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Mori T, Yamane F, Sano C, Ohta R. Gradually Progressive Interstitial Pneumonia Following COVID-19 in an Older Patient: A Case Report. Cureus 2023; 15:e49807. [PMID: 38161571 PMCID: PMC10757861 DOI: 10.7759/cureus.49807] [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] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Since its confirmation in Wuhan, Hubei Province, China, at the end of 2019, the novel coronavirus disease (COVID-19) has rapidly spread worldwide in multiple epidemic waves while undergoing mutations. To date, numerous individuals have been infected. Symptoms range from asymptomatic and common cold-like to acute respiratory failure and acute respiratory distress syndrome (ARDS), which can lead to death. Here, we present the case of an 81-year-old woman with a fever that persisted for more than five days after infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). She underwent chest imaging that revealed complications of interstitial pneumonia presumed to be caused by COVID-19. Computed tomography (CT) findings in COVID-19 pneumonia are often nonspecific. In this case, scattered frosted shadows were observed in both lung fields, and blood tests revealed elevated Krebs von den Lungen 6 (KL-6) levels. Immediate therapeutic treatment is warranted when patients with multiple risk factors for COVID-19 present with interstitial pneumonia.
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Affiliation(s)
| | | | - Chiaki Sano
- Community Medicine Management, Shimane University Faculty of Medicine, Izumo, JPN
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2
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Histopathological and molecular links of COVID-19 with novel clinical manifestations for the management of coronavirus-like complications. Inflammopharmacology 2022; 30:1219-1257. [PMID: 35637319 PMCID: PMC9150634 DOI: 10.1007/s10787-022-00999-9] [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: 03/31/2022] [Accepted: 04/12/2022] [Indexed: 01/08/2023]
Abstract
Coronavirus disease 2019 (COVID-19) causes transmissible viral illness of the respiratory tract prompted by the SARS-CoV-2 virus. COVID-19 is one of the worst global pandemics affecting a large population worldwide and causing catastrophic loss of life. Patients having pre-existing chronic disorders are more susceptible to contracting this viral infection. This pandemic virus is known to cause notable respiratory pathology. Besides, it can also cause extra-pulmonary manifestations. Multiple extra-pulmonary tissues express the SARS-CoV-2 entry receptor, hence causing direct viral tissue damage. This insightful review gives a brief description of the impact of coronavirus on the pulmonary system, extra-pulmonary systems, histopathology, multiorgan consequences, the possible mechanisms associated with the disease, and various potential therapeutic approaches to tackle the manifestations.
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3
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Ryan N, Meskell P. The experience of people with idiopathic pulmonary fibrosis living through the COVID-19 pandemic. J Adv Nurs 2022; 78:2232-2244. [PMID: 35179243 DOI: 10.1111/jan.15187] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/12/2022] [Accepted: 01/25/2022] [Indexed: 12/23/2022]
Abstract
AIM To explore the experience of people with idiopathic pulmonary fibrosis living through the COVID-19 pandemic. DESIGN A qualitative descriptive design using semi-structured interviews. METHOD Purposive sampling was employed to recruit 13 participants with idiopathic pulmonary fibrosis attending the respiratory department of a large urban teaching hospital in Limerick, Ireland. Data were collected between January 2021 and February 2021 through semi-structured interviews, using an online platform. Reflective thematic analysis was used for data analysis. RESULTS Four key themes were identified from participant's experience of living through the COVID-19 pandemic: (1) fear of contracting COVID-19 disease, (2) living with reduced social interaction, (3) the adjustment in the relationship with healthcare professionals (HCP) and (4) navigating an altered landscape. CONCLUSION Healthcare professionals have a key role in protecting the physical and psychological health of the person with idiopathic pulmonary fibrosis during this time and into the future. Through being cognisant of the additional supportive care needs of people with idiopathic pulmonary fibrosis, HCP can focus on developing targeted interventions aimed to enhance care provision. IMPACT This study considers people with idiopathic pulmonary fibrosis as a particularly vulnerable group whose experiences of living through the COVID-19 pandemic warrant specific attention. Participants felt compelled to self-isolate due to fear and anxiety of contracting COVID-19 disease. Participants reported increased social isolation with some experiencing anger and resentment at loss of precious time with loved ones. Participants felt an increased responsibility for self-monitoring their condition and had concerns about differentiating symptoms of COVID-19 disease from an exacerbation. A variety of strategies that helped them cope through the pandemic were identified and also the important role these played. The results from this study can be used to inform HCP' understanding of challenges experienced by people with idiopathic pulmonary fibrosis during enforced restrictions related to the COVID-19 pandemic.
