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Yao X, Wu J, Zou W, Lin X, Xie B. A predictive model for post-COVID-19 pulmonary parenchymal abnormalities based on dual-center data. Sci Rep 2024; 14:29257. [PMID: 39587159 PMCID: PMC11589148 DOI: 10.1038/s41598-024-79715-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Accepted: 11/12/2024] [Indexed: 11/27/2024] Open
Abstract
Documented radiological and physiological anomalies among coronavirus disease 2019 survivors necessitate prompt recognition of residual pulmonary parenchymal abnormalities for effective management of chronic pulmonary consequences. This study aimed to devise a predictive model to identify patients at risk of such abnormalities post-COVID-19. Our prognostic model was derived from a dual-center retrospective cohort comprising 501 hospitalized COVID-19 cases from July 2022 to March 2023. Of these, 240 patients underwent Chest CT scans three months post-infection. A predictive model was developed using stepwise regression based on the Akaike Information Criterion, incorporating clinical and laboratory parameters. The model was trained and validated on a split dataset, revealing a 33.3% incidence of pulmonary abnormalities. It achieved strong discriminatory power in the training set (area under the curve: 0.885, 95% confidence interval 0.832-0.938), with excellent calibration and decision curve analysis suggesting substantial net benefits across various threshold settings. We have successfully developed a reliable prognostic tool, complemented by a user-friendly nomogram, to estimate the probability of residual pulmonary parenchymal abnormalities three months post-COVID-19 infection. This model, demonstrating high performance, holds promise for guiding clinical interventions and improving the management of COVID-19-related pulmonary sequela.
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Affiliation(s)
- Xiujuan Yao
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China
- Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, 350001, China
| | - Jianman Wu
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China
- Radiology department, Fujian Provincial Hospital, Fuzhou, 350001, China
| | - Wei Zou
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China
- Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, 350001, China
| | - Xiaohong Lin
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China
- Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, 350001, China
| | - Baosong Xie
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China.
- Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, 350001, China.
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Suleiman A, Munoz-Acuna R, Redaelli S, Ahrens E, Tartler TM, Ashrafian S, Hashish MM, Santarisi A, Chen G, Riedel S, Talmor D, Baedorf Kassis EN, Schaefer MS, Goodspeed V. Previous Coronavirus Disease-2019 Infection and Lung Mechanics in Surgical Patients: A Hospital Registry Study. Anesth Analg 2024; 139:997-1005. [PMID: 39058628 DOI: 10.1213/ane.0000000000007015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
BACKGROUND Long-term pulmonary complications have been reported after a coronavirus disease-2019 (COVID-19). We hypothesized that a history of COVID-19 is associated with a measurable decrease in baseline respiratory system compliance in patients undergoing general anesthesia. METHODS In this hospital registry study, we included adult patients undergoing general anesthesia between January 2020 and March 2022 at a tertiary health care network in Massachusetts. We excluded patients with an American Society of Anesthesiologists physical status >IV, laryngoscopic surgeries, and patients who arrived intubated. The primary exposure was a history of COVID-19. The primary outcome was baseline respiratory system compliance (mL/cmH 2 O). Effects of severity of infection, surges (Alpha 1 , Alpha 2 , Delta, and Omicron), patient demographics, and time between infection and assessment of compliance were investigated. RESULTS A total of 19,921 patients were included. Approximately 1386 (7.0%) patients had a history of COVID-19. A history of COVID-19 at any time before surgery was associated with a measurably lower baseline respiratory system compliance (ratio of means adj = 0.96; 95% confidence interval [CI], 0.94-0.97; P < .001; adjusted compliance difference: -1.6 mL/cmH 2 O). The association was more pronounced in patients with a severe form of COVID-19 (ratio of means adj = 0.95; 95% CI, 0.90-0.99; P = .02, adjusted compliance difference: -2 mL/cmH 2 O). Alpha 1 , Alpha 2 , and Delta surges, but not Omicron, led to a lower baseline respiratory system compliance ( P < .001, P = .02, and P < .001). The Delta surge effect was magnified in Hispanic ethnicity ( P -for-interaction = 0.003; ratio of means adj = 0.83; 95% CI, 0.74-0.93; P = .001; adjusted compliance difference: -4.6 mL/cmH 2 O). CONCLUSIONS A history of COVID-19 infection during Alpha 1 , Alpha 2 , and Delta surges was associated with a measurably lower baseline respiratory system compliance.
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Affiliation(s)
- Aiman Suleiman
- From the Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Anesthesia and Intensive Care, Faculty of Medicine, University of Jordan, Amman, Jordan
| | - Ricardo Munoz-Acuna
- From the Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Simone Redaelli
- From the Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Anesthesia, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Elena Ahrens
- From the Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Tim M Tartler
- From the Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Sarah Ashrafian
- From the Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - May M Hashish
- From the Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Abeer Santarisi
- From the Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Guanqing Chen
- From the Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Stefan Riedel
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Daniel Talmor
- From the Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Elias N Baedorf Kassis
- From the Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Pulmonary, Critical Care & Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Maximilian S Schaefer
- From the Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Anesthesiology, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Valerie Goodspeed
- From the Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
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Kim C, Seok H, Kim J, Park DW, van Assen M, De Cecco CN, Choi H, Kim C, Hwang SH, Yong HS, Oh YW, Choi WS. COVID-19's Radiologic, Functional, and Serologic Consequences at 6-Month and 18-Month Follow-up: A Prospective Cohort Study. J Korean Med Sci 2024; 39:e228. [PMID: 39164053 PMCID: PMC11333807 DOI: 10.3346/jkms.2024.39.e228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/27/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND We evaluated the radiologic, pulmonary functional, and antibody statuses of coronavirus disease 2019 (COVID-19) patients 6 and 18 months after discharge, comparing changes in status and focusing on risk factors for residual computed tomography (CT) abnormalities. METHODS This prospective cohort study was conducted on COVID-19 patients discharged between April 2020 and January 2021. Chest CT, pulmonary function testing (PFT), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) measurements were performed 6 and 18 months after discharge. We evaluated factors associated with residual CT abnormalities and the correlation between lesion volume in CT (lesionvolume), PFT, and IgG levels. RESULTS This study included 68 and 42 participants evaluated 6 and 18 months, respectively, after hospitalizations for COVID-19. CT abnormalities were noted in 22 participants (32.4%) at 6 months and 13 participants (31.0%) at 18 months. Lesionvolume was significantly lower at 18 months than 6 months (P < 0.001). Patients with CT abnormalities at 6 months showed lower forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC), and patients with CT abnormalities at 18 months exhibited lower FVC. FVC significantly improved between 6 and 18 months of follow-up (all P < 0.0001). SARS-CoV-2 IgG levels were significantly higher in patients with CT abnormalities at 6 and 18 months (P < 0.001). At 18-month follow-up assessments, age was associated with CT abnormalities (odds ratio, 1.17; 95% confidence interval, 1.03-1.32; P = 0.01), and lesionvolume showed a positive correlation with IgG level (r = 0.643, P < 0.001). CONCLUSION At 18-month follow-up assessments, 31.0% of participants exhibited residual CT abnormalities. Age and higher SARS-CoV-2 IgG levels were significant predictors, and FVC was related to abnormal CT findings at 18 months. Lesionvolume and FVC improved between 6 and 18 months. TRIAL REGISTRATION Clinical Research Information Service Identifier: KCT0008573.
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Affiliation(s)
- Cherry Kim
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Hyeri Seok
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Jooyun Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Dae Won Park
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Marly van Assen
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Translational Laboratory for Cardiothoracic Imaging and Artificial Intelligence, Emory University School of Medicine, Atlanta, GA, USA
| | - Carlo N De Cecco
- Translational Laboratory for Cardiothoracic Imaging and Artificial Intelligence, Emory University School of Medicine, Atlanta, GA, USA
- Division of Cardiothoracic Imaging, Department of Radiology, Emory University, Atlanta, GA, USA
| | - Hangseok Choi
- Medical Science Research Center, Korea University College of Medicine, Seoul, Korea
| | - Chohee Kim
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Sung Ho Hwang
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hwan Seok Yong
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yu-Whan Oh
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.
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Razi O, Teixeira AM, Tartibian B, Zamani N, Knechtle B. Respiratory issues in patients with multiple sclerosis as a risk factor during SARS-CoV-2 infection: a potential role for exercise. Mol Cell Biochem 2023; 478:1533-1559. [PMID: 36411399 PMCID: PMC9684932 DOI: 10.1007/s11010-022-04610-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 11/04/2022] [Indexed: 11/23/2022]
Abstract
Coronavirus disease-2019 (COVID-19) is associated with cytokine storm and is characterized by acute respiratory distress syndrome (ARDS) and pneumonia problems. The respiratory system is a place of inappropriate activation of the immune system in people with multiple sclerosis (MS), and this may cause damage to the lung and worsen both MS and infections.The concerns for patients with multiple sclerosis are because of an enhance risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The MS patients pose challenges in this pandemic situation, because of the regulatory defect of autoreactivity of the immune system and neurological and respiratory tract symptoms. In this review, we first indicate respiratory issues associated with both diseases. Then, the main mechanisms inducing lung damages and also impairing the respiratory muscles in individuals with both diseases is discussed. At the end, the leading role of physical exercise on mitigating respiratory issues inducing mechanisms is meticulously evaluated.
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Affiliation(s)
- Omid Razi
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Razi University, Kermanshah, Iran
| | - Ana Maria Teixeira
- Research Center for Sport and Physical Activity, Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Bakhtyar Tartibian
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Allameh Tabataba’i University, Tehran, Iran
| | - Nastaran Zamani
- Department of Biology, Faculty of Science, Payame-Noor University, Tehran, Iran
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
- Medbase St. Gallen Am Vadianplatz, Vadianstrasse 26, 9001 St. Gallen, Switzerland
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Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, Kang L, Guo L, Liu M, Zhou X, Luo J, Huang Z, Tu S, Zhao Y, Chen L, Xu D, Li Y, Li C, Peng L, Li Y, Xie W, Cui D, Shang L, Fan G, Xu J, Wang G, Wang Y, Zhong J, Wang C, Wang J, Zhang D, Cao B. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 2023; 401:e21-e33. [PMID: 37321233 PMCID: PMC10258565 DOI: 10.1016/s0140-6736(23)00810-3] [Citation(s) in RCA: 119] [Impact Index Per Article: 59.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/02/2023] [Accepted: 04/13/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND The long-term health consequences of COVID-19 remain largely unclear. The aim of this study was to describe the long-term health consequences of patients with COVID-19 who have been discharged from hospital and investigate the associated risk factors, in particular disease severity. METHODS We did an ambidirectional cohort study of patients with confirmed COVID-19 who had been discharged from Jin Yin-tan Hospital (Wuhan, China) between Jan 7 and May 29, 2020. Patients who died before follow-up; patients for whom follow-up would be difficult because of psychotic disorders, dementia, or readmission to hospital; those who were unable to move freely due to concomitant osteoarthropathy or immobile before or after discharge due to diseases such as stroke or pulmonary embolism; those who declined to participate; those who could not be contacted; and those living outside of Wuhan or in nursing or welfare homes were all excluded. All patients were interviewed with a series of questionnaires for evaluation of symptoms and health-related quality of life, underwent physical examinations and a 6-min walking test, and received blood tests. A stratified sampling procedure was used to sample patients according to their highest seven-category scale during their hospital stay as 3, 4, and 5-6, to receive pulmonary function test, high resolution CT of the chest, and ultrasonography. Enrolled patients who had participated in the Lopinavir Trial for Suppression of SARS-CoV-2 in China received SARS-CoV-2 antibody tests. Multivariable adjusted linear or logistic regression models were used to evaluate the association between disease severity and long-term health consequences. FINDINGS In total, 1733 of 2469 discharged patients with COVID-19 were enrolled after 736 were excluded. Patients had a median age of 57·0 years (IQR 47·0-65·0) and 897 (52%) were male and 836 (48%) were female. The follow-up study was done from June 16 to Sept 3, 2020, and the median follow-up time after symptom onset was 186·0 days (175·0-199·0). Fatigue or muscle weakness (52%, 855 of 1654) and sleep difficulties (26%, 437 of 1655) were the most common symptoms. Anxiety or depression was reported among 23% (367 of 1616) of patients. The proportions of 6-min walking distance less than the lower limit of the normal range were 17% for those at severity scale 3, 13% for severity scale 4, and 28% for severity scale 5-6. The corresponding proportions of patients with diffusion impairment were 22% for severity scale 3, 29% for scale 4, and 56% for scale 5-6, and median CT scores were 3·0 (IQR 2·0-5·0) for severity scale 3, 4·0 (3·0-5·0) for scale 4, and 5·0 (4·0-6·0) for scale 5-6. After multivariable adjustment, patients showed an odds ratio (OR) of 1·61 (95% CI 0·80-3·25) for scale 4 versus scale 3 and 4·60 (1·85-11·48) for scale 5-6 versus scale 3 for diffusion impairment; OR 0·88 (0·66-1·17) for scale 4 versus scale 3 and OR 1·76 (1·05-2·96) for scale 5-6 versus scale 3 for anxiety or depression, and OR 0·87 (0·68-1·11) for scale 4 versus scale 3 and 2·75 (1·61-4·69) for scale 5-6 versus scale 3 for fatigue or muscle weakness. Of 94 patients with blood antibodies tested at follow-up, the seropositivity (96·2% vs 58·5%) and median titres (19·0 vs 10·0) of the neutralising antibodies were significantly lower compared with at the acute phase. 107 of 822 participants without acute kidney injury and with an estimated glomerular filtration rate (eGFR) of 90 mL/min per 1·73 m2 or more at acute phase had eGFR less than 90 mL/min per 1·73 m2 at follow-up. INTERPRETATION At 6 months after acute infection, COVID-19 survivors were mainly troubled with fatigue or muscle weakness, sleep difficulties, and anxiety or depression. Patients who were more severely ill during their hospital stay had more severe impaired pulmonary diffusion capacities and abnormal chest imaging manifestations, and are the main target population for intervention of long-term recovery. FUNDING National Natural Science Foundation of China, Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, National Key Research and Development Program of China, Major Projects of National Science and Technology on New Drug Creation and Development of Pulmonary Tuberculosis, and Peking Union Medical College Foundation.
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Affiliation(s)
- Chaolin Huang
- Medical Department, Jin Yin-tan Hospital, Wuhan, China; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, China
| | - Lixue Huang
- Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Pulmonary and Critical Care Medicine, Capital Medical University, Beijing, China
| | - Yeming Wang
- Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xia Li
- Department of COVID-19 Re-examination Clinic, Jin Yin-tan Hospital, Wuhan, China; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, China
| | - Lili Ren
- NHC Key Laboratory of Systems Biology of Pathogens and Christophe Merieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoying Gu
- Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China; Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Liang Kang
- Medical Department, Jin Yin-tan Hospital, Wuhan, China; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, China
| | - Li Guo
- NHC Key Laboratory of Systems Biology of Pathogens and Christophe Merieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Min Liu
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Xing Zhou
- Department of COVID-19 Re-examination Clinic, Jin Yin-tan Hospital, Wuhan, China; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, China
| | - Jianfeng Luo
- Department of COVID-19 Re-examination Clinic, Jin Yin-tan Hospital, Wuhan, China; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, China
| | - Zhenghui Huang
- Department of COVID-19 Re-examination Clinic, Jin Yin-tan Hospital, Wuhan, China; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, China
| | - Shengjin Tu
- Department of COVID-19 Re-examination Clinic, Jin Yin-tan Hospital, Wuhan, China; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, China
| | - Yue Zhao
- Department of COVID-19 Re-examination Clinic, Jin Yin-tan Hospital, Wuhan, China
| | - Li Chen
- Department of COVID-19 Re-examination Clinic, Jin Yin-tan Hospital, Wuhan, China
| | - Decui Xu
- Department of COVID-19 Re-examination Clinic, Jin Yin-tan Hospital, Wuhan, China
| | - Yanping Li
- Department of COVID-19 Re-examination Clinic, Jin Yin-tan Hospital, Wuhan, China
| | - Caihong Li
- Department of COVID-19 Re-examination Clinic, Jin Yin-tan Hospital, Wuhan, China
| | - Lu Peng
- Department of COVID-19 Re-examination Clinic, Jin Yin-tan Hospital, Wuhan, China
| | - Yong Li
- Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wuxiang Xie
- Peking University Clinical Research Institute, Beijing, China
| | - Dan Cui
- Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Harbin Medical University, Harbin, China
| | - Lianhan Shang
- Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Beijing University of Chinese Medicine, Beijing, China
| | - Guohui Fan
- Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China; Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiuyang Xu
- Tsinghua University School of Medicine, Beijing, China
| | - Geng Wang
- NHC Key Laboratory of Systems Biology of Pathogens and Christophe Merieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Ying Wang
- NHC Key Laboratory of Systems Biology of Pathogens and Christophe Merieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingchuan Zhong
- NHC Key Laboratory of Systems Biology of Pathogens and Christophe Merieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chen Wang
- Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China
| | - Jianwei Wang
- NHC Key Laboratory of Systems Biology of Pathogens and Christophe Merieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dingyu Zhang
- Medical Department, Jin Yin-tan Hospital, Wuhan, China; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, China
| | - Bin Cao
- Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Pulmonary and Critical Care Medicine, Capital Medical University, Beijing, China; Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China.
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In silico study of novel niclosamide derivatives, SARS-CoV-2 nonstructural proteins catalytic residue-targeting small molecules drug candidates. ARAB J CHEM 2023; 16:104654. [PMID: 36777994 PMCID: PMC9904858 DOI: 10.1016/j.arabjc.2023.104654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/10/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-mediated coronavirus disease 2019 (COVID-19) infection remains a global pandemic and health emergency with overwhelming social and economic impacts throughout the world. Therapeutics for COVID-19 are limited to only remdesivir; therefore, there is a need for combined, multidisciplinary efforts to develop new therapeutic molecules and explore the effectiveness of existing drugs against SARS-CoV-2. In the present study, we reported eight (SCOV-L-02, SCOV-L-09, SCOV-L-10, SCOV-L-11, SCOV-L-15, SCOV-L-18, SCOV-L-22, and SCOV-L-23) novel structurally related small-molecule derivatives of niclosamide (SCOV-L series) for their targeting potential against angiotensin-converting enzyme-2 (ACE2), type II transmembrane serine protease (TMPRSS2), and SARS-COV-2 nonstructural proteins (NSPs) including NSP5 (3CLpro), NSP3 (PLpro), and RdRp. Our correlation analysis suggested that ACE2 and TMPRSS2 modulate host immune response via regulation of immune-infiltrating cells at the site of tissue/organs entries. In addition, we identified some TMPRSS2 and ACE2 microRNAs target regulatory networks in SARS-CoV-2 infection and thus open up a new window for microRNAs-based therapy for the treatment of SARS-CoV-2 infection. Our in vitro study revealed that with the exception of SCOV-L-11 and SCOV-L-23 which were non-active, the SCOV-L series exhibited strict antiproliferative activities and non-cytotoxic effects against ACE2- and TMPRSS2-expressing cells. Our molecular docking for the analysis of receptor-ligand interactions revealed that SCOV-L series demonstrated high ligand binding efficacies (at higher levels than clinical drugs) against the ACE2, TMPRSS2, and SARS-COV-2 NSPs. SCOV-L-18, SCOV-L-15, and SCOV-L-09 were particularly found to exhibit strong binding affinities with three key SARS-CoV-2's proteins: 3CLpro, PLpro, and RdRp. These compounds bind to the several catalytic residues of the proteins, and satisfied the criteria of drug-like candidates, having good adsorption, distribution, metabolism, excretion, and toxicity (ADMET) pharmacokinetic profile. Altogether, the present study suggests the therapeutic potential of SCOV-L series for preventing and managing SARs-COV-2 infection and are currently under detailed investigation in our lab.
