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Lanfranchi F, Maggio S, Delucchi C, Bertoldi F, Corica F, De Feo MS, Marini C, Aloè T, Frantellizzi V, De Vincentis G, Morbelli S, Sambuceti G, Barisione E, Bauckneht M. The added value of lung perfusion scintigraphy semiquantitative measures in post-COVID patients with persistent dyspnea without pulmonary embolism. Expert Rev Med Devices 2023; 20:1243-1249. [PMID: 37897179 DOI: 10.1080/17434440.2023.2277236] [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: 07/03/2023] [Accepted: 10/04/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Persistent dyspnea is frequent in post-COVID patients, even in the absence of pulmonary embolism (PE). In this scenario, the role of lung perfusion scintigraphy is unclear. The present study correlated scintigraphy-based semiquantitative perfusion parameters with chest high-resolution computed tomography (hrCT) volumetric indexes and clinical data in post-COVID patients with persistent dyspnea. RESEARCH DESIGN AND METHODS Sixty patients (30 post-COVID and 30 not previously affected by COVID-19) with persistent dyspnea submitted to lung perfusion scintigraphy and hrCT were retrospectively recruited. Perfusion rates of the pulmonary fields and hrCT-based normalized inflated, emphysematous, infiltrated, collapsed, and vascular lung volumes were calculated. Inflammatory and coagulation biomarkers were collected. PE at imaging was an exclusion criterion. RESULTS Compared to controls, reduced perfusion rates of the lower pulmonary fields and higher perfusion rates of the middle ones were observed in post-COVID patients, while hrCT findings were superimposable between the two groups. Perfusion rates of lower pulmonary fields were significantly associated only with abnormal lung volumes at hrCT. CONCLUSIONS In post-COVID dyspnea without PE, lung perfusion scintigraphy may reveal a pulmonary involvement not detectable by hrCT. Post-COVID patients may show decreased perfusion rates of lower pulmonary fields in the presence of normal vascular density and markers of inflammation/coagulation.
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Affiliation(s)
| | - Sara Maggio
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Carlo Delucchi
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesca Bertoldi
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Ferdinando Corica
- Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Silvia De Feo
- Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Cecilia Marini
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- CNR Institute of Molecular Bioimaging and Physiology, Milan, Italy
| | - Teresita Aloè
- Interventional Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Viviana Frantellizzi
- Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Giuseppe De Vincentis
- Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Silvia Morbelli
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gianmario Sambuceti
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Emanuela Barisione
- Interventional Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Bauckneht
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Kewalramani N, Heenan KM, McKeegan D, Chaudhuri N. Post-COVID Interstitial Lung Disease—The Tip of the Iceberg. Immunol Allergy Clin North Am 2023; 43:389-410. [PMID: 37055095 PMCID: PMC9982726 DOI: 10.1016/j.iac.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
The proportion of symptomatic patients with post-coronavirus 2019 (COVID-19) condition (long COVID) represents a significant burden on the individual as well as on the health care systems. A greater understanding of the natural evolution of symptoms over a longer period and the impacts of interventions will improve our understanding of the long-term impacts of the COVID-19 disease. This review will discuss the emerging evidence for the development of post-COVID interstitial lung disease focusing on the pathophysiological mechanisms, incidence, diagnosis, and impact of this potentially new and emerging respiratory disease.
