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RESPIRATORY European Edition Vol. 8.1 November 2020 emjreviews.com + ERS INTERNATIONAL CONGRESS 2020 + EDITOR’S PICK + INTERVIEWS Two ERS 2020 Award Winners Improving Antenatal provide fascinating insights into their area of expertise in Asthma Management: cardiopulmonary rehabilitation A Complex Journey and intensive care medicine. + ABSTRACT REVIEWS Captivating reviews of abstracts presented at ERS International Congress 2020. WELCOME TO THE BREATHING HOTSPOT. Visit www.wehale.life/hcp GO TO DESTINATION FOR HEALTHCARE PROFESSIONALS WORKING WITH ASTHMA AND COPD • Patient support materials • Instruction and tutorial videos • Information about the Easyhaler® product family ENTER CHECK THE LATEST SCIENTIFIC INSIGHTS Terapia wziewna – ze szczególnym uwzględnieniem steroidów – w okresie pandemii COVID-19. Scientific Presentations at Virtual ERS Congress 2020 Performance under simulated www.wehale.life/de/Corona/ Sponsored by Orion Pharma. real-life conditions. Cercano al inhalador ideal: fácil y conveniente. (NL) Switching asthma and COPD patients to Easyhaler® Potilaiden tyytyväisyys inhalaattoriin Costs of switching to low global warming leads to improved clinical outcomes and QOL. on yhteydessä parempaan hoitomyönty- potential inhalers. UK Prescribing Information (FR) Pharmacokinetics of salmeterol and fluticasone vyyteen ja astman hoitotasapainoon. propionate delivered in combination via Easyhaler® Evaluation of the efficiency of single-inhaler and Diskus® dry powder inhalers. combination therapy with budesonide/ Adverse events should be reported. formoterol fumarate in patients with Reporting forms and information can be found at www.mhra.gov.uk/yellowcard. Adverse events should also be reported to Orion Pharma (UK) Ltd on 01635 520300. CORP-EASYH-991/09-2020 bronchial asthma in daily clinical practice. June2020/EASYH-830/ Contents + EDITORIAL BOARD 6 + WELCOME 9 + FOREWORD 11 + CONGRESS REVIEW Review of the European Respiratory Society (ERS) International 12 Congress 2020, 6th–9th September + SYMPOSIUM REVIEWS The Treatment of Severe Respiratory Disorders in Challenging Times 26 Successful Inhalation Therapy in 2020: Patients and Inhalers in Focus 35 Importance of Detecting Wheezing in Young Children to Minimise 44 Asthma Exacerbation + POSTER REVIEWS Dupilumab in Moderate-to-Severe Asthma: Updates from the ERS 50 International Congress 2020 Dupilumab Improves Outcomes for Patients with Severe Chronic 57 Rhinosinusitis with Nasal Polyps Irrespective of the Number of Surgeries and the Time Since Surgery or Diagnosis + ABSTRACT REVIEWS 65 + CONGRESS INTERVIEW Dina Brooks and Greet Van den Berghe 84 4 RESPIRATORY • November 2020 EMJ “Always open access, always at the forefront; please enjoy the following pages, and I hope that this content adds value to your medical practice, whatever your role in the field.” Spencer Gore, CEO + INTERVIEW Sore Throat Treatment Guidelines are Fanning the Flames of 90 Antimicrobial Resistance Martin Duerden + FEATURE Loose ENDs: Electronic Nicotine Delivery Systems and the FDA’s 93 Recent Enforcement Policy Ahmad et al. + ARTICLES Editor’s Pick: Improving Antenatal Asthma Management: 97 A Complex Journey Chen et al. Spatiotemporal Cellular Networks Maintain Immune Homeostasis in 108 the Lung Borger Risk Factors for Severe Coronavirus Disease (COVID-19) 120 Hussain et al. Effects of Noninvasive Versus Invasive Mechanical Ventilation on Sleep 127 in the Intensive Care Unit – A Pilot Study Ugurlu et al. Cryobiopsy In Flexi-Rigid Pleuroscopy in a Region with Low 137 Mesothelioma Prevalence Nyanti et al. Creative Commons Attribution-Non Commercial 4.0 November 2020 • RESPIRATORY 5 Editorial Board Editor-in-Chief Dr Antonio Rossi IQVIA, Milan, Italy Editorial Board Dr Martin Balzan University of Malta, Malta Prof Peter Barnes Imperial College London, UK Dr Catharina Belge University Hospitals Leuven, Belgium Prof Dr Jacques Bouchard Université Laval, Canada, and CIUSSS Capitale-Nationale, Canada Prof Andrew Bush Imperial College London, UK Prof Giorgio Walter Canonica Humanitas Research Hospital, Italy Prof Enrico Clini University of Modena, Italy Prof Dr Oliver Eickelberg University of Colorado Anschutz Medical Campus, USA Dr Atul Gupta King's College London, UK Prof Dr Nicholas Hill Tufts Medical