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Rodriguez Lima DR, Rubio Ramos C, Diaz Quiroz MA, Rodríguez Aparicio EE, Gómez Cortes LA, Otálora González L, Hernández-Herrera G, Pinzón Rondón ÁM, Ruiz Sternberg ÁM. Resilience and quality of life in patients who underwent mechanical ventilation due to COVID-19, one year after discharge: a cross-sectional study. J Patient Rep Outcomes 2024; 8:70. [PMID: 38995437 PMCID: PMC11245452 DOI: 10.1186/s41687-024-00748-2] [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: 03/05/2024] [Accepted: 06/22/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Patients with COVID-19 often experience severe long-term sequelae. This study aimed to assess resilience and Quality of Life (QoL) of patients who underwent mechanical ventilation due to COVID-19, one year after discharge. METHODS This cross-sectional study enrolled patients who received mechanical ventilation for severe COVID-19 and were assessed one-year post-discharge. Participants completed a structured questionnaire via telephone comprising the Connor-Davidson Resilience Scale (CD-RISC) and the Post-COVID-19 Functional Status scale (PCFS). To establish the association between QoL and resilience, Spearman correlations were calculated between the PCFS and the CD-RISC. Linear regression models were adjusted to evaluate which factors were associated with QoL, with the total score of PCFS as the dependent variable. RESULTS A total of 225 patients were included in the analysis. The CD-RISC had a median score of 83 (IQR 74-91). The PCFS results showed that 61.3% (n = 138) of the patients were able to resume their daily activities without limitations. Among them, 37.3% (n = 84) were classified as Grade 0 and 24% (n = 54) as Grade 1. Mild and moderate functional limitations were found in 33.7% of the patients, with 24.8% (n = 56) classified as Grade 2 and 8.8% (n = 20) as Grade 3. Severe functional limitations (Grade 4) were observed in 4.8% (n = 11) of the patients. High CD-RISC scores were associated with lower levels of PCFS score (p < 0.001). CONCLUSIONS In this cohort of critically ill patients who underwent mechanical ventilation due to COVID-19, 38% of patients experienced a significant decline in their QoL one year after hospital discharge. Finally, a high level of resilience was strongly associated with better QoL one year after discharge.
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Affiliation(s)
- David Rene Rodriguez Lima
- Critical and Intensive Care Medicine, Hospital Universitario Mayor-Méderi, Bogotá, Colombia.
- Grupo de Investigación Clínica, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia.
- Doctorado Investigación Clínica, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia.
| | - Cristhian Rubio Ramos
- Critical and Intensive Care Medicine, Hospital Universitario Mayor-Méderi, Bogotá, Colombia
| | - Mateo Andrés Diaz Quiroz
- Grupo de Investigación Clínica, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | | | | | - Laura Otálora González
- Facultad de Medicina, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Gilma Hernández-Herrera
- Doctorado Investigación Clínica, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Ángela María Pinzón Rondón
- Grupo de Investigación Clínica, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
- Doctorado Investigación Clínica, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Ángela María Ruiz Sternberg
- Grupo de Investigación Clínica, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
- Doctorado Investigación Clínica, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
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Valenzuela C, de la Fuente L, Hernández S, Olivera MJ, Molina C, Montes N, Benavides C, Caballero P. Persistent pulmonary abnormalities after 18 months of SARS-CoV-2 pneumonia. RADIOLOGIA 2024; 66 Suppl 1:S47-S56. [PMID: 38642961 DOI: 10.1016/j.rxeng.2023.10.002] [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: 08/10/2023] [Accepted: 10/19/2023] [Indexed: 04/22/2024]
Abstract
OBJECTIVE To describe persistent pulmonary abnormalities detected on HRCT after 18 months of SARS-CoV-2 pneumonia, and to determine their extension and correlation with pulmonary function. PATIENTS AND METHODS A prospective cross-sectional study with an initial cohort of 90 patients in follow-up due to persisting lung abnormalities on imaging, functional respiratory impairment and/or respiratory symptoms. Of these, 31 (34%) were selected for analysis due to the persistence of their lung abnormalities on HRCT at 18 months after infection. A double reading was performed for each HRCT (62 observations). RESULTS Of the 31 patients included: 20 (65%) were men; mean age was 67 years; 17 (55%) were smokers/ex-smokers. The mean hospitalisation time was 38 days. Eighteen (58%) patients were admitted to intensive care units. Five patients (16%) suffered an acute pulmonary thromboembolism and three (9.7%) had a pneumothorax. The mean time between the onset of pneumonia and the follow-up HRCT was 20.34 months. Nineteen percent of patients suffered from total lung function abnormalities; and ground-glass opacities and reticulation were present in 12% and 4.5% respectively. The findings of the 62 readings were: ground-glass opacities (100%), reticulation (83%), subpleural curvilinear lines (62%), parenchymal bands (34%), traction bronchiectasis (69%), displacement of vessels/fissures (46%) and honeycombing (4.9%). Pulmonary function 18 months after the acute episode revealed a mean FVC of 92% of predicted value, with an FVC < 80% of predicted value in 11 patients (35.4%). Mean DLCO was 71% of predicted value, with a DLCO < 80% in 22 patients (70%). We observed a statistically significant relationship between total lung function abnormalities on HRCT and FVC (P < 0.05), and a trend towards statistical significance with DLCO (P = 0.051); there was a statistically significant relationship between the presence of ground-glass opacities and FEV1/FVC (P < 0.01). The relationships between reticulation and FVC, FVC%, FEV1, FEV1% and DLCO% were also considered statistically significant (P < 0.05). CONCLUSION Persistent interstitial lung abnormalities are seen on HRCT for a subset of patients infected with SARS-CoV-2 pneumonia. Seventy percent of these patients suffered a slight decrease in DLCO.
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Affiliation(s)
- C Valenzuela
- Servicio de Neumología, Hospital Universitario La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - L de la Fuente
- Servicio de Radiología, Hospital Universitario La Princesa. Universidad Autónoma de Madrid, Madrid, Spain
| | - S Hernández
- Servicio de Radiología, Hospital Universitario La Princesa. Universidad Autónoma de Madrid, Madrid, Spain
| | - M J Olivera
- Servicio de Radiología, Hospital Universitario La Princesa. Universidad Autónoma de Madrid, Madrid, Spain
| | - C Molina
- Servicio de Radiología, Hospital Universitario La Princesa. Universidad Autónoma de Madrid, Madrid, Spain
| | - N Montes
- Unidad de Apoyo Metodológico, Instituto de Investigación Sanitaria del Hospital Universitario La Princesa, Madrid, Spain
| | - C Benavides
- Servicio de Radiología, Hospital Universitario La Princesa. Universidad Autónoma de Madrid, Madrid, Spain
| | - P Caballero
- Servicio de Radiología, Hospital Universitario La Princesa. Universidad Autónoma de Madrid, Madrid, Spain.