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Li K, Wu Q, Li H, Sun H, Xing Z, Li L, Chen H. Multiomic characterisation of the long-term sequelae of SARS survivors: a clinical observational study. EClinicalMedicine 2023; 58:101884. [PMID: 36873427 PMCID: PMC9969173 DOI: 10.1016/j.eclinm.2023.101884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND We aimed to characterise the long-term health outcomes of survivors of severe acute respiratory syndrome (SARS) and determine their recovery status and possible immunological basis. METHODS We performed a clinical observational study on 14 health workers who survived SARS coronavirus infection between Apr 20, 2003 and Jun 6, 2003 in Haihe Hospital (Tianjin, China). Eighteen years after discharge, SARS survivors were interviewed using questionnaires on symptoms and quality of life, and received physical examination, laboratory tests, pulmonary function tests, arterial blood gas analysis, and chest imaging. Plasma samples were collected for metabolomic, proteomic, and single-cell transcriptomic analyses. The health outcomes were compared 18 and 12 years after discharge. Control individuals were also health workers from the same hospital but did not infect with SARS coronavirus. FINDINGS Fatigue was the most common symptom in SARS survivors 18 years after discharge, with osteoporosis and necrosis of the femoral head being the main sequelae. The respiratory function and hip function scores of the SARS survivors were significantly lower than those of the controls. Physical and social functioning at 18 years was improved compared to that after 12 years but still worse than the controls. Emotional and mental health were fully recovered. Lung lesions on CT scans remained consistent at 18 years, especially in the right upper lobe and left lower lobe lesions. Plasma multiomics analysis indicated an abnormal metabolism of amino acids and lipids, promoted host defense immune responses to bacteria and external stimuli, B-cell activation, and enhanced cytotoxicity of CD8+ T cells but impaired antigen presentation capacity of CD4+ T cells. INTERPRETATION Although health outcomes continued to improve, our study suggested that SARS survivors still suffered from physical fatigue, osteoporosis, and necrosis of the femoral head 18 years after discharge, possibly related to plasma metabolic disorders and immunological alterations. FUNDING This study was funded by the Tianjin Haihe Hospital Science and Technology Fund (HHYY-202012) and Tianjin Key Medical Discipline (Specialty) Construction Project (TJYXZDXK-063B, TJYXZDXK-067C).
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Affiliation(s)
- Kuan Li
- Department of Basic Medicine, Haihe Hospital, Tianjin University, Tianjin, China
| | - Qian Wu
- Department of Respiratory Medicine, Haihe Hospital, Tianjin Medical University, Tianjin, China
| | - Hongjie Li
- Department of Clinical Laboratory, Haihe Hospital, Tianjin University, Tianjin, China
| | - Haibai Sun
- Department of Clinical Laboratory, Haihe Hospital, Tianjin University, Tianjin, China
| | - Zhiheng Xing
- Department of Radiology, Haihe Hospital, Tianjin University, Tianjin, China
| | - Li Li
- Department of Respiratory Medicine, Haihe Hospital, Tianjin Medical University, Tianjin, China
- Key Research Laboratory for Infectious Disease Prevention for State Administration of Traditional Chinese Medicine, Tianjin Institute of Respiratory Diseases, Tianjin, China
- Tianjin Key Laboratory of Lung Regenerative Medicine, Tianjin, China
| | - Huaiyong Chen
- Department of Basic Medicine, Haihe Hospital, Tianjin University, Tianjin, China
- Key Research Laboratory for Infectious Disease Prevention for State Administration of Traditional Chinese Medicine, Tianjin Institute of Respiratory Diseases, Tianjin, China
- Tianjin Key Laboratory of Lung Regenerative Medicine, Tianjin, China
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Cheema T, Saroha A, Kumar A, Panda PK, Saxena S. Chest CT findings and outcomes of COVID-19 in second wave: A cross-sectional study in a tertiary care centre in Northern India.. [DOI: 10.1101/2023.03.17.23287423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2025]
Abstract
AbstractIntroductionThe COVID-19 pandemic has posed a serious threat to global health, with developing nations like India being amongst the worst affected. Chest CT scans play a pivotal role in the diagnosis and evaluation of COVID-19, and certain CT features may aid in predicting the prognosis of COVID-19 illness.MethodsThis was a single-centre, hospital-based, cross-sectional study conducted at a tertiary care centre in Northern India during the second wave of the COVID-19 pandemic from May-June 2021. The study included 473 patients who tested positive for COVID-19. A high-resolution chest CT scan was performed within five days of hospitalization, and patient-related information was extracted retrospectively from medical records. Univariable and Multivariable analysis was done to study the predictors of poor outcome.ResultsA total of 473 patients were included in the study, with 75.5% being males. The mean total CT score was 29.89 ± 9.06. Fibrosis was present in 17.1% of patients, crazy paving in 3.6%, pneumomediastinum in 8.9%, and pneumothorax in 3.6%. Males had a significantly higher total score, while the patients who survived (30.00 ± 9.55 vs 35.00 v 6.21, p value - <.001), received Steroids at day 2 (28.04 ± 9.71 vs 31.66 ± 7.12, p value – 0.002) or Remdesivir had lower total scores (28.04 ± 9.71 vs 31.66 ± 7.12, p-value – 0.002). Total CT score (aHR 1.05, 95% CI 1.02 – 1.08, p – 0.001), pneumothorax (aHR 1.38, 95 % CI 0.67 – 2.87, p – 0.385), pneumomediastinum (aHR 1.20, 95% CI 0.71 - 2.03, p=0.298) and cardiovascular accident (CVA, aHR 4.75, 95% CI 0.84 – 26.72, p – 0.077) were associated with increased mortality, but the results were not significant after adjusting with other variables on multiple regression analysis.ConclusionThis study identifies several radiological parameters, including fibrosis, crazy paving, pneumomediastinum, and pneumothorax, that are associated with poor prognosis in COVID-19. These findings highlight the role of CT thorax in COVID-19 illness and the importance of timely identification and interventions in severe and critical cases of COVID-19 to reduce mortality and morbidity.
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Behr J, Berger M, Blum TG, Bonella F, Dinkel J, Gläser S, Hagmeyer L, Kneidinger N, Koschel D, Prasse A, Slevogt H, Stacher-Priehse E, Woehrle H, Kreuter M. [SARS-CoV-2-Infection and Interstitial Lung Disease: Position paper of the German Respiratory Society]. Pneumologie 2023; 77:143-157. [PMID: 36918016 DOI: 10.1055/a-2007-9845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
The SARS-CoV-2 pandemic had a tremendous impact on diagnosis and treatment of interstitial lung diseases (ILD). Especially in the early phase of the pandemic, when the delta variant was prevailling, a huge number of viral pneumonias were observed, which worsened pre-existing, triggered de novo occurence or discovery of previously subclincal interstitial lung diseases. The effect of SARS-CoV-2 infection - without or with accompanying viral pneumonia - on the further development of pre-existing ILD as well of new pulmonary inflitrates and consolidiations is difficult to predict and poses a daily challenge to interdisciplinary ILD boards. This position paper of the German Respiratory Society (DGP e.V.) provides answers to the most pressing questions based on current knowledge.
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Affiliation(s)
- Jürgen Behr
- Medizinische Klinik und Poliklinik V, LMU Klinikum der Universität München, Mitglied des Deutschen Zentrums für Lungenforschung (DZL), München, Deutschland
| | - Melanie Berger
- Lungenklinik Köln-Merheim und Lehrstuhl für Pneumologie, Universität Witten/Herdecke, Kliniken der Stadt Köln gGmbH, Köln, Deutschland
| | - Torsten Gerriet Blum
- Klinik für Pneumologie, Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin, Deutschland
| | - Francesco Bonella
- Zentrum für interstitielle und seltene Lungenerkrankungen, Klinik für Pneumologie, Ruhrlandklinik, Universitätsmedizin Essen, Essen, Deutschland
| | - Julien Dinkel
- Klinik und Poliklinik für Radiologie, LMU Klinikum der Universität München, München, Deutschland
| | - Sven Gläser
- Klinik für Innere Medizin - Pneumologie und Infektiologie, Vivantes Klinikum Neukölln, Berlin, Deutschland
| | - Lars Hagmeyer
- Klinik für Pneumologie und Allergologie, Krankenhaus Bethanien, Solingen, Deutschland
| | - Nikolaus Kneidinger
- Medizinische Klinik und Poliklinik V, LMU Klinikum der Universität München, Mitglied des Deutschen Zentrums für Lungenforschung (DZL), München, Deutschland
| | - Dirk Koschel
- Abteilung für Innere Medizin und Pneumologie, Fachkrankenhaus Coswig, Lungenzentrum, Coswig, Deutschland.,Bereich Pneumologie der Medizinischen Klinik, Carl Gustav Carus Universitätsklinik, Dresden, Deutschland
| | - Antje Prasse
- Klinik für Pneumologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | | | | | | | - Michael Kreuter
- Zentrum für interstitielle und seltene Lungenerkrankungen, Thoraxklinik, Universitätsklinikum Heidelberg und Deutsches Zentrum für Lungenforschung, Heidelberg, Deutschland
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10
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Fabbri L, Moss S, Khan FA, Chi W, Xia J, Robinson K, Smyth AR, Jenkins G, Stewart I. Parenchymal lung abnormalities following hospitalisation for COVID-19 and viral pneumonitis: a systematic review and meta-analysis. Thorax 2023; 78:191-201. [PMID: 35338102 PMCID: PMC8977456 DOI: 10.1136/thoraxjnl-2021-218275] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/03/2022] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Persisting respiratory symptoms in COVID-19 survivors may be related to development of pulmonary fibrosis. We assessed the proportion of chest CT scans and pulmonary function tests consistent with parenchymal lung disease in the follow-up of people hospitalised with COVID-19 and viral pneumonitis. METHODS Systematic review and random effects meta-analysis of proportions using studies of adults hospitalised with SARS-CoV-2, SARS-CoV, MERS-CoV or influenza pneumonia and followed up within 12 months. Searches performed in MEDLINE and Embase. Primary outcomes were proportion of radiological sequelae on CT scans; restrictive impairment; impaired gas transfer. Heterogeneity was explored in meta-regression. RESULTS Ninety-five studies (98.9% observational) were included in qualitative synthesis, 70 were suitable for meta-analysis including 60 SARS-CoV-2 studies with a median follow-up of 3 months. In SARS-CoV-2, the overall estimated proportion of inflammatory sequelae was 50% during follow-up (0.50; 95% CI 0.41 to 0.58; I2=95%), fibrotic sequelae were estimated in 29% (0.29; 95% CI 0.22 to 0.37; I2=94.1%). Follow-up time was significantly associated with estimates of inflammatory sequelae (-0.036; 95% CI -0.068 to -0.004; p=0.029), associations with fibrotic sequelae did not reach significance (-0.021; 95% CI -0.051 to 0.009; p=0.176). Impaired gas transfer was estimated at 38% of lung function tests (0.38 95% CI 0.32 to 0.44; I2=92.1%), which was greater than restrictive impairment (0.17; 95% CI 0.13 to 0.23; I2=92.5%), neither were associated with follow-up time (p=0.207; p=0.864). DISCUSSION Sequelae consistent with parenchymal lung disease were observed following COVID-19 and other viral pneumonitis. Estimates should be interpreted with caution due to high heterogeneity, differences in study casemix and initial severity. PROSPERO REGISTRATION NUMBER CRD42020183139.
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Affiliation(s)
- Laura Fabbri
- National Heart & Lung Institute, Imperial College London, London, UK
- Nottingham NIHR Biomedical Research Centre, University of Nottingham, Nottingham, UK
| | - Samuel Moss
- National Heart & Lung Institute, Imperial College London, London, UK
- Nottingham NIHR Biomedical Research Centre, University of Nottingham, Nottingham, UK
| | - Fasihul A Khan
- Nottingham NIHR Biomedical Research Centre, University of Nottingham, Nottingham, UK
| | - Wenjie Chi
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Jun Xia
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Karen Robinson
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Alan Robert Smyth
- Nottingham NIHR Biomedical Research Centre, University of Nottingham, Nottingham, UK
- Division of Child Health, Obstetrics & Gynaecology, University of Nottingham, Nottingham, UK
| | - Gisli Jenkins
- National Heart & Lung Institute, Imperial College London, London, UK
- Nottingham NIHR Biomedical Research Centre, University of Nottingham, Nottingham, UK
| | - Iain Stewart
- National Heart & Lung Institute, Imperial College London, London, UK
- Nottingham NIHR Biomedical Research Centre, University of Nottingham, Nottingham, UK
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Schlemmer F, Valentin S, Boyer L, Guillaumot A, Chabot F, Dupin C, Le Guen P, Lorillon G, Bergeron A, Basille D, Delomez J, Andrejak C, Bonnefoy V, Goussault H, Assié JB, Choinier P, Ruppert AM, Cadranel J, Mennitti MC, Roumila M, Colin C, Günther S, Sanchez O, Gille T, Sésé L, Uzunhan Y, Faure M, Patout M, Morelot-Panzini C, Laveneziana P, Zysman M, Blanchard E, Raherison-Semjen C, Giraud V, Giroux-Leprieur E, Habib S, Roche N, Dinh-Xuan AT, Sifaoui I, Brillet PY, Jung C, Boutin E, Layese R, Canoui-Poitrine F, Maitre B. Respiratory recovery trajectories after severe-to-critical COVID-19: a 1-year prospective multicentre study. Eur Respir J 2023; 61:13993003.01532-2022. [PMID: 36669777 PMCID: PMC10066566 DOI: 10.1183/13993003.01532-2022] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 12/20/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Survivors of severe-to-critical COVID-19 may have functional impairment, radiological sequelae and persistent symptoms requiring prolonged follow-up. This pragmatic study aimed to describe their clinical follow-up and determine their respiratory recovery trajectories, and factors that could influence them and their health-related quality of life. METHODS Adults hospitalised for severe-to-critical COVID-19 were evaluated at 3 months and up to 12 months post-hospital discharge in this prospective, multicentre, cohort study. RESULTS Among 485 enrolled participants, 293 (60%) were reassessed at 6 months and 163 (35%) at 12 months; 89 (51%) and 47 (27%) of the 173 ones initially managed with standard oxygen were reassessed at 6 and 12 months, respectively. At 3 months, 34%, 70% and 56% of the participants had a restrictive lung defect, impaired DLCO and significant radiological sequelae, respectively. During extended follow-up, DLCO and FVC (% of predicted value) increased by means of +4 points at 6 months, and +6 points at 12 months. Sex, body mass index, chronic respiratory disease, immunosuppression, pneumonia extent or corticosteroid use during acute COVID-19 and prolonged invasive mechanical ventilation (IMV) were associated with DLCO at month 3, but not its trajectory thereafter. Among 475 (98%) patients with at least one chest computed-tomography scan during follow-up, 196 (41%) had significant sequelae on their last images. CONCLUSION Although pulmonary function and radiological abnormalities improved up to 1 year post-acute-COVID-19, high percentages of severe-to-critical disease survivors, including a notable proportion of those managed with standard oxygen, had significant lung sequelae and residual symptoms justifying prolonged follow-up.
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Affiliation(s)
- Frédéric Schlemmer
- Unité de Pneumologie, Assistance Publique-Hôpitaux de Paris (APHP), Hôpitaux Universitaires Henri-Mondor, Créteil, France .,Univ Paris Est-Créteil, Faculté de Santé, INSERM, IMRB, Créteil, France
| | - Simon Valentin
- CHRU de Nancy, Pôle des Spécialités Médicales/Département de Pneumologie, Vandœuvre-lès-Nancy, France.,Université de Lorraine, Faculté de Médecine de Nancy, INSERM UMR_S 1116, Vandœuvre-lès-Nancy, France
| | - Laurent Boyer
- Univ Paris Est-Créteil, Faculté de Santé, INSERM, IMRB, Créteil, France.,APHP, Hôpitaux Universitaires Henri-Mondor, Service des Explorations Fonctionnelles, Créteil, France
| | - Anne Guillaumot
- CHRU de Nancy, Pôle des Spécialités Médicales/Département de Pneumologie, Vandœuvre-lès-Nancy, France
| | - François Chabot
- CHRU de Nancy, Pôle des Spécialités Médicales/Département de Pneumologie, Vandœuvre-lès-Nancy, France.,Université de Lorraine, Faculté de Médecine de Nancy, INSERM UMR_S 1116, Vandœuvre-lès-Nancy, France
| | - Clairelyne Dupin
- APHP, Hôpital Saint-Louis, Service de Pneumologie, Université de Paris, Paris, France
| | - Pierre Le Guen
- APHP, Hôpital Saint-Louis, Service de Pneumologie, Université de Paris, Paris, France
| | - Gwenael Lorillon
- APHP, Hôpital Saint-Louis, Service de Pneumologie, Université de Paris, Paris, France
| | - Anne Bergeron
- Hôpitaux Universitaires de Genève, Service de Pneumologie, Genève, Switzerland
| | - Damien Basille
- CHU Amiens-Picardie, Service de Pneumologie, UR 4294 AGIR, Université Picardie Jules-Verne, Amiens, France
| | - Julia Delomez
- CHU Amiens-Picardie, Service de Pneumologie, UR 4294 AGIR, Université Picardie Jules-Verne, Amiens, France
| | - Claire Andrejak
- CHU Amiens-Picardie, Service de Pneumologie, UR 4294 AGIR, Université Picardie Jules-Verne, Amiens, France
| | - Valentine Bonnefoy
- Service de Pneumologie, Centre Hospitalier Intercommunal, Créteil, France
| | - Hélène Goussault
- Service de Pneumologie, Centre Hospitalier Intercommunal, Créteil, France
| | - Jean-Baptiste Assié
- Unité de Pneumologie, Assistance Publique-Hôpitaux de Paris (APHP), Hôpitaux Universitaires Henri-Mondor, Créteil, France
| | - Pascaline Choinier
- APHP, Service de Pneumologie, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Anne-Marie Ruppert
- APHP, Service de Pneumologie, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Jacques Cadranel
- APHP, Service de Pneumologie, Hôpital Tenon, Sorbonne Université, Paris, France
| | | | - Mehdi Roumila
- Département de Pneumologie, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Charlotte Colin
- Département de Pneumologie, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Sven Günther
- APHP, Hôpital Européen Georges-Pompidou, Service de Physiologie, Université de Paris, Paris, France
| | - Olivier Sanchez
- APHP, Hôpital Européen Georges-Pompidou, Service de Pneumologie, Université de Paris, Paris, France
| | - Thomas Gille
- APHP, Hôpitaux Universitaire Paris-Seine-Saint-Denis (HUPSSD), Hôpital Avicenne, Service de Physiologie et Explorations Fonctionnelles, Bobigny, France.,Université Sorbonne Paris Nord, UFR SMBH Léonard de Vinci, Inserm UMR 1272 "Hypoxie et Poumon", Bobigny, France
| | - Lucile Sésé
- APHP, Hôpitaux Universitaire Paris-Seine-Saint-Denis (HUPSSD), Hôpital Avicenne, Service de Physiologie et Explorations Fonctionnelles, Bobigny, France.,Université Sorbonne Paris Nord, UFR SMBH Léonard de Vinci, Inserm UMR 1272 "Hypoxie et Poumon", Bobigny, France
| | - Yurdagul Uzunhan
- Université Sorbonne Paris Nord, UFR SMBH Léonard de Vinci, Inserm UMR 1272 "Hypoxie et Poumon", Bobigny, France.,APHP, Hôpitaux Universitaire Paris-Seine-Saint-Denis (HUPSSD), Hôpital Avicenne, Service de Pneumologie, Centre de Reference Maladies Pulmonaires Rares de l'Adulte (site constitutif), Bobigny, France
| | - Morgane Faure
- Service de Pneumologie (Département R3S), APHP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Maxime Patout
- Service de Pneumologie (Département R3S), APHP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France.,Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - Capucine Morelot-Panzini
- Service de Pneumologie (Département R3S), APHP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France.,Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - Pierantonio Laveneziana
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,Service des Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée (Département R3S), APHP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, hôpitaux Pitié-Salpêtrière, Saint-Antoine et Tenon, Paris, France
| | - Maeva Zysman
- Département de Pneumologie, CHU Haut-Lévèque, Bordeaux, France.,Univ. Bordeaux, Centre de Recherche Cardio-thoracique, INSERM U1045, Pessac, France
| | - Elodie Blanchard
- Département de Pneumologie, CHU Haut-Lévèque, Bordeaux, France.,Univ. Bordeaux, Centre de Recherche Cardio-thoracique, INSERM U1045, Pessac, France
| | - Chantal Raherison-Semjen
- Département de Pneumologie, CHU Guadeloupe, Guadeloupe, France.,Univ. Bordeaux, Centre de Recherche Cardio-thoracique, INSERM 1219 Epicene Team, Pessac, France
| | - Violaine Giraud
- APHP, Hôpital Ambroise-Paré, Service de Pneumologie et Oncologie thoracique, Boulogne, France
| | - Etienne Giroux-Leprieur
- APHP, Hôpital Ambroise-Paré, Service de Pneumologie et Oncologie thoracique, Boulogne, France.,Univ Paris-Saclay, Université de Versailles-Saint-Quentin (UVSQ), Boulogne, France
| | - Stéfanie Habib
- APHP, Hôpital Cochin, Service de Pneumologie, Université Paris Cité, Institut Cochin (UMR1016), Paris, France
| | - Nicolas Roche
- APHP, Hôpital Cochin, Service de Pneumologie, Université Paris Cité, Institut Cochin (UMR1016), Paris, France
| | - Anh Tuan Dinh-Xuan
- APHP, Hôpital Cochin, Service de Physiologie et Explorations Fonctionnelles, Université de Paris, Paris, France
| | - Islem Sifaoui
- Département d'Imagerie Médicale, APHP, Hôpitaux Universitaires Henri-Mondor, Créteil, France
| | | | - Camille Jung
- Centre Hospitalier Intercommunal, CRC, Créteil, France
| | - Emmanuelle Boutin
- APHP, Hôpitaux Universitaires Henri-Mondor, Service de Santé Publique, Créteil, France.,Univ Paris-Est Créteil, INSERM, IMRB, Equipe CEpiA (Clinical Epidemiology and Ageing), Créteil, France
| | - Richard Layese
- APHP, Hôpitaux Universitaires Henri-Mondor, Service de Santé Publique, Créteil, France.,Univ Paris-Est Créteil, INSERM, IMRB, Equipe CEpiA (Clinical Epidemiology and Ageing), Créteil, France
| | - Florence Canoui-Poitrine
- APHP, Hôpitaux Universitaires Henri-Mondor, Service de Santé Publique, Créteil, France.,Univ Paris-Est Créteil, INSERM, IMRB, Equipe CEpiA (Clinical Epidemiology and Ageing), Créteil, France.,APHP, Hôpitaux Universitaires Henri-Mondor, Unité de Recherche Clinique (URC Mondor), Créteil, France.,These two authors contributed equally to this work
| | - Bernard Maitre
- Univ Paris Est-Créteil, Faculté de Santé, INSERM, IMRB, Créteil, France.,Service de Pneumologie, Centre Hospitalier Intercommunal, Créteil, France.,These two authors contributed equally to this work
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Han K, Wang J, Zou Y, Zhang Y, Zhou L, Yin Y. Association between emphysema and other pulmonary computed tomography patterns in COVID-19 pneumonia. J Med Virol 2023; 95:e28293. [PMID: 36358023 PMCID: PMC9828029 DOI: 10.1002/jmv.28293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/22/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
To evaluate the chest computed tomography (CT) findings of patients with Corona Virus Disease 2019 (COVID-19) on admission to hospital. And then correlate CT pulmonary infiltrates involvement with the findings of emphysema. We analyzed the different infiltrates of COVID-19 pneumonia using emphysema as the grade of pneumonia. We applied open-source assisted software (3D Slicer) to model the lungs and lesions of 66 patients with COVID-19, which were retrospectively included. we divided the 66 COVID-19 patients into the following two groups: (A) 12 patients with less than 10% emphysema in the low-attenuation area less than -950 Hounsfield units (%LAA-950), (B) 54 patients with greater than or equal to 10% emphysema in %LAA-950. Imaging findings were assessed retrospectively by two authors and then pulmonary infiltrates and emphysema volumes were measured on CT using 3D Slicer software. Differences between pulmonary infiltrates, emphysema, Collapsed, affected of patients with CT findings were assessed by Kruskal-Wallis and Wilcoxon test, respectively. Statistical significance was set at p < 0.05. The left lung (A) affected left lung 20.00/affected right lung 18.50, (B) affected left lung 13.00/affected right lung 11.50 was most frequently involved region in COVID-19. In addition, collapsed left lung, (A) collapsed left lung 4.95/collapsed right lung 4.65, (B) collapsed left lung 3.65/collapsed right lung 3.15 was also more severe than the right one. There were significant differences between the Group A and Group B in terms of the percentage of CT involvement in each lung region (p < 0.05), except for the inflated affected total lung (p = 0.152). The median percentage of collapsed left lung in the Group A was 20.00 (14.00-30.00), right lung was 18.50 (13.00-30.25) and the total was 19.00 (13.00-30.00), while the median percentage of collapsed left lung in the Group B was 13.00 (10.00-14.75), right lung was 11.50 (10.00-15.00) and the total was 12.50 (10.00-15.00). The percentage of affected left lung is an independent predictor of emphysema in COVID-19 patients. We need to focus on the left lung of the patient as it is more affected. The people with lower levels of emphysema may have more collapsed segments. The more collapsed segments may lead to more serious clinical feature.
