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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The first patient with pneumonia of unknown origin was admitted to Wuhan Hospital&#44; China&#44; on December 8th&#44; 2019&#46; On January 7th&#44; 2020&#44; a new coronavirus&#44; SARS-CoV-2&#44; was identified as causing this pneumonia &#40;later defined as a characteristic of Covid-19 disease&#41;&#46; On March 11th&#44; the World Health Organization &#40;WHO&#41; declared Covid-19 a pandemic&#44; with 118&#44;319 cases and 4292 deaths worldwide&#46; In a matter of days&#44; by March 14th&#44; the day on which the state of alarm was declared in Spain&#44; the number of confirmed cases of Covid-19 had increased to 142&#44;434&#44; with 5392 deaths worldwide&#44; of which 4232 cases and 120 deaths had been registered in Spain&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The SARS-CoV-2 virus was so destructive on such a large scale that it was able to paralyze the world&#44; including healthcare services&#58; within 100 days&#44; lung function laboratories &#40;LFL&#41; had become partially inactive&#46; A survey of all pulmonology departments carried out by the Techniques and Transplantation area of the Spanish Society of Pulmonology and Thoracic Surgery &#40;SEPAR&#41; found that 74&#37; of the 108 LFLs that responded had changed their activity in March&#44; at the height of the pandemic&#46; Half of the laboratories had closed completely&#44; and the other 50&#37; continued some of their activities&#44; spirometry in particular&#44; while some still performed carbon monoxide transfer capacity &#40;DLCO&#41; testing&#46; It was not until May&#44; almost 2 months after the state of alarm was declared&#44; that only 51&#37; of these units cautiously resumed their activities&#44; but 49&#37; of LFLs still remain closed&#46; This highlights the need to reorganize LFLs in a standardized fashion so that they can resume their services with sufficient guarantees for both patients and professionals&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Lung function tests entail a risk of infection for both patients and staff&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> This risk is mainly indirect&#44; via the equipment and consumables used&#44; primarily due to the aerosolization that occurs during the tests&#46; Prior to the SARS-CoV-2 pandemic&#44; basic hygiene measures&#44; such as proper hand washing&#44; were recommended to prevent the transmission of infections&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> The use of disposable antibacterial filters in lung function equipment was also recommended&#44; provided&#44; of course&#44; that they did not create airflow resistance&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">However&#44; SARS-CoV-2 is still with us and has not yet been neutralized&#44; so we need to rethink hygiene and safety measures in our LFLs&#46; Initially&#44; recommendations were distributed by various medical societies&#44; such as the Chinese Expert Consensus&#44; the American Thoracic Society &#40;ATS&#41;&#44; the Thoracic Society of Australia and New Zealand &#40;TSANZ&#47;ANZSRS&#41;&#44; the Sociedade Portuguesa de Pneumologia &#40;SPP&#41;&#44; the European Respiratory Society &#40;ERS&#41;&#44; the Irish Thoracic Society &#40;IRS&#41;&#44; and SEPAR&#44; limiting or even banning lung function testing during the community transmission phase of the infection&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#8211;10</span></a> But this first wave of the Covid-19 has been overcome&#44; and the time has come for LFL activity to begin again in both hospitals and primary care&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The recommendations of the SEPAR experts are based on two aspects&#58; reorganizing LFLs and empowering health professionals&#44;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> and focus on both structural elements&#8212;such as the ideal size of rooms or the need for ventilation&#8212;and&#44; primarily&#44; a reorganization of activities&#46; This includes patient flow management&#44; a strategy that will revolutionize LFL activity&#46; The clinical management of the new LFLs can only be carried out by empowering healthcare professionals with specific training on lung function testing&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Adapting LFLs to the SARS-CoV-2 pandemic will reduce the number of tests performed&#44; making it necessary to reorganize lab working hours and increase operations&#46; But now should also be the time for exploring new technologies in a wide range of studies&#46; Research is needed on the design of safer lung function equipment to prevent the indirect transmission of infection without sacrificing the quality of respiratory determinations&#44; while progress should also be made in communication technologies to improve LFL efficiency&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Covid-19 has massively accelerated the use of telemedicine&#46; In the USA&#44; the number of consumers using telemedicine has risen from 11&#37; in 2019 to 46&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> This has led healthcare providers to rapidly scale up these services&#44; and they are now seeing 50&#8211;175 times the number of patients via telehealth than they did before&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> Lung