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Kardiasyah A, Syarani F, Bihar S, Lubis ND, Mutiara E, Syahputra H. Relationship between interleukin-6 (IL-6) levels and chest X-ray severity scoring in COVID-19 patients. NARRA J 2024; 4:e690. [PMID: 38798831 PMCID: PMC11125309 DOI: 10.52225/narra.v4i1.690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/14/2024] [Indexed: 05/29/2024]
Abstract
The severity of coronavirus disease 2019 (COVID-19) may be measured by interleukin-6 (IL-6) and chest X-rays. Brixia score of the chest radiographs is usually used to monitor COVID-19 patients' lung problems. The aim of this study was to demonstrate the relationship between IL-6 levels and chest radiographs (Brixia score) that represent COVID-19 severity. A retrospective cohort study was conducted among COVID-19 patients who had a chest X-ray and examination of IL-6 levels at H. Adam Malik General Hospital, Medan, Indonesia. A multinomial logistic regression analysis was conducted to evaluate the association between IL-6 levels and the severity of the chest radiograph. A total of 76 COVID-19 patients were included in the study and 39.5% of them were 60-69 years old, with more than half were female (52.6%). A total of 17.1%, 48.7%, and 34.2% had IL-6 level of <7 pg/mL, 7-50 pg/mL and >50 pg/mL, respectively. There were 39.5%, 36.8% and 23.7% of the patients had mild, moderate and severe chest X-rays based on Brixia score, respectively. Statistics analysis revealed that moderate (OR: 1.77; 95% CI: 1.05- 3.32) and severe (OR: 1.33; 95% CI: 1.03-3.35) lung conditions in the chest X-rays were significantly associated with IL-6 levels of 7-50 pg/mL. IL-6 more than 50 pg/mL was associated with severe chest X-ray condition (OR: 1.97; 95% CI: 1.15-3.34). In conclusion, high IL-6 levels significantly reflected COVID-19 severity through chest X-rays in COVID-19 patients.
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Affiliation(s)
- Alzi Kardiasyah
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Department of Pulmonology and Respiratory Medicine, Universitas Sumatera Utara General Hospital, Medan, Indonesia
| | - Fajrinur Syarani
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Department of Pulmonology and Respiratory Medicine, Universitas Sumatera Utara General Hospital, Medan, Indonesia
| | - Syamsul Bihar
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Department of Pulmonology and Respiratory Medicine, Universitas Sumatera Utara General Hospital, Medan, Indonesia
| | - Netty D. Lubis
- Department of Radiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Department of Radiology, Universitas Sumatera Utara General Hospital, Medan, Indonesia
| | - Erna Mutiara
- Department of Community and Preventive Medicine, Faculty of Public Health, Universitas Sumatera Utara, Medan, Indonesia
| | - Hafid Syahputra
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Universitas Sumatera Utara, Medan, Indonesia
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Ruzicka M, Ibarra Fonseca GJ, Sachenbacher S, Heimkes F, Grosse-Wentrup F, Wunderlich N, Benesch C, Pernpruner A, Valdinoci E, Rueb M, Uebleis AO, Karch S, Bogner J, Mayerle J, von Bergwelt-Baildon M, Subklewe M, Heindl B, Stubbe HC, Adorjan K. Substantial differences in perception of disease severity between post COVID-19 patients, internists, and psychiatrists or psychologists: the Health Perception Gap and its clinical implications. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01700-z. [PMID: 37955681 DOI: 10.1007/s00406-023-01700-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 10/02/2023] [Indexed: 11/14/2023]
Abstract
Patient-reported outcome measures (PROMs) such as the Numeric Pain Rating Scale (NPRS) or Likert scales addressing various domains of health are important tools to assess disease severity in Post COVID-19 (PC) patients. By design, they are subjective in nature and prone to bias. Our findings reveal substantial differences in the perception of disease severity between patients (PAT), their attending internists (INT) and psychiatrists/psychologists (PSY). Patients rated almost all aspects of their health worse than INT or PSY. Most of the differences were statistically highly significant. The presence of fatigue and mood disorders correlated negatively with health perception. The physical health section of the WHO Quality of Life Assessment (WHOQoL-BREF) and Karnofsky index correlated positively with overall and mental health ratings by PAT and INT. Health ratings by neither PAT, PSY nor INT were associated with the number of abnormal findings in diagnostic procedures. This study highlights how strongly perceptions of disease severity diverge between PC patients and attending medical staff. Imprecise communication, different experiences regarding health and disease, and confounding psychological factors may explain these observations. Discrepancies in disease perception threaten patient-physician relationships and pose strong confounders in clinical studies. Established scores (e.g., WHOQoL-BREF, Karnofsky index) may represent an approach to overcome these discrepancies. Physicians and psychologists noting harsh differences between a patient's and their own perception of the patient's health should apply screening tools for mood disorders (i.e., PHQ-9, WHOQoL-BREF), psychosomatic symptom burden (SSD-12, FCV-19) and consider further psychological evaluation. An interdisciplinary approach to PC patients remains imperative. Trial Registration Number & Date of Registration: DRKS00030974, 22 Dec 2022, retrospectively registered.
