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How to Beat ‘Flu this Winter

The influenza, or ‘flu, virus can cause infections all year round, but in the UK, it is most common in the winter. There are many strains, some of which are worse than others, such as swine ‘flu (H1N1 strain) which tends to have a more rapid onset, high fevers and stomach upset and has caused fatalities, often in previously fit adults.  ‘Flu affects 10% of the population each year, but rises to 25-30% during a ‘flu epidemic. In contrast, adults have approximately 2 to 3 colds per year and children 5 to 6.

Do I Have ‘Flu, a Cold or COVID-19?

‘Flu Features
Cold Features
COVID-19 Symptoms
 

Symptoms can appear suddenly

Leaves you exhausted and unable to move, affecting the whole body.

Can cause complications, including pneumonia.

Sometimes fatal.

Lasts for one week, then you get better.

 

Symptoms appear gradually.

Affects only nose, throat, sinuses and upper chest.

Still able to function.

Recover fully in a week.

 

Fever.

New continuous cough.

Loss of smell or taste.

 

NB: If you have any of the above symptoms, get a PCR test as soon as possible: https://www.gov.uk/get-coronavirus-test

Vaccination Against the ‘Flu                         

Anyone can get the ‘flu and, the more a person is in close contact with people who have the virus, the more likely they are to get it.  Certain at risk groups are advised to have a ‘flu vaccination. They include:

  • Everyone over the age of 65.
  • People of any age with lung diseases, heart disease, kidney disease, liver disease, diabetes or lowered immunity.
  • Anyone living in a residential or nursing home.
  • Carers of those at risk.
  • Children aged 2 to 18.

The UK is fortunate to have a safe and effective vaccination against the ‘flu, which is provided free of charge by the NHS. ‘Flu vaccination is advised annually as the type of ‘flu virus causing infections changes every year.  Despite popular belief, the ‘flu vaccination can not give you ‘flu. It’s true that some people experience symptoms of a heavy cold at the same time or just after they’ve had the ‘flu jab – this is simply a coincidence and the symptoms are caused by one of the many common cold viruses in the autumn and winter.  It is still possible to suffer heavy colds after a vaccination, as the ‘flu jab only protects people from the ‘flu virus, not other viruses.

The ‘flu vaccination is available from October each year.  Anyone who thinks they need it should talk to their doctor or nurse.

Special Considerations for Winter 2021-2022

The lockdown resulted in very little ‘flu in winter 2020-2021, but this means the population is less immune and, combined with the reduction in social distancing measures, indicates that a large ‘flu outbreak is likely in the winter of 2021-2022.  In addition, the NHS is under significant pressure due to ongoing COVID-19 infections and catching up on medical care delayed by the lockdown.  ‘Flu vaccination will help ease this by preventing people ending up  in hospital due to ‘flu infection.

How to Treat the ‘Flu

Antibiotics are of no use in treating ‘flu. Anti-viral medication is available from the GP for at risk groups, but it needs to be taken early on in the disease to stop the virus multiplying and may only reduce the symptoms rather than treating the infection.

The best ways to treat the symptoms of ‘flu are:

  • Get plenty of rest. The body uses a lot of energy fighting infections, so resting for the first couple of days gets it off to a good start.
  • Keep warm.
  • Make sure you drink plenty of water to avoid dehydration, and try hot water with lemon, ginger and honey to relieve symptoms such as sore throat.
  • Take paracetamol or anti-inflammatory medicines such as ibuprofen to lower a high temperature and relieve aches.

Always contact your doctor if you’re not getting better after a few days, if you’re unduly short of breath or if you’re coughing up blood or large amounts of yellow or green phlegm.

How to Keep Healthy and Avoid Getting the ‘Flu

  • Keep your immune system strong by eating a healthy diet.
  • Take regular exercise.
  • Get enough rest and relaxation.
  • Do not smoke.
  • Take regular vitamins and bump up your vitamin C.
  • Wash your hands often and keep a bottle of antibacterial hand cleanser around.
  • Avoid people who are coughing and sneezing, especially if they’re not covering their mouth and nose.
  • Use and bin your tissues.

