key: cord-0057293-zj4xk9vc authors: Morais-Almeida, Mário; Barbosa, Miguel T.; Sousa, Cláudia S.; Almeida, Isabel; Pimenta, Lara; Aguiar, Rita title: Spirometry Outside the Hospital date: 2021-03-10 journal: Arch Bronconeumol DOI: 10.1016/j.arbr.2020.10.011 sha: 3e6fc1a37ba16976cd8d86ac04fba8e9c291da78 doc_id: 57293 cord_uid: zj4xk9vc nan Letter to the Editor / Arch Bronconeumol. 2021;57(3):234-236 We carefully read the editorial by Burgos Rincón et al., titled Impact of the COVID-19 Pandemic on Lung Function Laboratories: Considerations for "Today" and the "Day After", recently published in Archivos de Bronconeumología. 1 The study considered important aspects, including the need to reorganize the lung function laboratories to recover the healthcare activity with sufficient security guarantees for both patients and professionals. 1 The study also stated that current COVID-19-related limitations warrant the need for respiratory teams to engage and explore innovative methods for lung function assessment. 1 Home-based spirometry, particularly, those with on-screen encouragement and/or remote guidance by a technician, could be an alternative to conventional spirometry for management and telemonitoring of chronic respiratory diseases. Home-based spirometry transmits the lung function data from patients' home to a remote monitoring center (generally on a daily basis from previously trained patients) for a cautious evaluation by a respiratory function technician and interpretation by an expert physician, upholding the quality of the lung function assessment. 2, 3 In 1997, Brudeman et al. described a home-based portable spirometry system to detect early signs of asthma deterioration, which improved asthma management, quality of life, and reduced emergency department visits and hospitalizations. 2 For chronic obstructive pulmonary disease (COPD), Rodriguez-Roisin et al. compared the results of home-based spirometries performed by more than 2000 patients with severe COPD, after face-to-face training, and in clinical settings (using the same spirometry device); they found a good agreement between in-clinic and home-based measurements. 3 In contrast, telespirometry conducted by respiratory function technicians in outpatient clinics might be an acceptable alternative after the resolution of regional COVID-19 outbreaks. Telespirometry uses a portable spirometer and transmits the lung function data online from a primary care clinic to a specialized center for interpretation. Consequently, some national networks were implemented, with positive outcomes. [4] [5] [6] [7] Results from the "RespiraNet Program" in Brazil and a Spanish study by Marina et al. showed that telespirometries performed by previously trained technicians, and analyzed and interpreted remotely by expert physicians, is a useful alternative to improve the diagnosis and management of chronic obstructive lung diseases. 4,5 Furthermore, another Spanish study by Masa et al. concluded that telespirometry performed by a remotely located technician controlling the spirometer computer online enhanced the quality and the reliability of the maneuver. 6 The "Alliance" study results showed that Italian general practitioners accepted telespirometry as an useful exploratory modality to improve the early diagnosis, monitoring, and management of COPD and asthma. 7 Thus, home-based spirometry could decrease the burden on hospital services, avoid gathering of patients in high-risk facilities, and obviate the need for transportations of patients to central areas during the COVID-19 pandemic. In addition, after the pandemic, telespirometry could be a key add-on to improve the response to future demand related to currently postponed laboratory lung function tests. No funding was received for the publication of this article. de la pandemia COVID-19 en los laboratorios de función pulmonar: consideraciones sobre el «hoy» y el «día después Telespirometry: novel system for home monitoring of asthmatic patients Daily home-based spirometry during withdrawal of inhaled corticosteroid in severe to very severe chronic obstructive pulmonary disease RespiraNet Program: the first tele-spirometry service in South Brazil Telemedicine spirometry training and quality assurance program in primary care centers of a public health system Validity of spirometry performed online Office spirometry can improve the diagnosis of obstructive airway disease in primary care setting None declared.