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Affiliation(s)
- Michael Ruzicka
- Department of Medicine III, Ludwig Maximilian University (LMU) University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.
| | | | - Simone Sachenbacher
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Fides Heimkes
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Fabienne Grosse-Wentrup
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Nora Wunderlich
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Christopher Benesch
- Department of Medicine II, LMU University Hospital, LMU Munich, Munich, Germany
- German Center for Infection Research, Partner Site Munich, Munich, Germany
| | - Anna Pernpruner
- Department of Medicine II, LMU University Hospital, LMU Munich, Munich, Germany
- German Center for Infection Research, Partner Site Munich, Munich, Germany
| | - Elisabeth Valdinoci
- Department of Medicine II, LMU University Hospital, LMU Munich, Munich, Germany
- German Center for Infection Research, Partner Site Munich, Munich, Germany
| | - Mike Rueb
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Aline Olivia Uebleis
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Johannes Bogner
- Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
| | - Julia Mayerle
- Department of Medicine II, LMU University Hospital, LMU Munich, Munich, Germany
| | - Michael von Bergwelt-Baildon
- Department of Medicine III, Ludwig Maximilian University (LMU) University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Marion Subklewe
- Department of Medicine III, Ludwig Maximilian University (LMU) University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Bernhard Heindl
- Stabstelle Strategische Unternehmenssteuerung, LMU Munich, Munich, Germany
| | - Hans Christian Stubbe
- Department of Medicine II, LMU University Hospital, LMU Munich, Munich, Germany
- German Center for Infection Research, Partner Site Munich, Munich, Germany
| | - Kristina Adorjan
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
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Seyoum AB, Tegegnework SS, Mengistu MM, Mekonnen TD, Asabel AM, Dagnaw AG, Deribe AG, Derese TN, Hundie TG, Getahun BK, Huluka DK. Post-COVID-19 pulmonary complications among recovered COVID-19 patients: a cross-sectional study from Addis Ababa, Ethiopia. BMC Pulm Med 2023; 23:409. [PMID: 37891593 PMCID: PMC10612275 DOI: 10.1186/s12890-023-02731-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 10/23/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has been linked to chronic pulmonary complications all over the world. Respiratory complications such as chronic cough, dyspnea, increased respiratory rate, and oxygen support demand are prevalent in recovered COVID-19 patients. These problems are long-term and have a negative impact on one's quality of life. Patients must be evaluated for potential complications, and risk factors must be found. Some reports around the world explain the factors that contribute to the development of these complications. However, to the best of our understanding, no reports of post-COVID-19 complications have been reported from Ethiopia. METHODS Facility based cross-sectional study was done among 405 participants selected by simple random sampling technique. Structured questionnaire which includes participants' demographic, clinical and 3rd month visit characteristics was collected by Open Data Kit and exported to SPSS version 25.0 for analysis. Percentage with frequency and median with Interquartile range was used in descriptive statistics. The association between variables was analyzed with bivariate and multi variable logistic regression. A statistical significance was declared at p-value < 0.05, with 95% confidence interval. RESULTS The median (Interquartile range) age of participants was 57.0 (43.0, 65.0) years, 63.2% were males. The prevalence of post-COVID-19 pulmonary complication in recovered COVID-19 patients was 14.1% (95% CI: 10.8%, 17.8%). After adjusting for possible confounders on multivariate analysis, older age [AOR = 0.227, 95% CI (0.08-0.66)] and consolidation [AOR = 0.497, 95% CI (0.258-0.957)] were shown to have significant association with post COVID-19 pulmonary complications. CONCLUSION The prevalence of post COVID-19 pulmonary complication was observed to be lower than other reports globally. Older age and the presence of consolidation on lung imaging were associated with those complications. Clinicians are recommended to consider assessing the lasting effects of the pandemic, beyond immediate care, and should also investigate the COVID-19 history in patients presenting with respiratory issues.
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Duong-Quy S, Vo-Pham-Minh T, Tran-Xuan Q, Huynh-Anh T, Vo-Van T, Vu-Tran-Thien Q, Nguyen-Nhu V. Post-COVID-19 Pulmonary Fibrosis: Facts-Challenges and Futures: A Narrative Review. Pulm Ther 2023; 9:295-307. [PMID: 37209374 PMCID: PMC10199290 DOI: 10.1007/s41030-023-00226-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/19/2023] [Indexed: 05/22/2023] Open
Abstract
Patients with coronavirus disease 2019 (COVID-19) usually suffer from post-acute sequelae of coronavirus disease 2019 (PASC). Pulmonary fibrosis (PF) has the most significant long-term impact on patients' respiratory health, called post-COVID-19 pulmonary fibrosis (PC19-PF). PC19- PF can be caused by acute respiratory distress syndrome (ARDS) or pneumonia due to COVID-19. The risk factors of PC19-PF, such as older age, chronic comorbidities, the use of mechanical ventilation during the acute phase, and female sex, should be considered. Individuals with COVID-19 pneumonia symptoms lasting at least 12 weeks following diagnosis, including cough, dyspnea, exertional dyspnea, and poor saturation, accounted for nearly all disease occurrences. PC19-PF is characterized by persistent fibrotic tomographic sequelae associated with functional impairment throughout follow-up. Thus, clinical examination, radiology, pulmonary function tests, and pathological findings should be done to diagnose PC19-PF patients. PFT indicated persistent limitations in diffusion capacity and restrictive physiology, despite the absence of previous testing and inconsistency in the timeliness of assessments following acute illness. It has been hypothesized that PC19-PF patients may benefit from idiopathic pulmonary fibrosis treatment to prevent continued infection-related disorders, enhance the healing phase, and manage fibroproliferative processes. Immunomodulatory agents might reduce inflammation and the length of mechanical ventilation during the acute phase of COVID-19 infection, and the risk of the PC19-PF stage. Pulmonary rehabilitation, incorporating exercise training, physical education, and behavioral modifications, can improve the physical and psychological conditions of patients with PC19-PF.