 

 

Online Christmas Concert with The Holst Singers, December 2021

We are unfortunately not able to hold our usual Christmas concert again this year in light of the COVID-19 pandemic, but we are delighted that The Holst Singers, as last year, are recording a selection of traditional carols and seasonal music for us to share and bring us all together during the festive season.

The concert recording link will be available to download from the Breathing Matters website from mid-December and we will also be posting a link for our Christmas Concert JustGiving page – all the profit from the donations received will go towards Professor Brown’s research into bronchiectasis and lung infection.

For further information about this year’s online Christmas Concert please email Jane Walker – missjanewalker@hotmail.com

If you’ve not attended one of our ‘live’ concerts in previous years, please do download the link and have a listen to the Holst Singers – they really are a superb choir!!

Here is an excerpt from last year’s recording to whet your appetite: https://bit.ly/3aA4Bnt

 

Article in The Guardian Respiratory Health Supplement

Professor Jo Porter, our Medical Director, has had an article published in the Respiratory Health Supplement in The Guardian today (22.6.21), explaining research into the impact of COVID-19 on lung fibrosis

This is what Prof Porter had to say:

A study is underway to assess the impact of COVID-19 on lung fibrosis development.  Interstitial lung disease (ILD), or lung fibrosis, diagnosed by CT scan, causes difficulty breathing by affecting the delicate membrane separating the blood and air in the lungs.  Joanna Porter, Professor of Respiratory Medicine at University College London, says there are more than 200 causes of ILD, including asbestos, mould, feathers, underlying conditions such as rheumatoid arthritis, and infection.  COVID-19 infection may be the latest contributor to ILD development.

COVID-19 impact – Dividing her research role with clinical work as head of the national NHS centre for ILD at University College London Hospitals, Professor Porter says there are an estimated 16,000 new ILD cases per year but this could be an underestimate as some people may not know they have the disease.  Specialists agree that current evidence is limited, however there is concern regarding the impact of COVID-19 on ILD and lung fibrosis patients. What is known is that patients with the most severe form of ILD – idiopathic pulmonary fibrosis (IPF) – do less well if they catch the virus.  The UK ILD Post-COVID Study is now following up hospitalised and non-hospitalised post-COVID patients to see how many develop a new ILD as a result of SARS-CoV-2 infection.  This UKRI funded multicentre study will look at patients in the PHOSP study who had a CT scan three months after their initial infection and compare that with their 12-month follow-up scan to identify ongoing and resolved issues.  Although we do not know the final figures, unpublished preliminary data from UCLH suggest around 4% of patients may be affected.

Professor Porter is also Medical Director of Breathing Matters, a UCLH charity, dedicated to finding a cure for all forms of ILD/pulmonary fibrosis. She points out that anything we learn from post-COVID ILD will almost certainly help other patients with lung fibrosis. Breathing Matters has continued vital research throughout the pandemic to address these critical questions.

Read the full Respiratory Health Campaign to find out more about key respiratory conditions, new innovations and the importance of good air quality

You can also read more on the online campaign at healthawareness.co.uk/respiratory

 

How COVID-19 Is Helping Research Into Pulmonary Fibrosis?

The interstitial lung diseases (ILDs) are a group of over 200 different diseases that may result in lung inflammation or (in the worst case) pulmonary fibrosis (PF). There are many different aetiologies for ILD/PF and in some cases, we do not know the cause, so called ‘idiopathic’.

One of the questions that we at Breathing Matters want to answer is – can COVID-19 give you pulmonary fibrosis? There are a few clues that this might be the case. Other coronaviruses such as Severe Acute Respiratory Syndrome (SARS) or Middle East Respiratory Syndrome (MERS) have been reported to cause PF in a small percentage of patients, but of course the numbers of patients affected by SARS-CoV-2, the virus that causes COVID-19, will be much greater so, even if only a small percentage are affected, the numbers may still be very large. The diagnosis of ILD/PF is suggested by a clinical finding of breathlessness and abnormal lung function. The diagnosis is then confirmed with a CT scan of the chest.

