Publications by authors named "G. Tzouvelekis"

Background And Aim: There is limited data on the prevalence of SARS-COV-2 in sarcoidosis patients and the underlying parameters linked to severity. We aimed to conduct a national multicenter study to explore the prevalence of SARS-COV-2 in sarcoidosis patients and investigate its impact on hospitalization and infection rates, describe the characteristics of the infected population and assess the role of these characteristics in determining the likelihood of infection or hospitalization.

Methods: We recruited all the adult sarcoidosis patients with who were examined across eight Greek Health Interstitial Lung Disease Referral Centers from the beginning of the pandemic until August 1, 2022.

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  • Depression and anxiety are common issues for patients with idiopathic pulmonary fibrosis (IPF), negatively impacting their quality of life, especially during the COVID-19 pandemic.
  • A study aimed to evaluate how COVID-19 vaccination affects these mental health issues in IPF patients, using the Hospital Anxiety and Depression Scale (HADS) to measure changes before and after vaccination.
  • Results showed a significant improvement in both anxiety and depression scores one month after vaccination, indicating that the vaccine may have beneficial effects on mental health for IPF patients, regardless of factors like age or previous mental health history.
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  • The STEPINCOPD study investigated the factors influencing the escalation or de-escalation of inhaled COPD therapies in clinical practice, especially after updated guidelines were released in 2019 and 2020.
  • Conducted over 12 weeks with 1429 patients from various centers in Greece, the study focused on understanding why patients had changes in their inhaled medication based on GOLD's 2021 recommendations.
  • Findings revealed that reasons for treatment changes included lack of response to previous treatment and COPD exacerbations, with a high adherence rate (over 80%) to the GOLD recommendations among physicians, influenced by factors such as their age and patients' CAT scores.
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Background: Mediastinal lymph node enlargement is prevalent in patients with idiopathic pulmonary fibrosis (IPF). Studies investigating whether this phenomenon reflects specific immunologic activation are lacking.

Methods: Programmed cell death-1 (PD-1)/ programmed cell death ligand-1 (PD-L1) expression in mediastinal lymph nodes and lung tissues was analyzed.

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Background: Sarcopenia, defined as a small cross-sectional area (CSA) in computed tomography (CT) measurements of skeletal muscles, serves as a disease severity marker in various clinical scenarios, including pulmonary conditions and critical illness. Another parameter of sarcopenia, the level of myosteatosis, reflected by the tissue's radiodensity, in the thoracic skeletal muscles group, has been linked to disease progression in coronavirus disease 2019 (COVID-19) patients. We hypothesize that CT-derived measurements of the skeletal muscle density (SMD) and the CSA of thoracic skeletal muscles can predict outcomes in COVID-19 pneumonia.

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In the years of Coronavirus Disease 2019 (COVID-19), various treatment options have been utilized. COVID-19 continues to circulate in the global population, and the evolution of the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has posed significant challenges to the treatment and prevention of infection. Remdesivir (RDV), an anti-viral agent with in vitro efficacy against coronaviruses, is a potent and safe treatment as suggested by a plethora of in vitro and in vivo studies and clinical trials.

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Purpose: AAntitrypsin deficiency (AATD) pathogenic mutations are expanding beyond the PI*Z and PI*S to a multitude of rare variants.

Aim: to investigate genotype and clinical profile of Greeks with AATD.

Methods: Symptomatic adult-patients with early-emphysema defined by fixed airway obstruction and computerized-tomography scan and lower than normal serum AAT levels were enrolled from reference centers all over Greece.

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Objective: Randomized controlled trials comparing tocilizumab and baricitinib in patients with coronavirus disease 2019 (COVID-19) are needed. This was an open-label, randomized controlled trial aiming to address this unmet need.

Methods: To determine whether baricitinib was non-inferior to tocilizumab, we assessed whether the upper boundary of the two-sided 95% CI of the hazard ratio (HR) did not exceed 1.

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Background And Objective: There remains a paucity of large databases for patients with idiopathic pulmonary fibrosis (IPF) and lung cancer. We aimed to create a European registry.

Methods: This was a multicentre, retrospective study across seven European countries between 1 January 2010 and 18 May 2021.

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Background: Diagnostic work-up of pulmonary embolism (PE) remains a challenge. Methods: We retrospectively studied all patients referred for computed tomography pulmonary angiography (CTPA) with suspicion of PE during a 12-month period (2018). The diagnostic accuracy of different D-dimer (Dd) cutoff thresholds for ruling out PE was evaluated.