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Affiliation(s)
- Sy Duong-Quy
- Clinical Research Unit, Lam Dong Medical College and Bio-Medical Research Centre, Dalat, Vietnam
- Immuno-Allergology Division, Hershey Medical Center, Penn State Medical College, State College, PA, USA
- Outpatient Department, Pham Ngoc Thach Medical University, Ho Chi Minh City, Vietnam
- Department of Respiratory Functional Exploration, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Thu Vo-Pham-Minh
- Department of Internal Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Quynh Tran-Xuan
- Department of Internal Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Tuan Huynh-Anh
- Department of Respiratory Diseases, Hoan My Cuu Long Hospital, Can Tho, Vietnam
| | - Tinh Vo-Van
- Outpatient Department, Pham Ngoc Thach Medical University, Ho Chi Minh City, Vietnam
| | - Quan Vu-Tran-Thien
- Department of Respiratory Functional Exploration, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Vinh Nguyen-Nhu
- Department of Respiratory Functional Exploration, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
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Ebong U, Büttner SM, Schmidt SA, Flack F, Korf P, Peters L, Grüner B, Stenger S, Stamminger T, Kestler H, Beer M, Kloth C. Quantitative Evaluation of COVID-19 Pneumonia CT Using AI Analysis-Feasibility and Differentiation from Other Common Pneumonia Forms. Diagnostics (Basel) 2023; 13:2129. [PMID: 37371024 DOI: 10.3390/diagnostics13122129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/14/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
PURPOSE: To implement the technical feasibility of an AI-based software prototype optimized for the detection of COVID-19 pneumonia in CT datasets of the lung and the differentiation between other etiologies of pneumonia. METHODS: This single-center retrospective case-control-study consecutively yielded 144 patients (58 female, mean age 57.72 ± 18.25 y) with CT datasets of the lung. Subgroups including confirmed bacterial (n = 24, 16.6%), viral (n = 52, 36.1%), or fungal (n = 25, 16.6%) pneumonia and (n = 43, 30.7%) patients without detected pneumonia (comparison group) were evaluated using the AI-based Pneumonia Analysis prototype. Scoring (extent, etiology) was compared to reader assessment. RESULTS: The software achieved an optimal sensitivity of 80.8% with a specificity of 50% for the detection of COVID-19; however, the human radiologist achieved optimal sensitivity of 80.8% and a specificity of 97.2%. The mean postprocessing time was 7.61 ± 4.22 min. The use of a contrast agent did not influence the results of the software (p = 0.81). The mean evaluated COVID-19 probability is 0.80 ± 0.36 significantly higher in COVID-19 patients than in patients with fungal pneumonia (p < 0.05) and bacterial pneumonia (p < 0.001). The mean percentage of opacity (PO) and percentage of high opacity (PHO ≥ -200 HU) were significantly higher in COVID-19 patients than in healthy patients. However, the total mean HU in COVID-19 patients was -679.57 ± 112.72, which is significantly higher than in the healthy control group (p < 0.001). CONCLUSION: The detection and quantification of pneumonia beyond the primarily trained COVID-19 datasets is possible and shows comparable results for COVID-19 pneumonia to an experienced reader. The advantages are the fast, automated segmentation and quantification of the pneumonia foci.
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Affiliation(s)
- Una Ebong
- Department of Diagnostic and Interventional Radiology, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Susanne Martina Büttner
- Department of Diagnostic and Interventional Radiology, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Stefan A Schmidt
- Department of Diagnostic and Interventional Radiology, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Franziska Flack
- Scientific Collaborations Siemens Healthcare GmbH Erlangen, 91052 Erlangen, Germany
| | - Patrick Korf
- Scientific Collaborations Siemens Healthcare GmbH Erlangen, 91052 Erlangen, Germany
| | - Lynn Peters
- Division of Infectious Diseases, University Hospital and Medical Centre of Ulm, 89081 Ulm, Germany
| | - Beate Grüner
- Division of Infectious Diseases, University Hospital and Medical Centre of Ulm, 89081 Ulm, Germany
| | - Steffen Stenger
- Institute of Medical Microbiology and Hygiene, Ulm University Medical Center, 89081 Ulm, Germany
| | - Thomas Stamminger
- Institute of Virology, Ulm University Medical Center, 89081 Ulm, Germany
| | - Hans Kestler
- Institute for Medical Systems Biology, Ulm University, 89081 Ulm, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Christopher Kloth
- Department of Diagnostic and Interventional Radiology, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
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Sarıoğlu N, Aksu GD, Çoban H, Bülbül E, Demirpolat G, Arslan AT, Erel F. Clinical and radiological outcomes of longCOVID: Is the post-COVID fibrosis common? Tuberk Toraks 2023; 71:48-57. [PMID: 36912409 PMCID: PMC10795271 DOI: 10.5578/tt.20239907] [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: 03/14/2023] Open
Abstract
Introduction COVID-19 survivors may take longer to regain full well-being. This study aimed to investigate clinical and functional evaluation and radiologic changes in the third month after COVID-19. Materials and Methods A total of 126 patients were assessed in the third month for symptoms, pulmonary function, exercise capacity, radiologic imaging, and quality of life after being discharged following COVID-19 treatment. Two radiologists evaluated the initial and follow-up images. Result At the third month follow-up visit, the most common persisting symptoms were shortness of breath (32.5%), cough (12.7%), and muscle pain (12.7%). At the follow-up visit, oxygen saturations at rest and after a sixmin walking test were lower in patients with prior intensive care hospitalization compared to those without (p<0.001, p= 0.004). Computed tomography (CT) scans revealed persisting pulmonary pathologies in 64.6% of patients at the third month follow-up. The most common pathologies on follow-up thoracic CT were fibrotic-like changes in 44.2% and ground-glass opacities (GGO) in 33.3%. Regression analysis unveiled that age [95% confidence interval (CI), 1.01 to 1.15; p= 0.020], male sex (95% CI, 4.06 to 95.3, p<0.001), first CT severity score (95% CI, 1.02 to 1.41, p= 0.028), duration of hospitalization (95% CI, 1.02 to 1.18, p= 0.012), oxygen saturation (95% CI, 0.86 to 0.96, p<0.001) were independent predictors of fibrotic-like changes. Conclusions In the third month following COVID-19, the most common symptom was dyspnea, and the most common radiological findings were fibrotic-like changes and GGO. Longer follow-up studies of COVID-19 survivors are needed to observe lasting changes.
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Affiliation(s)
- Nurhan Sarıoğlu
- Department of Pulmonology, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye
| | - Gülden Deniz Aksu
- Department of Pulmonology, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye
| | - Hikmet Çoban
- Department of Pulmonology, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye
| | - Erdoğan Bülbül
- Department of Radiology, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye
| | - Gülen Demirpolat
- Department of Radiology, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye
| | - Ayşegül Tuğçe Arslan
- Department of Pulmonology, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye
| | - Fuat Erel
- Department of Pulmonology, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye
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Alghamdi F, Owen R, Ashton REM, Obotiba AD, Meertens RM, Hyde E, Faghy MA, Knapp KM, Rogers P, Strain WD. Post-acute COVID syndrome (long COVID): What should radiographers know and the potential impact for imaging services. Radiography (Lond) 2022; 28 Suppl 1:S93-S99. [PMID: 36109264 PMCID: PMC9468096 DOI: 10.1016/j.radi.2022.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/30/2022] [Accepted: 08/22/2022] [Indexed: 11/30/2022]
Abstract
Objectives The COVID-19 pandemic caused an unprecedented health crisis resulting in over 6 million deaths worldwide, a figure, which continues to grow. In addition to the excess mortality, there are individuals who recovered from the acute stages, but suffered long-term changes in their health post COVID-19, commonly referred to as long COVID. It is estimated there are currently 1.8 million long COVID sufferers by May 2022 in the UK alone. The aim of this narrative literature review is to explore the signs, symptoms and diagnosis of long COVID and the potential impact on imaging services. Key findings Long COVID is estimated to occur in 9.5% of those with two doses of vaccination and 14.6% if those with a single dose or no vaccination. Long COVID is defined by ongoing symptoms lasting for 12 or more weeks post acute infection. Symptoms are associated with reductions in the quality of daily life and may involve multisystem manifestations or present as a single symptom. Conclusion The full impact of long COVID on imaging services is yet to be realised, but there is likely to be significant increased demand for imaging, particularly in CT for the assessment of lung disease. Educators will need to include aspects related to long COVID pathophysiology and imaging presentations in curricula, underpinned by the rapidly evolving evidence base. Implications for practice Symptoms relating to long COVID are likely to become a common reason for imaging, with a particular burden on Computed Tomography services. Planning, education and updating protocols in line with a rapidly emerging evidence base is going to be essential.
