CHEST 2021: Pandemic Still Dominates 18 Months In

Allergies & Asthma

It’s probably no surprise that the most significant respiratory disease epidemic in 100 years is the number one subject at this year’s CHEST meeting. But healthcare professionals with interests in more traditional topics shouldn’t feel cheated, a review of abstracts and scheduled sessions indicates.

Of the nearly 2,100 abstracts published ahead of the meeting — to be held exclusively online beginning Sunday — 458 had “COVID-19” in the title, not to mention others that included it in the abstract body.

Nearly all were single-center reports of their experiences in treating COVID patients. A fair number, for example, examined outcomes of prone positioning for patients in intensive care (which were not universally favorable). Another common topic was extracorporeal membrane oxygenation (ECMO).

One of the latter was highlighted by CHEST’s organizers prior to the meeting, in which researchers found that mortality among patients treated with ECMO increased markedly during the pandemic’s “second wave” last winter, as opposed to the initial spike in the spring of 2020.

Many of the COVID-related reports dealt with investigational treatments such as gargling with ethanol or with risk factors for adverse outcomes. Another popular topic was “long COVID,” including one study that examined respiratory function in detail months after overt infection had resolved.

The pandemic’s effects on healthcare personnel was not neglected. For example, researchers at Emory University in Atlanta surveyed physicians and other staff there about their experiences with restrictions on visitors, finding that these likely contributed to burnout.

Of course, the majority of CHEST sessions and presentations will deal with other issues, running the gamut from heart surgery and lung cancer to septic shock and sleep-disordered breathing.

Randomized clinical trials are always an important part of any medical meeting. This year’s CHEST won’t feature any major phase III studies with primary results reported for the first time. But for several drugs, the meeting will offer a series of secondary analyses that should be of interest. These include:

  • Tezepelumab, a first-in-class medication for asthma, for which there will be presentations on prespecified subgroups, patient-reported outcomes, and lung function parameters. (The drug’s sponsors are so confident of an impending FDA approval that they have already begun advertising its hoped-for trade name, Tezspire.)
  • FT218, a new formulation of sodium oxybate for narcolepsy treatment, which can be given once instead of twice each night as is needed for currently approved versions of this agent.
  • Gefapixant, a P2X3 antagonist for chronic cough, for which primary results were released a year ago; now come analyses of data pooled from its two phase III trials.

As is traditional at CHEST, the meeting will feature dozens of case reports. Some that stood out in MedPage Today‘s scan included a novel case series of Lady Windermere’s syndrome; a potential danger from marijuana in people with certain fruit allergies; and the saga of a man who put a cotton swab where he shouldn’t.

Naturally, the meeting will also include the customary array of lectures, debates, and industry-sponsored symposia. This year, though, the online format also allowed the organizers to stage a variety of contests and games in which attendees can participate from the comfort of their homes and offices, as well as straightforward educational content such as virtual patient tours.

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    John Gever was Managing Editor from 2014 to 2021; he is now a regular contributor.

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