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Affiliation(s)
- Ke Han
- Department of Cardiothoracic Vascular Surgery, Renmin HospitalHubei University of MedicineShiyanHubeiP. R. China
| | - Jing Wang
- Department of Dermatology, Renmin HospitalHubei University of MedicineShiyanHubeiP. R. China
| | - Yulin Zou
- Department of Dermatology, Renmin HospitalHubei University of MedicineShiyanHubeiP. R. China,Department of Dermatology, Jinzhou Medical University Graduate Training Base, Renmin HospitalHubei University of MedicineShiyanHubeiP. R. China
| | - Yuxin Zhang
- Department of Dermatology, Renmin HospitalHubei University of MedicineShiyanHubeiP. R. China
| | - Lin Zhou
- Department of Medical Imaging Center, Renmin HospitalHubei University of MedicineShiyanHubeiP. R. China
| | - Yiping Yin
- Department of Pulmonary & Critical Care Medicine, Renmin HospitalHubei University of MedicineShiyanHubeiP. R. China
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Tas SK, Coskunpinar E, Yildiz P, Bayraktaroğlu M, Kose T, Altunkanat D, Kirkik D, Tukenmez M. Investigation of the effects of mir-219-1 gene variants on the development of disease in non-small cell lung cancer patients. Afr Health Sci 2022; 22:37-45. [PMID: 37092101 PMCID: PMC10117453 DOI: 10.4314/ahs.v22i4.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Various variants of the miR-219-1 gene are one of the first genes associated with NSCLC prognosis in the literature. OBJECTIVES We aimed to genotype two different variants of the miR-219-1 gene and to investigate to using of the result as a biomarker in the diagnosis and treatment of NSCLC. MATERIALS AND METHODS The patients were chosen according to International NSCLC criteria and genomic DNA was isolated from blood (138 patients and 100 healthy individuals). Then qRT-PCR was applied to determine the rs213210 and rs421446 variants of miR-219-1 gene polymorphisms. Allele and genotype frequencies were compared using Pearson's chi-square and Fisher's exact tests test. RESULTS We found that TT genotype (p=0,381) in rs213210 compared with CC genotype (p=0,165) and CC genotype (p=0,823) in rs421446 compared with TT genotype (p=0,537) did not show a significantly increased risk of NSCLC. There is no relationship between polymorphisms in miR-219-1 and the outcome of NSCLC. CONCLUSION miRNA single nucleotide polymorphisms can be used as genetic biomarkers to predict cancer susceptibility, early diagnosis, and prognosis. Our study has shown that two variants of miR-219-1 were not related to NSCLC in the Turkish population. The reason for this can be differences in ethnicity, regions, and background of population and these differences could lead to various outcomes.
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Affiliation(s)
- Sevgi Kalkanli Tas
- University of Health Sciences Turkey, Hamidiye Faculty of Medicine, Department of Immunology, Istanbul, Turkey
| | - Ender Coskunpinar
- University of Health Sciences Turkey, Hamidiye Faculty of Medicine, Department of Medical Biology, Istanbul, Turkey
| | - Pinar Yildiz
- University of Health Sciences Turkey, Yedikule Chest Diseases and Chest Surgery Research and Training Hospital, Third Clinic, Istanbul, Turkey
| | - Mesut Bayraktaroğlu
- University of Health Sciences Turkey, Yedikule Chest Diseases and Chest Surgery Research and Training Hospital, Third Clinic, Istanbul, Turkey
| | - Tuba Kose
- University of Health Sciences Turkey, Hamidiye Faculty of Medicine, Department of Medical Biology, Istanbul, Turkey
| | - Derya Altunkanat
- University of Health Sciences Turkey, Hamidiye Faculty of Medicine, Department of Medical Biology, Istanbul, Turkey
| | - Duygu Kirkik
- University of Health Sciences Turkey, Hamidiye Faculty of Medicine, Department of Medical Biology, Istanbul, Turkey
| | - Mustafa Tukenmez
- Istanbul University, Istanbul Faculty of Medicine, Department of General Surgery, Istanbul, Turkey
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Chen L, Wu F, Huang J, Yang J, Fan W, Nie Z, Jiang H, Wang J, Xia W, Yang F. Well-Aerated Lung and Mean Lung Density Quantified by CT at Discharge to Predict Pulmonary Diffusion Function 5 Months after COVID-19. Diagnostics (Basel) 2022; 12:2921. [PMID: 36552928 PMCID: PMC9776504 DOI: 10.3390/diagnostics12122921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/12/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background: The aim of this study was to explore the predictive values of quantitative CT indices of the total lung and lung lobe tissue at discharge for the pulmonary diffusion function of coronavirus disease 2019 (COVID-19) patients at 5 months after symptom onset. Methods: A total of 90 patients with moderate and severe COVID-19 underwent CT scans at discharge, and pulmonary function tests (PFTs) were performed 5 months after symptom onset. The differences in quantitative CT and PFT results between Group 1 (patients with abnormal diffusion function) and Group 2 (patients with normal diffusion function) were compared by the chi-square test, Fisher’s exact test or Mann−Whitney U test. Univariate analysis, stepwise linear regression and logistic regression were used to determine the predictors of diffusion function in convalescent patients. Results: A total of 37.80% (34/90) of patients presented diffusion dysfunction at 5 months after symptom onset. The mean lung density (MLD) of the total lung tissue in Group 1 was higher than that in Group 2, and the percentage of the well-aerated lung (WAL) tissue volume (WAL%) of Group 1 was lower than that of Group 2 (all p < 0.05). Multiple stepwise linear regression identified only WAL and WAL% of the left upper lobe (LUL) as parameters that positively correlated with the percent of the predicted value of diffusion capacity of the lungs for carbon monoxide (WAL: p = 0.002; WAL%: p = 0.004), and multiple stepwise logistic regression identified MLD and MLDLUL as independent predictors of diffusion dysfunction (MLD: OR (95%CI): 1.011 (1.001, 1.02), p = 0.035; MLDLUL: OR (95%CI): 1.016 (1.004, 1.027), p = 0.008). Conclusion: At five months after symptom onset, more than one-third of moderate and severe COVID-19 patients presented with diffusion dysfunction. The well-aerated lung and mean lung density quantified by CT at discharge could be predictors of diffusion function in convalesce.
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Affiliation(s)
- Leqing Chen
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Feihong Wu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Jia Huang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Jinrong Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Wenliang Fan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Zhuang Nie
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Hongwei Jiang
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Jiazheng Wang
- MSC Clinical & Technical Solutions, Philips Healthcare, Floor 7, Building 2, World Profit Center, Beijing 100600, China
| | - Wenfang Xia
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Fan Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
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15
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Xiong L, Li Q, Cao X, Xiong H, Huang M, Yang F, Meng D, Zhou M, Zhang Y, Fan Y, Tang L, Jin Y, Xia J, Hu Y. Recovery of functional fitness, lung function, and immune function in healthcare workers with nonsevere and severe COVID-19 at 13 months after discharge from the hospital: a prospective cohort study. Int J Infect Dis 2022; 123:119-126. [PMID: 35793753 PMCID: PMC9250704 DOI: 10.1016/j.ijid.2022.06.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/21/2022] [Accepted: 06/28/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the recovery of functional fitness, lung function, and immune function in healthcare workers (HCWs) with nonsevere and severe COVID-19 at 13 months after discharge from the hospital. METHODS The participants of "Rehabilitation Care Project for Medical Staff Infected with COVID-19" underwent a functional fitness test (muscle strength, flexibility, and agility/dynamic balance), lung function test, and immune function test (including cytokines and lymphocyte subsets) at 13 months after discharge. RESULTS The project included 779 HCWs (316 nonsevere COVID-19 and 463 severe COVID-19). This study found that 29.1% (130/446) of the HCWs have not yet recovered their functional fitness. The most affected lung function indicator was lung perfusion capacity (34% with diffusion capacity for carbon monoxide-single breath <80%). The increase of interleukin-6 (64/534, 12.0%) and natural killer cells (44/534, 8.2%) and the decrease of CD3+ T cells (58/534, 10.9%) and CD4+ T cells (26/534, 4.9%) still existed at 13 months after discharge. No significant difference was found in the HCWs with nonsevere and severe COVID-19 regarding recovery of functional fitness, lung function, and immune function at 13 months after discharge. CONCLUSION The majority of Chinese HCWs with COVID-19 had recovered their functional fitness, lung function, and immune function, and the recovery status in HCWs with severe COVID-19 is no worse than that in HCWs with nonsevere COVID-19 at 13 months after discharge from the hospital.
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Affiliation(s)
- Lijuan Xiong
- Department of Nosocomial Infection Management, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qian Li
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiongjing Cao
- Department of Nosocomial Infection Management, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huangguo Xiong
- Department of Nosocomial Infection Management, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ming Huang
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Fengwen Yang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Daquan Meng
- Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mei Zhou
- Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanzhao Zhang
- Department of Rehabilitation, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yunzhou Fan
- Department of Nosocomial Infection Management, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liang Tang
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Jin
- Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiahong Xia
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Yu Hu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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16
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GÜZEL E, BAYDAR TOPRAK O. Post-COVID kortikosteroid kullanımı ve pulmoner fibrozis: 1 yıllık izlem. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1139209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Purpose: Depending on the prevalence and severity of COVID-19 disease, pulmonary sequelae and fibrotic lung disease continue to pose significant problems for patients in the post-COVID period. In our study, we aimed to determine the risk factors for pulmonary sequelae and fibrosis with post-COVID patient management.
Materials and Methods: The study comprised 67 post-COVID patients who were released from the hospital after receiving low-dose corticosteroids (0.5 mg/kg daily methylprednisolone) as a result of COVID-19. Socio-demographic data, radiological and laboratory findings of the patients were recorded. All patients were followed up at 3, 6, and 12 months after discharge, and the diagnosis of pulmonary fibrosis was made according to high resolution computed tomography (HRCT) findings, by evaluating with detailed biochemical blood tests and HRCT.
Results: Thirtyfour (50.7%) of the 67 patients were male and the mean age was 57±16.33 (min.19–max.90). At 3 months, there were 59 patients (88.1%) with aberrant thoracic computed tomography (CT) findings, 28 (41.8%) at 6 months, and 21 (31.3%) at 12 months. In the 12th month follow-up, pulmonary fibrosis was detected in a total of 9 (13.4%) patients according to thorax CT findings.
Conclusion: In our study, the most important risk factors for the development of post-COVID pulmonary fibrosis were intensive care unit (ICU) follow-up, lymphocyte count
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Jiang J, Liu Y, Han P, Zhang P, Shao H, Peng H, Duan X. Psychological resilience of emergency nurses during COVID-19 epidemic in Shanghai: A qualitative study. Front Public Health 2022; 10:1001615. [PMID: 36187606 PMCID: PMC9524357 DOI: 10.3389/fpubh.2022.1001615] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 08/22/2022] [Indexed: 01/27/2023] Open
Abstract
Background In early 2022, an outbreak of Coronavirus Disease 2019 (COVID-19) occurred in Shanghai, China. The spread of the epidemic put a large amount of stress on the local healthcare system, especially emergency nurses (ENs), which may affect their well-being and performance. Enhancing the psychological resilience of ENs during COVID-19 pandemic may improve job satisfaction, retention, and public health emergency response. However, few studies have researched the perception and psychological resilience of ENs during COVID-19 pandemic. Objective To understand ENs' perception and psychological resilience and their coping strategies with adversity during COVID-19 in Shanghai, as well as factors associated with psychological resilience. Methods This qualitative study was conducted using a phenomenological approach. A total of 17 ENs from a 3rd level hospital in Shanghai were selected using a method of purposive sampling. Between April and May 2022, in-depth semi-structured interviews and Colaizzi seven-step method were performed for data collection and analysis. Results The investigation discovered three themes and nine subthemes. The first theme is "risk factors." Risk factors for ENs to remain resilience are sudden multiplication of workload, stressful of screening of infected patients, and the support nurses being unfamiliar with the procedure. The second theme is "promoting factors." ENs emphasized the importance of management assurance and humanistic care, as well as social support. They recognized adversity and resilience, and used self-management strategies to cope with the situation. The third theme is "motivated by altruism." ENs were driven by altruism to respond to adversity with a positive attitude. They realized their self-worth by helping patients with a sense of sacred mission. Conclusions Psychological resilience is not a stable psychological characteristic but a constantly changing process that is affected by internal and external factors. Enhancing resilience of ENs during the COVID-19 pandemic may improve work satisfaction, retention, and public health emergency response. Adequate preparation before a pandemic, reasonable arrangement, a trustworthy working atmosphere, encouragement and improvement of individual and collective strategies for nurses to cope with adversity, timely rewards, and nurse empowerment, as well as counseling and training, can be used to enhance psychological resilience of ENs.
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Affiliation(s)
- Jinxia Jiang
- Emergency Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yue Liu
- Emergency Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Peng Han
- Emergency Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Pengjia Zhang
- Emergency Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Haiyan Shao
- Emergency Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Hu Peng
- Emergency Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China,*Correspondence: Hu Peng
| | - Xia Duan
- Nursing Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China,Xia Duan
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18
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Spiegl C, Schiefermeier-Mach N, Schifferegger E, Wiederin C, Scheiber B. Physiotherapeutic evaluation of patients with post COVID-19 condition: current use of measuring instruments by physiotherapists working in Austria and South Tyrol. Arch Physiother 2022; 12:21. [PMID: 36104802 PMCID: PMC9473730 DOI: 10.1186/s40945-022-00147-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 07/17/2022] [Indexed: 11/29/2022] Open
Abstract
Background The implementation of standardized assessments in physiotherapeutic practice strongly supports diagnostic and treatment plans. Previous studies reported insufficient usage of standardized assessments due to lack of time, lack of knowledge, lack of resources and other barriers. Physiotherapy in outpatient settings became essential for the rehabilitation of patients with post COVID-19 condition but it remains unknown to what extent assessments are implemented into the evaluation of these patients. In this study, we explored the current use and barriers regarding the implementation of physiotherapeutic assessments to evaluate patients with post COVID-19 condition. Methods A cross-sectional online survey was carried out among 180 physiotherapists working in outpatient settings in Austria and South Tyrol. Results The majority of physiotherapists (88%) indicated that standardized assessments are useful, though less than a fifth of participants actually implement assessments in practice. Among implementation barriers, “insufficient experience” (41.8%) and “lack of knowledge” (36.6%) were mentioned most often. Concerning specific post COVID-19 assessments, the evaluation of “physical and respiratory function”, “quality of life” and “activities of daily living” were stated to be of particular relevance. Conclusions Our study revealed a low implementation rate and identified the main barriers regarding the non-usage of standardized assessments for post COVID-19 patients. Trial registration The Private University for Health Sciences and Health Technology (UMIT TIROL), and the Research Committee for Scientific Ethical Questions granted approval for the survey (RCSEQ, Hall in Tirol, Austria, Number 2834). Supplementary Information The online version contains supplementary material available at 10.1186/s40945-022-00147-0.
