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Our survey found that, during the COVID-19 epidemic in Beijing, the majority of our asthma patients had their disease controlled as defined by GINA, and the percentage of controlled asthma was higher than that reported before the pandemic. Patients with mild-to-moderate or well-controlled asthma were encouraged to use digital medical services.7 Outpatient service should be prioritized for patients who have poorly controlled asthma, worsening asthma symptoms, or who have required dose escalations of asthma medications in the past several months' time.4 Since our survey was cross-sectional, no definite conclusion can be drawn about the causal relationship between risk factors and uncontrolled asthma. Dr Chang, Dr Zhang, Dr Dong, Dr Liang, Dr Chen, Dr Shang, Dr Abulikemu, and Dr Sun have nothing to disclose. [Extracted from the article]

Background Few studies have investigated the short-term respiratory effects of ambient air pollution in chronic obstructive pulmonary disease (COPD) patients in the context of high pollution levels in Asian cities. Methods A panel of 23 stable COPD patients was repeatedly measured for biomarkers of airway inflammation including exhaled nitric oxide (FeNO) and exhaled hydrogen sulfide (FeH 2 S) (215 measurements) and recorded for daily respiratory symptoms (794 person-days) in two study periods in Beijing, China in January–September 2014. Daily ambient air pollution data were obtained from nearby central air-monitoring stations. Mixed-effects models were used to estimate the associations between exposures and health measurements with adjustment for potential confounders including temperature and relative humidity. Results Increasing levels of air pollutants were associated with significant increases in both FeNO and FeH 2 S. Interquartile range (IQR) increases in PM 2.5 (76.5 μg/m 3 , 5-day), PM 10 (75.0 μg/m 3 , 5-day) and SO 2 (45.7 μg/m 3 , 6-day) were associated with maximum increases in FeNO of 13.6% (95% CI: 4.8%, 23.2%), 9.2% (95% CI: 2.1%, 16.8%) and 34.2% (95% CI: 17.3%, 53.4%), respectively; and the same IQR increases in PM 2.5 (6-day), PM 10 (6-day) and SO 2 (7-day) were associated with maximum increases in FeH 2 S of 11.4% (95% CI: 4.6%, 18.6%), 7.8% (95% CI: 2.3%, 13.7%) and 18.1% (95% CI: 5.5%, 32.2%), respectively. Increasing levels of air pollutants were also associated with increased odds ratios of sore throat, cough, sputum, wheeze and dyspnea. Conclusions FeH 2 S may serve as a novel biomarker to detect adverse respiratory effects of air pollution. Our results provide potential important public health implications that ambient air pollution may pose risk to respiratory health in the context of high pollution levels in densely-populated cities in the developing world. [ABSTRACT FROM AUTHOR]

The cardiopulmonary effects of chemical constituents and sources of indoor fine particulate matter (PM 2.5) remain unclear. To examine the individual and joint effects of constituents of indoor PM 2.5 on cardiopulmonary function of patients with chronic obstructive pulmonary disease (COPD) and the role of identified sources. This panel study recruited 43 stable COPD patients from November 2015 to May 2016 in Beijing, China. Daily indoor and outdoor PM 2.5 were collected for five consecutive days simultaneously. Twenty-four elements were measured and principal component analysis was used for source appointment. Pulmonary function and blood pressure (BP) were also measured at daily visit. The linear mixed-effect models were used to estimate the effect of each constituent and source. Bayesian kernel machine regression (BKMR) models were used to estimate the overall effect of all measured constituents. The combustion, indoor soil/dust and road dust sources were identified as the main sources of indoor PM 2.5 and combustion sources contributed over 40% during the heating season. Most constituents were significantly associated with elevated BP of COPD patients and the joint effects of mixed exposures were also significant especially during the heating season. Most associations of chemical constituents with pulmonary function were negative but not statistically significant during the heating season, as was the joint effect. Few associations were observed during the non-heating season. Further, we observed combustion sources throughout the study period and road dust sources during the heating season were significantly associated with increased BP but not decreased pulmonary function. The combustion and road dust sources and their related constituents of indoor PM 2.5 could cause adverse effects on cardiovascular function of COPD patients especially during the heating season, but the effect on pulmonary function still needs to be further studied. • The sources of indoor PM 2.5 and their contribution in different seasons were identified. • Cardiopulmonary effects of indoor PM 2.5 constituents and sources were estimated. • This is the first study to assess the joint effect of multiple PM 2.5 constituents. • The cardiovascular effect of indoor PM 2.5 constituents was stronger than respiratory. • The cardiovascular effects of combustion and road dust sources may merit attention. [ABSTRACT FROM AUTHOR]