Center, USA Dr Neil Holden University of Lincoln, UK Dr Islam Ibrahim University of California, USA Dr Ravi Kalhan Northwestern University Feinberg School of Medicine, USA Prof Dario Olivieri University of Parma, Italy Dr Joanna Porter University College London Hospital, UK Dr Paraschiva Postolache Grigore T. Popa University of Medicine and Pharmacy, Romania Prof Mohammad Azizur Rahman Dhaka University, Dhaka, Bangladesh VIEW IN FULL 6 RESPIRATORY • November 2020 EMJ Aims and Scope We are always keen to hear from healthcare professionals wishing to discuss potential submissions, please email: EMJ is an online only, peer-reviewed, open access general [email protected] journal, targeted towards readers in the medical sciences. We aim to make all our articles accessible to readers from To submit a paper, use our online submission site: any medical discipline. www.editorialmanager.com/e-m-j EMJ allows healthcare professionals to stay abreast of Submission details can be found through our website: key advances and opinions across Europe. www.emjreviews.com/contributors/authors EMJ aims to support healthcare professionals in continuously developing their knowledge, effectiveness, Reprints and productivity. The editorial policy is designed to All articles included in EMJ are available as reprints encourage discussion among this peer group. (minimum order 1,000). Please contact [email protected] if you would like to order reprints. EMJ is published quarterly and comprises review articles, case reports, practice guides, theoretical discussions, and original research. Distribution and Readership EMJ also publishes 16 therapeutic area journals, which EMJ is distributed through controlled circulation to provide concise coverage of salient developments at healthcare professionals in the relevant fields the leading European congresses. These are published across Europe. annually, approximately 6 weeks after the relevant congress. Further details can be found on our website: Indexing and Availability www.emjreviews.com EMJ is indexed on DOAJ, the Royal Society of Medicine, and Google Scholar®; selected articles are indexed in Editorial Expertise PubMed Central®. 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Editorial staff, following consultation with either a This Publication member of the Editorial Board or the author(s) if ISSN 2054-3166 necessary, identify three appropriate reviewers, who are selected based on their specialist knowledge in the EMJ Respiratory is published once relevant area. a year. For subscription details please visit: www.emjreviews.com All peer review is double blind. All information obtained by EMJ and each of the Following review, papers are either accepted without contributions from various sources is as current and modification, returned to the author(s) to incorporate accurate as possible. However, due to human or required changes, or rejected. mechanical errors, EMJ and the contributors cannot guarantee the accuracy, adequacy, or completeness of Editorial staff have final discretion over any any information, and cannot be held responsible for proposed amendments. any errors or omissions. EMJ is completely independent of the review event (ERS 2020) and the use of the Submissions organisations does not constitute endorsement or media partnership in any form whatsoever. We welcome contributions from professionals, consultants, academics, and industry leaders on relevant Front cover and contents photograph: and topical subjects. Vienna, Austria. © vichie81 / 123rf.com We seek papers with the most current, interesting, and relevant information in each therapeutic area and accept original research, review articles, case reports, and features. Creative Commons Attribution-Non Commercial 4.0 November 2020 • RESPIRATORY 7 EMJ Respiratory 8.1 Chairman of Advisory Board Head of Operations Prof Jonathan Sackier Keith Moule Chief Executive Officer Operations Assistants Spencer Gore Satkartar Chagger, Emma Knight Chief Commercial Officer Editor Daniel Healy Evgenia Koutsouki Chief Operations Officer Deputy Managing Editor Dan Scott Sam Davis Head of Publishing Content Manager Hamish Dickie Kirstie Turner Head of Content Marketing Editorial Assistants Sen Boyaci Lenos Archer-Diaby, Michaila Byrne, Katherine Colvin, Rachel Donnison, Anaya Malik, Isabel Head of Commercial O’Brien,