Initial studies from China, Italy and the UK have remarkably similar findings. Of patients with COVID-19 discharged from a hospital in China, nearly half had abnormal lung function (Mo X, et al. European Respiratory Journal 55: 2001217, 2020).  Data from Leeds of patients with COVID-19 discharged from hospital showed that the majority (75% of those admitted to intensive care, and 65% of those admitted to the regular wards) still suffered from fatigue at 6 to 8 weeks post discharge. The number suffering from continual breathlessness was also high (70% of those admitted to intensive care, and 45% of those admitted to the ward).  (Halpin S et al. Journal Medical Virology, First published: 30 July 2020, DOI: (10.1002/jmv.26368).  An Italian study from Rome found that at 60 days around 55% of patients were suffering from fatigue and 40% from breathlessness.  It is unclear what is the cause of these high levels of breathlessness, but a study from Austria is following their patients up in more detail at 6, 12 and 24 weeks after discharge. So far, they have found that at 6 weeks 47% of patients are short of breath and this falls to 39% at 12 weeks. In addition, 33% have abnormal lung function suggestive of lung fibrosis, but this falls to 22% at 12 weeks. Of course, to diagnose lung fibrosis requires at CT scan of the chest and they found that CT scans suggested an interstitial lung disease (ILD) or lung fibrosis in 88% falling to 56% at 12 weeks. However, it is also important to know how much of the lung is affected, and many of the studies do not clarify this, but just comment on whether ILD is present or not. The result is that it is hard to know whether these patients had minimal or significant ILD changes on the CT scan. Clearly, Breathing Matters will be looking out for the 24 week data.

Our own experience is that of around 800 patients seen at UCLH with COVID-19, in the first wave approximately 4-6% have persistent or slowly resolving CT changes at 12 months suggestive of interstitial lung involvement. The incidence of ILD may be less in subsequent waves because of the wider use of the steroid, dexamethasone, in patients with COVID-19 pneumonitis. Currently, our main priority is to analyse the scans of 20,000 patients who were hospitalised with COVID-19 and are taking part in the national PHOSP study, to see how common the development of ILD/ PF is in a much larger group of patients.  We will also look at 10,000 patients who had COVID-19 but were not hospitalised. This study funded by UKRI is a multicentre study that will look at the incidence of post COVID-ILD, investigate how much of the lung is affected and what the critical contributory factors are. It may be that this virus and the enormous numbers of patients that have been infected will shed some light on the pathogenesis of other ILD/PF diseases.​

We will keep you informed of any new findings.

 

Top 10 Highlights in 10 Years

1: Involving You

We have had many opportunities to meet our supporters over the years from small personal meetings to large tours; both are very special to us – you are the lifeblood, or the lungs (!), of Breathing Matters.

Our launch event on 19th January 2011 seems like only yesterday.  Professor Geoffrey Laurent, the then Director of the Centre for Respiratory Centre, was joined by his team of scientists and researchers as well as respiratory doctors.  It was attended by over 100 patients and relatives.  Speakers included Jo Porter, Malcolm Weallans and Manjiry Tamhane who spoke about topics ranging from living with respiratory disease through to the importance of patient support in shaping future scientific research and ways you could directly help us.  Our scientists were inspired by meeting our supporters and the patients whom their work helps.

Since then, you have attended our research meetings, events and our patient supporter meetings; you have helped us steer the way forward and shaped our research; you have advised on our fundraising and awareness strategies, you have attended our centre tours to see our labs and talk to our researchers about our work, and you have helped celebrate our achievements.

2: The First UK Treatments for IPF

In 2014, UCLH became an NHS-England Specialist Centre for the diagnosis and management of Interstitial Lung Disease.  This was important and timely as it enabled our doctors to prescribe idiopathic pulmonary fibrosis patients with Pirfenidone and Nintedanib – the first treatments in the UK available to IPF patients. These antifibrotic therapies slow decline in lung function and reduce the risk of acute respiratory deteriorations.