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Huang L, Li X, Gu X, Zhang H, Ren L, Guo L, Liu M, Wang Y, Cui D, Wang Y, Zhang X, Shang L, Zhong J, Wang X, Wang J, Cao B. Health outcomes in people 2 years after surviving hospitalisation with COVID-19: a longitudinal cohort study. THE LANCET. RESPIRATORY MEDICINE 2022; 10:863-876. [PMID: 35568052 PMCID: PMC9094732 DOI: 10.1016/s2213-2600(22)00126-6] [Citation(s) in RCA: 341] [Impact Index Per Article: 113.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 03/25/2022] [Accepted: 03/31/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND With the ongoing COVID-19 pandemic, growing evidence shows that a considerable proportion of people who have recovered from COVID-19 have long-term effects on multiple organs and systems. A few longitudinal studies have reported on the persistent health effects of COVID-19, but the follow-up was limited to 1 year after acute infection. The aim of our study was to characterise the longitudinal evolution of health outcomes in hospital survivors with different initial disease severity throughout 2 years after acute COVID-19 infection and to determine their recovery status. METHODS We did an ambidirectional, longitudinal cohort study of individuals who had survived hospitalisation with COVID-19 and who had been discharged from Jin Yin-tan Hospital (Wuhan, China) between Jan 7 and May 29, 2020. We measured health outcomes 6 months (June 16-Sept 3, 2020), 12 months (Dec 16, 2020-Feb 7, 2021), and 2 years (Nov 16, 2021-Jan 10, 2022) after symptom onset with a 6-min walking distance (6MWD) test, laboratory tests, and a series of questionnaires on symptoms, mental health, health-related quality of life (HRQoL), return to work, and health-care use after discharge. A subset of COVID-19 survivors received pulmonary function tests and chest imaging at each visit. Age-matched, sex-matched, and comorbidities-matched participants without COVID-19 infection (controls) were introduced to determine the recovery status of COVID-19 survivors at 2 years. The primary outcomes included symptoms, modified British Medical Research Council (mMRC) dyspnoea scale, HRQoL, 6MWD, and return to work, and were assessed in all COVID-19 survivors who attended all three follow-up visits. Symptoms, mMRC dyspnoea scale, and HRQoL were also assessed in controls. FINDINGS 2469 patients with COVID-19 were discharged from Jin Yin-tan Hospital between Jan 7 and May 29, 2020. 1192 COVID-19 survivors completed assessments at the three follow-up visits and were included in the final analysis, 1119 (94%) of whom attended the face-to-face interview 2 years after infection. The median age at discharge was 57·0 years (48·0-65·0) and 551 (46%) were women. The median follow-up time after symptom onset was 185·0 days (IQR 175·0-197·0) for the visit at 6 months, 349·0 days (337·0-360·0) for the visit at 12 months, and 685·0 days (675·0-698·0) for the visit at 2 years. The proportion of COVID-19 survivors with at least one sequelae symptom decreased significantly from 777 (68%) of 1149 at 6 months to 650 (55%) of 1190 at 2 years (p<0·0001), with fatigue or muscle weakness always being the most frequent. The proportion of COVID-19 survivors with an mMRC score of at least 1 was 168 (14%) of 1191 at 2 years, significantly lower than the 288 (26%) of 1104 at 6 months (p<0·0001). HRQoL continued to improve in almost all domains, especially in terms of anxiety or depression: the proportion of individuals with symptoms of anxiety or depression decreased from 256 (23%) of 1105 at 6 months to 143 (12%) 1191 at 2 years (p<0·0001). The proportion of individuals with a 6MWD less than the lower limit of the normal range declined continuously in COVID-19 survivors overall and in the three subgroups of varying initial disease severity. 438 (89%) of 494 COVID-19 survivors had returned to their original work at 2 years. Survivors with long COVID symptoms at 2 years had lower HRQoL, worse exercise capacity, more mental health abnormality, and increased health-care use after discharge than survivors without long COVID symptoms. COVID-19 survivors still had more prevalent symptoms and more problems in pain or discomfort, as well as anxiety or depression, at 2 years than did controls. Additionally, a significantly higher proportion of survivors who had received higher-level respiratory support during hospitalisation had lung diffusion impairment (43 [65%] of 66 vs 24 [36%] of 66, p=0·0009), reduced residual volume (41 [62%] vs 13 [20%], p<0·0001), and total lung capacity (26 [39%] vs four [6%], p<0·0001) than did controls. INTERPRETATION Regardless of initial disease severity, COVID-19 survivors had longitudinal improvements in physical and mental health, with most returning to their original work within 2 years; however, the burden of symptomatic sequelae remained fairly high. COVID-19 survivors had a remarkably lower health status than the general population at 2 years. The study findings indicate that there is an urgent need to explore the pathogenesis of long COVID and develop effective interventions to reduce the risk of long COVID.
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Affiliation(s)
- Lixue Huang
- Department of Pulmonary and Critical Care Medicine, China–Japan Friendship Hospital, Capital Medical University, Beijing, China,Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China–Japan Friendship Hospital, Beijing, China,China–Japan Friendship Hospital, Beijing, China
| | - Xia Li
- Department of COVID-19 Re-examination Clinic, Hubei Provincial Clinical Research Center for Infectious Diseases, Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, China
| | - Xiaoying Gu
- Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China–Japan Friendship Hospital, Beijing, China,Institute of Clinical Medical Sciences, China–Japan Friendship Hospital, Beijing, China,China–Japan Friendship Hospital, Beijing, China
| | - Hui Zhang
- Department of Pulmonary and Critical Care Medicine, China–Japan Friendship Hospital, Capital Medical University, Beijing, China,Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China–Japan Friendship Hospital, Beijing, China,China–Japan Friendship Hospital, Beijing, China
| | - LiLi Ren
- Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,NHC Key Laboratory of Systems Biology of Pathogens and Christophe Merieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences, Beijing, China
| | - Li Guo
- Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,NHC Key Laboratory of Systems Biology of Pathogens and Christophe Merieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences, Beijing, China
| | - Min Liu
- Department of Radiology, China–Japan Friendship Hospital, Beijing, China
| | - Yimin Wang
- Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China–Japan Friendship Hospital, Beijing, China,China–Japan Friendship Hospital, Beijing, China,Department of Pulmonary and Critical Care Medicine, Hubei Provincial Clinical Research Center for Infectious Diseases, Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, China
| | - Dan Cui
- Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China–Japan Friendship Hospital, Beijing, China,China–Japan Friendship Hospital, Beijing, China,Department of Pulmonary and Critical Care Medicine, 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China
| | - Yeming Wang
- Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China–Japan Friendship Hospital, Beijing, China,China–Japan Friendship Hospital, Beijing, China
| | - Xueyang Zhang
- Tsinghua University School of Medicine, Beijing, China
| | - Lianhan Shang
- Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China–Japan Friendship Hospital, Beijing, China,China–Japan Friendship Hospital, Beijing, China
| | - Jingchuan Zhong
- Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,NHC Key Laboratory of Systems Biology of Pathogens and Christophe Merieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences, Beijing, China
| | - Xinming Wang
- Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,NHC Key Laboratory of Systems Biology of Pathogens and Christophe Merieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences, Beijing, China
| | - Jianwei Wang
- Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,NHC Key Laboratory of Systems Biology of Pathogens and Christophe Merieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences, Beijing, China,Prof Jianwei Wang, NHC Key Laboratory of Systems Biology of Pathogens and Christophe Merieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Bin Cao
- Department of Pulmonary and Critical Care Medicine, China–Japan Friendship Hospital, Capital Medical University, Beijing, China,Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China–Japan Friendship Hospital, Beijing, China,China–Japan Friendship Hospital, Beijing, China,Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, China,Tsinghua University–Peking University Joint Center for Life Sciences, Beijing, China,Correspondence to: Prof Bin Cao, Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China–Japan Friendship Hospital, Beijing 100029, China
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Tang YF, Han JY, Ren AM, Chen L, Xue TJ, Yan YH, Wang X, Wang Y, Jin RH. Assessment of Long-Term Effects on Pulmonary Functions Between Severe and Non-Severe Convalescent COVID-19 Patients: A Single-Center Study in China. J Inflamm Res 2022; 15:4751-4761. [PMID: 36017172 PMCID: PMC9397529 DOI: 10.2147/jir.s371283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/01/2022] [Indexed: 11/23/2022] Open
Abstract
Objective To explore the long-term effects of SARS-Cov-2 infection on the pulmonary function in the severe convalescent COVID-19 patients for 6 to 9 months follow-up in Beijing, China. Methods A total of 64 cases of COVID-19 patients were recruited for the study and discharged from the Beijing Ditan Hospital, Capital Medical University, for 6 to 9 months. COVID-19 patients were divided into non-severe (mild and moderate) and severe groups. The follow-up investigated the lung function tests, the novel coronavirus antibody (IgM and IgG), chest CT and blood tests. Results About 25.00% (16/64) patients had pulmonary ventilation dysfunction and 35.9% (23/64) had diffusion dysfunction. In the severe group, 56.50% (13/23) individuals showed decreased diffusion function. The diffusion dysfunction of the severe group was significantly decreased than the non-severe group (P = 0.01). Among 56 cases, the positive rate of IgG titers was 73.2% (41/56). The result of chest CT showed 55.36% (31/56) cases in nodules, 44.64% (25/56) in strip-like changes, 37.5% (21/56) in-ground glass shadow, and 5.36% (3/56) in grid shadow, which was significantly different between the severe group and the non-severe group. Patients tended to have ground glass changes in the severe group while nodules in the non-severe group. Conclusion For the 6 to 9 months in convalescent COVID-19 patients, 56.50% (13/23) of severe patients had pulmonary diffusion dysfunction. Convalescent COVID-19 patients should have their pulmonary function regularly tested, especially those with severe illness.
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Affiliation(s)
- Yan-Fen Tang
- Department of Respiratory, Beijing Ditan Hospital Capital Medical University, Beijing, 100015, People's Republic of China.,National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China
| | - Jun-Yan Han
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China.,Institute of Infectious Diseases, Beijing Key Laboratory of Emerging Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China.,Beijing Institute of Infectious Diseases, Beijing, 100015, People's Republic of China
| | - Ai-Min Ren
- Department of Respiratory, Beijing Ditan Hospital Capital Medical University, Beijing, 100015, People's Republic of China.,National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China
| | - Li Chen
- Department of Respiratory, Beijing Ditan Hospital Capital Medical University, Beijing, 100015, People's Republic of China.,National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China
| | - Tian-Jiao Xue
- Department of Respiratory, Beijing Ditan Hospital Capital Medical University, Beijing, 100015, People's Republic of China.,National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China
| | - Yong-Hong Yan
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China.,Institute of Infectious Diseases, Beijing Key Laboratory of Emerging Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China.,Beijing Institute of Infectious Diseases, Beijing, 100015, People's Republic of China
| | - Xi Wang
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China.,Institute of Infectious Diseases, Beijing Key Laboratory of Emerging Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China.,Beijing Institute of Infectious Diseases, Beijing, 100015, People's Republic of China
| | - Yu Wang
- Department of Respiratory, Beijing Ditan Hospital Capital Medical University, Beijing, 100015, People's Republic of China.,National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China
| | - Rong-Hua Jin
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China.,Institute of Infectious Diseases, Beijing Key Laboratory of Emerging Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China.,Changping Laboratory, Beijing, 102299, People's Republic of China
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21
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Zhi H, Ji X, Zhao Z, Liang H, Zhong S, Luo Y, Zhong M, Zhan C, Gao Y, Deng X, Li S, Li J, Zhong N, Jiang M, Chen R. Risk factors for impaired pulmonary diffusion function in convalescent COVID-19 patients: A systematic review and meta-analysis. EClinicalMedicine 2022; 49:101473. [PMID: 35663303 PMCID: PMC9137275 DOI: 10.1016/j.eclinm.2022.101473] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/08/2022] [Accepted: 05/09/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The long-term prognosis of COVID-19 survivors remains poorly understood. It is evidenced that the lung is the main damaged organ in COVID-19 survivors, most notably in impairment of pulmonary diffusion function. Hence, we conducted a meta-analysis of the potential risk factors for impaired diffusing capacity for carbon monoxide (DLCO) in convalescent COVID-19 patients. METHODS We performed a systematic search of PubMed, Web of Science, Embase, and Ovid databases for relevant studies from inception until January 7, 2022, limited to papers involving human subjects. Studies were reviewed for methodological quality. Fix-effects and random-effects models were used to pool results. Heterogeneity was assessed using I2. The publication bias was assessed using the Egger's test. PROSPERO registration: CRD42021265377. FINDINGS A total of eighteen qualified articles were identified and included in the systematic review, and twelve studies were included in the meta-analysis. Our results showed that female (OR: 4.011; 95% CI: 2.928-5.495), altered chest computerized tomography (CT) (OR: 3.002; 95% CI: 1.319-6.835), age (OR: 1.018; 95% CI: 1.007-1.030), higher D-dimer levels (OR: 1.012; 95% CI: 1.001-1.023) and urea nitrogen (OR: 1.004;95% CI: 1.002-1.007) were identified as risk factors for impaired DLCO. INTERPRETATION Pulmonary diffusion capacity was the most common impaired lung function in recovered patients with COVID-19. Several risk factors, such as female, altered chest CT, older age, higher D-dimer levels and urea nitrogen are associated with impairment of DLCO. Raising awareness and implementing interventions for possible modifiable risk factors may be valuable for pulmonary rehabilitation. FUNDING This work was financially supported by Emergency Key Program of Guangzhou Laboratory (EKPG21-29, EKPG21-31), Incubation Program of National Science Foundation for Distinguished Young Scholars by Guangzhou Medical University (GMU2020-207).
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Key Words
- ACE2, angiotensin-converting enzyme 2
- ARDS, acute respiratory distress syndrome
- CIs, confidence intervals
- COVID-19
- COVID-19, Coronavirus Disease 2019
- CT, computerized tomography
- DLCO
- DLCO, diffusing capacity for carbon monoxide
- DLNO, diffusion capacity for nitric oxide
- GRADE, Grading of Recommendations Assessment, Development, and Evaluation
- HR, hazard ratio
- MERS, Middle East Respiratory Syndrome
- Meta-analysis
- NOS, Newcastle-Ottawa scale
- OR, odds ratio
- PFTs, pulmonary function tests
- Pulmonary diffusion function
- RASI, renin-angiotensin system inhibitors
- RR, relative risk
- RT-PCR, reverse transcription-polymerase chain reaction
- Risk factors
- SARS-CoV-2, Severe Acute Respiratory Syndrome Coronavirus 2
- TSS, total severity score
- WHO, World Health Organization
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Affiliation(s)
- Haopeng Zhi
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
- Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Xiaolong Ji
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
- Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Zifan Zhao
- Nanshan College, Guangzhou Medical University, Guangzhou, Guangdong, 510180, China
| | - Hanwen Liang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Shuxin Zhong
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
- Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Yiting Luo
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
- Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Mingyu Zhong
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
- Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Chen Zhan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
- Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Yi Gao
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Xilong Deng
- Guangzhou Eighth People's Hospital, Guangzhou Medical University, 510060, Guangdong, China
| | - Shiyue Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Jing Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
- Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
- Corresponding authors.
| | - Nanshan Zhong
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
- Guangzhou Laboratory, Bio-Island, Guangzhou, 510320, Guangdong, China
- Corresponding authors.
| | - Mei Jiang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
- Guangzhou Laboratory, Bio-Island, Guangzhou, 510320, Guangdong, China
- Corresponding authors.
| | - Ruchong Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
- Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
- Guangzhou Laboratory, Bio-Island, Guangzhou, 510320, Guangdong, China
- Lead contact: State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health; Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University. 151, Yanjiangxi Rd, Guangzhou, Guangdong, 510120, China.
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22
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Keijsers CJPW, Broeders MEAC, Baptista Lopes V, Klinkert AF, van Baar JWM, Nahar-van Venrooij LMW, Kerckhoffs APM. Memory impairment and concentration problems in COVID-19 survivors eight weeks after non-ICU hospitalization: a retrospective cohort study. J Med Virol 2022; 94:4512-4517. [PMID: 35509111 PMCID: PMC9348267 DOI: 10.1002/jmv.27831] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/22/2022] [Accepted: 05/03/2022] [Indexed: 11/21/2022]
Abstract
Studies on the severe acute respiratory syndrome coronavirus 1 have shown long‐term effects on health, rehabilitation, and quality of life in patients.To evaluate effects on recovery and mental health in COVID‐19 survivors.A single center, retrospective cohort study in (non‐ICU admitted) adult patients with COVID‐19 infection was conducted. Next to baseline characteristics during hospital admission, data on remaining symptoms and radiographic abnormalities were extracted at the 8‐week follow‐up at the outpatient clinic. The Hospital Anxiety and Depression Scale (HADS) was used to detect anxiety and depression.Resulting in two hundred and eleven patients were included, median age of 63 years, 61% male, with overweight (average body mass index 28.6 kg/m2). At the outpatient clinic 13% of the patients were symptom free, whereas 25% reported more than three symptoms. Persisting physical symptoms were mainly fatigue 68%, dyspnea 56%, and cough 26%. Most patients had normalization of chest X‐ray (61.1%) and oxygen saturation (89.9%). Interestingly, 33% reported memory impairment and concentration problems 28%. 7.8% scored for anxiety and 7.1% for depression on the HADS. Correlations were found between the number of physical symptoms and scores on the HADS.In conclusion, only 13% had symptom‐free recovery after 8 weeks. Besides physical symptoms memory problems were frequently seen. The number of mental and physical symptoms were correlated.
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Affiliation(s)
| | | | | | - A F Klinkert
- department of pulmonary disease, Jeroen Bosch hospital
| | | | | | - A P M Kerckhoffs
- department of geriatric medicine and internal medicine, Jeroen Bosch hospital
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23
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Perspectives post-COVID-19 : le point de vue des pneumologues. ANESTHÉSIE & RÉANIMATION 2022. [PMCID: PMC9122778 DOI: 10.1016/j.anrea.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Plus de 5 millions de personnes en France ont présenté une infection par le SARS-CoV-2. Lors des précédentes épidémies de coronavirus (SARS-CoV, Mers-CoV), les patients ont développé des séquelles pulmonaires avec une dyspnée, une diminution de la capacité de diffusion du monoxyde de carbone et/ou des lésions de fibrose. Le but de cette revue était d’évaluer les séquelles respiratoires et de faire une synthèse des principaux symptômes respiratoires après une infection au COVID-19 et de leurs étiologies. Les quatre principales causes de dyspnée sont les séquelles respiratoires, le déconditionnement, l’hyperventilation et les causes classiques de dyspnée. Les principales séquelles respiratoires étaient l’altération de la capacité de diffusion du monoxyde de carbone et le schéma de fibrose. La prévalence de ces séquelles respiratoires est actuellement inconnue.
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24
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Bordas-Martínez J, Luzardo-González A, Arencibia A, Tormo F, Matéu L, Vicens-Zygmunt V, Bermudo G, Santos S, Molina-Molina M, Planas R, Suarez-Cuartín G. Effects of Early Physical Therapy and Follow-Up in Acute Severe Coronavirus Disease 2019 Pneumonia: A Retrospective Observational Study. Front Med (Lausanne) 2022; 9:866055. [PMID: 35479948 PMCID: PMC9035928 DOI: 10.3389/fmed.2022.866055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 03/10/2022] [Indexed: 01/08/2023] Open
Abstract
Background Rehabilitation in subjects with severe coronavirus disease 2019 (COVID-19) pneumonia has been widely recommended. However, data regarding the starting time of rehabilitation, subjects and healthcare workers' safety, as well as rehabilitation program features are limited. We aimed to assess the safety and characterize the effect of early and non-early physiotherapy on severe COVID-19 pneumonia subjects. Methods A retrospective cohort study, including a consecutive sample of surviving subjects admitted to an acute care hospital due to severe COVID-19 pneumonia from March 13th to May 15th of 2020, is made. Subjects were separated into three groups: non-physical therapy, early physiotherapy (onset <7 days of admission), and non-early physiotherapy. Subject and therapist safety and length of hospital stay were the main evaluated outcomes. Results A total of 159 subjects were included (72% men; median age 62 years). Rehabilitation was performed on 108 subjects (32 early and 76 non-early physiotherapies). The length of hospital stay was 19 [interquartile range (IQR) 36.25] and 34 days (IQR 27.25) (p = 0.001) for early and non-early physiotherapy groups, respectively. No physiotherapist was infected and no subject adverse effect was identified. Multivariate analysis of subjects receiving physiotherapy during admission identified obesity [odds ratio (OR) 3.21; p-value 0.028], invasive mechanical ventilation (OR 6.25; p-value <0.001), and non-early physiotherapy (OR 3.54; p-value 0.017) as independent factors associated with a higher risk of prolonged hospital stay. Survivors' follow-up after hospital discharge at 8 weeks was completed by 54% of subjects. Conclusion Rehabilitation in acute severe COVID-19 pneumonia is safe for subjects and healthcare workers and could reduce the length of hospitalization stay, especially in those that may start early.