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Affiliation(s)
- Noelle Ryan
- Respiratory Department, University Hospital of Limerick, Limerick, Ireland
| | - Pauline Meskell
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
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4
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Antoniou KM, Vasarmidi E, Russell AM, Andrejak C, Crestani B, Delcroix M, Dinh-Xuan AT, Poletti V, Sverzellati N, Vitacca M, Witzenrath M, Tonia T, Spanevello A. European Respiratory Society Statement on Long COVID-19 Follow-Up. Eur Respir J 2022; 60:13993003.02174-2021. [PMID: 35144991 PMCID: PMC9349784 DOI: 10.1183/13993003.02174-2021] [Citation(s) in RCA: 68] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/28/2021] [Indexed: 12/11/2022]
Abstract
Patients diagnosed with coronavirus disease 2019 (COVID-19) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection frequently experience symptom burden post-acute infection or post-hospitalisation. We aimed to identify optimal strategies for follow-up care that may positively impact the patient's quality of life (QoL). A European Respiratory Society (ERS) Task Force convened and prioritised eight clinical questions. A targeted search of the literature defined the timeline of “long COVID” as 1–6 months post-infection and identified clinical evidence in the follow-up of patients. Studies meeting the inclusion criteria report an association of characteristics of acute infection with persistent symptoms, thromboembolic events in the follow-up period, and evaluations of pulmonary physiology and imaging. Importantly, this statement reviews QoL consequences, symptom burden, disability and home care follow-up. Overall, the evidence for follow-up care for patients with long COVID is limited. Follow-up care of patients infected with SARS-CoV-2 is crucial and may improve their quality of life. More evidence and research is emerging to understand the causes, mechanisms and risks of long COVID consequences.https://bit.ly/3J1WMWy
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Affiliation(s)
- Katerina M Antoniou
- Laboratory of Molecular and Cellular Pneumonology, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Eirini Vasarmidi
- Laboratory of Molecular and Cellular Pneumonology, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece.,Université de Paris, Inserm U1152, Labex Inflamex, Paris, France.,Authors contributed equally
| | - Anne-Marie Russell
- College of Medicine and Health, University of Exeter, Exeter, UK.,Authors contributed equally
| | - Claire Andrejak
- Service de Pneumologie, CHU Amiens-Picardie, UR 4294 AGIR, université Picardie Jules-Verne, Amiens, France
| | - Bruno Crestani
- Université de Paris, Inserm U1152, Labex Inflamex, Paris, France.,Centre de Référence des Maladies Pulmonaires Rares (site Constitutif), AP-HP, Service de Pneumologie, Hôpital Bichat, Paris, France
| | - Marion Delcroix
- Department of Pneumonology, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Anh Tuan Dinh-Xuan
- AP-HP Centre, Hôpital Cochin, Respiratory Physiology Unit, Thoracic Diseases Department, Université de Paris, Paris, France
| | - Venerino Poletti
- Pulmonology Unit, Thoracic Diseases Department, G.B. Morgagni Hospital, Forlì, Italy.,Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
| | - Nicola Sverzellati
- Division of Radiology, Department of Surgical Sciences, University Hospital of Parma, Parma, Italy
| | - Michele Vitacca
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, Brescia, Italy
| | - Martin Witzenrath
- Department of Internal Medicine/Infectious Diseases and Respiratory Medicine, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Thomy Tonia
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Antonio Spanevello
- Department of Medicine and Surgery, University of Insubria, Varese.,Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institute, IRCCS Tradate, Varese, Italy
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5
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Althobiani MA, Evans RA, Alqahtani JS, Aldhahir AM, Russell AM, Hurst JR, Porter JC. Home monitoring of physiology and symptoms to detect interstitial lung disease exacerbations and progression: a systematic review. ERJ Open Res 2021; 7:00441-2021. [PMID: 34938799 PMCID: PMC8685510 DOI: 10.1183/23120541.00441-2021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/27/2021] [Indexed: 12/11/2022] Open
Abstract
Background Acute exacerbations (AEs) and disease progression in interstitial lung disease (ILD) pose important challenges to clinicians and patients. AEs of ILD are variable in presentation but may result in rapid progression of ILD, respiratory failure and death. However, in many cases AEs of ILD may go unrecognised so that their true impact and response to therapy is unknown. The potential for home monitoring to facilitate early, and accurate, identification of AE and/or ILD progression has gained interest. With increasing evidence available, there is a need for a systematic review on home monitoring of patients with ILD to summarise the existing data. The aim of this review was to systematically evaluate the evidence for use of home monitoring for early detection of exacerbations and/or progression of ILD. Method We searched Ovid-EMBASE, MEDLINE and CINAHL using Medical Subject Headings (MeSH) terms in accordance with the PRISMA guidelines (PROSPERO registration number CRD42020215166). Results 13 studies involving 968 patients have demonstrated that home monitoring is feasible and of potential benefit in patients with ILD. Nine studies reported that mean adherence to home monitoring was >75%, and where spirometry was performed there was a significant correlation (r=0.72–0.98, p<0.001) between home and hospital-based readings. Two studies suggested that home monitoring of forced vital capacity might facilitate detection of progression in idiopathic pulmonary fibrosis. Conclusion Despite the fact that individual studies in this systematic review provide supportive evidence suggesting the feasibility and utility of home monitoring in ILD, further studies are necessary to quantify the potential of home monitoring to detect disease progression and/or AEs. First systematic review that provides supportive evidence for the feasibility and utility of home monitoring in ILD; further studies are necessary to evaluate approaches to detect exacerbation and/or progressionhttps://bit.ly/2Y8OCJL
