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• Several cardiovascular/hemostatic disturbances haves been reported in patients with COVID-19, but the real frequency and their potential association with the pathogenic mechanisms of SARS-CoV-19 still remain to be defined. • We investigated the relative frequency of acute coronary syndrome, deep venous thrombosis, pulmonary embolism, stroke and upper gastrointestinal bleeding in COVID patents attending emergency departments (EDs), before hospitalization and compared them with frequencies in the general ED population attending 50 Spanish EDs. • We found that the risk of pulmonary embolism is clearly increased in COVID patients, with an OR of 4.53 with respect to non-COVID patients (95% confidence interval 4.03- 5.10). Additionally, the diagnosis of pulmonary embolism was 2 fold more frequent among ED comers in 2020 compared to 2019, suggesting a SARS-CoV-2 role in such increment of cases.. The remaining entities studied were not found to be unequivocally increased in the present study and need further investigation.

Background Control has been proposed as a dynamic tool that can capture changes in the clinical status of patients with COPD. Methods This prospective, multicenter, observational study aimed to compare changes in control over a 3-month period with changes in risk level, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage, and clinical phenotype (nonexacerbator, asthma-COPD overlap, or exacerbator with emphysema or with chronic bronchitis). Control was defined as the presence of low clinical impact, assessed according to the degree of dyspnea, use of rescue medication, physical activity and sputum color, and clinical stability assessed by clinical changes and exacerbations in the last 3 months. Impact and stability were alternatively assessed with COPD Assessment Test (CAT) scores. Results We included 354 patients, with a mean FEV1 of 49.8% ± 16.9%. At 3 months, the proportion of controlled patients was 50.3% according to clinical evaluation and 47.8% according to CAT score. Eighty-seven patients (29.2%) changed their control status as assessed by clinical variables, and 85 patients (28.5%) changed their status according to CAT score. In contrast, the risk level only changed in 26 patients (8.7%) (P Conclusions In only 3 months, almost one-third of patients experienced changes in their control status. Changes in control status were significantly more frequent than changes in phenotype, risk level, and GOLD stage, and resulted in significant changes in health status.

Control has been proposed as a dynamic tool that can capture changes in the clinical status of patients with COPD.This prospective, multicenter, observational study aimed to compare changes in control over a 3-month period with changes in risk level, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage, and clinical phenotype (nonexacerbator, asthma-COPD overlap, or exacerbator with emphysema or with chronic bronchitis). Control was defined as the presence of low clinical impact, assessed according to the degree of dyspnea, use of rescue medication, physical activity and sputum color, and clinical stability assessed by clinical changes and exacerbations in the last 3 months. Impact and stability were alternatively assessed with COPD Assessment Test (CAT) scores.We included 354 patients, with a mean FEVIn only 3 months, almost one-third of patients experienced changes in their control status. Changes in control status were significantly more frequent than changes in phenotype, risk level, and GOLD stage, and resulted in significant changes in health status.

Juan José Soler-Cataluña,1,2 Maribel Marzo,3 Pablo Catalán,1 Cristina Miralles,1 Bernardino Alcazar,2,4 Marc Miravitlles2,5 1Pneumology Department, Hospital Arnau de Vilanova, Valencia, Spain; 2CIBER of Respiratory Diseases (CIBERES), Spain; 3Emergency Department, Hospital General de Requena, Valencia, Spain; 4Respiratory Department, Hospital de Alta Resolución de Loja, Granada, Spain; 5Pneumology Department, University Hospital Vall d’Hebron/Vall d’Hebron Research Institute (VHIR), Barcelona, Spain Background: It has recently been proposed that the concept of clinical control in COPD may be useful for deciding treatment in COPD, but the original control criteria (OCC) were considered too restrictive.Objective: Define and subsequently validate “modified” control criteria (MCC) of COPD.Method: Prospective observational study in COPD patients with a 1-year follow-up. Control was defined as the presence of low clinical impact and clinical stability. To evaluate clinical impact, the following clinical parameters were assessed: the degree of dyspnea, use of rescue medication, physical activity, and sputum color. Stability was assessed by clinical changes and exacerbations in the last 3 months. The COPD assessment test score and their changes were also evaluated as alternative control criteria. To define the MCC, adjustment for disease severity using BODEx index (MCC-B) or FEV1 (MCC-F) was evaluated, and the best cutoff point was established. Time to first combined event (emergency visit, hospitalization, or death) was analyzed to evaluate the predictive capacity of risk of the OCC, MCC-B, and MCC-F.Results: We included 265 patients, 224 (83.9%) men, with a mean age (±SD) of 68±9 years and FEV1 of 58%±17%. The proportion of controlled patients was higher using clinical MCC-B or MCC-F (61.5% and 59.6%) than OCC (27.5%). Similar percentages were found using COPD assessment test scores. The time to the first combined event was significantly greater in controlled patients using MCC criteria (P

Introduction: Clinical control in COPD has recently been proposed. However the original criteria (OCC) are too restrictive. Objective: Define and validate a new tool to assess COPD control using "modified" criteria (MCC) and assess its value as a risk predictor. Methodology: Prospective observational study in a cohort of COPD patients. Control is defined as the presence of low clinical impact and clinical stability. The adjustment for disease-severity and the best cut-off point in each item was evaluated to define the MCC. Patients were followed during 12 months. Time to event (composite outcome of emergency visit, hospitalization or death) was evaluated using cox regression analysis. Results: A total of 265 patients were included, 224 (83.9%) men, with a mean age (± SD) of 68 ± 9 years and FEV1 of 58 ± 17%. Percentage of control according OCC was 27,5% and for MCC: 61,5% with adjustment by BODEx index and 59,6% with adjustment by FEV1(%). Time to event (figure 1) was significantly greater in patients controlled with MCC criteria (p Conclusions: With the use of MCC a higher rate of controlled COPD patients is identified, compared to OCC. These patients have a lower risk of future events. Figure 1. Time to event (emergency visit, hospitalization or death) using modified control criteria, with adjustment by FEV1% (MCC-F)