This was a game-changer.

3: Funding Clinical Fellows and Their Research

Breathing Matters has funded three celebrated Clinical Fellows:

  1. Lawrence Matz Clinical Fellow – Dr Theresia Mikolasch, who set up our Cryoscope Service and was the original soldier in our Neutrophil Army.
  2. Mark Hulme Clinical Fellow – Dr Helen Garthwaite, who worked on our important PET response studies.
  3. Christopher Whittington Clinical Fellow – Dr Emma Denneny, who is currently working on novel biomarkers to detect lung fibrosis with a blood test, earlier than standard CT imaging.

The work that our Clinical Fellows have done has enabled us to leverage a further £450,000 in grants.

4: Pioneering Diagnostics – Cryoscope

Our Lawrence Matz Clinical Fellow set up the Cryoscopic Lung Biopsy Service at UCLH, a pioneering minimally invasive diagnostic technique.  The cryoscope was part-funded by Breathing Matters.  In February 2013, UCLH diagnosed idiopathic pulmonary fibrosis from a cryoscopic lung biopsy – this was a UK first.

This was important for:

  • The Patient: who undergoes a day case procedure as opposed to a surgical lung biopsy, thereby avoiding hospital admission, an unsightly and painful scar and a chest drain.
  • The histopathologist: who said the quality of the tissue and preservation were excellent and much better than other minimally invasive biopsies due to the freezing during the procedure.
  • Our ILD research programme: We now have access to lung tissue that is removed, but is excess to that needed for clinical diagnosis.

5: Predicting and Detecting Pulmonary Fibrosis

A lot of our research is looking at better ways to detect pulmonary fibrosis even whilst the lung CT scan is normal. Our ultimate aim is to make an early diagnosis of PF with a blood test. Until then, we are looking at using very very sensitive imaging techniques, such as PET scans and MRI, to detect early changes in radiologically normal lung on CT scans. We have found that we can predict how severe PF is and how quickly it will progress from these PET scans and they may even help us guide treatment. Another exciting area is radiogenomics in which we use imaging patterns to understand the role of genes that predispose individuals to developing IPF.

6: Breakthroughs in Lung Infection

Through work partly done at UCL/H, bronchiectasis was proven to be more prevalent in the UK than previously thought – leading to better GP awareness, diagnosis and treatment.

We highlighted that bronchiectasis in those with weakened immune systems due to haematological disease develops very quickly; better awareness will make doctors much better at recognizing these patients and referring them to specialist centres, such as UCLH.

Our other work uses computers and CT scans to measure the exact degree of the dilatation of the bronchi in patients with bronchiectasis.  This is a significant breakthrough as it will allow us to follow what happens to a particular patient over time, and rapidly identify if things are getting worse.

The Bronch UK national study was the first study funded by the Medical Research Council into bronchiectasis for many years. The aim of the study was to look into the spectrum of disease caused by bronchiectasis, how severe the disease is and how it actually affects the patients’ quality of life.  Thank you to our 150 recruits!

Breathing Matters has supported the important PHOSP-COVID Urgent Public Health study looking into the long term effects of the COVID-19 virus which causes lung infection.

7: Spreading the Word

Where would the medical world be without scientists and researchers?  How would they get new treatments for their patients?  How would GPs find out about new or little known diseases and know when and how to act quickly?

Breathing Matters has reached out and spread awareness through various ways over the last 10 years.  Each September, we highlight global pulmonary fibrosis awareness month through our #Breathtember campaigns, we communicate regularly with you via our website, newsletters and social media, we have held awareness stalls in our hospital [world pneumonia day, #Breathtember, organ transplant month, bronchiectasis charity stalls] and at local institutions, including Sainsbury’s where we were Local Charity of the Year.  We even advised on the IPF storyline on Coronation Street in 2019.

