The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COronaVirus Disease 2019 (COVID-19), has resulted in a worldwide pandemic and currently represents a major public health issue. It has caused outbreaks of illness due to person-to-person transmission of the virus mainly via close contacts and droplets produced by an infected person’s cough or sneeze. Although aerosol therapy is a mainstay procedure for treating obstructive airway diseases at home and healthcare settings, there is concern about the hypothesized enhanced risk for transmission of SARS-CoV-2 in the form of aerosolised respiratory droplets during the nebulised treatment of patients with COVID-19. Consequently, the use of hand-held inhalers, particularly pressurised metered dose inhalers, has risen considerably as an alternative to nebulisers, which has led to inadequate supplies in some countries. However, switching to hand-held inhalers may result in unintended consequences for some patients, who may be unable to adequately use their new device or benefit fully from treatment via hand-held inhalers. Furthermore, there is no evidence supporting an increased risk of viral transmission during nebulisation in COVID-19 patients. Thus, there is no compelling reason to alter aerosol modality for patients with established nebuliser-based regimens. The purpose of this paper is to discuss the current evidence and understanding of the use of aerosol therapies during the SARS-CoV-2 pandemic and to provide some guidance on the measures to be taken to minimise the hypothetical enhanced risk of infection, if any, during aerosol therapies.
La pandemia mondiale da coronavirus 2 (SARS-CoV-2) rappresenta un importante problema di salute pubblica con focolai di malattia dovuti alla trasmissione del virus da persona a persona principalmente tramite contatti stretti e goccioline (“droplets”) prodotte dalla tosse o dallo starnuto di una persona infetta. L’aerosolterapia rappresenta una procedura fondamentale per il trattamento delle malattie ostruttive delle vie aeree a domicilio e in ospedale. Tuttavia, vi è preoccupazione per l’ipotetico aumentato rischio di trasmissione di SARS-CoV-2 sotto forma di goccioline aerosolizzate durante il trattamento aerosolico di pazienti affetti da COVID-19. Di conseguenza, l’uso di inalatori portatili, in particolare inalatori pressurizzati e predosati, è notevolmente aumentato come alternativa ai nebulizzatori, determinando forniture inadeguate di questo tipo di dispositivi inalatori in alcuni Paesi. È importante ricordare che la sostituzione dei nebulizzatori con inalatori portatili può associarsi a conseguenze indesiderate nei pazienti non in grado di utilizzare adeguatamente il nuovo dispositivo o trarre pieno vantaggio dal trattamento somministrato da inalatori portatili. Inoltre, non ci sono prove a sostegno di un aumento del rischio di trasmissione virale durante la nebulizzazione nei pazienti COVID-19. Pertanto, non vi è alcun motivo valido per modificare la modalità di produzione dell’aerosol per i pazienti che da tempo assumono terapia inalatoria per mezzo di nebulizzatori. Lo scopo di questo articolo è quello di discutere le attuali conoscenze sull’uso dell’aerosolterapia durante la pandemia da SARS-CoV-2 e fornire indicazioni sulle misure da adottare per ridurre al minimo il supposto rischio di infezione, se presente, durante la terapia aerosolica.
Aerosol therapies during the SARS-CoV-2 pandemic = Aerosolterapia durante la pandemia da SARS-CoV-2 / F. Lavorini, F.E. Pregliasco. - In: RASSEGNA DI PATOLOGIA DELL’APPARATO RESPIRATORIO. - ISSN 0033-9563. - 36:(2021), pp. 31-37. [10.36166/2531-4920-A053]
Aerosol therapies during the SARS-CoV-2 pandemic = Aerosolterapia durante la pandemia da SARS-CoV-2
F.E. PregliascoCo-primo
2021
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COronaVirus Disease 2019 (COVID-19), has resulted in a worldwide pandemic and currently represents a major public health issue. It has caused outbreaks of illness due to person-to-person transmission of the virus mainly via close contacts and droplets produced by an infected person’s cough or sneeze. Although aerosol therapy is a mainstay procedure for treating obstructive airway diseases at home and healthcare settings, there is concern about the hypothesized enhanced risk for transmission of SARS-CoV-2 in the form of aerosolised respiratory droplets during the nebulised treatment of patients with COVID-19. Consequently, the use of hand-held inhalers, particularly pressurised metered dose inhalers, has risen considerably as an alternative to nebulisers, which has led to inadequate supplies in some countries. However, switching to hand-held inhalers may result in unintended consequences for some patients, who may be unable to adequately use their new device or benefit fully from treatment via hand-held inhalers. Furthermore, there is no evidence supporting an increased risk of viral transmission during nebulisation in COVID-19 patients. Thus, there is no compelling reason to alter aerosol modality for patients with established nebuliser-based regimens. The purpose of this paper is to discuss the current evidence and understanding of the use of aerosol therapies during the SARS-CoV-2 pandemic and to provide some guidance on the measures to be taken to minimise the hypothetical enhanced risk of infection, if any, during aerosol therapies.File | Dimensione | Formato | |
---|---|---|---|
526-File dell'articolo-1439-3-10-20210601.pdf
accesso aperto
Tipologia:
Publisher's version/PDF
Dimensione
237.83 kB
Formato
Adobe PDF
|
237.83 kB | Adobe PDF | Visualizza/Apri |
Pubblicazioni consigliate
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.