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Affiliation(s)
- Jaume Bordas-Martínez
- Respiratory Department, Bellvitge University Hospital, IDIBELL, Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain
| | - Ana Luzardo-González
- Rehabilitation Department, Bellvitge University Hospital, IDIBELL, Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain
| | - Alejandro Arencibia
- Rehabilitation Department, Bellvitge University Hospital, IDIBELL, Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain
| | - Franco Tormo
- Rehabilitation Department, Bellvitge University Hospital, IDIBELL, Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain
| | - Lluís Matéu
- Rehabilitation Department, Bellvitge University Hospital, IDIBELL, Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain
| | - Vanesa Vicens-Zygmunt
- Respiratory Department, Bellvitge University Hospital, IDIBELL, Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain
| | - Guadalupe Bermudo
- Respiratory Department, Bellvitge University Hospital, IDIBELL, Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain
| | - Salud Santos
- Respiratory Department, Bellvitge University Hospital, IDIBELL, Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain
| | - María Molina-Molina
- Respiratory Department, Bellvitge University Hospital, IDIBELL, Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain
| | - Rosa Planas
- Rehabilitation Department, Bellvitge University Hospital, IDIBELL, Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain
| | - Guillermo Suarez-Cuartín
- Respiratory Department, Bellvitge University Hospital, IDIBELL, Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain
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25
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Jutant EM, Meyrignac O, Beurnier A, Jaïs X, Pham T, Morin L, Boucly A, Bulifon S, Figueiredo S, Harrois A, Jevnikar M, Noël N, Pichon J, Roche A, Seferian A, Soliman S, Duranteau J, Becquemont L, Monnet X, Sitbon O, Bellin MF, Humbert M, Savale L, Montani D. Respiratory symptoms and radiological findings in post-acute COVID-19 syndrome. ERJ Open Res 2022; 8:00479-2021. [PMID: 35445129 PMCID: PMC8685862 DOI: 10.1183/23120541.00479-2021] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/27/2021] [Indexed: 01/08/2023] Open
Abstract
Rationale The characteristics of patients with respiratory complaints and/or lung radiologic abnormalities after hospitalisation for coronavirus disease 2019 (COVID-19) are unknown. The objectives were to determine their characteristics and the relationships between dyspnoea, radiologic abnormalities and functional impairment. Methods In the COMEBAC (Consultation Multi-Expertise de Bicêtre Après COVID-19) cohort study, 478 hospital survivors were evaluated by telephone 4 months after hospital discharge, and 177 who had been hospitalised in an intensive care unit (ICU) or presented relevant symptoms underwent an ambulatory evaluation. New-onset dyspnoea and cough were evaluated, and the results of pulmonary function tests and high-resolution computed tomography of the chest were collected. Results Among the 478 patients, 78 (16.3%) reported new-onset dyspnoea, and 23 (4.8%) new-onset cough. The patients with new-onset dyspnoea were younger (56.1±12.3 versus 61.9±16.6 years), had more severe COVID-19 (ICU admission 56.4% versus 24.5%) and more frequent pulmonary embolism (18.0% versus 6.8%) (all p≤0.001) than patients without dyspnoea. Among the patients reassessed at the ambulatory care visit, the prevalence of fibrotic lung lesions was 19.3%, with extent <25% in 97% of the patients. The patients with fibrotic lesions were older (61±11 versus 56±14 years, p=0.03), more frequently managed in an ICU (87.9 versus 47.4%, p<0.001), had lower total lung capacity (74.1±13.7 versus 84.9±14.8% pred, p<0.001) and diffusing capacity of the lung for carbon monoxide (D LCO) (73.3±17.9 versus 89.7±22.8% pred, p<0.001). The combination of new-onset dyspnoea, fibrotic lesions and D LCO <70% pred was observed in eight out of 478 patients. Conclusions New-onset dyspnoea and mild fibrotic lesions were frequent at 4 months, but the association of new-onset dyspnoea, fibrotic lesions and low D LCO was rare.
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Affiliation(s)
- Etienne-Marie Jutant
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- INSERM UMR_S 999, Hôpital Marie Lannelongue, Le
Plessis Robinson, France
- AP-HP, Dept of Respiratory and Intensive Care Medicine,
Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU
5 Thorinno, Le Kremlin-Bicêtre, France
| | - Olivier Meyrignac
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- AP-HP, Service de radiologie diagnostique et
interventionnelle, BioMaps, Hôpital de Bicêtre, DMU 14 Smart Imaging,
Le Kremlin-Bicêtre, France
| | - Antoine Beurnier
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- INSERM UMR_S 999, Hôpital Marie Lannelongue, Le
Plessis Robinson, France
- AP-HP, Dept of Physiology – Pulmonary Function
Testing, DMU 5 Thorinno, Hôpital Bicêtre, Le Kremlin-Bicêtre,
France
| | - Xavier Jaïs
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- INSERM UMR_S 999, Hôpital Marie Lannelongue, Le
Plessis Robinson, France
- AP-HP, Dept of Respiratory and Intensive Care Medicine,
Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU
5 Thorinno, Le Kremlin-Bicêtre, France
| | - Tai Pham
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- AP-HP, Service de Médecine
Intensive-Réanimation, Hôpital de Bicêtre, DMU 4 CORREVE
Maladies du Cœur et des Vaisseaux, FHU Sepsis, Le Kremlin-Bicêtre,
France
| | - Luc Morin
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- AP-HP, Service de Réanimation Pédiatrique et
Médecine Néonatale, Hôpital de Bicêtre, DMU3
Santé de l'Enfant et de l'Adolescent, Le
Kremlin-Bicêtre, France
| | - Athénaïs Boucly
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- INSERM UMR_S 999, Hôpital Marie Lannelongue, Le
Plessis Robinson, France
- AP-HP, Dept of Respiratory and Intensive Care Medicine,
Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU
5 Thorinno, Le Kremlin-Bicêtre, France
| | - Sophie Bulifon
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- INSERM UMR_S 999, Hôpital Marie Lannelongue, Le
Plessis Robinson, France
- AP-HP, Dept of Respiratory and Intensive Care Medicine,
Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU
5 Thorinno, Le Kremlin-Bicêtre, France
| | - Samy Figueiredo
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- AP-HP, Service
d'anesthésie-réanimation et médecine
péri-opératoire, Hôpital de Bicêtre, DMU 12
Anesthésie, réanimation, douleur, Le Kremlin-Bicêtre,
France
| | - Anatole Harrois
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- AP-HP, Service
d'anesthésie-réanimation et médecine
péri-opératoire, Hôpital de Bicêtre, DMU 12
Anesthésie, réanimation, douleur, Le Kremlin-Bicêtre,
France
| | - Mitja Jevnikar
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- INSERM UMR_S 999, Hôpital Marie Lannelongue, Le
Plessis Robinson, France
- AP-HP, Dept of Respiratory and Intensive Care Medicine,
Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU
5 Thorinno, Le Kremlin-Bicêtre, France
| | - Nicolas Noël
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- AP-HP, Service de médecine interne et immunologie
clinique, Hôpital de Bicêtre, DMU 7
Endocrinologie-immunités-inflammations-cancer-urgences, Le
Kremlin-Bicêtre, France
| | - Jérémie Pichon
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- INSERM UMR_S 999, Hôpital Marie Lannelongue, Le
Plessis Robinson, France
- AP-HP, Dept of Respiratory and Intensive Care Medicine,
Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU
5 Thorinno, Le Kremlin-Bicêtre, France
| | - Anne Roche
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- INSERM UMR_S 999, Hôpital Marie Lannelongue, Le
Plessis Robinson, France
- AP-HP, Dept of Respiratory and Intensive Care Medicine,
Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU
5 Thorinno, Le Kremlin-Bicêtre, France
| | - Andrei Seferian
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- INSERM UMR_S 999, Hôpital Marie Lannelongue, Le
Plessis Robinson, France
- AP-HP, Dept of Respiratory and Intensive Care Medicine,
Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU
5 Thorinno, Le Kremlin-Bicêtre, France
| | - Samer Soliman
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- AP-HP, Service de radiologie diagnostique et
interventionnelle, BioMaps, Hôpital de Bicêtre, DMU 14 Smart Imaging,
Le Kremlin-Bicêtre, France
| | - Jacques Duranteau
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- AP-HP, Service
d'anesthésie-réanimation et médecine
péri-opératoire, Hôpital de Bicêtre, DMU 12
Anesthésie, réanimation, douleur, Le Kremlin-Bicêtre,
France
| | - Laurent Becquemont
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- AP-HP, Centre de recherche Clinique Paris-Saclay, DMU 13
Santé publique, Information médicale, Appui à la recherche
clinique, INSERM U1018, CESP (Centre de Recherche en Epidémiologie et
Santé des Populations), Paris, France
| | - Xavier Monnet
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- AP-HP, Service de Médecine
Intensive-Réanimation, Hôpital de Bicêtre, DMU 4 CORREVE
Maladies du Cœur et des Vaisseaux, FHU Sepsis, Le Kremlin-Bicêtre,
France
| | - Olivier Sitbon
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- INSERM UMR_S 999, Hôpital Marie Lannelongue, Le
Plessis Robinson, France
- AP-HP, Dept of Respiratory and Intensive Care Medicine,
Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU
5 Thorinno, Le Kremlin-Bicêtre, France
| | - Marie-France Bellin
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- AP-HP, Service de radiologie diagnostique et
interventionnelle, BioMaps, Hôpital de Bicêtre, DMU 14 Smart Imaging,
Le Kremlin-Bicêtre, France
| | - Marc Humbert
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- INSERM UMR_S 999, Hôpital Marie Lannelongue, Le
Plessis Robinson, France
- AP-HP, Dept of Respiratory and Intensive Care Medicine,
Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU
5 Thorinno, Le Kremlin-Bicêtre, France
| | - Laurent Savale
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- INSERM UMR_S 999, Hôpital Marie Lannelongue, Le
Plessis Robinson, France
- AP-HP, Dept of Respiratory and Intensive Care Medicine,
Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU
5 Thorinno, Le Kremlin-Bicêtre, France
- These authors contributed equally
| | - David Montani
- Faculty of Medicine, Université Paris-Saclay, Le
Kremlin-Bicêtre, France
- INSERM UMR_S 999, Hôpital Marie Lannelongue, Le
Plessis Robinson, France
- AP-HP, Dept of Respiratory and Intensive Care Medicine,
Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU
5 Thorinno, Le Kremlin-Bicêtre, France
- These authors contributed equally
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Klinkert AF, Baptista Lopes V, van Baar JM, Broeders MEAC, van Rijswijk HNAJ(R, Cornegé‐Blokland E, Siegers‐Siebelink C, Kerckhoffs APM, Keijsers CJPW. Integrating healthcare for follow-up of adult COVID-19 patients in an outpatient clinic: A matter of cooperation. Health Sci Rep 2022; 5:e504. [PMID: 35155829 PMCID: PMC8827273 DOI: 10.1002/hsr2.504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 11/10/2022] Open
Abstract
RATIONALE AIMS AND OBJECTIVES A large number of patients infected with SARS-CoV-2 (COVID-19) need outpatient follow-up after hospitalization. As these patients may experience a broad range of symptoms, as do patients infected with the related SARS-CoV-1 virus, we set up a multidisciplinary outpatient clinic involving pulmonologists, internists, and geriatricians. Patients were allocated to a specialist based on symptoms reported on a self-developed questionnaire of expected symptoms of COVID-19. This study aimed to evaluate the effectiveness of this outpatient clinic. METHODS In this retrospective study, the medical records of patients who presented to the outpatient clinic for follow-up after hospitalization for COVID-19 up to 31 August 2020, were reviewed. RESULTS In total, 266 patients were seen at the outpatient clinic at least once. Overall, 100 patients were seen by a pulmonologist, 97 by an internist, and 65 by a geriatrician. A referral between these 3 medical specialists was needed for only 14 patients (5.3%). Fifty patients were seen by a psychologist, mostly those with a HADS score >10. Only 5 (2.2%) of the 221 patients who were not directly referred to a psychologist based on triage needed psychological support. Forty-eight patients (18%) were also seen by a physiatrist. CONCLUSION Identifying which medical specialist (pulmonologist, internist, and/or geriatrician) should see patients attending a post-COVID outpatient clinic based on patient-reported symptoms proved an effective approach to managing the flow of post-COVID patients.
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Affiliation(s)
- Aryan F. Klinkert
- Department of PulmonologyJeroen Bosch Hospital's‐HertogenboschNetherlands
| | | | | | | | | | | | | | - Angèle P. M. Kerckhoffs
- Department of GeriatricsJeroen Bosch Hospital's‐HertogenboschNetherlands
- Department of Internal MedicineJeroen Bosch Hospital's‐HertogenboschNetherlands
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27
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Jiménez-Rodríguez BM, Gutiérrez-Fernández J, Ramos-Urbina EM, Romero-Ortiz AD, García-Flores PI, Santiago-Puertas MI, Martín-López MJ, López-Milena G, Fabregas R, Morales-García C. On the single and multiple associations of COVID-19 post-acute sequelae: 6-month prospective cohort study. Sci Rep 2022; 12:3402. [PMID: 35233062 PMCID: PMC8888754 DOI: 10.1038/s41598-022-07433-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 02/15/2022] [Indexed: 01/08/2023] Open
Abstract
Medical research is progressing to clarify the full spectrum of sub-acute and long-term effects of the post-COVID-19 syndrome. However, most manuscripts published to date only analyze the effects of post-COVID-19 in patients discharged from hospital, which may induce significant bias. Here, we propose a pioneering study to analyze the single and multiple associations between post-COVID-19 characteristics with up to 6-months of follow-up in hospitalized and non-hospitalized COVID-19 patients. The cohort study was conducted from May to October 2020 at the University Hospital Virgen de la Nieves, the leading hospital assigned for patients with COVID-19 in Granada, Spain. A total of 372 and 217 patients-with 217 and 207 included in the first and second follow-up visits-were referred 2 and 6 months after diagnosing COVID-19, respectively. We find out that post-COVID-19 clinical and mental health impairment symptoms are correlated with patient gender. Logistic adjustments showed strong statistically robust single and multiple associations of demographic, clinical, mental health, X-ray, laboratory indices, and pulmonary function variables. The functional lung tests are good predictors of chest CT imaging abnormalities in elderly patients. Bilateral lung involvement, subpleural reticulum, ground-glass opacity, peripheral lung lesions, and bronchiectasis were the most common findings of the high-resolution computed tomography images. Non-hospitalized patients suffer more severe thromboembolic events and fatigue than those hospitalized.
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Affiliation(s)
- Beatriz María Jiménez-Rodríguez
- Department of Pneumology, University Hospital Virgen de Las Nieves, Granada, Spain.
- Department of Microbiology, School of Medicine and PhD Program in Clinical Medicine and Public Health, University of Granada-IBS, 18010, Granada, Spain.
| | - José Gutiérrez-Fernández
- Department of Microbiology, School of Medicine and PhD Program in Clinical Medicine and Public Health, University of Granada-IBS, 18010, Granada, Spain
- Department of Microbiology, University Hospital Virgen de Las Nieves, Granada, Spain
- Biosanitary Research Institute of Granada-Ibs, Granada, Spain
| | | | - Ana Dolores Romero-Ortiz
- Department of Pneumology, University Hospital Virgen de Las Nieves, Granada, Spain
- Biosanitary Research Institute of Granada-Ibs, Granada, Spain
| | | | | | | | - Genaro López-Milena
- Department of Radiodiagnosis, University Hospital Virgen de Las Nieves, Granada, Spain
| | - Rene Fabregas
- Department of Applied Mathematics and Research Unit "Modeling Nature" (MNat), Faculty of Sciences, University of Granada, 18071, Granada, Spain.
- Department of Physics and Astronomy, University of Manchester, Manchester, M13 9PL, UK.
| | - Concepción Morales-García
- Department of Pneumology, University Hospital Virgen de Las Nieves, Granada, Spain.
- Biosanitary Research Institute of Granada-Ibs, Granada, Spain.
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28
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de Roos MP, Siegerink S, Dijkstra NG, Broekman BFP, Brinkman K, Jonkman NH, Bresser P. Pulmonary function and Quality of Life in a prospective cohort of (non-) hospitalized COVID-19 pneumonia survivors up to six months. Chron Respir Dis 2022; 19:14799731221114271. [PMID: 36367295 PMCID: PMC9659768 DOI: 10.1177/14799731221114271] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 06/27/2022] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVES A decrease of both diffusion capacity (DLCO) and Quality of Life (QoL) was reported after discharge in hospitalized COVID-19 pneumonia survivors. We studied three and 6 month outcomes in hospitalized and non-hospitalized patients. METHODS COVID-19 pneumonia survivors (n = 317) were categorized into non-hospitalized "moderate" cases (n = 59), hospitalized "severe" cases (n = 180) and ICU-admitted "critical" cases (n = 39). We studied DLCO and QoL (Short Form SF-36 health survey) 3 and 6 months after discharge. Data were analyzed using (repeated measures) ANOVA, Kruskal-Wallis or Chi-square test (p < .05). RESULTS At 3 months DLCO was decreased in 44% of moderate-, 56% of severe- and 82% of critical cases (p < .003). Mean DLCO in critical cases (64±14%) was lower compared to severe (76 ± 17%) and moderate (81±15%) cases (p < .001). A total of 159/278 patients had a decreased DLCO (<80%), of whom the DLCO improved after 6 months in 45% (71/159). However the DLCO did not normalize in the majority (89%) of the cases (63 ± 10% vs 68±10%; p < .001). At 3 months, compared to critical cases, moderate cases scored lower on SF-36 domain "general health" (p < .05); both moderate and severe cases scored lower on the domain of "health change" (p < .05). At 6 months, there were no differences in SF-36 between the subgroups. Compared to 3 months, in all groups "physical functioning" improved; in contrast all groups scored significantly lower on "non-physical" SF-36 domains. CONCLUSION Three months after COVID-19 pneumonia, DLCO was still decreased in the more severely affected patients, with an incomplete recovery after 6 months. At 3 months QoL was impaired. At 6 months, while "physical functioning" improved, a decrease in "non-physical" QoL was observed but did not differ between the moderate and severely affected patients.
