Publications by authors named "Horsley A"
Objective: Post-COVID syndrome involves prolonged symptoms with multi-system and functional impairment lasting at least 12 weeks after acute COVID-19. We aimed to determine the efficacy of exercise-based rehabilitation interventions, either face-to-face or remote, compared to usual care in individuals experiencing Post-COVID syndrome following a hospitalisation of acute COVID-19.
Design: This single-blind randomised controlled trial compared two COVID exercise-based rehabilitation interventions (face-to-face or remote) to usual care in participants with Post-COVID syndrome following a hospitalisation.
Background: People with diabetes are at increased risk of hospitalisation, morbidity, and mortality following SARS-CoV-2 infection. Long-term outcomes for people with diabetes previously hospitalised with COVID-19 are, however, unknown. This study aimed to determine the longer-term physical and mental health effects of COVID-19 in people with and without diabetes.
View Article and Find Full Text PDFBackground: The goal of cystic fibrosis transmembrane conductance regulator (CFTR) modulators is to reach normal CFTR function in people with cystic fibrosis. Vanzacaftor-tezacaftor-deutivacaftor restored CFTR function in vitro and in phase 2 trials in participants aged 18 years and older resulting in improvements in CFTR function, as measured by sweat chloride concentrations and lung function as measured by spirometry. We aimed to evaluate the efficacy and safety of vanzacaftor-tezacaftor-deutivacaftor compared with standard of care elexacaftor-tezacaftor-ivacaftor in individuals with cystic fibrosis aged 12 years and older.
View Article and Find Full Text PDFArticle Synopsis
- Musculoskeletal issues are common among people with cystic fibrosis (CF), but there’s a lack of accurate data on how often these problems occur and their effects.
- A study surveyed 489 adults from UK CF centers, finding that nearly half experienced musculoskeletal symptoms that impacted daily activities, with back and knee pain being especially prevalent.
- The research concluded that while musculoskeletal symptoms are frequent in CF, they are often not caused by inflammatory arthritis, indicating a need for better understanding and management of these issues.
Background: People hospitalised for coronavirus disease 2019 (COVID-19) have elevated incidence of diabetes. However, it is unclear whether this is due to shared risk factors, confounding or stress hyperglycaemia in response to acute illness.
Methods: We analysed a multicentre prospective cohort study (PHOSP-COVID) of people ≥18 years discharged from NHS hospitals across the United Kingdom following COVID-19.
Airway constriction and blockage in obstructive lung diseases cause ventilation heterogeneity and create barriers to effective drug deposition. Established computational particle-deposition models have not accounted for these impacts of disease. We present a new particle-deposition model that calculates ventilation based on the resistance of each airway, such that ventilation responds to airway constriction.
View Article and Find Full Text PDFBackground: In patients with coronavirus disease 2019 (COVID-19) requiring supplemental oxygen, dexamethasone reduces acute severity and improves survival, but longer-term effects are unknown. We hypothesised that systemic corticosteroid administration during acute COVID-19 would be associated with improved health-related quality of life (HRQoL) 1 year after discharge.
Methods: Adults admitted to hospital between February 2020 and March 2021 for COVID-19 and meeting current guideline recommendations for dexamethasone treatment were included using two prospective UK cohort studies (Post-hospitalisation COVID-19 and the International Severe Acute Respiratory and emerging Infection Consortium).
Background: Multiple breath washout is a lung function test based on tidal breathing that assesses lung volume and ventilation distribution. The aim of this analysis was to use the Global Lung Function Initiative methodology to develop all-age reference equations for the multiple breath washout indices lung clearance index (LCI) and functional residual capacity (FRC).
Methods: Multiple breath washout data from healthy individuals were collated from sites.
Article Synopsis
- The study focused on ION-827359, an antisense oligonucleotide aimed at reducing ENaC protein levels, which are typically hyperactive in cystic fibrosis (CF).
- It involved healthy volunteers and people with CF receiving different doses, with safety as the main outcome; results showed ION-827359 was well-tolerated and had a low systemic drug exposure.
- The treatment led to a dose-dependent decrease in ENaC mRNA in lung cells and a slight improvement in lung function for CF patients, supporting further research into the drug's efficacy.
Article Synopsis
- The study aimed to assess the effectiveness of ECG in detecting cardiac issues in post-hospitalized COVID-19 patients through cardiac magnetic resonance (CMR) imaging.
- Results showed that these patients had significantly more ECG abnormalities compared to healthy controls, yet both groups had similar levels of CMR abnormalities.
- Adding additional analyses on repolarization improved ECG's ability to identify patients with CMR abnormalities and reduced the reliance on sex in the diagnostic process.
Background: COVID-19 is known to be associated with increased risks of cognitive and psychiatric outcomes after the acute phase of disease. We aimed to assess whether these symptoms can emerge or persist more than 1 year after hospitalisation for COVID-19, to identify which early aspects of COVID-19 illness predict longer-term symptoms, and to establish how these symptoms relate to occupational functioning.
Methods: The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study of adults (aged ≥18 years) who were hospitalised with a clinical diagnosis of COVID-19 at participating National Health Service hospitals across the UK.
Article Synopsis
- Pulmonary embolism (PE) is a serious complication of COVID-19 that can lead to chronic thromboembolic pulmonary disease (CTEPD) and chronic thromboembolic pulmonary hypertension (CTEPH), but the true burden and best screening methods for these conditions are still not clear.