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Affiliation(s)
- Malik A Althobiani
- UCL Respiratory, University College London, London, UK.,Dept of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rebecca A Evans
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Jaber S Alqahtani
- UCL Respiratory, University College London, London, UK.,Dept of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Abdulelah M Aldhahir
- Respiratory Care Dept, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Anne-Marie Russell
- University of Exeter College of Medicine and Health, Exeter, UK.,These authors contributed equally
| | - John R Hurst
- UCL Respiratory, University College London, London, UK.,These authors contributed equally
| | - Joanna C Porter
- UCL Respiratory, University College London, London, UK.,These authors contributed equally
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6
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Nakshbandi G, Moor CC, Johannson KA, Maher TM, Kreuter M, Wijsenbeek MS. Worldwide experiences and opinions of healthcare providers on eHealth for patients with interstitial lung diseases in the COVID-19 era. ERJ Open Res 2021; 7:00405-2021. [PMID: 34471631 PMCID: PMC8256489 DOI: 10.1183/23120541.00405-2021] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 11/25/2022] Open
Abstract
Interstitial lung diseases (ILD) comprise a group of pulmonary diseases characterised by diffuse parenchymal abnormalities, which can lead to irreversible pulmonary fibrosis [1]. The #COVID19 pandemic has led to an increase in the use of eHealth for patients with interstitial lung disease. Healthcare providers worldwide are positive towards further implementation of eHealth for research and clinical practice.https://bit.ly/3h2545M
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Affiliation(s)
- Gizal Nakshbandi
- Dept of Respiratory Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Catharina C Moor
- Dept of Respiratory Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | | | - Toby M Maher
- Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Michael Kreuter
- Center for Interstitial and Rare Lung Diseases, Thoraxklinik, University of Heidelberg, Germany and German Center for Lung Research, Heidelberg, Germany
| | - Marlies S Wijsenbeek
- Dept of Respiratory Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
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7
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Post-COVID-19 Pulmonary Fibrosis: Novel Sequelae of the Current Pandemic. J Clin Med 2021; 10:jcm10112452. [PMID: 34205928 PMCID: PMC8199255 DOI: 10.3390/jcm10112452] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/21/2021] [Accepted: 05/27/2021] [Indexed: 12/15/2022] Open
Abstract
Since the initial identification of the novel coronavirus SARS-CoV-2 in December 2019, the COVID-19 pandemic has become a leading cause of morbidity and mortality worldwide. As effective vaccines and treatments begin to emerge, it will become increasingly important to identify and proactively manage the long-term respiratory complications of severe disease. The patterns of imaging abnormalities coupled with data from prior coronavirus outbreaks suggest that patients with severe COVID-19 pneumonia are likely at an increased risk of progression to interstitial lung disease (ILD) and chronic pulmonary vascular disease. In this paper, we briefly review the definition, classification, and underlying pathophysiology of interstitial lung disease (ILD). We then review the current literature on the proposed mechanisms of lung injury in severe COVID-19 infection, and outline potential viral- and immune-mediated processes implicated in the development of post-COVID-19 pulmonary fibrosis (PCPF). Finally, we address patient-specific and iatrogenic risk factors that could lead to PCPF and discuss strategies for reducing risk of pulmonary complications/sequelae.
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8
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Shah NM, Kaltsakas G. Telemedicine in the management of patients with chronic respiratory failure. Breathe (Sheff) 2021; 17:210008. [PMID: 34295411 PMCID: PMC8291909 DOI: 10.1183/20734735.0008-2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 03/12/2021] [Indexed: 12/20/2022] Open
Abstract
Patients with chronic respiratory failure are often required to attend multiple hospital appointments, which may be difficult due to their physical disabilities and the amount of equipment they are required to bring. Their caregivers often struggle with the lack of immediate care available when the patient suffers difficulties at home. Telemedicine is an opportunity to bridge the gap between home and healthcare professionals by allowing the healthcare team to reach into patients' homes to provide more frequent support. The evidence for the use of telemedicine in patients with chronic respiratory failure remains equivocal. Although the uptake of telemedicine has been slow, the SARS-CoV-2 pandemic has resulted in the rapid dissemination of telemedicine to allow the delivery of care to vulnerable patients while reducing the need for their attendance in hospital. Logistical and legal challenges to the delivery of telemedicine remain, but the pandemic may serve as a driver to ameliorate these challenges and facilitate wider use of this technology to improve the experience of patients with chronic respiratory failure. Educational aims To provide an overview of the rationale for delivering care via telemedicine for patients with chronic respiratory failure.To provide the evidence base for establishing a telemedicine service.To highlight the potential opportunities and challenges in delivering a telemedicine service for patients with chronic respiratory failure.