function cannot be immune to these developments&#44; and monitoring and telematic follow-up with forced spirometry will soon be implemented&#59; the ATS&#44; for example&#44; has launched an initiative to standardize lung function data so that they can be integrated into electronic medical records&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Solutions for the management of respiratory diseases such as COPD&#44; asthma&#44; cystic fibrosis&#44; and post-lung transplantation&#44; that can be monitored remotely at home are available&#46; Platforms with standardized&#44; interoperable data can and should play a significant role&#44; because they have great potential for improving adherence to medication and disease self-management&#44; and for reducing healthcare costs&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> The necessary organizational and infrastructure changes will inevitably force a radical rethink of the services offered by both hospitals and primary care&#44; and this must be done now&#44; before we are caught off guard again by a new episode of this or another pandemic&#46; It seems very likely that the pandemic will accelerate innovations of this type and the rapid introduction of novel diagnostic techniques&#46; As with all aspects of healthcare&#44; today&#39;s challenges are tomorrow&#39;s opportunities&#46; LFLs will have to address these challenges safely&#44; rapidly and intelligently&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">In short&#44; Covid-19 has brought about a change in LFLs&#44; which after an initial stoppage went on to gain momentum and improve in terms of quality and performance&#46; LFLs must adapt to the times we live in and to the times to come&#46; Every dramatic situation forces us to analyze our current position in order to eliminate uncertainty and put in practice the lessons learned for a better future&#46; SARS-CoV-2 has come to stay&#44; without a doubt&#44; but it has provided us with the impetus to improve and to offer our patients better quality healthcare&#46;</p></span>"
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Editorial
Impact of the COVID-19 Pandemic on Lung Function Laboratories: Considerations for “Today” and the “Day After”
Impacto de la pandemia COVID-19 en los laboratorios de función pulmonar: consideraciones sobre el «hoy» y el «día después»
Felip Burgos Rincóna,b,c,
Corresponding author
fburgos@clinic.cat

Corresponding author.
, Juana Martínez Llorensd,e, Rosa Cordovilla Pérezf,g
a Centro de Diagnóstico Respiratorio, Hospital Clínic, Barcelona, Spain
b Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
c Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES)-Madrid CIBERES, ISCiii, Madrid, Spain
d Servicio de Neumología, Hospital del Mar – IMIM, Parc de Salut Mar, Barcelona, Spain
e DCEXS, Universitat Pompeu Fabra, Barcelona, Spain
f Servicio de Neumología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
g Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The first patient with pneumonia of unknown origin was admitted to Wuhan Hospital&#44; China&#44; on December 8th&#44; 2019&#46; On January 7th&#44; 2020&#44; a new coronavirus&#44; SARS-CoV-2&#44; was identified as causing this pneumonia &#40;later defined as a characteristic of Covid-19 disease&#41;&#46; On March 11th&#44; the World Health Organization &#40;WHO&#41; declared Covid-19 a pandemic&#44; with 118&#44;319 cases and 4292 deaths worldwide&#46; In a matter of days&#44; by March 14th&#44; the day on which the state of alarm was declared in Spain&#44; the number of confirmed cases of Covid-19 had increased to 142&#44;434&#44; with 5392 deaths worldwide&#44; of which 4232 cases and 120 deaths had been registered in Spain&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The SARS-CoV-2 virus was so destructive on such a large scale that it was able to paralyze the world&#44; including healthcare services&#58; within 100 days&#44; lung function laboratories &#40;LFL&#41; had become partially inactive&#46; A survey of all pulmonology departments carried out by the Techniques and Transplantation area of the Spanish Society of Pulmonology and Thoracic Surgery &#40;SEPAR&#41; found that 74&#37; of the 108 LFLs that responded had changed their activity in March&#44; at the height of the pandemic&#46; Half of the laboratories had closed completely&#44; and the other 50&#37; continued some of their activities&#44; spirometry in particular&#44; while some still performed carbon monoxide transfer capacity &#40;DLCO&#41; testing&#46; It was not until May&#44; almost 2 months after the state of alarm was declared&#44; that only 51&#37; of these units cautiously resumed their activities&#44; but 49&#37; of LFLs still remain closed&#46; This highlights the need to reorganize LFLs in a standardized fashion so that they can resume their services with sufficient guarantees for both patients and professionals&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Lung function tests entail a risk of infection for both patients and staff&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> This risk is mainly indirect&#44; via the equipment and consumables used&#44; primarily due to the aerosolization that occurs during the tests&#46; Prior to the SARS-CoV-2 pandemic&#44; basic hygiene measures&#44; such as proper hand washing&#44; were recommended to prevent the transmission of