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  • The study aimed to observe the risks of COVID-19 in patients with severe asthma who are treated with biologics during the pandemic.
  • Data was collected from 591 severe asthmatics across Greece, revealing that only 4.4% tested positive for SARS-CoV-2, with a small number requiring hospitalization.
  • Findings suggest that severe asthma patients on biologics do not have a higher risk of COVID-19 infection or adverse outcomes compared to the general population.
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Background: Monogenic and polygenic inheritances are evidenced for idiopathic pulmonary fibrosis (IPF). Pathogenic variations in surfactant protein-related genes, telomere-related genes (TRGs), and a single-nucleotide polymorphism in the promoter of MUC5B gene encoding mucin 5B (rs35705950 T risk allele) are reported. This French-Greek collaborative study, Gen-Phen-Re-GreekS in inheritable IPF (iIPF), aimed to investigate genetic components and patients' characteristics in the Greek national IPF cohort with suspected heritability.

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  • - COVID-19, along with its serious complication ARDS, is noted as the most significant global health crisis in the last 100 years, comparable to past coronavirus outbreaks like SARS and MERS.
  • - Many survivors of COVID-19 experience long-term effects, known as long-COVID-19 syndrome, which can last for up to 6 months and affect various organs.
  • - This review focuses on the lung-related symptoms of long COVID, including their clinical presentations, potential treatments such as steroids and rehabilitation programs, and strategies for early detection and management.
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  • Idiopathic Pulmonary Fibrosis (IPF) is a chronic lung disease with an unpredictable progression, and this study aimed to assess the prognostic value of complete blood count parameters in patients diagnosed with IPF.
  • The research involved analyzing data from 489 treatment-naïve IPF patients across two cohorts, focusing on monocyte count and red cell distribution width (RDW) to categorize them into high and low groups.
  • Results showed that higher monocyte counts and RDW were linked to significantly poorer lung function and higher mortality rates, with similar findings confirmed in a validation cohort.
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Introduction: During the first COVID-19 wave, a considerable decline in hospital admissions was observed worldwide.

Aim: This retrospective cohort study aimed to assess if there were any changes in the number of patients hospitalized for respiratory diseases in Greece during the first CO-VID-19 wave.

Methods: In the present study, we evaluated respiratory disease hospitalization rates across 9 tertiary hospitals in Greece during the study period (March-April 2020) and the corresponding period of the 2 previous years (2018-2019) that served as the control periods.

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Background: Currently there is major lack of agreement on the diagnostic and therapeutic management of patients with idiopathic pulmonary fibrosis (IPF) and lung cancer. Our aim was to identify variations in diagnostic and management strategies across different institutions and provide rationale for a consensus statement on this issue.

Methods: This was a joint-survey by European Respiratory Society (ERS) Assemblies 8, 11 and 12.

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Background: Fibrotic hypersensitivity pneumonitis (f-HP) can exhibit a progressive course similar to idiopathic pulmonary fibrosis (IPF). The lack of diagnostic guidelines and randomised controlled trials in this population represent a significant unmet need.

Objectives: To describe our clinical experience with antifibrotics in patients with f-HP.

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  • A 52-year-old man with a significant smoking history presented with cough, yellow sputum, and right chest pain, but no fever, night sweats, or weight loss.
  • A chest X-ray showed a large mass in the right upper lung lobe, prompting further investigation.
  • His medical history includes COPD, for which he's being treated, and anxiety disorder, for which he is prescribed quetiapine.
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Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is an often deadly complication of IPF. No focussed international guidelines for the management of AE-IPF exist. The aim of this international survey was to assess the global variability in prevention, diagnostic and treatment strategies for AE-IPF.

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Nintedanib is a tyrosine kinase inhibitor approved for the treatment of idiopathic pulmonary fibrosis (IPF). In a retrospective, real-world study across seven Greek hospitals, we evaluated the effectiveness and safety of nintedanib in routine clinical practice. Patients diagnosed with IPF, as per guideline criteria or multidisciplinary diagnosis, received nintedanib between January 2013 and January 2018.

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Background: Abundant evidence supports an association between Idiopathic Pulmonary Fibrosis (IPF) and lung cancer development. Data on diagnosis and management of patients with IPF and lung cancer are still scarce.

Patients And Methods: This was a retrospective multicenter study, enrolling 1016 patients with IPF from eight different centers between 2011 and 2018 in Greece.

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Dose optimization is required to increase carbapenem's efficacy against carbapenemase-producing isolates. Four clinical Klebsiella pneumoniae isolates were used: one susceptible to meropenem with minimum inhibitory concentration (MIC) 0.031 mg/L and 3 verona integron-borne metallo bete-lactamase-1-producing isolates with MICs 8, 16, and 128 mg/L.

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VIM-producing Klebsiella pneumoniae isolates are usually associated with high MICs to carbapenems. Preclinical studies investigating the pharmacokinetic-pharmacodynamic (PK-PD) characteristics of carbapenems against these isolates are lacking. The in vitro antibacterial activity of meropenem against one WT and three VIM-producing K.

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