8: FUNdraising and FUNdraisers

Breathing Matters has had some amazing and innovative fundraising challenges over the last 10 years.  We started our fundraising journey in 2011 with the first of our charity bike rides in Richmond Park.  After 4 years, we went bigger and moved to the Olympic Velodrome offering a myriad of biking challenges.  One of our star fundraisers, Jane Walker, with the help of many of our supporters, including the Holst Singers, has now raised £30K for bronchiectasis research through the Breathing Matters charity stalls and charity concerts-amazing!  Keeping ahead of the curve, our charity silent discos at the London Steam Museum were a big hit and 2020’s virtual fundraisers were challenging in a different but safe way. But our supporters have come up with some of the BEST ideas, including golf days, head shaves and hairdressing days, jewellery sales, bake sales, house clearance sales, swims/walks/runs/bike rides of all distances, motorbike challenges, spinathons, zumbathons, charity CD, concerts and recitals, going up mountains, falling from planes or bungying, books, boxing, dieting, giving up alcohol or smoking, charity beer, charity dinners, pancake events, husky sled trails and even a tractor run … among many many more!

9: Royal Visit

In 2016, UCL Respiratory was honoured when HRH Princess Anne paid us a visit.  The Princess Royal attended in her official capacity as Chancellor of UCL to officially open the refurbished labs.  During her visit, HRH met with the designers and architects along with our important researchers and scientists, and was treated to a tour of the labs.

The Breathing Matters team was introduced to the Princess Royal and it was a huge honour to have the opportunity to talk with her about the charity and what we’ve accomplished.  HRH asked us to “keep up the good work” and, with your help, we have done just that!

10: Your Support

You, our supporters, have helped us achieve so much.

With YOUR help, at 3 years, we had reached £250K; at 7 years, we had reached £500K; and at 9 years, we reached an incredible £750K – all because of you!

We have decided to keep our charity small so we have little overheads, enabling all your hard-earned fundraising and donations to be funnelled into our vital research.

 

If you would like to help us ‘keep up the good work’ and make a difference, you can do so via our Justgiving Page or email us on breathingmatters@ucl.ac.uk for our bank details.

 

 

Autumn 2020 Newsletter – Out Now

 

For the Autumn 2020 newsletter, please click here

 

 

 

 

Can COVID-19 cause lung fibrosis?

The interstitial lung diseases (ILDs) are a group of over 200 different diseases that may result in lung inflammation or (in the worst case) pulmonary fibrosis (PF). There are many different aetiologies for ILD/PF and in some cases,  we do not know the cause, so called ‘idiopathic’. One of the questions that we at Breathing Matters want to answer is can COVID-19 give you pulmonary fibrosis? There are a few clues that this might be the case. Other coronaviruses such as Severe Acute Respiratory Syndrome (SARS) or Middle East Respiratory Syndrome (MERS) have been reported to cause PF in a small percentage of patients, but of course the numbers of patients affected by SARS-CoV-2, the virus that causes COVID-19, will be much greater so, even if only a small percentage are affected, the numbers may still be very large. The diagnosis of ILD/PF is suggested by a clinical finding of breathlessness and abnormal lung function. The diagnosis is then confirmed with a CT scan of the chest.

Initial studies from China, Italy and the UK have remarkably similar findings. Of patients with COVID-19 discharged from a hospital in China, nearly half had abnormal lung function (Mo X, et al. European Respiratory Journal 55: 2001217, 2020).  Data from Leeds of patients with COVID-19 discharged from hospital showed that the majority (75% of those admitted to intensive care, and 65% of those admitted to the regular wards) still suffered from fatigue at 6 to 8 weeks post discharge. The number suffering from continual breathlessness was also high (70% of those admitted to intensive care, and 45% of those admitted to the ward).  (Halpin S et al. Journal Medical Virology, First published: 30 July 2020, DOI: (10.1002/jmv.26368).  An Italian study from Rome found that at 60 days around 55% of patients were suffering from fatigue and 40% from breathlessness.  It is unclear what is the cause of these high levels of breathlessness, but a study from Austria is following their patients up in more detail at 6, 12 and 24 weeks after discharge. So far, they have found that at 6 weeks 47% of patients are short of breath and this falls to 39% at 12 weeks. In addition, 33% have abnormal lung function suggestive of lung fibrosis, but this falls to 22% at 12 weeks. Of course, to diagnose lung fibrosis requires at CT scan of the chest and they found that CT scans suggested an interstitial lung disease (ILD) or lung fibrosis in 88% falling to 56% at 12 weeks. However, it is also important to know how much of the lung is affected, and many of the studies do not clarify this, but just comment on whether ILD is present or not. The result is that it is hard to know whether these patients had minimal or significant ILD changes on the CT scan. Clearly, Breathing Matters will be looking out for the 24 week data.