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Affiliation(s)
- Namrata Kewalramani
- Department for BioMedical Research DBMR, Inselspital, Bern University Hospital, University of Bern, Switzerland,Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland,Corresponding author. Department of Biomedical Research, Lung Precision Medicine, Room 340, Murtenstrasse 24, Bern 3008. Switzerland
| | - Kerri-Marie Heenan
- Department of Respiratory Medicine, Antrim Area Hospital, Northern Health and Social Care Trust, Antrim, Northern Ireland, UK
| | - Denise McKeegan
- Department of Respiratory Medicine, Antrim Area Hospital, Northern Health and Social Care Trust, Antrim, Northern Ireland, UK
| | - Nazia Chaudhuri
- University of Ulster Magee Campus, Northland Road, Londonderry, Northern Ireland, UK
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Alkodaymi MS, Omrani OA, Fawzy NA, Shaar BA, Almamlouk R, Riaz M, Obeidat M, Obeidat Y, Gerberi D, Taha RM, Kashour Z, Kashour T, Berbari EF, Alkattan K, Tleyjeh IM. Prevalence of post-acute COVID-19 syndrome symptoms at different follow-up periods: a systematic review and meta-analysis. Clin Microbiol Infect 2022; 28:657-666. [PMID: 35124265 PMCID: PMC8812092 DOI: 10.1016/j.cmi.2022.01.014] [Citation(s) in RCA: 224] [Impact Index Per Article: 112.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Post-acute coronavirus 2019 (COVID-19) syndrome is now recognized as a complex systemic disease that is associated with substantial morbidity. OBJECTIVES To estimate the prevalence of persistent symptoms and signs at least 12 weeks after acute COVID-19 at different follow-up periods. DATA SOURCES Searches were conducted up to October 2021 in Ovid Embase, Ovid Medline, and PubMed. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS Articles in English that reported the prevalence of persistent symptoms among individuals with confirmed severe acute respiratory syndrome coronavirus 2 infection and included at least 50 patients with a follow-up of at least 12 weeks after acute illness. METHODS Random-effect meta-analysis was performed to produce a pooled prevalence for each symptom at four different follow-up time intervals. Between-study heterogeneity was evaluated using the I2 statistic and was explored via meta-regression, considering several a priori study-level variables. Risk of bias was assessed using the Joanna Briggs Institute tool and the Newcastle-Ottawa Scale for prevalence studies and comparative studies, respectively. RESULTS After screening 3209 studies, a total of 63 studies were eligible, with a total COVID-19 population of 257 348. The most commonly reported symptoms were fatigue, dyspnea, sleep disorder, and difficulty concentrating (32%, 25%, 24%, and 22%, respectively, at 3- to <6-month follow-up); effort intolerance, fatigue, sleep disorder, and dyspnea (45%, 36%, 29%, and 25%, respectively, at 6- to <9-month follow-up); fatigue (37%) and dyspnea (21%) at 9 to <12 months; and fatigue, dyspnea, sleep disorder, and myalgia (41%, 31%, 30%, and 22%, respectively, at >12-month follow-up). There was substantial between-study heterogeneity for all reported symptom prevalences. Meta-regressions identified statistically significant effect modifiers: world region, male sex, diabetes mellitus, disease severity, and overall study quality score. Five of six studies including a comparator group consisting of COVID-19-negative cases observed significant adjusted associations between COVID-19 and several long-term symptoms. CONCLUSIONS This systematic review found that a large proportion of patients experience post-acute COVID-19 syndrome 3 to 12 months after recovery from the acute phase of COVID-19. However, available studies of post-acute COVID-19 syndrome are highly heterogeneous. Future studies need to have appropriate comparator groups, standardized symptom definitions and measurements, and longer follow-up.
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Affiliation(s)
| | - Osama Ali Omrani
- The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom,Barts and the London School of Medicine and Dentistry, Queen Mary University, London, United Kingdom
| | - Nader A. Fawzy
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | | | - Muhammad Riaz
- Center for Trial Research, School of Medicine, Cardiff University, United Kingdom
| | - Mustafa Obeidat
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Yasin Obeidat
- UMass Chan Medical School–Baystate, Springfield, MA, USA
| | - Dana Gerberi
- Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, USA
| | - Rand M. Taha
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Zakaria Kashour
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Tarek Kashour
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Elie F. Berbari
- Infectious Diseases Section, Department of Medical Specialties King Fahad Medical City, Riyadh, Saudi Arabia
| | - Khaled Alkattan
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Imad M. Tleyjeh
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia,Infectious Diseases Section, Department of Medical Specialties King Fahad Medical City, Riyadh, Saudi Arabia,Division of Infectious Diseases, Mayo Clinic College of Medicine and Science, Rochester, MN, USA,Department of Epidemiology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA,Corresponding author. Imad M. Tleyjeh, Section of Infectious Diseases, King Fahd Medical City, PO Box 59046, Riyadh 11525, Saudi Arabia