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Affiliation(s)
- F Alghamdi
- College of Medicine and Health, University of Exeter, Exeter, UK.
| | - R Owen
- Human Sciences Research Centre, University of Derby, Derby, UK
| | - R E M Ashton
- Human Sciences Research Centre, University of Derby, Derby, UK
| | - A D Obotiba
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - R M Meertens
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - E Hyde
- College of Health, Psychology and Social Care, University of Derby, Derby, UK
| | - M A Faghy
- Human Sciences Research Centre, University of Derby, Derby, UK
| | - K M Knapp
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - P Rogers
- Medical Imaging, Royal Devon and Exeter NHS Foundation Trust, UK
| | - W D Strain
- College of Medicine and Health, University of Exeter, Exeter, UK
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10
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Maggialetti N, Villanova I, Castrì A, Greco CN, Inchingolo F, Virgilio D, Moschetta M, Sardaro A, Stabile Ianora AA, Scardapane A. COVID-19 in Italy: Comparison of CT Findings from Time Zero to the Delta Variant. Microorganisms 2022; 10:microorganisms10040796. [PMID: 35456846 PMCID: PMC9026540 DOI: 10.3390/microorganisms10040796] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/24/2022] [Accepted: 04/07/2022] [Indexed: 12/27/2022] Open
Abstract
On 12 March 2020, the World Health Organization (WHO) declared the novel Coronavirus (CoV) disease a global Pandemic and an emerging risk. In order to understand patterns that are typical in COVID-19 pneumonia and track the evolution of the disease, the role of the chest computed tomography (CT) is pivotal. The impact of the illness as well as the efficiency of the therapy are also monitored carefully when performing this imaging exam. Coronaviruses, specifically CoV-2, as RNA viruses, have a tendency to frequently change their genome, giving the virus beneficial characteristics such as greater transmissibility, pathogenicity and the possibility to escape the previously acquired immunity. Therefore, genome evaluation became an extremely important routine practice worldwide. In particular, in Italy, four variants have been recognised and each of them represent a specific temporal wave of the disease. Hence, our goal was to describe imaging findings of COVID-19 pneumonia, specifically its most typical imaging identified during the period of our study, and to assess whether or not SARS-CoV-2 variants determine different CT patterns. Our analyses revealed that the SARS-CoV-2 genotype seems not to interfere with the severity of CT patterns and, in particular, bilateral Ground Glass Opacities (GGOs) are the most frequent findings in all COVID-19 waves.
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Affiliation(s)
- Nicola Maggialetti
- Department of Medical Science, Neuroscience and Sensory Organs (DSMBNOS), University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Ilaria Villanova
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (I.V.); (A.C.); (D.V.); (M.M.); (A.S.); (A.A.S.I.); (A.S.)
| | - Annalisa Castrì
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (I.V.); (A.C.); (D.V.); (M.M.); (A.S.); (A.A.S.I.); (A.S.)
| | - Chiara Noemi Greco
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (I.V.); (A.C.); (D.V.); (M.M.); (A.S.); (A.A.S.I.); (A.S.)
- Correspondence:
| | - Francesco Inchingolo
- Interdisciplinary Department of Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Daniele Virgilio
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (I.V.); (A.C.); (D.V.); (M.M.); (A.S.); (A.A.S.I.); (A.S.)
| | - Marco Moschetta
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (I.V.); (A.C.); (D.V.); (M.M.); (A.S.); (A.A.S.I.); (A.S.)
- Breast Unit, Policlinic Hospital of Bari, 70124 Bari, Italy
| | - Angela Sardaro
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (I.V.); (A.C.); (D.V.); (M.M.); (A.S.); (A.A.S.I.); (A.S.)
| | - Amato Antonio Stabile Ianora
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (I.V.); (A.C.); (D.V.); (M.M.); (A.S.); (A.A.S.I.); (A.S.)
| | - Arnaldo Scardapane
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (I.V.); (A.C.); (D.V.); (M.M.); (A.S.); (A.A.S.I.); (A.S.)
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11
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López-Sampalo A, Bernal-López MR, Gómez-Huelgas R. [Persistent COVID-19 syndrome. A narrative review]. Rev Clin Esp 2022; 222:241-250. [PMID: 34803180 PMCID: PMC8590955 DOI: 10.1016/j.rce.2021.10.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/12/2021] [Indexed: 01/09/2023]
Abstract
As the coronavirus-2019 disease (COVID-19) pandemic, caused by the infection with severe acute respiratory syndrome (SARS-CoV-2) coronavirus type 2, has progressed, persistent COVID-19 syndrome is an increasingly recognized problem on which a significant volume of medical literature is developing. Symptoms may be persistent or appear, after an asymptomatic period, weeks or months after the initial infection. The clinical picture is as markedly heterogeneous and multisystemic as in the acute phase, so multidisciplinary management is required. In addition, their appearance is not related to the severity of the initial infection, so they can affect both mild patients, even asymptomatic, and seriously ill patients who have required hospitalization. Although it can affect people of any age, it is more common in middle-aged women. The sequelae can generate a high impact on the quality of life, and in the work and social environment. The objective of this paper is to review persistent COVID-19 syndrome, to know its clinical manifestations and the strategies for the management and follow-up of these patients.