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Affiliation(s)
- Marlise P de Roos
- Department of Respiratory Medicine, OLVG, Amsterdam, The Netherlands
| | - Sebastiaan Siegerink
- Department of Medical Psychiatry, Amsterdam UMC and OLVG, Amsterdam, The Netherlands
| | - Nynke G Dijkstra
- Department of Respiratory Medicine, OLVG, Amsterdam, The Netherlands
| | - Birit FP Broekman
- Department of Medical Psychiatry, Amsterdam UMC and OLVG, Amsterdam, The Netherlands
| | - Kees Brinkman
- Department of Internal Medicine and Infectious diseases, OLVG, Amsterdam, The Netherlands
| | - Nini H Jonkman
- Department of Research and Epidemiology, OLVG, Amsterdam, The Netherlands
| | - Paul Bresser
- Department of Respiratory Medicine, OLVG, Amsterdam, The Netherlands
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29
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Zhou F, Tao M, Shang L, Liu Y, Pan G, Jin Y, Wang L, Hu S, Li J, Zhang M, Fu Y, Yang S. Assessment of Sequelae of COVID-19 Nearly 1 Year After Diagnosis. Front Med (Lausanne) 2021; 8:717194. [PMID: 34888318 PMCID: PMC8649686 DOI: 10.3389/fmed.2021.717194] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 10/25/2021] [Indexed: 12/12/2022] Open
Abstract
Background: A previous study has shown that 81% of the COVID-19 patients had mild or moderate symptoms. However, most studies on the sequelae in COVID-19 patients focused on severe cases and the long-term follow-up studies on the health consequences in non-severe cases are limited. The current study aimed to assess the sequelae of COVID-19 in patients nearly 1 year after diagnosis with a particular focus on the recovery of patients with non-severe COVID-19. Methods: We enrolled 120 patients infected with SARS-CoV-2 discharged from Wuhan Union hospital west district (designated hospital for COVID-19) and Fangcang shelter hospitals between January 29, 2020 and April 1, 2020. All participants were asked to complete a series of questionnaires to assess their symptoms and quality of life and for psychological evaluation. Also, pulmonary function test, chest CT, 6-min walking test (6MWT), routine blood test, liver and kidney function tests, fasting blood glucose test, lipid test, and immunoglobulin G antibody test were performed to evaluate their health. Results: The mean age of the study population was 51.6 ± 10.8 years. Of the 120 patients, 104 (86.7%) were cases of non-severe COVID-19. The follow-up study was performed between November 23, 2020 and January 11, 2021, and the median time between the diagnosis and the follow-up was 314.5 (IQR, 296–338) days. Sleep difficulties, shortness of breath, fatigue, and joint pain were common symptoms observed during follow-up and nearly one-third of the non-severe cases had these symptoms. A total of 50 (41.7%) and 45 (37.5%) patients reported anxiety and depression, respectively. And 18.3% of the patients showed negative results in the IgG test at the follow-up, which correlated with the severity of the infection (R = 0.203, p = 0.026), and the proportion of IgG negative cases in non-severe COVID-19 patients was higher than that in the severe cases (20.2 vs. 6.3%). Pulmonary diffusion impairment was reported in 30 (26.1%) out of 115 patients, and 24 (24.2%) out of the 99 non-severe cases. The values of forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FVC/FEV1, vital capacity (VC), total lung capacity (TLC), and residual volume (RV) were less than the normal range in 1.7, 8.6, 0.9, 11.2, 7.0, and 0.9% of the patients, respectively. A total of 55 (56.7%) out of the 97 patients showed abnormal CT findings, including ground-glass opacities (GGO), bronchiectasis, nodules, lines and bands, and fibrosis. Furthermore, there was a correlation between all the SF-36-domain scores and the duration of hospitalization, pulmonary function, and a 6MWT. Conclusions: At the nearly 1-year follow-up, COVID-19 survivors still had multi-system issues, including those in the respiratory functioning, radiography, quality of life, and anxiety and depression. Moreover, non-severe cases also showed some sequelae and the proportion of IgG negative cases in the non-severe patients was higher than that in severe cases. Therefore, conducting follow-ups and preventing the reinfection of SARS-CoV-2 in this group is necessary.
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Affiliation(s)
- Fangyuan Zhou
- Department of Traditional Chinese Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meihui Tao
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Luorui Shang
- Department of Traditional Chinese Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuhan Liu
- Department of Traditional Chinese Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guangtao Pan
- Department of Traditional Chinese Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Jin
- Department of Emergency, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Wang
- Department of Emergency, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shaoke Hu
- Department of Medical Engineering, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinxiao Li
- Department of Traditional Chinese Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengqi Zhang
- Department of Traditional Chinese Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Fu
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shenglan Yang
- Department of Traditional Chinese Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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30
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Pednekar P, Amoah K, Homer R, Ryu C, Lutchmansingh DD. Case Report: Bullous Lung Disease Following COVID-19. Front Med (Lausanne) 2021; 8:770778. [PMID: 34869488 PMCID: PMC8635639 DOI: 10.3389/fmed.2021.770778] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 10/12/2021] [Indexed: 12/24/2022] Open
Abstract
More than 87% of patients report the persistence of at least one symptom after recovery from the Coronavirus disease 2019 (COVID-19). Dyspnea is one of the most frequently reported symptoms following severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) infection with persistent chest radiological abnormalities up to 3 months after symptom onset. These radiological abnormalities are variable and most commonly include ground-glass opacities, reticulations, mosaic attenuation, parenchymal bands, interlobular septal thickening, bronchiectasis, and fibrotic-like changes. However, in this case report, we describe findings of bullous lung disease as a complication of SARS CoV-2 infection. As the pandemic continues, there is a need to understand the multiple respiratory manifestations of post-acute sequelae of COVID-19. We, therefore, present this case to add to the current body of literature describing pulmonary disease as a consequence of SARS CoV-2 infection.
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Affiliation(s)
- Prachi Pednekar
- Department of Internal Medicine, Bridgeport Hospital, Bridgeport, CT, United States
| | - Kwesi Amoah
- Section of Pulmonary, Critical Care, and Sleep Medicine, Bridgeport Hospital, Bridgeport, CT, United States
| | - Robert Homer
- Department of Pathology, Yale School of Medicine, New Haven, CT, United States
| | - Changwan Ryu
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Denyse D Lutchmansingh
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT, United States
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31
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Abstract
Pulmonary fibrosis is the end stage of a broad range of heterogeneous interstitial lung diseases and more than 200 factors contribute to it. In recent years, the relationship between virus infection and pulmonary fibrosis is getting more and more attention, especially after the outbreak of SARS-CoV-2 in 2019, however, the mechanisms underlying the virus-induced pulmonary fibrosis are not fully understood. Here, we review the relationship between pulmonary fibrosis and several viruses such as Human T-cell leukemia virus (HTLV), Human immunodeficiency virus (HIV), Cytomegalovirus (CMV), Epstein–Barr virus (EBV), Murine γ-herpesvirus 68 (MHV-68), Influenza virus, Avian influenza virus, Middle East Respiratory Syndrome (MERS)-CoV, Severe acute respiratory syndrome (SARS)-CoV and SARS-CoV-2 as well as the mechanisms underlying the virus infection induced pulmonary fibrosis. This may shed new light on the potential targets for anti-fibrotic therapy to treat pulmonary fibrosis induced by viruses including SARS-CoV-2.
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Affiliation(s)
- Wei Jie Huang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiao Xiao Tang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. .,Guangzhou Laboratory, Bio-island, Guangzhou, China.
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32
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Li J, Zheng Y, Zhao L, Yue Z, Pan F, Chen Y, Yu B, Chen Y, Zhao G, Zhou Y, Gao Z. Investigation of the impact of SARS-CoV infection on the immunologic status and lung function after 15 years. BMC Infect Dis 2021; 21:1183. [PMID: 34819019 PMCID: PMC8611627 DOI: 10.1186/s12879-021-06881-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 11/01/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND We investigate the long-term effects of SARS-CoV on patients' lung and immune systems 15 years post-infection. SARS-CoV-2 pandemic is ongoing however, another genetically related beta-coronavirus SARS-CoV caused an epidemic in 2003-2004. METHODS We enrolled 58 healthcare workers from Peking University People's Hospital who were infected with SARS-CoV in 2003. We evaluated lung damage by mMRC score, pulmonary function tests, and chest CT. Immune function was assessed by their serum levels of globin, complete components, and peripheral T cell subsets. ELISA was used to detect SARS-CoV-specific IgG antibodies in sera. RESULTS After 15 years of disease onset, 19 (36.5%), 8 (34.6%), and 19 (36.5%) subjects had impaired DL (CO), RV, and FEF25-75, respectively. 17 (30.4%) subjects had an mMRC score ≥ 2. Fourteen (25.5%) cases had residual CT abnormalities. T regulatory cells were a bit higher in the SARS survivors. IgG antibodies against SARS S-RBD protein and N protein were detected in 11 (18.97%) and 12 (20.69%) subjects, respectively. Subgroup analysis revealed that small airway dysfunction and CT abnormalities were more common in the severe group than in the non-severe group (57.1% vs 22.6%, 54.5% vs 6.1%, respectively, p < 0.05). CONCLUSIONS SARS-CoV could cause permanent damage to the lung, which requires early pulmonary rehabilitation. The long-lived immune memory response against coronavirus requires further studies to assess the potential benefit. Trial registration ClinicalTrials.gov, NCT03443102. Registered prospectively on 25 January 2018.
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Affiliation(s)
- Jia Li
- Department of Pulmonary and Critical Care Medicine, Peking University People's Hospital, Beijing, 100044, China
| | - Yali Zheng
- Department of Pulmonary and Critical Care Medicine, Peking University People's Hospital, Beijing, 100044, China
| | - Lili Zhao
- Department of Pulmonary and Critical Care Medicine, Peking University People's Hospital, Beijing, 100044, China
| | - Zhihong Yue
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, 100044, China
| | - Feng Pan
- Department of Radiology, Peking University People's Hospital, Beijing, 100044, China
| | - Yuehong Chen
- Institute of Microbial Epidemiology, Academy of Military Medical Sciences, Beijing, 100039, China
| | - Bing Yu
- Department of Pulmonary and Critical Care Medicine, Peking University People's Hospital, Beijing, 100044, China
| | - Yanwen Chen
- Department of Pulmonary and Critical Care Medicine, Peking University People's Hospital, Beijing, 100044, China
| | - Guangyu Zhao
- Institute of Microbial Epidemiology, Academy of Military Medical Sciences, Beijing, 100039, China
| | - Yusen Zhou
- Institute of Microbial Epidemiology, Academy of Military Medical Sciences, Beijing, 100039, China
| | - Zhancheng Gao
- Department of Pulmonary and Critical Care Medicine, Peking University People's Hospital, Beijing, 100044, China.
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33
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Li Y, Han X, Huang J, Alwalid O, Jia X, Yuan M, Cao Y, Shao G, Cui Y, Liu J, Fan Y, Xu X, Shi H. Follow-up study of pulmonary sequelae in discharged COVID-19 patients with diabetes or secondary hyperglycemia. Eur J Radiol 2021; 144:109997. [PMID: 34634534 PMCID: PMC8500791 DOI: 10.1016/j.ejrad.2021.109997] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 09/26/2021] [Accepted: 09/30/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE To determine chest CT changes 6 months and 12 months after the onset of coronavirus disease 2019 (COVID-19) in patients with diabetes or hyperglycemia and the risk factors for these residual lung abnormalities. METHODS In total, 141 COVID-19 patients were assigned to group 1 (diabetes), group 2 (secondary hyperglycemia) or group 3 (controls). Initial and six- and twelve-month follow-up computed tomography (CT) scans were performed 16 days, 175 days and 351 days after symptom onset, respectively. CT findings and clinical and peak laboratory parameters were collected and compared. Univariable and multivariable logistic regression analyses were performed to identify the independent predictors for the presence of residual lung abnormalities at the 6-month follow-up exam. Seven variables (age; the presence of acute respiratory distress syndrome; the duration of hospitalization; the peak levels of lactate dehydrogenase (LDH) and C-reactive protein; and the initial total CT score) were chosen in the final multivariable models. RESULTS At the six-month follow-up, abnormalities were still observed on chest CT in 77/141 (54.6%) patients. Reticular patterns (40/141, 28.4%) and ground-glass opacities (GGOs) (29/141, 20.6%) were the most common CT abnormalities on the follow-up CT scans. Patients in Groups 1 and 2 had significantly higher incidences of residual lung abnormalities than those in Group 3 (65.4% and 58.3%, respectively vs. 36.6%; p < 0.05). Twelve months after disease onset, the chest CT changes persisted in 13/25 (52.0%) patients. A duration of hospitalization > 20 days (OR: 5.630, 95% CI: 1.394-22.744, p = 0.015), an LDH level ≥ 317 U/L (OR: 7.020, 95% CI: 1.032-47.743, p = 0.046) and a total CT score > 15 (OR: 9.919, 95% CI: 1.378-71.415, p = 0.023) were independent predictors of residual pulmonary abnormalities in patients with diabetes or secondary hyperglycemia. CONCLUSIONS A considerable proportion of surviving COVID-19 patients with diabetes or secondary hyperglycemia had residual pulmonary abnormalities six months after disease onset, and we found evidence of persistent chest CT changes at the one-year follow-up. Residual lung abnormalities were associated with longer hospital stays, higher peak LDH levels and higher initial total CT scores.
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Affiliation(s)
- Yumin Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Xiaoyu Han
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Jing Huang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Osamah Alwalid
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Xi Jia
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Mei Yuan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Yukun Cao
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Guozhu Shao
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Yue Cui
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Jia Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Yangqing Fan
- Department of Radiology, Wuhan Jinyintan Hospital, No.1 Yintan Road, Dongxihu District, Wuhan 430022, China.
| | - Xiangyang Xu
- Department of Radiology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, China.
| | - Heshui Shi
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China.
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Larsen NW, Stiles LE, Miglis MG. Preparing for the long-haul: Autonomic complications of COVID-19. Auton Neurosci 2021; 235:102841. [PMID: 34265539 PMCID: PMC8254396 DOI: 10.1016/j.autneu.2021.102841] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 06/13/2021] [Accepted: 06/28/2021] [Indexed: 12/25/2022]
Abstract
As global numbers of COVID-19 grow, chronic neurological symptoms, including those of autonomic dysfunction, are being reported with increasing frequency. Mounting evidence suggests that many patients experience chronic and sometimes debilitating symptoms long after their acute infectious period, leading to the new diagnostic category of post-acute COVID syndrome. Many symptoms of post-acute COVID syndrome appear autonomic in nature, suggesting that autonomic impairment may play a central role in the underlying pathophysiology. In this review, we discuss the autonomic symptoms and manifestations of post-acute COVID syndrome, potential mechanisms involved, and future directions for a better understanding of this novel condition.
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Affiliation(s)
- Nicholas W Larsen
- Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA, USA
| | - Lauren E Stiles
- Department of Neurology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA
| | - Mitchell G Miglis
- Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA, USA.
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35
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The impact of Post-COVID-Syndrome on functioning - results from a community survey in patients after mild and moderate SARS-CoV-2-infections in Germany. J Occup Med Toxicol 2021; 16:45. [PMID: 34620202 PMCID: PMC8495185 DOI: 10.1186/s12995-021-00337-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 09/28/2021] [Indexed: 12/27/2022] Open
Abstract
Background In COVID-19 survivors a relatively high number of long-term symptoms have been observed. Besides impact on quality of life, these symptoms (now called Post-COVID-Syndrome) may have an impact on functioning and may also hinder to participation in social life in affected people. However, little is known about developing such syndrome a for patients with mild and moderate COVID-19 who did not need hospitalization or intensive care. Methods A cross-sectional study in 1027 patients with mild or moderate COVID-19 was performed in two communities in Bavaria, Germany. The Rehabilitation-Needs-Survey (RehabNeS) including the Short Form 36 Health Survey (SF-36) on health-related quality of life, was used. Descriptive statistics were calculated. Results In all, 97.5% of patients reported one symptom in the infection stage, such as fatigue, respiratory problems, limitations of the senses of taste and smell, fear and anxiety and other symptoms. In this time period, 84.1% of the participants experienced activity limitations and participation restrictions such as carrying out daily routines, handling stress, getting household tasks done, caring for/supporting others, and relaxing and leisure concerns. In all, 61.9% of participants reported persisting symptoms more than 3 months after infection. These were fatigue, sleep disturbances, respiratory problems, pain, fear and anxiety, and restrictions in movement; 49% of the participants reported activity limitations and participation restrictions. Predominately, these were handling stress, carrying out daily routines, looking after one’s health, relaxing and leisure activities and doing house work. The impacts on quality of life and vocational performance were rather low. Conclusion The results show that long-term symptoms after mild and moderate COVID-19 are common and lead to limitations of activities and participation. However, it seems that in most cases they are not severe and do not lead to frequent or serious issues with quality of life or work ability.
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36
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Aul DR, Gates DJ, Draper DA, Dunleavy DA, Ruickbie DS, Meredith DH, Walters DN, van Zeller DC, Taylor DV, Bridgett DM, Dunwoody DR, Grubnic DS, Jacob DT, Ean Ong DY. Complications after discharge with COVID-19 infection and risk factors associated with development of post-COVID pulmonary fibrosis. Respir Med 2021; 188:106602. [PMID: 34536697 PMCID: PMC8425673 DOI: 10.1016/j.rmed.2021.106602] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 08/08/2021] [Accepted: 09/04/2021] [Indexed: 12/15/2022]
Abstract
Introduction Survivors of COVID-19 infection may develop post-covid pulmonary fibrosis (PCF) and suffer from long term multi-system complications. The magnitude and risk factors associated with these are unknown. Objectives We investigated the prevalence and risk factors associated with PCF and other complications in patients discharged after COVID-19 infection. Methods Patients had phone assessment 6 weeks post hospital discharge after COVID-19 infection using a set protocol. Those with significant respiratory symptoms were investigated with a CTPA, Pulmonary Function Tests and echocardiogram. Prevalence of myalgia, fatigue, psychological symptoms and PCF was obtained. Risk factors associated with these were investigated. Results A large number of patients had persistent fatigue (45.1%), breathlessness (36.5%), myalgia (20.5%) and psychological symptoms (19.5%). PCF was seen in 9.5% of the patients and was associated with persistent breathlessness at 6 weeks and inpatient ventilation [adjusted OR 5.02(1.76–14.27) and 4.45(1.27–15.58)] respectively. It was more common in men and in patients with peak CRP >171.5 mg/L, peak WBC count ≥12 × 10 9/L, severe inpatient COVID-19 CXR changes and CT changes. Ventilation was also a risk factor for persisting fatigue and myalgia, the latter was also more common in those with severe cytokine storm and severe COVID-19 inpatient CXR changes. Conclusions All the patients discharged after COVID-19 should be assessed using a set protocol by a multidisciplinary team. Patients who had severe COVID-19 infection particularly those who were intubated and who have persistent breathlessness are at risk of developing PCF. They should have a CT Chest and have respiratory follow-up.
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Affiliation(s)
- Dr Raminder Aul
- St George's University Hospitals NHS Foundation Trust, London, UK.
| | - Dr Jessica Gates
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Dr Adrian Draper
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Dr Anne Dunleavy
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | | | | | | | | | | | | | - Dr Sisa Grubnic
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Dr Tersesa Jacob
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Dr Yee Ean Ong
- St George's University Hospitals NHS Foundation Trust, London, UK
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Li X, Liu R, Cui Y, Liang J, Bi Z, Li S, Miao Y, Zhang L, Li X, Zhou H, Yang C. Protective Effect of Remdesivir Against Pulmonary Fibrosis in Mice. Front Pharmacol 2021; 12:692346. [PMID: 34512328 PMCID: PMC8427522 DOI: 10.3389/fphar.2021.692346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/13/2021] [Indexed: 01/12/2023] Open
Abstract
Pulmonary fibrosis is a known sequela of severe or persistent lung damage. Existing clinical, imaging and autopsy studies have shown that the lungs exhibit a pathological pulmonary fibrosis phenotype after infection with coronaviruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Pulmonary fibrosis may be one of the most serious sequelae associated with coronavirus disease 2019 (COVID-19). In this study, we aimed to examine the preventative effects of the antiviral drug remdesivir on pulmonary fibrosis. We used a mouse model of bleomycin-induced pulmonary fibrosis to evaluate the effects of remdesivir on pulmonary fibrosis in vivo and further explored the potential pharmacological mechanisms of remdesivir in lung fibroblasts and alveolar epithelial cells in vitro. The preventive remdesivir treatment was started on the day of bleomycin installation, and the results showed that remdesivir significantly alleviated bleomycin-induced collagen deposition and improved pulmonary function. In vitro experiments showed that remdesivir dose-dependently suppressed TGF-β1-induced lung fibroblast activation and improved TGF-β1-induced alveolar epithelial to mesenchymal transition. Our results indicate that remdesivir can preventatively alleviate the severity of pulmonary fibrosis and provide some reference for the prevention of pulmonary fibrosis in patients with COVID-19.