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Affiliation(s)
- Neeraj M Shah
- Lane Fox Respiratory Service, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Lane Fox Clinical Respiratory Physiology Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Centre for Human and Applied Physiological Sciences (CHAPS), King's College London, London, UK
| | - Georgios Kaltsakas
- Lane Fox Respiratory Service, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Lane Fox Clinical Respiratory Physiology Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Centre for Human and Applied Physiological Sciences (CHAPS), King's College London, London, UK
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9
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Udwadia ZF, Koul PA, Dhooria S. The impact of COVID-19 on patients with preexisting interstitial lung disease: High mortality in these high-risk patients. Lung India 2021; 38:S1-S3. [PMID: 33686971 PMCID: PMC8104356 DOI: 10.4103/lungindia.lungindia_60_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- Zarir Farokh Udwadia
- Department of Pulmonary Medicine, Hinduja Hospital and Research Center, Mumbai, Maharashtra, India
| | - Parvaiz A Koul
- Department of Pulmonary Medicine, SKIMS, Srinagar, Jammu and Kashmir, India
| | - Sahajal Dhooria
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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10
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Tzilas V, Bouros D. Update on COVID-19: A teleconference with the Paediatric Virology Study Group (Review). Exp Ther Med 2020; 20:293. [PMID: 33209137 PMCID: PMC7668150 DOI: 10.3892/etm.2020.9423] [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: 07/31/2020] [Accepted: 10/24/2020] [Indexed: 11/06/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted to humans mainly via contact and droplet transmission and its entry into cells is mediated by the efficient binding of the spike (S) viral protein with the angiotensin converting enzyme-2 (ACE2) receptors. Although acute respiratory distress syndrome (ARDS) caused by SARS-CoV-2 fulfills the criteria of the Berlin definition, in a considerable proportion of patients with COVID-19, there is a dissociation between their relatively well-preserved lung mechanics and the severity of hypoxaemia. The extent of pneumococcal related morbidity and mortality is largely unknown. Respiratory comorbidities that increase the risk of severe disease and mortality due to SARS-CoV-2 include chronic obstructive pulmonary disease, asthma, bronchiectasis and fibrotic interstitial lung diseases, regardless of aetiology. Pneumococcal and seasonal influenza vaccinations are useful in preventing a substantial burden of mortality in high-risk populations, while general quarantine and social distancing can reduce the infiltration of the virus within the community. To date, several therapeutic agents have been studied or are currently examined, such as hydroxychloroquine, chloroquine, ritonavir/lopinavir, remdesivir, colchicines and interleukin-6 inhibitors. However, the usage of most of these into clinical practice was not based on randomised clinical trials and their results should be viewed with extreme caution; remdesivir seems to be the more promising option. Rigorous efforts are under way for the development of a safe and successful vaccine against SARS-CoV-2.
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Affiliation(s)
- Vasilios Tzilas
- First Academic Department of Pneumonology, National and Kapodistrian University of Athens School of Medicine, 11527 Athens, Greece
| | - Demosthenes Bouros
- First Academic Department of Pneumonology, National and Kapodistrian University of Athens School of Medicine, 11527 Athens, Greece
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11
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Tzilas V, Manali E, Papiris S, Bouros D. Intravenous Immunoglobulin for the Treatment of COVID-19: A Promising Tool. Respiration 2020; 99:1087-1089. [PMID: 33212437 PMCID: PMC7801989 DOI: 10.1159/000512727] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 10/22/2020] [Indexed: 11/22/2022] Open
Affiliation(s)
- Vasilios Tzilas
- First Academic Department of Pneumonology, Interstitial Lung Diseases Unit, Hospital for Diseases of the Chest, "Sotiria," Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Athens Medical Center, Athens, Greece
| | - Effrosyni Manali
- Second Pulmonary Medicine Department, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Spyridon Papiris
- Second Pulmonary Medicine Department, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Demosthenes Bouros
- First Academic Department of Pneumonology, Interstitial Lung Diseases Unit, Hospital for Diseases of the Chest, "Sotiria," Medical School, National and Kapodistrian University of Athens, Athens, Greece, .,Athens Medical Center, Athens, Greece,
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