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Ribeiro Baptista B, d'Humières T, Schlemmer F, Bendib I, Justeau G, Al-Assaad L, Hachem M, Codiat R, Bardel B, Abou Chakra L, Belmondo T, Audureau E, Hue S, Mekontso-Dessap A, Derumeaux G, Boyer L. Identification of factors impairing exercise capacity after severe COVID-19 pulmonary infection: a 3-month follow-up of prospective COVulnerability cohort. Respir Res 2022; 23:68. [PMID: 35317815 PMCID: PMC8938727 DOI: 10.1186/s12931-022-01977-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 03/06/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Patient hospitalized for coronavirus disease 2019 (COVID-19) pulmonary infection can have sequelae such as impaired exercise capacity. We aimed to determine the frequency of long-term exercise capacity limitation in survivors of severe COVID-19 pulmonary infection and the factors associated with this limitation. METHODS Patients with severe COVID-19 pulmonary infection were enrolled 3 months after hospital discharge in COVulnerability, a prospective cohort. They underwent cardiopulmonary exercise testing, pulmonary function test, echocardiography, and skeletal muscle mass evaluation. RESULTS Among 105 patients included, 35% had a reduced exercise capacity (VO2peak < 80% of predicted). Compared to patients with a normal exercise capacity, patients with reduced exercise capacity were more often men (89.2% vs. 67.6%, p = 0.015), with diabetes (45.9% vs. 17.6%, p = 0.002) and renal dysfunction (21.6% vs. 17.6%, p = 0.006), but did not differ in terms of initial acute disease severity. An altered exercise capacity was associated with an impaired respiratory function as assessed by a decrease in forced vital capacity (p < 0.0001), FEV1 (p < 0.0001), total lung capacity (p < 0.0001) and DLCO (p = 0.015). Moreover, we uncovered a decrease of muscular mass index and grip test in the reduced exercise capacity group (p = 0.001 and p = 0.047 respectively), whilst 38.9% of patients with low exercise capacity had a sarcopenia, compared to 10.9% in those with normal exercise capacity (p = 0.001). Myocardial function was normal with similar systolic and diastolic parameters between groups whilst reduced exercise capacity was associated with a slightly shorter pulmonary acceleration time, despite no pulmonary hypertension. CONCLUSION Three months after a severe COVID-19 pulmonary infection, more than one third of patients had an impairment of exercise capacity which was associated with a reduced pulmonary function, a reduced skeletal muscle mass and function but without any significant impairment in cardiac function.
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Affiliation(s)
| | - Thomas d'Humières
- Université Paris Est Créteil (UPEC), FHU SENEC, IMRB, INSERM, Créteil, France.,Département de Physiologie-Explorations Fonctionnelles, Hôpitaux Universitaires Henri Mondor, AP-HP, Avenue Maréchal de Lattre de Tassigny, Créteil, France
| | - Frédéric Schlemmer
- Université Paris Est Créteil (UPEC), FHU SENEC, IMRB, INSERM, Créteil, France.,Unité de Pneumologie, Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Inès Bendib
- Université Paris Est Créteil (UPEC), FHU SENEC, IMRB, INSERM, Créteil, France.,Département de Physiologie-Explorations Fonctionnelles, Hôpitaux Universitaires Henri Mondor, AP-HP, Avenue Maréchal de Lattre de Tassigny, Créteil, France.,Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France
| | - Grégoire Justeau
- Université Paris Est Créteil (UPEC), FHU SENEC, IMRB, INSERM, Créteil, France
| | - Lara Al-Assaad
- Département de Physiologie-Explorations Fonctionnelles, Hôpitaux Universitaires Henri Mondor, AP-HP, Avenue Maréchal de Lattre de Tassigny, Créteil, France
| | - Mouna Hachem
- Université Paris Est Créteil (UPEC), FHU SENEC, IMRB, INSERM, Créteil, France.,Unité de Pneumologie, Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Rebecca Codiat
- Département de Physiologie-Explorations Fonctionnelles, Hôpitaux Universitaires Henri Mondor, AP-HP, Avenue Maréchal de Lattre de Tassigny, Créteil, France
| | - Benjamin Bardel
- Département de Physiologie-Explorations Fonctionnelles, Hôpitaux Universitaires Henri Mondor, AP-HP, Avenue Maréchal de Lattre de Tassigny, Créteil, France
| | - Laure Abou Chakra
- Département de Physiologie-Explorations Fonctionnelles, Hôpitaux Universitaires Henri Mondor, AP-HP, Avenue Maréchal de Lattre de Tassigny, Créteil, France
| | - Thibaut Belmondo
- Département d'Hématologie et d'Immunologie Biologiques, AP-HP, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Etienne Audureau
- Biostatistics Department, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France.,CEpiA IMRB U955, FHU SENEC, Université Paris Est (UPEC), Créteil, France
| | - Sophie Hue
- Université Paris Est Créteil (UPEC), FHU SENEC, IMRB, INSERM, Créteil, France.,Département d'Hématologie et d'Immunologie Biologiques, AP-HP, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Armand Mekontso-Dessap
- Université Paris Est Créteil (UPEC), FHU SENEC, IMRB, INSERM, Créteil, France.,Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France
| | - Geneviève Derumeaux
- Université Paris Est Créteil (UPEC), FHU SENEC, IMRB, INSERM, Créteil, France.,Département de Physiologie-Explorations Fonctionnelles, Hôpitaux Universitaires Henri Mondor, AP-HP, Avenue Maréchal de Lattre de Tassigny, Créteil, France
| | - Laurent Boyer
- Université Paris Est Créteil (UPEC), FHU SENEC, IMRB, INSERM, Créteil, France. .,Département de Physiologie-Explorations Fonctionnelles, Hôpitaux Universitaires Henri Mondor, AP-HP, Avenue Maréchal de Lattre de Tassigny, Créteil, France.