Our own experience is that of around 800 patients seen at UCLH with COVID-19, around 8% have persistent or slowly resolving CT changes at 5 months suggestive of interstitial lung involvement. Our main priority at the moment is to analyse our data from the ‘first wave’ to see how common the development of ILD/ PF is in these patients, how much of the lung is affected and what the critical contributory factors are. It may be that this virus and the enormous numbers of patients that have been infected will shed some light on the pathogenesis of other ILD/PF diseases.

We will let you know as soon as we have reviewed all these patients and their scans.

 

Clean Air Day Campaign

We are honoured to have worked with Health Awareness on the 2020 Respiratory Health Clean Air Day Campaign.

A printed publication is enclosed within every copy of the Guardian newspaper published on 8th October 2020 and the content is available online at www.healthawareness.co.uk/respiratory.

The campaign features exclusive content from key thought leaders and industry voices about respiratory conditions and external risk factors such as air pollution and COVID-19.

All You Want for Christmas is a Santa Dash

The Virtual Santa Dash is a 5K fun run to be done with friends and family/pets or competitively on your own. Take this 5K challenge anytime in November or December 2020. Do it in your running gear alone or dressed as Christmas elves with the family! Earn the offical Santa Dash Medal and goodie bag. Simply register for the event and you will be given access to the Virtual Marathon Series runners portal where you can submit your evidence before or on your run day.

The Virtual Santa Dash has a special challenge attached and requires you to dress up in Christmas fancy dress to complete it. The Virtual Marathon Series are also offering two prizes:

  1. The first one is for the fastest time in Christmas fancy dress, become the Christmas world record holder.
  2. Secondly, to the person who raises the most money for their chosen charity by Christmas Day.

They will donate £250 to the charities chosen by the 2 winners who will receive a goodies pack from their partner Run Through in the post.

All you need to do now is register – here’s how:

  1. Register here – you will receive a confirmation email to log in to the Secure Charity Portal where you can pay your registration fee [£25 covers the cost of the place and medal only and does not go to the charity].
  2. Breathing Matters will get notification that you have signed up for your challenge and will contact you – or you can contact us directly at breathingmatters@ucl.ac.uk
  3. Set up a Breathing Matters personal fundraising page.  It is up to you how much you want to raise for Breathing Matters; there is no minimum sponsorship limit.
  4. Sort out your Santa outfit and start training!!!

New COVID-19 Clinical Trials Funded

Professor Joanna Porter was delighted to be awarded over £2M from LifeArc to run two clinical trials in COVID-19.

The first, ATTRACT, is in collaboration with Vicore Pharma, whom we have worked with for over 10 years on developing novel approaches for pulmonary fibrosis. The drug, VP01 (Compound 21; C21) is hoped to recalibrate the renin-angiotensin- system towards repair rather than inflammation.  This should indirectly help our research into pulmonary fibrosis too.

The second study, COVASE, is a collaboration with Veni Papayannopoulos and Veronique Brilaut at The Francis Crick Institute, to investigate an approved nebulised recombinant human deoxyribonuclease I (Dornase alfa) to reduce hyperinflammation from neutrophil extracellular traps in the lungs of hospitalised participants with COVID-19.

ATTRACT is open to recruitment and COVASE will open in the next two weeks.

Here’s the LifeArc press release with more info: https://www.lifearc.org/funding/covid-19-funding/