- During the study from 2017 to 2022, only a small percentage of CTEPH cases were linked to previous COVID-19 infections, with the CTEPH rates returning to pre-pandemic levels after the second year of the pandemic.
- The findings suggest that while the risk of developing CTEPH after hospitalization for COVID-19 is low, using simple clinical risk scores can help identify patients who may need further evaluation.
Article Synopsis
- The PHOSP-COVID study examined long-term outcomes in COVID-19 hospitalised patients with pre-existing airway diseases compared to those without.* -
- Out of 615 participants with airway diseases, many reported lower recovery rates, higher anxiety and depression levels, and greater mobility issues one year post-discharge.* -
- Overall, individuals with pre-existing airway conditions experienced worse health-related quality of life and more persistent symptoms like breathlessness and fatigue after recovering from COVID-19.*
Background: Pre-existing cardiovascular disease (CVD) or cardiovascular risk factors have been associated with an increased risk of complications following hospitalisation with COVID-19, but their impact on the rate of recovery following discharge is not known.
Objectives: To determine whether the rate of patient-perceived recovery following hospitalisation with COVID-19 was affected by the presence of CVD or cardiovascular risk factors.
Methods: In a multicentre prospective cohort study, patients were recruited following discharge from the hospital with COVID-19 undertaking two comprehensive assessments at 5 months and 12 months.
Background: Significant progress in the field of cystic fibrosis (CF) has substantially extended the life expectancy of patients with CF (pwCF). Consequently, the population of adult pwCF has outnumbered paediatric patients in most developed countries. Ageing is a new factor that can contribute to disease complexity and can require adaptation of CF units.
View Article and Find Full Text PDFArticle Synopsis
- One in ten COVID-19 infections lead to long COVID, characterized by prolonged symptoms, but the underlying mechanisms remain unclear.
- In a study of 657 individuals, certain inflammatory markers were linked to long COVID symptoms, revealing connections to cardiorespiratory issues, fatigue, anxiety, gastrointestinal problems, cognitive impairments, and potential nerve tissue repair disturbances.
- Findings suggest that targeting specific inflammatory pathways could offer new therapeutic options for treating different subtypes of long COVID in future clinical trials.*
Article Synopsis
- * Magnetic resonance imaging (MRI) has emerged as a valuable tool for assessing both structural and functional lung issues without radiation, particularly beneficial for early detection in smokers and COPD patients.
- * These imaging techniques allow for comprehensive evaluations of lung structure and function, helping to better understand disease patterns and guide treatment decisions.
Background: Chronic infection and consequent airway inflammation are the leading causes of morbidity and early mortality for people living with cystic fibrosis (CF). However, lower airway infections across a range of chronic respiratory diseases, including in CF, do not follow classical 'one microbe, one disease' concepts of infection pathogenesis. Instead, they are comprised of diverse and temporally dynamic lung infection microbiota.
View Article and Find Full Text PDFA proportion of patients infected with severe acute respiratory syndrome coronavirus 2 experience a range of neuropsychiatric symptoms months after infection, including cognitive deficits, depression and anxiety. The mechanisms underpinning such symptoms remain elusive. Recent research has demonstrated that nervous system injury can occur during COVID-19.
View Article and Find Full Text PDFObjective: Endocrine systems are disrupted in acute illness, and symptoms reported following coronavirus disease 2019 (COVID-19) are similar to those found with clinical hormone deficiencies. We hypothesised that people with severe acute COVID-19 and with post-COVID symptoms have glucocorticoid and sex hormone deficiencies.
Design/patients: Samples were obtained for analysis from two UK multicentre cohorts during hospitalisation with COVID-19 (International Severe Acute Respiratory Infection Consortium/World Health Organisation [WHO] Clinical Characterization Protocol for Severe Emerging Infections in the UK study), and at follow-up 5 months after hospitalisation (Post-hospitalisation COVID-19 study).
Background: Gastrointestinal symptoms in cystic fibrosis (CF) are common and intrusive to daily life. Relieving gastrointestinal symptoms was identified as an important research priority and previously explored in an international survey in 2018. However, following the widespread introduction of cystic fibrosis transmembrane conductance regulator (CFTR) modulators in 2019, the landscape of CF treatment has changed.
View Article and Find Full Text PDFBackground: Increased serum interleukin (IL)-33 predicts poor outcomes in patients hospitalised with coronavirus disease 2019 (COVID-19). We examined the efficacy and safety of tozorakimab, a monoclonal antibody that neutralises IL-33, in improving outcomes in ACCORD-2 (EudraCT: 2020-001736-95).
Methods: ACCORD-2 was an open-label, phase 2a study in adults hospitalised with COVID-19.
To assess how the presence of surfactant in lung airways alters the flow of mucus that leads to plug formation and airway closure, we investigate the effect of insoluble surfactant on the instability of a viscoplastic liquid coating the interior of a cylindrical tube. Evolution equations for the layer thickness using thin-film and long-wave approximations are derived that incorporate yield-stress effects and capillary and Marangoni forces. Using numerical simulations and asymptotic analysis of the thin-film system, we quantify how the presence of surfactant slows growth of the Rayleigh-Plateau instability, increases the size of initial perturbation required to trigger instability and decreases the final peak height of the layer.
View Article and Find Full Text PDF