be restricted to patients with COPD, but should be open to any patient suffering from extra-pulmonary consequences of lung diseases in general. To establish the indication for a rehabilitation program, a formal exercise test should be carried out. Exercise intolerance is indeed an important reason to refer a patient for rehabilitation. Rehabilitation programs are oriented toward patients who are symptomatic and have reduced activities of daily life, encouraging assessment of symptoms and health-related quality of life, and physical activity.