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Affiliation(s)
- A López-Sampalo
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, España
| | - M R Bernal-López
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, España
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, España
| | - R Gómez-Huelgas
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, España
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, España
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12
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Díaz-Resendiz KJG, Benitez-Trinidad AB, Covantes-Rosales CE, Toledo-Ibarra GA, Ortiz-Lazareno PC, Girón-Pérez DA, Bueno-Durán AY, Pérez-Díaz DA, Barcelos-García RG, Girón-Pérez MI. Loss of mitochondrial membrane potential (ΔΨ m ) in leucocytes as post-COVID-19 sequelae. J Leukoc Biol 2022; 112:23-29. [PMID: 35355308 PMCID: PMC9088601 DOI: 10.1002/jlb.3ma0322-279rrr] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 03/04/2022] [Indexed: 12/15/2022] Open
Abstract
The mitochondrial membrane potential (ΔΨm) is a parameter often used to determine mitochondrial function; therefore, it can be used to determine the integrity and functionality of cells. A decrement of ΔΨm is implicated in several inflammatory‐related pathologies, such phenomena can be related to COVID‐19 infection. The present work aimed to compare the ΔΨm in leucocytes (human PBMCs; HPBMC) isolated from healthy control (HC) subjects, patients with COVID‐19 (C‐19), recovered subjects at 40 ± 13 (R1) and 335 ± 20 (R2) days after infection (dai). Obtained data showed that ΔΨm decreased in HPBMC of subjects with C‐19, R1, and R2 compared with HC. When analyzing the ΔΨm data by sex, in females, a significant decrease was observed in R1 and R2 groups versus HC. Regarding men, a significant decrease of ΔΨm was observed in R1, with respect to HC, contrary to R2 group, who reestablished this parameter. Obtained results suggest that the loss of ΔΨm could be related to the long‐COVID.
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Affiliation(s)
| | - Alma Betsaida Benitez-Trinidad
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Nayarit, Mexico
| | - Carlos Eduardo Covantes-Rosales
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Nayarit, Mexico
| | - Gladys Alejandra Toledo-Ibarra
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Nayarit, Mexico
| | - Pablo Cesar Ortiz-Lazareno
- Instituto Mexicano del Seguro Social (IMSS), Centro de Investigación Biomédica de Occidente (CIBO), Guadalajara, Jalisco, Mexico
| | - Daniel Alberto Girón-Pérez
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Nayarit, Mexico
| | - Adela Yolanda Bueno-Durán
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Nayarit, Mexico
| | - Daniela Alejandra Pérez-Díaz
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Nayarit, Mexico
| | - Rocío Guadalupe Barcelos-García
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Nayarit, Mexico
| | - Manuel Iván Girón-Pérez
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Nayarit, Mexico
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13
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Barini M, Percivale I, Danna P, Longo V, Costantini P, Paladini A, Airoldi C, Bellan M, Saba L, Carriero A. 18 months computed tomography follow-up after Covid-19 interstitial pneumonia. J Public Health Res 2022; 11. [PMID: 35315262 PMCID: PMC8973211 DOI: 10.4081/jphr.2022.2782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/10/2022] [Indexed: 01/07/2023] Open
Abstract
Background: Our aim is to evaluate the possible persistence of lung parenchyma alterations, in patients who have recovered from Covid-19. Design and methods: We enrolled a cohort of 115 patients affected by Covid-19, who performed a chest CT scan in the Emergency Department and a chest CT 18 months after hospital discharge. We performed a comparison between chest CT scan 18 months after discharge and spirometric data of patients enrolled. We obtained quantitative scores related to well-aerated parenchyma, interstitial lung disease and parenchymal consolidation. A radiologist recorded the characteristics indicated by the Fleischner Society and “fibrotic like” changes, expressed through a CT severity score ranging from 0 (no involvement) to 25 (maximum involvement). Results: 115 patients (78 men, 37 women; mean age 60.15 years old ±12.52). On quantitative analysis, after 18 months, the volume of normal ventilated parenchyma was significantly increased (16.34 points on average ±14.54, p<0.0001). Groundglass opacities and consolidation values tend to decrease (-9.80 and -6.67 points, p<0.0001). On semiquantitative analysis, pneumonia extension, reactive lymph nodes and crazy paving reached statistical significance (p<0.0001). The severity score decreased by 2.77 points on average (SD 4.96; p<0.0001). There were not statistically significant changes on “fibrotic-like” changes correlated with level of treatment and there was not a statistically significant correlation between CT lung score and spirometric results obtained 18 months after discharge. Conclusions: Patients recovered from Covid-19 seem to have an improvement of ventilated parenchyma and “fibrotic-like” alterations. The level of treatment does not appear to influence fibrotic changes. Significance for public health After more than a year from first SARS-CoV-2 infection cases in Europe, alongside the always current problems of diagnosis and clinical management, a new criticism is emerging: the possible long-term outcomes that Covid-19 patients may have. To try to answer at least in part this question, in agreement with the pulmonologists of our center, we decided to select a group of patients who have overcome Covid-19, with heterogeneous levels of intensity of care, and to perform a radiological and clinical 18 months follow-up. In this paper we made a comparison between the chest CT performed at the onset of the disease and the CT performed after 18 months, evaluating the evolution of the parenchymal alterations. We hope that the results obtained in this study can provide useful information in the future follow-up of patients affected by Covid-19, a central issue of public health in the coming years in many areas of the world.
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Affiliation(s)
- Michela Barini
- Department of Diagnosis and Treatment Services, Radiodiagnostics, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara.
| | - Ilaria Percivale
- Department of Diagnosis and Treatment Services, Radiodiagnostics, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara.
| | - Pietro Danna
- Department of Diagnosis and Treatment Services, Radiodiagnostics, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara.
| | - Vittorio Longo
- Department of Diagnosis and Treatment Services, Radiodiagnostics, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara.
| | - Pietro Costantini
- Department of Diagnosis and Treatment Services, Radiodiagnostics, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara.
| | - Andrea Paladini
- Department of Diagnosis and Treatment Services, Radiodiagnostics, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara.
| | - Chiara Airoldi
- Department of Translational Medicine, University of Piemonte Orientale, Novara.
| | - Mattia Bellan
- Department of Translational Medicine, University of Piemonte Orientale, Novara.
| | - Luca Saba
- Department of Medical Science, University of Cagliari.
| | - Alessandro Carriero
- Department of Diagnosis and Treatment Services, Radiodiagnostics, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara.