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Affiliation(s)
- Xiaohe Li
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy and Tianjin Key Laboratory of Molecular Drug Research, Nankai University, Tianjin, China.,Tianjin Key Laboratory of Molecular Drug Research, Tianjin International Joint Academy of Biomedicine, Tianjin, China
| | - Rui Liu
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy and Tianjin Key Laboratory of Molecular Drug Research, Nankai University, Tianjin, China.,Tianjin Key Laboratory of Molecular Drug Research, Tianjin International Joint Academy of Biomedicine, Tianjin, China
| | - Yunyao Cui
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy and Tianjin Key Laboratory of Molecular Drug Research, Nankai University, Tianjin, China.,Tianjin Key Laboratory of Molecular Drug Research, Tianjin International Joint Academy of Biomedicine, Tianjin, China
| | - Jingjing Liang
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy and Tianjin Key Laboratory of Molecular Drug Research, Nankai University, Tianjin, China.,Tianjin Key Laboratory of Molecular Drug Research, Tianjin International Joint Academy of Biomedicine, Tianjin, China
| | - Zhun Bi
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy and Tianjin Key Laboratory of Molecular Drug Research, Nankai University, Tianjin, China
| | - Shimeng Li
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy and Tianjin Key Laboratory of Molecular Drug Research, Nankai University, Tianjin, China.,Tianjin Key Laboratory of Molecular Drug Research, Tianjin International Joint Academy of Biomedicine, Tianjin, China
| | - Yang Miao
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy and Tianjin Key Laboratory of Molecular Drug Research, Nankai University, Tianjin, China
| | - Liang Zhang
- Department of Thoracic Surgery, Tian Jin First Central Hospital, Tianjin, China
| | - Xiaoping Li
- Department of Thoracic Surgery, Tian Jin First Central Hospital, Tianjin, China
| | - Honggang Zhou
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy and Tianjin Key Laboratory of Molecular Drug Research, Nankai University, Tianjin, China.,Tianjin Key Laboratory of Molecular Drug Research, Tianjin International Joint Academy of Biomedicine, Tianjin, China
| | - Cheng Yang
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy and Tianjin Key Laboratory of Molecular Drug Research, Nankai University, Tianjin, China.,Tianjin Key Laboratory of Molecular Drug Research, Tianjin International Joint Academy of Biomedicine, Tianjin, China
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38
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Eksombatchai D, Wongsinin T, Phongnarudech T, Thammavaranucupt K, Amornputtisathaporn N, Sungkanuparph S. Pulmonary function and six-minute-walk test in patients after recovery from COVID-19: A prospective cohort study. PLoS One 2021; 16:e0257040. [PMID: 34473811 PMCID: PMC8412277 DOI: 10.1371/journal.pone.0257040] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 08/20/2021] [Indexed: 12/21/2022] Open
Abstract
Objectives To study abnormality of spirometry, six-minute walk distance, and chest radiograph among patients recovered from Coronavirus Disease 2019 (COVID-19). Methods and study design A prospective cohort study was conducted in 87 COVID-19 confirmed cases who recovered and discharged from a medical school hospital in Thailand. At the follow-up visit on day 60 after onset of symptoms, patients underwent an evaluation by spirometry (FVC, FEV1, FEV1/FVC, FEF25-75, and PEF), a six-minute-walk test (6MWT), and a chest radiograph. Results There were 35 men and 52 women, with a mean age of 39.6±11.8 years and the mean body mass index (BMI) was 23.8±4.3 kg/m2. Of all, 45 cases had mild symptoms; 35 had non-severe pneumonia, and 7 had severe pneumonia. Abnormality in spirometry was observed in 15 cases (17.2%), with 8% of restrictive defect and 9.2% of obstructive defect. Among the patients with an abnormal spirometry, the majority of the cases were in the severe pneumonia group (71.4%), compared with 15.6% in the non-severe pneumonia group, and 10.2% in the mild symptom group (p = 0.001). The mean six-minute-walk distance (6MWD) in the mild symptom and non-severe pneumonia groups was 538±56.8 and 527.5±53.5 meters, respectively. Although the severe pneumonia group tended to have a shorter mean 6-min walking distance, but this was not statistically significant (p = 0.118). Twelve patients (13.8%) had abnormal chest radiographs that showed residual fibrosis. This abnormality was more common in the severe pneumonia group (85.7%) and in others (7.5%) (p<0.001). Conclusions Abnormal spirometry was noted in 17.2% of COVID-19 survivors with both restrictive and obstructive defects. Severe COVID-19 pneumonia patients had higher prevalence rates of abnormal spirometry and residual fibrosis on the chest radiographs when compared to patients in the mild symptom and non-severe pneumonia groups.
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Affiliation(s)
- Dararat Eksombatchai
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Thananya Wongsinin
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
- * E-mail:
| | - Thanyakamol Phongnarudech
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
| | - Kanin Thammavaranucupt
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
| | | | - Somnuek Sungkanuparph
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
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Khamis AH, Jaber M, Azar A, AlQahtani F, Bishawi K, Shanably A. Clinical and laboratory findings of COVID-19: A systematic review and meta-analysis. J Formos Med Assoc 2021; 120:1706-1718. [PMID: 33376008 PMCID: PMC7832677 DOI: 10.1016/j.jfma.2020.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/08/2020] [Accepted: 12/03/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND/PURPOSE The aim of this study was to systematically review all COVID-19 publications to summarize the clinical features, assess comorbidities, prevalence, and disease outcomes. METHODS Included were all COVID-19 published studies between January 1 to July 20, 2020. The random effect model was used to calculate the pooled prevalence and corresponding 95% confidence interval (CI). Publication bias was assessed using the funnel plot for the standard error by logit event. RESULTS The mean age of the patients was 46.8 years (95% CI, 41.0-52.6) and males comprised 54.0% (95% CI, 51.3-56.7). Total co-morbidities prevalence was 29.5% (95% CI, 19.0-36.6), with diabetes mellitus being the most prevalent 13.8% (95% CI, 8.7-21.1), followed by hypertension 11.7% (95% CI, 5.7-22.6), and cardiovascular disease 9.7% (95% CI, 6.5-14.2). The most common clinical manifestations were fever, 82.0% (95% CI, 67.7-90.8), cough 54.3% (95% CI, 45.5-62.9), fatigue 30.2% (95% CI, 23.3-38.1), sputum 28.5% (95% CI, 21.2-37.2), sore throat 21.7% (95% CI, 14.6-31.0), and headache 11.0% (95% CI, 7.9-15.2). The most common COVID-19 serious complications were RNA Anemia 98.2% (95% CI, 96.2-99.2), hospitalization 83.7% (95% CI, 76.0-89.3), bilateral pneumonia 70.9% (95% CI, 58.2-81.0); of those hospitalized 43.5% (95% CI, 24.9-64.2) were discharged. Fatality accounted for 10.5% (95% CI 6.8-16.1). CONCLUSION Patients infected with COVID-19 coronavirus showed a wide range of clinical presentation with non-specific symptoms.
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Affiliation(s)
- Amar Hassan Khamis
- Biostatistics, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, P.O Box 505055, Dubai UAE, Building 14, Dubai Healthcare City, United Arab Emirates
| | - Mohamed Jaber
- Clinical Sciences Department, College of Dentistry, Ajman University, P.O Box 346, Ajman, Ajman, United Arab Emirates.
| | - Aida Azar
- Epidemiology, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, P.O Box 505055, Dubai UAE, Building 14, Dubai Healthcare City, United Arab Emirates
| | - Feras AlQahtani
- College of Dentistry, Ajman University, United Arab Emirates, P.O Box 346, Ajman, Ajman, United Arab Emirates
| | - Khaled Bishawi
- College of Dentistry, Ajman University, United Arab Emirates, P.O Box 346, Ajman, Ajman, United Arab Emirates
| | - Ahmed Shanably
- College of Dentistry, Ajman University, United Arab Emirates, P.O Box 346, Ajman, Ajman, United Arab Emirates
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40
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Miliani A, Cherid H, Rachedi M. Modèles alternatifs dans la pratique de la rééducation à l’ère de la pandémie de Covid-19. KINÉSITHÉRAPIE, LA REVUE 2021. [PMCID: PMC7862881 DOI: 10.1016/j.kine.2021.01.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
La pandémie de Covid-19 a imposé un changement soudain et forcé dans le spectre des soins de santé qui s’est produit avec une rapidité sans précédent. La nécessité d’accommoder le changement à une grande échelle a exigé de l’ingéniosité et une réflexion décisive. Ces changements affectent les acteurs du domaine de la médecine physique et de la réadaptation (MPR) personnellement et professionnellement. Les experts réfléchissent maintenant à la manière d’améliorer la pratique médicale en utilisant de nouvelles approches en réadaptation. Les modèles et les expériences rapportés dans la littérature, tels que la téléréadaptation, la préadaptation et l’activité physique adaptée sont basés sur la stratégie de l’auto-rééducation collaborative qui est proposée comme un élément-clé de ces voies alternatives. Ces approches innovantes aideront à restructurer les processus d’exercice de la réadaptation, non seulement dans ces moments inhabituels, mais aussi dans l’avenir de la MPR. Niveau de preuve NA.
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Long-Term Impact of COVID-19: A Systematic Review of the Literature and Meta-Analysis. Biomedicines 2021; 9:biomedicines9080900. [PMID: 34440104 PMCID: PMC8389585 DOI: 10.3390/biomedicines9080900] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 02/07/2023] Open
Abstract
Background: The long-term impact of COVID-19 is still unknown. This study aimed to explore post COVID-19 effects on patients chest computed tomography (CT), lung function, respiratory symptoms, fatigue, functional capacity, health-related quality of life (HRQoL), and the ability to return to work beyond 3 months post infection. Methods: A systematic search was performed on PubMed, Web of Science, and Ovid MEDLINE on 22 May 2021, to identify studies that reported persistent effects of COVID-19 beyond 3 months follow-up. Data on the proportion of patients who had the outcome were collected and analyzed using a one-group meta-analysis. Results: Data were extracted from 24 articles that presented information on a total of 5323 adults, post-infection, between 3 to 6 months after symptom onset or hospital discharge. The pooled prevalence of CT abnormalities was 59% (95% CI 44–73, I2 = 96%), abnormal lung function was 39% (95% CI 24–55, I2 = 94%), fatigue was 38% (95% CI 27–49, I2 = 98%), dyspnea was 32% (95% CI 24–40, I2 = 98%), chest paint/tightness was 16% (95% CI 12–21, I2 = 94%), and cough was 13%, (95% CI 9–17, I2 = 94%). Decreased functional capacity and HRQoL were found in 36% (95% CI 22–49, I2 = 97%) and 52% (95% CI 33–71, I2 = 94%), respectively. On average, 8 out of 10 of the patients had returned to work or reported no work impairment. Conclusion: Post-COVID-19 patients may experience persistent respiratory symptoms, fatigue, decreased functional capacity and decreased quality of life up to 6 months after infection. Further studies are needed to establish the extent to which post-COVID-19 effects continue beyond 6 months, how they interact with each other, and to clarify their causes and their effective management.
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Li X, Yu R, Wang P, Wang A, Huang H. Effects of Exercise Training on Cardiopulmonary Function and Quality of Life in Elderly Patients with Pulmonary Fibrosis: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7643. [PMID: 34300094 PMCID: PMC8306771 DOI: 10.3390/ijerph18147643] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 12/21/2022]
Abstract
(1) Objective: Our objective was to conduct a meta-analysis of randomized controlled trials that have evaluated the benefits of exercise training for elderly pulmonary fibrosis (PF) patients. (2) Methods: Studies in either English or Chinese were retrieved from the China National Knowledge Infrastructure (CNKI) and the Wanfang, PubMed, Web of Science and SPORTDiscus databases from inception until the first week of April 2021. Age, body mass index (BMI), and exercise frequency, intensity, type, and duration were considered for each participant. The specific data recorded were the six-minute walk distance (6MWD), maximal rate of oxygen consumption (peak VO2), predicted forced vital capacity (FVC% pred), predicted diffusing capacity of the lung for carbon monoxide (DLCO% pred), predicted total lung capacity (TLC% pred), St. George's respiratory questionnaire (SGRQ) total score and a modified medical research council score (mMRC). (3) Results: Thirteen studies comprised this meta-analysis (eleven randomized controlled trials and two prospective studies design), wherein 335 patients were exercised and 334 were controls. The results showed that exercise training increased the 6MWD (Cohen's d = 0.77, MD = 34.04 (95% CI, 26.50-41.58), p < 0.01), peak VO2 (Cohen's d = 0.45, MD = 1.13 (95% CI, 0.45-1.82), p = 0.0001) and FVC% pred (Cohen's d = 0.42, MD = 3.94 (95% CI, 0.91-6.96), p = 0.01). However, exercise training reduced scores for the SGRQ (Cohen's d = 0.89, MD = -8.79 (95% CI, -10.37 to -7.21), p < 0.01) and the mMRC (Cohen's d = 0.64, MD = -0.58 (95% CI, -0.79 to -0.36), p < 0.01). In contrast, exercise training could not increase DLCO% pred (Cohen's d = 0.16, MD = 1.86 (95% CI, -0.37-4.09), p = 0.10) and TLC% pred (Cohen's d = 0.02, MD = 0.07 (95% CI, -6.53-6.67), p = 0.98). Subgroup analysis showed significant differences in frequency, intensity, type, and age in the 6MWD results (p < 0.05), which were higher with low frequency, moderate intensity, aerobic-resistance-flexibility-breathing exercises and age ≤ 70. Meanwhile, the subgroup analysis showed significant differences in exercise intensity and types in the mMRC results (p < 0.05), which were lower with moderate intensity and aerobic-resistance exercises. (4) Conclusions: Exercise training during pulmonary rehabilitation can improved cardiopulmonary endurance and quality of life in elderly patients with PF. The 6MWDs were more noticeable with moderate exercise intensity, combined aerobic-resistance-flexibility-breathing exercises and in younger patients, which all were not affected by BMI levels or exercise durations. As to pulmonary function, exercise training can improve FVC% pred, but has no effect on DLCO% pred and TLC% pred.
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Affiliation(s)
- Xiaohan Li
- Faculty of Sport Science, Research Academy of Grand Health, Ningbo University, Ningbo 315211, China;
| | - Rongfang Yu
- School of Physical Education & Sport Training, Shanghai University of Sport, Shanghai 200438, China;
| | - Ping Wang
- School of Physical Education and Exercise Sciences, Lingnan Normal University, Zhanjiang 524048, China;
| | - Aiwen Wang
- Faculty of Sport Science, Research Academy of Grand Health, Ningbo University, Ningbo 315211, China;
| | - Huiming Huang
- Faculty of Sport Science, Research Academy of Grand Health, Ningbo University, Ningbo 315211, China;
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Ball L, Barisione E, Mastracci L, Campora M, Costa D, Robba C, Battaglini D, Micali M, Costantino F, Cittadini G, Patroniti N, Pelosi P, Fiocca R, Grillo F. Extension of Collagen Deposition in COVID-19 Post Mortem Lung Samples and Computed Tomography Analysis Findings. Int J Mol Sci 2021; 22:7498. [PMID: 34299124 PMCID: PMC8305333 DOI: 10.3390/ijms22147498] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/30/2021] [Accepted: 07/09/2021] [Indexed: 01/07/2023] Open
Abstract
Lung fibrosis has specific computed tomography (CT) findings and represents a common finding in advanced COVID-19 pneumonia whose reversibility has been poorly investigated. The aim of this study was to quantify the extension of collagen deposition and aeration in postmortem cryobiopsies of critically ill COVID-19 patients and to describe the correlations with qualitative and quantitative analyses of lung CT. Postmortem transbronchial cryobiopsy samples were obtained, formalin fixed, paraffin embedded and stained with Sirius red to quantify collagen deposition, defining fibrotic samples as those with collagen deposition above 10%. Lung CT images were analyzed qualitatively with a radiographic score and quantitatively with computer-based analysis at the lobe level. Thirty samples from 10 patients with COVID-19 pneumonia deceased during invasive mechanical ventilation were included in this study. The median [interquartile range] percent collagen extension was 6.8% (4.6-16.2%). In fibrotic compared to nonfibrotic samples, the qualitative score was higher (260 (250-290) vs. 190 (120-270), p = 0.036) while the gas fraction was lower (0.46 (0.32-0.47) vs. 0.59 (0.37-0.68), p = 0.047). A radiographic score above 230 had 100% sensitivity (95% confidence interval, CI: 66.4% to 100%) and 66.7% specificity (95% CI: 41.0% to 92.3%) to detect fibrotic samples, while a gas fraction below 0.57 had 100% sensitivity (95% CI: 66.4% to 100%) and 57.1% specificity (95% CI: 26.3% to 88.0%). In COVID-19 pneumonia, qualitative and quantitative analyses of lung CT images have high sensitivity but moderate to low specificity to detect histopathological fibrosis. Pseudofibrotic CT findings do not always correspond to increased collagen deposition.
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Affiliation(s)
- Lorenzo Ball
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16126 Genoa, Italy; (L.M.); (C.R.); (M.M.); (F.C.); (N.P.); (P.P.); (R.F.); (F.G.)
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy;
| | - Emanuela Barisione
- Interventional Pulmonology Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy;
| | - Luca Mastracci
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16126 Genoa, Italy; (L.M.); (C.R.); (M.M.); (F.C.); (N.P.); (P.P.); (R.F.); (F.G.)
- Anatomic Pathology Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
| | - Michela Campora
- Surgical Pathology Unit, Santa Chiara Hospital, Provincial Agency for Health Services, 38122 Trento, Italy;
| | - Delfina Costa
- Molecular Oncology and Angiogenesis Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy;
| | - Chiara Robba
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16126 Genoa, Italy; (L.M.); (C.R.); (M.M.); (F.C.); (N.P.); (P.P.); (R.F.); (F.G.)
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy;
| | - Denise Battaglini
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy;
| | - Marco Micali
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16126 Genoa, Italy; (L.M.); (C.R.); (M.M.); (F.C.); (N.P.); (P.P.); (R.F.); (F.G.)
| | - Federico Costantino
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16126 Genoa, Italy; (L.M.); (C.R.); (M.M.); (F.C.); (N.P.); (P.P.); (R.F.); (F.G.)
| | - Giuseppe Cittadini
- Radiology Department, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy;
| | - Nicolò Patroniti
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16126 Genoa, Italy; (L.M.); (C.R.); (M.M.); (F.C.); (N.P.); (P.P.); (R.F.); (F.G.)
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy;
| | - Paolo Pelosi
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16126 Genoa, Italy; (L.M.); (C.R.); (M.M.); (F.C.); (N.P.); (P.P.); (R.F.); (F.G.)
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy;
| | - Roberto Fiocca
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16126 Genoa, Italy; (L.M.); (C.R.); (M.M.); (F.C.); (N.P.); (P.P.); (R.F.); (F.G.)
- Anatomic Pathology Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
| | - Federica Grillo
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16126 Genoa, Italy; (L.M.); (C.R.); (M.M.); (F.C.); (N.P.); (P.P.); (R.F.); (F.G.)