infections&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> The use of disposable antibacterial filters in lung function equipment was also recommended&#44; provided&#44; of course&#44; that they did not create airflow resistance&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">However&#44; SARS-CoV-2 is still with us and has not yet been neutralized&#44; so we need to rethink hygiene and safety measures in our LFLs&#46; Initially&#44; recommendations were distributed by various medical societies&#44; such as the Chinese Expert Consensus&#44; the American Thoracic Society &#40;ATS&#41;&#44; the Thoracic Society of Australia and New Zealand &#40;TSANZ&#47;ANZSRS&#41;&#44; the Sociedade Portuguesa de Pneumologia &#40;SPP&#41;&#44; the European Respiratory Society &#40;ERS&#41;&#44; the Irish Thoracic Society &#40;IRS&#41;&#44; and SEPAR&#44; limiting or even banning lung function testing during the community transmission phase of the infection&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#8211;10</span></a> But this first wave of the Covid-19 has been overcome&#44; and the time has come for LFL activity to begin again in both hospitals and primary care&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The recommendations of the SEPAR experts are based on two aspects&#58; reorganizing LFLs and empowering health professionals&#44;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> and focus on both structural elements&#8212;such as the ideal size of rooms or the need for ventilation&#8212;and&#44; primarily&#44; a reorganization of activities&#46; This includes patient flow management&#44; a strategy that will revolutionize LFL activity&#46; The clinical management of the new LFLs can only be carried out by empowering healthcare professionals with specific training on lung function testing&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Adapting LFLs to the SARS-CoV-2 pandemic will reduce the number of tests performed&#44; making it necessary to reorganize lab working hours and increase operations&#46; But now should also be the time for exploring new technologies in a wide range of studies&#46; Research is needed on the design of safer lung function equipment to prevent the indirect transmission of infection without sacrificing the quality of respiratory determinations&#44; while progress should also be made in communication technologies to improve LFL efficiency&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Covid-19 has massively accelerated the use of telemedicine&#46; In the USA&#44; the number of consumers using telemedicine has risen from 11&#37; in 2019 to 46&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> This has led healthcare providers to rapidly scale up these services&#44; and they are now seeing 50&#8211;175 times the number of patients via telehealth than they did before&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> Lung function cannot be immune to these developments&#44; and monitoring and telematic follow-up with forced spirometry will soon be implemented&#59; the ATS&#44; for example&#44; has launched an initiative to standardize lung function data so that they can be integrated into electronic medical records&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Solutions for the management of respiratory diseases such as COPD&#44; asthma&#44; cystic fibrosis&#44; and post-lung transplantation&#44; that can be monitored remotely at home are available&#46; Platforms with standardized&#44; interoperable data can and should play a significant role&#44; because they have great potential for improving adherence to medication and disease self-management&#44; and for reducing healthcare costs&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> The necessary organizational and infrastructure changes will inevitably force a radical rethink of the services offered by both hospitals and primary care&#44; and this must be done now&#44; before we are caught off guard again by a new episode of this or another pandemic&#46; It seems very likely that the pandemic will accelerate innovations of this type and the rapid introduction of novel diagnostic techniques&#46; As with all aspects of healthcare&#44; today&#39;s challenges are tomorrow&#39;s opportunities&#46; LFLs will have to address these challenges safely&#44; rapidly and intelligently&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">In short&#44; Covid-19 has brought about a change in LFLs&#44; which after an initial stoppage went on to gain momentum and improve in terms of quality and performance&#46; LFLs must adapt to the times we live in and to the times to come&#46; Every dramatic situation forces us to analyze our current position in order to eliminate uncertainty and put in practice the lessons learned for a better future&#46; SARS-CoV-2 has come to stay&#44; without a doubt&#44; but it has provided us with the impetus to improve and to offer our patients better quality healthcare&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Burgos Rinc&#243;n F&#44; Mart&#237;nez Llorens J&#44; Cordovilla P&#233;rez R&#46; Impacto de la pandemia COVID-19 en los laboratorios de funci&#243;n pulmonar&#58; consideraciones sobre el &#171;hoy&#187; y el &#171;d&#237;a despu&#233;s&#187;&#46; Arch Bronconeumol&#46; 2020&#59;56&#58;611&#8211;612&#46;</p>"
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ISSN: 15792129
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