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14
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Air trapping in COVID-19 patients following hospital discharge: retrospective evaluation with paired inspiratory/expiratory thin-section CT. Eur Radiol 2022; 32:4427-4436. [PMID: 35226158 PMCID: PMC8884095 DOI: 10.1007/s00330-022-08580-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 12/13/2022]
Abstract
Objectives The study reports our experience with paired inspiration/expiration thin-section computed tomographic (CT) scans in the follow-up of COVID-19 patients with persistent respiratory symptoms. Methods From August 13, 2020, to May 31, 2021, 48 long-COVID patients with respiratory symptoms (27 men and 21 women; median age, 62.0 years; interquartile range: 54.0–69.0 years) underwent follow-up paired inspiration-expiration thin-section CT scans. Patient demographics, length of hospital stay, intensive care unit admission rate, and clinical and laboratory features of acute infection were also included. The scans were obtained on a median of 72.5 days after onset of symptoms (interquartile range: 58.5–86.5) and at least 30 days after hospital discharge. Thin-section CT findings included ground-glass opacity, mosaic attenuation pattern, consolidation, traction bronchiectasis, reticulation, parenchymal bands, bronchial wall thickening, and air trapping. We used a quantitative score to determine the degree of air trapping in the expiratory scans. Results Parenchymal abnormality was found in 50% (24/48) of patients and included air trapping (37/48, 77%), ground-glass opacities (19/48, 40%), reticulation (18/48, 38%), parenchymal bands (15/48, 31%), traction bronchiectasis (9/48, 19%), mosaic attenuation pattern (9/48, 19%), bronchial wall thickening (6/48, 13%), and consolidation (2/48, 4%). The absence of air trapping was observed in 11/48 (23%), mild air trapping in 20/48 (42%), moderate in 13/48 (27%), and severe in 4/48 (8%). Independent predictors of air trapping were, in decreasing order of importance, gender (p = 0.0085), and age (p = 0.0182). Conclusions Our results, in a limited number of patients, suggest that follow-up with paired inspiratory/expiratory CT in long-COVID patients with persistent respiratory symptoms commonly displays air trapping. Key Points • Our experience indicates that paired inspiratory/expiratory CT in long-COVID patients with persistent respiratory symptoms commonly displays air trapping. • Iterative reconstruction and dose-reduction options are recommended for demonstrating air trapping in long-COVID patients.
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15
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Díaz-Resendiz KJG, Covantes-Rosales CE, Benítez-Trinidad AB, Navidad-Murrieta MS, Razura-Carmona FF, Carrillo-Cruz CD, Frias-Delgadillo EJ, Pérez-Díaz DA, Díaz-Benavides MV, Zambrano-Soria M, Ventura-Ramón GH, Romero-Castro A, Alam-Escamilla D, Girón-Pérez MI. Effect of Fucoidan on the Mitochondrial Membrane Potential (ΔΨm) of Leukocytes from Patients with Active COVID-19 and Subjects That Recovered from SARS-CoV-2 Infection. Mar Drugs 2022; 20:99. [PMID: 35200630 PMCID: PMC8878973 DOI: 10.3390/md20020099] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 12/17/2022] Open
Abstract
Fucoidan is a polysaccharide obtained from marine brown algae, with anti-inflammatory, anti-viral, and immune-enhancing properties, thus, fucoidan may be used as an alternative treatment (complementary to prescribed medical therapy) for COVID-19 recovery. This work aimed to determine the ex-vivo effects of treatment with fucoidan (20 µg/mL) on mitochondrial membrane potential (ΔΨm, using a cationic cyanine dye, 3,3'-dihexyloxacarbocyanine iodide (DiOC6(3)) on human peripheral blood mononuclear cells (HPBMC) isolated from healthy control (HC) subjects, COVID-19 patients (C-19), and subjects that recently recovered from COVID-19 (R1, 40 ± 13 days after infection). In addition, ex-vivo treatment with fucoidan (20 and 50 µg/mL) was evaluated on ΔΨm loss induced by carbonyl cyanide 3-chlorophenylhydrazone (CCCP, 150 µM) in HPBMC isolated from healthy subjects (H) and recovered subjects at 11 months post-COVID-19 (R2, 335 ± 20 days after infection). Data indicate that SARS-CoV-2 infection induces HPBMC loss of ΔΨm, even 11 months after infection, however, fucoidan promotes recovery of ΔΨm in PBMCs from COVID-19 recovered subjects. Therefore, fucoidan may be a potential treatment to diminish long-term sequelae from COVID-19, using mitochondria as a therapeutic target for the recovery of cellular homeostasis.
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Affiliation(s)
- Karina Janice Guadalupe Díaz-Resendiz
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Calle Tres S/N. Colonia. Cd. Industrial, Tepic 63173, Nayarit, Mexico; (K.J.G.D.-R.); (C.E.C.-R.); (A.B.B.-T.); (M.S.N.-M.); (F.F.R.-C.); (C.D.C.-C.); (E.J.F.-D.); (D.A.P.-D.); (M.V.D.-B.); (M.Z.-S.); (G.H.V.-R.)
| | - Carlos Eduardo Covantes-Rosales
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Calle Tres S/N. Colonia. Cd. Industrial, Tepic 63173, Nayarit, Mexico; (K.J.G.D.-R.); (C.E.C.-R.); (A.B.B.-T.); (M.S.N.-M.); (F.F.R.-C.); (C.D.C.-C.); (E.J.F.-D.); (D.A.P.-D.); (M.V.D.-B.); (M.Z.-S.); (G.H.V.-R.)
| | - Alma Betsaida Benítez-Trinidad
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Calle Tres S/N. Colonia. Cd. Industrial, Tepic 63173, Nayarit, Mexico; (K.J.G.D.-R.); (C.E.C.-R.); (A.B.B.-T.); (M.S.N.-M.); (F.F.R.-C.); (C.D.C.-C.); (E.J.F.-D.); (D.A.P.-D.); (M.V.D.-B.); (M.Z.-S.); (G.H.V.-R.)
| | - Migdalia Sarahy Navidad-Murrieta
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Calle Tres S/N. Colonia. Cd. Industrial, Tepic 63173, Nayarit, Mexico; (K.J.G.D.-R.); (C.E.C.-R.); (A.B.B.-T.); (M.S.N.-M.); (F.F.R.-C.); (C.D.C.-C.); (E.J.F.-D.); (D.A.P.-D.); (M.V.D.-B.); (M.Z.-S.); (G.H.V.-R.)
| | - Francisco Fabian Razura-Carmona
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Calle Tres S/N. Colonia. Cd. Industrial, Tepic 63173, Nayarit, Mexico; (K.J.G.D.-R.); (C.E.C.-R.); (A.B.B.-T.); (M.S.N.-M.); (F.F.R.-C.); (C.D.C.-C.); (E.J.F.-D.); (D.A.P.-D.); (M.V.D.-B.); (M.Z.-S.); (G.H.V.-R.)
