COVID-19, Skills, Guidelines Highlights of ERS 2021 Congress

Jim Kling

August 31, 2021

The 2021 European Respiratory Society Congress will be held virtually, and COVID-19 and its respiratory aftermath will be an important topic of conversation. But treatments for asthma, interstitial lung disease, infections, and COPD will also garner attention.

The congress typically attracts 20,000 to 25,000 attendees. In 2020, that number rose to about 35,000, though fewer attended the full congress, choosing instead to drop in and out of individual sessions. This year's conference will have more than 350 sessions with about 300 speakers, and approximately 3000 abstracts and case presentations.

Highlights include Grand Rounds sessions, which are interactive sessions that feature well-documented clinical cases of interest to respiratory health professionals. There will be hot topics sessions and pro–con debates. Topics will include the "environment, air pollution, health, and respiratory diseases," "post-COVID interstitial lung disease syndrome," and "FeNo for the diagnosis of asthma."

New This Year

Dr Miriam Barrecheguren

A new feature of this year's conference will be skills labs, which are more practice-oriented workshops. Eight pre-recorded skills labs will explore techniques like ultrasound, cardiopulmonary exercise testing, and mechanical ventilation.

"It's going to cover different skills and techniques that are generally used in clinical practice, but maybe are not accessible for everyone. They will cover different techniques from the beginning: the procedures, the devices, and sometimes, how to interpret the results," said Miriam Barrecheguren, MD, PhD, who is a pulmonologist at Vall d'Hebron Hospital in Barcelona, Spain. Barrecheguren is a co-chair of the congress, along with Marc Miravitlles, MD, who is also a pulmonologist at Vall d'Hebron Hospital.

Guidelines Galore

Guideline sessions will be back, with discussions and presentations about those published over the past year. "Since I dedicated part of my career to the development of...guidelines, I'm always very interested about these documents. And the ERS, either alone or together with our sister scientific societies, is very active in developing clinical practice guidelines.

“And the congress every year is where these guidelines produced during the year are presented to the delegates. It's a summary of best practice, and they have also legal implications for clinical practice. So these sessions are usually always very well attended," said Miravitlles.

Key guidelines topics include use of high-flow nasal cannula and diagnosis of asthma in adults. The latter "has been long awaited," he added.

Research Advances

Dr Marc Miravitlles

On the research side, there will be results from clinical trials. "We are waiting to see some advances about treatments for COVID-19, but also other diseases such as interstitial lung disease, COPD, asthma, and infections. These are the main disease areas that we'll be seeing advances," said Miravitlles. COVID-19 treatments under investigation include monoclonal antibodies and antiviral agents, including antiproteases such as alpha-1 antitrypsin.

"Many drugs with different mechanisms of action have been tested. Unfortunately, we have not seen very good results for the majority of them. So, we are still in a huge need of new COVID-19 therapies," said Miravitlles.

Other studies will look at treatments and epidemiological aspects of COVID-19, including persistent respiratory symptoms. One sequela is fibrosis that, unlike idiopathic pulmonary fibrosis (IPF), does not seem to present a progressive phenotype. Corticosteroids and treatments for IPF are being investigated in that population. There will be a session on use of antifibrotic therapy in these patients.

"It's something that we are starting to debate and use now. Post-COVID fibrosis is something that we are starting to see more and more frequently, especially in severe COVID," said Barrecheguren.

Digital Healthcare

A key impact of the COVID-19 pandemic has been the acceleration of the adoption of digital healthcare, another area of focus at the conference. Sessions will highlight digital methods to monitor patients with chronic respiratory diseases, along with new technologies like wearable devices that can keep track of vital signs. Activity monitors will be an important element of digital care due to the importance of activity in patients with chronic respiratory disease.

Some devices can be used to measure and monitor sleep quality, others could keep track of vital signs in the hope of providing early warnings of COPD or asthma exacerbations. "All of these different technologies may help to intervene early and prevent exacerbations and improve the care of our patients, so there is intense development of these different technologies and strategies," said Miravitlles. A Chair's session will focus on digital health.

The conference will also feature various awards, including the Chair's Award, to be presented to Antonio Anzueto, MD, professor of pulmonology at UT Health San Antonio. Anzueto has done extensive research on COPD, infections, and intensive care in the United States, but also Spain and Latin America. 

Barrecheguren and Miravitlles have reported no relevant financial relationships.

European Respiratory Society (ERS) International Congress 2021. September 5-8, 2021.

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