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Andrenelli E, Negrini F, de Sire A, Lazzarini SG, Patrini M, Ceravolo MG. Rehabilitation and COVID-19: update of the rapid living systematic review by Cochrane Rehabilitation Field as of October 31st, 2021. Eur J Phys Rehabil Med 2022; 58:153-156. [PMID: 35229570 PMCID: PMC9980579 DOI: 10.23736/s1973-9087.22.07434-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Elisa Andrenelli
- Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | | | - Alessandro de Sire
- Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy -
| | | | | | - Maria G Ceravolo
- Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
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Zamora-Mendoza BN, Díaz de León-Martínez L, Rodríguez-Aguilar M, Mizaikoff B, Flores-Ramírez R. Chemometric analysis of the global pattern of volatile organic compounds in the exhaled breath of patients with COVID-19, post-COVID and healthy subjects. Proof of concept for post-COVID assessment. Talanta 2022; 236:122832. [PMID: 34635222 PMCID: PMC8411592 DOI: 10.1016/j.talanta.2021.122832] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/21/2021] [Accepted: 08/28/2021] [Indexed: 11/04/2022]
Abstract
The objective of this research was to evaluate the application of an electronic nose and chemometric analysis to discriminate volatile organic compounds between patients with COVID-19, post-COVID syndrome and controls in exhaled breath samples. A cross-sectional study was performed on 102 exhaled breath samples, 42 with COVID-19, 30 with the post-COVID syndrome and 30 control subjects. Breath-print analysis was performed by the Cyranose 320 electronic nose with 32 sensors. Group data were evaluated by Principal Component Analysis (PCA), Canonical Discriminant Analysis (CDA), and Support Vector Machine (SVM), and the test's diagnostic power was evaluated through a Receiver Operaring Characteristic curve(ROC curve). The results of the chemometric analysis indicate in the PCA a 97.6% (PC1 = 95.9%, PC2 = 1.0%, PC3 = 0.7%) of explanation of the variability between the groups by means of 3 PCs, the CDA presents a 100% of correct classification of the study groups, SVM a 99.4% of correct classification, finally the PLS-DA indicates an observable separation between the groups and the 12 sensors that were related. The sensitivity, specificity of post-COVID vs. controls value reached 97.6% (87.4%–99.9%) and 100% (88.4%–100%) respectively, according to the ROC curve. As a perspective, we consider that this technology, due to its simplicity, low cost and portability, can support strategies for the identification and follow-up of post-COVID patients. The proposed classification model provides the basis for evaluating post-COVID patients; therefore, further studies are required to enable the implementation of this technology to support clinical management and mitigation of effects.
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Affiliation(s)
- Blanca Nohemí Zamora-Mendoza
- Faculty of Medicine-Center for Applied Research on Environment and Health (CIAAS), Autonomous University of San Luis Potosí, Avenida Sierra Leona No. 550, Colonia Lomas Segunda Sección, CP, 78210, San Luis Potosí, SLP, Mexico
| | - Lorena Díaz de León-Martínez
- Faculty of Medicine-Center for Applied Research on Environment and Health (CIAAS), Autonomous University of San Luis Potosí, Avenida Sierra Leona No. 550, Colonia Lomas Segunda Sección, CP, 78210, San Luis Potosí, SLP, Mexico.
| | | | - Boris Mizaikoff
- Institute of Analytical and Bioanalytical Chemistry, Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany; Hahn-Schickard Institute for Microanalysis Systems, Sedanstrasse 14, 89077, Ulm, Germany
| | - Rogelio Flores-Ramírez
- CONACYT Research Fellow, Coordination for Innovation and Application of Science and Technology (CIACYT), Autonomous University of San Luis Potosí, Avenida Sierra Leona No. 550, CP, 78210, Colonia Lomas Segunda Sección, San Luis Potosí, SLP, Mexico.
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