| | - Christian Daniel Carrillo-Cruz
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Calle Tres S/N. Colonia. Cd. Industrial, Tepic 63173, Nayarit, Mexico; (K.J.G.D.-R.); (C.E.C.-R.); (A.B.B.-T.); (M.S.N.-M.); (F.F.R.-C.); (C.D.C.-C.); (E.J.F.-D.); (D.A.P.-D.); (M.V.D.-B.); (M.Z.-S.); (G.H.V.-R.)
| | - Edwin Jaime Frias-Delgadillo
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Calle Tres S/N. Colonia. Cd. Industrial, Tepic 63173, Nayarit, Mexico; (K.J.G.D.-R.); (C.E.C.-R.); (A.B.B.-T.); (M.S.N.-M.); (F.F.R.-C.); (C.D.C.-C.); (E.J.F.-D.); (D.A.P.-D.); (M.V.D.-B.); (M.Z.-S.); (G.H.V.-R.)
| | - Daniela Alejandra Pérez-Díaz
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Calle Tres S/N. Colonia. Cd. Industrial, Tepic 63173, Nayarit, Mexico; (K.J.G.D.-R.); (C.E.C.-R.); (A.B.B.-T.); (M.S.N.-M.); (F.F.R.-C.); (C.D.C.-C.); (E.J.F.-D.); (D.A.P.-D.); (M.V.D.-B.); (M.Z.-S.); (G.H.V.-R.)
| | - Matxil Violeta Díaz-Benavides
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Calle Tres S/N. Colonia. Cd. Industrial, Tepic 63173, Nayarit, Mexico; (K.J.G.D.-R.); (C.E.C.-R.); (A.B.B.-T.); (M.S.N.-M.); (F.F.R.-C.); (C.D.C.-C.); (E.J.F.-D.); (D.A.P.-D.); (M.V.D.-B.); (M.Z.-S.); (G.H.V.-R.)
| | - Mercedes Zambrano-Soria
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Calle Tres S/N. Colonia. Cd. Industrial, Tepic 63173, Nayarit, Mexico; (K.J.G.D.-R.); (C.E.C.-R.); (A.B.B.-T.); (M.S.N.-M.); (F.F.R.-C.); (C.D.C.-C.); (E.J.F.-D.); (D.A.P.-D.); (M.V.D.-B.); (M.Z.-S.); (G.H.V.-R.)
| | - Guadalupe Herminia Ventura-Ramón
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Calle Tres S/N. Colonia. Cd. Industrial, Tepic 63173, Nayarit, Mexico; (K.J.G.D.-R.); (C.E.C.-R.); (A.B.B.-T.); (M.S.N.-M.); (F.F.R.-C.); (C.D.C.-C.); (E.J.F.-D.); (D.A.P.-D.); (M.V.D.-B.); (M.Z.-S.); (G.H.V.-R.)
| | - Aurelio Romero-Castro
- División de Ciencias de la Salud, Universidad de Quintana Roo, Av. Erik Paolo Martínez S/N. Esquina Av. 4 de Marzo, Col. Magisterial, Chetumal 77039, Quintana Roo, Mexico;
| | - David Alam-Escamilla
- Departamento de Investigation, Desarrollo e Inovación, Earth and Life University, Selvamar, Paseo Selvamar, Playa del Carmen 77727, Quintana Roo, Mexico;
| | - Manuel Iván Girón-Pérez
- Laboratorio Nacional de Investigación para la Inocuidad Alimentaria (LANIIA)-Unidad Nayarit, Universidad Autónoma de Nayarit, Calle Tres S/N. Colonia. Cd. Industrial, Tepic 63173, Nayarit, Mexico; (K.J.G.D.-R.); (C.E.C.-R.); (A.B.B.-T.); (M.S.N.-M.); (F.F.R.-C.); (C.D.C.-C.); (E.J.F.-D.); (D.A.P.-D.); (M.V.D.-B.); (M.Z.-S.); (G.H.V.-R.)
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16
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Mylvaganam RJ, Bailey JI, Sznajder JI, Sala MA. Recovering from a pandemic: pulmonary fibrosis after SARS-CoV-2 infection. Eur Respir Rev 2021; 30:30/162/210194. [PMID: 34911696 PMCID: PMC8674935 DOI: 10.1183/16000617.0194-2021] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/24/2021] [Indexed: 12/15/2022] Open
Abstract
Acute manifestations of SARS-CoV-2 infection continue to impact the lives of many across the world. Post-acute sequelae of coronavirus disease 2019 (COVID-19) may affect 10–30% of survivors of COVID-19, and post-acute sequelae of COVID-19 (PASC)-pulmonary fibrosis is a long-term outcome associated with major morbidity. Data from prior coronavirus outbreaks (severe acute respiratory syndrome and Middle East respiratory syndrome) suggest that pulmonary fibrosis will contribute to long-term respiratory morbidity, suggesting that PASC-pulmonary fibrosis should be thoroughly screened for through pulmonary function testing and cross-sectional imaging. As data accumulates on the unique pathobiologic mechanisms underlying critical COVID-19, a focus on corollaries to the subacute and chronic profibrotic phenotype must be sought as well. Key aspects of acute COVID-19 pathobiology that may account for increased rates of pulmonary fibrosis include monocyte/macrophage–T-cell circuits, profibrotic RNA transcriptomics, protracted elevated levels of inflammatory cytokines, and duration of illness and ventilation. Mechanistic understanding of PASC-pulmonary fibrosis will be central in determining therapeutic options and will ultimately play a role in transplant considerations. Well-designed cohort studies and prospective clinical registries are needed. Clinicians, researchers and healthcare systems must actively address this complication of PASC to minimise disability, maximise quality of life and confront a post-COVID-19 global health crisis. A complication of COVID-19, PASC-pulmonary fibrosis, has the potential to become a global respiratory health crisis. Dedicated surveillance, mechanistic understanding and clinical and research efforts are needed to confront this emerging sequela of COVID-19.https://bit.ly/3GEyB04
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Affiliation(s)
- Ruben J Mylvaganam
- Division of Pulmonary and Critical Care Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Joseph I Bailey
- Division of Pulmonary and Critical Care Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Jacob I Sznajder
- Division of Pulmonary and Critical Care Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Marc A Sala
- Division of Pulmonary and Critical Care Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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