As millions of people worldwide recover from COVID-19, a substantial proportion continue to have persistent symptoms, pulmonary function abnormalities, and radiological findings suggestive of post-COVID interstitial lung disease (ILD). To date, there is limited scientific evidence on the management of post-COVID ILD, necessitating a consensus-based approach.A panel of experts in pulmonology and thoracic radiology was constituted. Key questions regarding the management of post-COVID ILD were identified. A search was performed on PubMed and EMBASE and updated till 1 March 2022. The relevant literature regarding the epidemiology, pathophysiology, diagnosis and treatment of post-COVID ILD was summarized. Subsequently, suggestions regarding the management of these patients were framed, and a consensus was obtained using the Delphi approach. Those suggestions which were approved by over 80% of the panelists were accepted. The final document was approved by all panel members.Dedicated facilities should be established for the care of patients with post-COVID ILD. Symptom screening, pulmonary function testing, and thoracic imaging have a role in the diagnosis. The pharmacologic and non-pharmacologic options for the management of post-COVID ILD are discussed. Further research into the pathophysiology and management of post-COVID ILD will improve our understanding of this condition.
e20729 Background: Approximately 70 to 80% of all cancer patients receiving chemotherapy experience emesis and 10 to 44% experience anticipatory emesis. Aprepitant a neurokinin 1 (NK 1) receptor antagonist is used in chemotherapy induced nausea and vomiting. The present study was undertaken to assess efficacy, safety, and tolerability of Aprepitant in adult patients with chemotherapy induced nausea and vomiting. Methods: The study was conducted as a prospective, multicenter, randomized, open label, single group, phase III study in adult patients with chemotherapy induced nausea and vomiting and patients admitted to hospital for any type of cancer. The final protocol was approved by the Institutional ethics committee before the initiation of the study. Informed consent was obtained from all the patients before enrollment in the study. Aprepitant capsules were given in the dose of 125mg orally one hour prior to chemotherapy on day 1 followed by 80 mg orally in the morning on days 2 & 3.Aprepitant was combined with oral Dexamethasone 12mg oral 30 minutes prior to chemotherapy on day one and 8mg on the following two days. Efficacy of aprepitant was evaluated through number of emetic episodes within 24 hours or requirement for the rescue medication. Self assessment of nausea was done by patients using a 100 mm visual analog scale. Safety and tolerability was assessed through monitoring of adverse events and physical examination. Results: A total 30 patients (13 males) (mean age 40.45 years) were enrolled in the study. Significant (p<0.05)changes in emetic episodes were seen after treatment with aprepitant. Overall global assessment of vomiting indicated that 19 patients (82.6 %) had very good improvement, 3 patients (13%) had good improvement and one patient (4.4%) showed fair improvement after treatment with aprepitant. The most common adverse events included fever, headache, diarrhoea skin rash, constipation, and blisters. Severity of adverse events was mild to moderate and the adverse events disappeared with continued therapy. Conclusions: Treatment with aprepitant is a useful therapeutic option for the management of chemotherapy induced nausea and vomiting. [Table: see text]
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