- Anatomic Pathology Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
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Li X, Shen C, Wang L, Majumder S, Zhang D, Deen MJ, Li Y, Qing L, Zhang Y, Chen C, Zou R, Lan J, Huang L, Peng C, Zeng L, Liang Y, Cao M, Yang Y, Yang M, Tan G, Tang S, Liu L, Yuan J, Liu Y. Pulmonary fibrosis and its related factors in discharged patients with new corona virus pneumonia: a cohort study. Respir Res 2021; 22:203. [PMID: 34243776 PMCID: PMC8267229 DOI: 10.1186/s12931-021-01798-6] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 07/01/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Thousands of Coronavirus Disease 2019 (COVID-19) patients have been discharged from hospitals Persistent follow-up studies are required to evaluate the prevalence of post-COVID-19 fibrosis. METHODS This study involves 462 laboratory-confirmed patients with COVID-19 who were admitted to Shenzhen Third People's Hospital from January 11, 2020 to April 26, 2020. A total of 457 patients underwent thin-section chest CT scans during the hospitalization or after discharge to identify the pulmonary lesion. A total of 287 patients were followed up from 90 to 150 days after the onset of the disease, and lung function tests were conducted about three months after the onset. The risk factors affecting the persistence of pulmonary fibrosis were identified through regression analysis and the prediction model of the persistence of pulmonary fibrosis was established. RESULTS Parenchymal bands, irregular interfaces, reticulation and traction bronchiectasis were the most common CT features in all COVID-19 patients. During the 0-30, 31-60, 61-90, 91-120 and > 120 days after onset, 86.87%, 74.40%, 79.56%, 68.12% and 62.03% patients developed with pulmonary fibrosis and 4.53%, 19.61%, 18.02%, 38.30% and 48.98% patients reversed pulmonary fibrosis, respectively. It was observed that Age, BMI, Fever, and Highest PCT were predictive factors for sustaining fibrosis even after 90 days from onset. A predictive model of the persistence with pulmonary fibrosis was developed based-on the Logistic Regression method with an accuracy, PPV, NPV, Sensitivity and Specificity of the model of 76%, 71%, 79%, 67%, and 82%, respectively. More than half of the COVID-19 patients revealed abnormal conditions in lung function after 90 days from onset, and the ratio of abnormal lung function did not differ on a statistically significant level between the fibrotic and non-fibrotic groups. CONCLUSIONS Persistent pulmonary fibrosis was more likely to develop in patients with older age, higher BMI, severe/critical condition, fever, a longer viral clearance time, pre-existing disease and delayed hospitalization. Fibrosis developed in COVID-19 patients could be reversed in about a third of the patients after 120 days from onset. The pulmonary function of less than half of COVID-19 patients could turn to normal condition after three months from onset. An effective prediction model with an average area under the curve (AUC) of 0.84 was established to predict the persistence of pulmonary fibrosis in COVID-19 patients for early diagnosis.
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Affiliation(s)
- Xiaohe Li
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29, Bulan Road, Longgang district, Shenzhen, 518112, China
| | - Chenguang Shen
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29, Bulan Road, Longgang district, Shenzhen, 518112, China.
- School of Public Health, Southern Medical University, Guangzhou, 510515, China.
| | - Lifei Wang
- Department of Radiology, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Sumit Majumder
- EEE Department, Southern University of Science & Technology, China and ECE Department, McMaster Univ., Hamilton, Canada
| | - Die Zhang
- Department of Radiology, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - M Jamal Deen
- EEE Department, Southern University of Science & Technology, China and ECE Department, McMaster Univ., Hamilton, Canada
| | - Yanjie Li
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29, Bulan Road, Longgang district, Shenzhen, 518112, China
| | - Ling Qing
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29, Bulan Road, Longgang district, Shenzhen, 518112, China
| | - Ying Zhang
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29, Bulan Road, Longgang district, Shenzhen, 518112, China
| | - Chuming Chen
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29, Bulan Road, Longgang district, Shenzhen, 518112, China
| | - Rongrong Zou
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29, Bulan Road, Longgang district, Shenzhen, 518112, China
| | - Jianfeng Lan
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29, Bulan Road, Longgang district, Shenzhen, 518112, China
| | - Ling Huang
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29, Bulan Road, Longgang district, Shenzhen, 518112, China
| | - Cheng Peng
- Department of Radiology, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Lijiao Zeng
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29, Bulan Road, Longgang district, Shenzhen, 518112, China
| | - Yanhua Liang
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29, Bulan Road, Longgang district, Shenzhen, 518112, China
| | - Mengli Cao
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29, Bulan Road, Longgang district, Shenzhen, 518112, China
| | - Yang Yang
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29, Bulan Road, Longgang district, Shenzhen, 518112, China
| | - Minghui Yang
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29, Bulan Road, Longgang district, Shenzhen, 518112, China
| | - Guoyu Tan
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29, Bulan Road, Longgang district, Shenzhen, 518112, China
| | - Shenghong Tang
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29, Bulan Road, Longgang district, Shenzhen, 518112, China
| | - Lei Liu
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29, Bulan Road, Longgang district, Shenzhen, 518112, China.
| | - Jing Yuan
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29, Bulan Road, Longgang district, Shenzhen, 518112, China.
| | - Yingxia Liu
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29, Bulan Road, Longgang district, Shenzhen, 518112, China.
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Eight months follow-up study on pulmonary function, lung radiographic, and related physiological characteristics in COVID-19 survivors. Sci Rep 2021; 11:13854. [PMID: 34226597 PMCID: PMC8257634 DOI: 10.1038/s41598-021-93191-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/15/2021] [Indexed: 12/13/2022] Open
Abstract
To describe the long-term health outcomes of patients with COVID-19 and investigate the potential risk factors. Clinical data during hospitalization and at a mean (SD) day of 249 (15) days after discharge from 40 survivors with confirmed COVID-19 (including 25 severe cases) were collected and analyzed retrospectively. At follow-up, severe cases had higher incidences of persistent symptoms, DLCO impairment, and higher abnormal CT score as compared with mild cases. CT score at follow-up was positively correlated with age, LDH level, cumulative days of oxygen treatment, total dosage of glucocorticoids used, and CT peak score during hospitalization. DLCO% at follow-up was negatively correlated with cumulative days of oxygen treatment during hospitalization. DLCO/VA% at follow-up was positively correlated with BMI, and TNF-α level. Among the three groups categorized as survivors with normal DLCO, abnormal DLCO but normal DLCO/VA, and abnormal DLCO and DLCO/VA, survivors with abnormal DLCO and DLCO/VA had the lowest serum IL-2R, IL-8, and TNF-α level, while the survivors with abnormal DLCO but normal DLCO/VA had the highest levels of inflammatory cytokines during hospitalization. Altogether, COVID-19 had a greater long-term impact on the lung physiology of severe cases. The long-term radiological abnormality maybe relate to old age and the severity of COVID-19. Either absent or excess of inflammation during COVID-19 course would lead to the impairment of pulmonary diffusion function.
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Wang X, Wang J, Shen J, Ji JS, Pan L, Liu H, Zhao K, Li L, Ying B, Fan L, Zhang L, Wang L, Shi X. Facilities for Centralized Isolation and Quarantine for the Observation and Treatment of Patients with COVID-19. ENGINEERING (BEIJING, CHINA) 2021; 7:908-913. [PMID: 33903828 PMCID: PMC8061092 DOI: 10.1016/j.eng.2021.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/25/2021] [Accepted: 04/22/2021] [Indexed: 05/26/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic increased the burden on many healthcare systems and in the process, exposed the need for medical resources and physical space. While few studies discussed the efficient utilization of medical resources and physical space so far. Therefore, this study aimed to summarize experiences related to facilities used for centralized isolation for medical observation and treatment during the COVID-19 pandemic in China and to provide suggestions to further improve the management of confirmed cases, suspected cases, and close contacts. In China, three types of facilities for centralized isolation (Fangcang shelter hospitals, refitted non-designated hospitals, and quarantine hotels) underwent retrofitting for the treatment and isolation of confirmed and suspected cases. These facilities mitigated the immediate high demand for space. Moreover, in order to minimize infection risks in these facilities, regulators and governmental agencies implemented new designs, management measures, and precautionary measures to minimize infection risk. Other countries and regions could refer to China's experience in optimally allocating social resources in response to the COVID-19 pandemic. As a conclusion, government should allocate social resources and construct centralized isolation and quarantine facilities for an emergency response, health authorities should issue regulations for centralized isolation facilities and pay strict attention to the daily management of these facilities, a multidisciplinary administration team is required to support the daily operation of a centralized isolation facility, in-depth studies and international collaboration on the centralized isolation policy are encouraged.
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Affiliation(s)
- Xianliang Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Jiao Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Jin Shen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - John S Ji
- Environmental Research Center, Duke Kunshan University, Kunshan 215316, China
- Nicholas School of the Environment, Duke University, Durham, NC 27708, USA
| | - Lijun Pan
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Hang Liu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Kangfeng Zhao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Li Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Bo Ying
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Lin Fan
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Liubo Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Lin Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Xiaoming Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
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Feng G, Shi L, Huang T, Ji N, Zheng Y, Lin H, Niu C, Wang Y, Li R, Huang M, Chen X, Shu L, Wu M, Deng K, Wei J, Wang X, Cao Y, Yan J. Human Umbilical Cord Mesenchymal Stromal Cell Treatment of Severe COVID-19 Patients: A 3-Month Follow-Up Study Following Hospital Discharge. Stem Cells Dev 2021; 30:773-781. [PMID: 34044609 DOI: 10.1089/scd.2021.0015] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Previously, we demonstrated the therapeutic effects of human umbilical cord mesenchymal stromal cells (hUC-MSCs) in severe coronavirus disease 2019 (COVID-19) patients. In this 3-month follow-up study, we examined discharged patients who had received hUC-MSC therapy to assess the safety of this therapy and the health-related quality of life (HRQL) of these patients. The follow-up cohort consisted of 28 discharged severe COVID-19 patients who received either the standard treatment (the control group) or the standard treatment plus hUC-MSC therapy. We examined liver function, kidney function, pulmonary function, coagulation, tumor markers, and vision. We also conducted electrocardiography (ECG) analysis, let the patients answer the St. George's Respiratory Questionnaire (SGRQ), and performed computed tomography (CT) imaging for assessing the lung changes. No obvious adverse effects were observed in the hUC-MSC group after 3 months. Measurements of blood routine index, C-reactive protein and procalcitonin, liver and kidney function, coagulation, ECG, tumor markers, and vision were almost within the normal ranges in both the treatment and control groups. Forced expiratory volumes in 1 s (FEV1) (% of predicted) were 71.88% ± 8.46% and 59.45% ± 27.45% in the hUC-MSC and control groups (P < 0.01), respectively, and FEV1/forced vital capacity (FEV1/FVC) ratios were 79.95% ± 8.00% and 58.97% ± 19.16% in the hUC-MSC and control groups, respectively (P < 0.05). SGRQ scores were lower in the hUC-MSC group than in the control group (15.25 ± 3.69 vs. 31.9 ± 8.78, P < 0.05). The rate of wheezing in the hUC-MSC group was also significantly lower than that in the control group (37.5% vs. 75%, P < 0.05). There were no significant differences in CT scores between the two groups (0.60 ± 0.88 vs. 1.00 ± 1.31, P = 0.917). Overall, the intravenous transplantation of hUC-MSCs accelerated partial pulmonary function recovery and improved HRQL, indicating relative safety and preliminary efficacy of this treatment for patients with severe COVID-19.
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Affiliation(s)
- Ganzhu Feng
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lei Shi
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Tingrong Huang
- Department of Nephrology, Huangshi Hospital of Traditional Chinese Medicine, Huangshi, China
| | - Ningfei Ji
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - You Zheng
- Department of Nephrology, Huangshi Hospital of Traditional Chinese Medicine, Huangshi, China
| | - Huan Lin
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Changming Niu
- Department of Critical Care Medicine, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yan Wang
- Jiangsu Cell Tech Medical Research Institute, Nanjing, China
| | - Ruyou Li
- Department of Nephrology, Huangshi Hospital of Traditional Chinese Medicine, Huangshi, China
| | - Mao Huang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaolin Chen
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Lei Shu
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Mingjing Wu
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Kaili Deng
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Jing Wei
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Xueli Wang
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Yang Cao
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Jiaxin Yan
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
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Blanco JR, Cobos-Ceballos MJ, Navarro F, Sanjoaquin I, Arnaiz de Las Revillas F, Bernal E, Buzon-Martin L, Viribay M, Romero L, Espejo-Perez S, Valencia B, Ibañez D, Ferrer-Pargada D, Malia D, Gutierrez-Herrero FG, Olalla J, Jurado-Gamez B, Ugedo J. Pulmonary long-term consequences of COVID-19 infections after hospital discharge. Clin Microbiol Infect 2021; 27:892-896. [PMID: 33662544 PMCID: PMC7920814 DOI: 10.1016/j.cmi.2021.02.019] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/09/2021] [Accepted: 02/18/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Coronavirus disease 2019 (COVID-19) survivors are reporting residual abnormalities after discharge from hospital. Limited information is available about this stage of recovery or the lingering effects of the virus on pulmonary function and inflammation. This study aimed to describe lung function in patients recovering from COVID-19 hospitalization and to identify biomarkers in serum and induced sputum samples from these patients. METHODS Patients admitted to Spanish hospitals with laboratory-confirmed COVID-19 infection by a real-time PCR (RT-PCR) assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were recruited for this study. Each hospital screened their lists of discharged patients at least 45 days after symptom onset. SARS-CoV-2-infected patients were divided into mild/moderate and severe disease groups according to the severity of their symptoms during hospitalization. Patients' epidemiological and medical histories, comorbidities, chronic treatments, and laboratory parameters were evaluated. Pulmonary function tests, the standardized 6-minute walk test (6MWT) and chest computed tomography (CT) were also performed. The levels of proteases, their inhibitors, and shed receptors were measured in serum and induced sputum samples. RESULTS A total of 100 patients with respiratory function tests were included in this study. The median number of days after the onset of symptoms was 104 (IQR 89.25, 126.75). COVID-19 was severe in 47% of patients (47/100). CT was normal in 48% of patients (48/100). Lung function was normal forced expiratory volume in one second (FEV1) ≥80%, forced vital capacity (FVC) ≥80%, FEV1/FVC ≥0.7, and diffusing capacity for carbon monoxide (DLCO) ≥80% in 92% (92/100), 94% (94/100), 100% (100/100) and 48% (48/100) of patients, respectively. Multivariate analysis showed that a DLCO <80% (OR 5.92; 95%CI 2.28-15.37; p < 0.0001) and a lower serum lactate dehydrogenase level (OR 0.98; 95%CI 0.97-0.99) were associated with the severe disease group of SARS-CoV-2 cases during hospital stay. CONCLUSIONS A diffusion deficit (DLCO <80%) was still present after hospital discharge and was associated with the most severe SARS-CoV-2 cases.
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Affiliation(s)
- Jose-Ramon Blanco
- Servicio de Enfermedades Infecciosas, Hospital Universitario San Pedro, Logroño, La Rioja, Spain; Centro de Investigación Biomédica de La Rioja, Logroño, La Rioja, Spain.
| | - Maria-Jesus Cobos-Ceballos
- Instituto Maimónides de Investigación Biomédica de Córdoba, Universidad de Córdoba, Spain; Servicio de Neumología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Francisco Navarro
- Servicio de Medicina Interna, Hospital Costal de Sol, Marbella, Málaga, Spain
| | - Isabel Sanjoaquin
- Servicio de Enfermedades Infecciosas, HCU Lozano Blesa, Zaragoza, Spain
| | | | - Enrique Bernal
- Sección de Enfermedades Infecciosas, Hospital General Universitario Reina Sofía de Murcia, Universidad de Murcia, Spain
| | - Luis Buzon-Martin
- Servicio de Medicina Interna, Hospital Universitario de Burgos, Spain
| | | | - Lourdes Romero
- Centro de Investigación Biomédica de La Rioja, Logroño, La Rioja, Spain
| | - Simona Espejo-Perez
- Instituto Maimónides de Investigación Biomédica de Córdoba, Universidad de Córdoba, Spain; Servicio de Radiología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Borja Valencia
- Servicio de Neumología, Hospital Costal de Sol, Marbella, Málaga, Spain
| | - David Ibañez
- Servicio de Radiología, HCU Lozano Blesa, Zaragoza, Spain
| | | | - Damian Malia
- Servicio de Neumología, Hospital General Universitario Reina Sofía de Murcia, Spain
| | | | - Julian Olalla
- Servicio de Medicina Interna, Hospital Costal de Sol, Marbella, Málaga, Spain
| | - Bernabe Jurado-Gamez
- Instituto Maimónides de Investigación Biomédica de Córdoba, Universidad de Córdoba, Spain; Servicio de Neumología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Javier Ugedo
- Servicio de Neumología, Hospital Universitario San Pedro, Logroño, La Rioja, Spain
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Tanni SE, Fabro AT, de Albuquerque A, Ferreira EVM, Verrastro CGY, Sawamura MVY, Ribeiro SM, Baldi BG. Pulmonary fibrosis secondary to COVID-19: a narrative review. Expert Rev Respir Med 2021; 15:791-803. [PMID: 33902377 DOI: 10.1080/17476348.2021.1916472] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) is still increasing worldwide, and as a result, the number of patients with pulmonary fibrosis secondary to COVID-19 will expand over time. Risk factors, histopathological characterization, pathophysiology, prevalence, and management of post-COVID-19 pulmonary fibrosis are poorly understood, and few studies have addressed these issues.Areas covered:This article reviews the current evidence regarding post-COVID-19 pulmonary fibrosis, with an emphasis on the potential risk factors, histopathology, pathophysiology, functional and tomographic features, and potential therapeutic modalities. A search on the issue was performed in the MEDLINE, Embase, and SciELO databases and the Cochrane library between 1 December 2019, and 25 January 2021. Studies were reviewed and relevant topics were incorporated into this narrative review. Expert opinion: Pulmonary sequelae may occur secondary to COVID-19, which needs to be included as a potential etiology in the current differential diagnosis of pulmonary fibrosis. Therefore, serial clinical, tomographic, and functional screening for pulmonary fibrosis is recommended after COVID-19, mainly in patients with pulmonary involvement in the acute phase of the disease. Further studies are necessary to determine the risk factors, markers, pathophysiology, and appropriate management of post-COVID-19 pulmonary fibrosis.
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Affiliation(s)
- Suzana Erico Tanni
- Division of Internal Medicine of Botucatu Medical School, São Paulo State University-UNESP, Botucatu, Brazil
| | - Alexandre Todorovic Fabro
- Department of Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - André de Albuquerque
- Divisão De Pneumologia, Instituto Do Coração (Incor), Hospital Das Clínicas HCFMUSP, Faculdade De Medicina, Universidade De São Paulo, São Paulo, SP, Brazil
| | | | | | - Márcio Valente Yamada Sawamura
- Instituto De Radiologia, Hospital Das Clínicas HCFMUSP, Faculdade De Medicina, Universidade De São Paulo, São Paulo, SP, Brazil
| | - Sergio Marrone Ribeiro
- Department of Radiology, Botucatu Medical School, São Paulo State University-UNESP, Botucatu, Brazil
| | - Bruno Guedes Baldi
- Divisão De Pneumologia, Instituto Do Coração (Incor), Hospital Das Clínicas HCFMUSP, Faculdade De Medicina, Universidade De São Paulo, São Paulo, SP, Brazil
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Evolution of lung function and chest CT 6 months after COVID-19 pneumonia: Real-life data from a Belgian University Hospital. Respir Med 2021; 182:106421. [PMID: 33901788 PMCID: PMC8053365 DOI: 10.1016/j.rmed.2021.106421] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/22/2021] [Accepted: 04/15/2021] [Indexed: 12/22/2022]
Abstract
Introduction Most post COVID-19 follow-up studies are limited to a follow-up of 3 months. Whether a favorable evolution in lung function and/or radiological abnormalities is to be expected beyond 3 months is uncertain. Materials and methods We conducted a real-life follow-up study assessing the evolution in lung function, chest CT and ventilation distribution between 10 weeks and 6 months after diagnosis of COVID-19 pneumonia. Results Seventy-nine patients were assessed at 6 months of whom 63 had chest CT at both follow-up visits and 46 had multiple breath washout testing to obtain lung clearance index (LCI). The study group was divided into a restrictive (n = 39) and a non-restrictive subgroup (n = 40) based on TLC z-score. Restriction was associated with a history of intubation, neuromuscular blockade use and critical illness polyneuropathy. Restriction significantly improved over time, but was not resolved by 6 months (median TLC z-score of −2.2 [IQR: −2.7; −1.5] at 6 months versus −2.7 [IQR: −3.1; −2.1] at 10 weeks). LCI did not evolve between both follow-up visits. Symptoms and chest CT score improved irrespective of restriction. Conclusion We observed a disconnect between the improvement of COVID-19 related symptoms, chest CT lesions, and corresponding lung function. While CT imaging is almost normalized at 6 months, a further reduction of pulmonary restriction may be hoped for beyond 6 months in those patients showing restriction at their first follow-up visit.
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