Dataset Information

Inflammation associated with lung function abnormalities in COVID-19 survivors.

ABSTRACT:

Background

Activation of inflammatory pathways promotes organ dysfunction in COVID-19. Currently, there are reports describing lung function abnormalities in COVID-19 survivors; however, the biological mechanisms remain unknown. The aim of this study was to analyze the association between serum biomarkers collected during and following hospitalization and pulmonary function in COVID-19 survivors.

Methods

Patients recovering from severe COVID-19 were prospectively evaluated. Serum biomarkers were analyzed from admission to hospital, peak during hospitalization, and at the time of discharge. Pulmonary function was measured approximately 6 weeks after discharge.

Results

100 patients (63% male) were included (age 48 years, SD ± 14) with 85% having at least one comorbidity. Patients with a restrictive spirometry pattern (n = 46) had greater inflammatory biomarkers compared to those with normal spirometry (n = 54) including peak Neutrophil-to-Lymphocyte ratio (NLR) value [9.3 (10.1) vs. 6.5 (6.6), median (IQR), p = 0.027] and NLR at hospital discharge [4.6 (2.9) vs. 3.2 (2.9) p = 0.005] and baseline C-reactive protein value [164.0 (147.0) vs. 106.5 (139.0) mg/dL, p = 0.083). Patients with an abnormal diffusing capacity (n = 35) had increased peak NLR [8.9 (5.9) vs. 5.6 (5.7) mg/L, p = 0.029]; baseline NLR [10.0 (19.0) vs. 4.0 (3.0) pg/ml, p = 0.002] and peak Troponin-T [10.0 (20.0) vs. 5.0 (5.0) pg/ml, p = 0.011] compared to patients with normal diffusing capacity (n = 42). Multivariable linear regression analysis identified predictors of restrictive spirometry and low diffusing capacity, but only accounted for a low degree of variance in pulmonary function outcome.

Conclusion

Overexpression of inflammatory biomarkers is associated with subsequent lung function abnormalities in patients recovered from severe COVID-19.

SUBMITTER: Mancilla-Ceballos R

PROVIDER: S-EPMC10314600 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

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Publications

Inflammation associated with lung function abnormalities in COVID-19 survivors.

Mancilla-Ceballos Roberto R Milne Kathryn M KM Guenette Jordan A JA Cortes-Telles Arturo A

BMC pulmonary medicine 20230701 1

<h4>Background</h4>Activation of inflammatory pathways promotes organ dysfunction in COVID-19. Currently, there are reports describing lung function abnormalities in COVID-19 survivors; however, the biological mechanisms remain unknown. The aim of this study was to analyze the association between serum biomarkers collected during and following hospitalization and pulmonary function in COVID-19 survivors.<h4>Methods</h4>Patients recovering from severe COVID-19 were prospectively evaluated. Serum ...[more]

PMID: 37391742

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Project description:BackgroundData on the long-term trajectories of lung function are scarce in COVID-19 survivors.MethodsWe re-analyzed the data from a prospective longitudinal cohort follow-up study of COVID-19 survivors over 2 years after infection. All participants were divided into scale 3, scale 4 and scale 5-6 groups according to seven-category ordinal scale. The changes of pulmonary function tests (PFTs), the Modified Medical Research Council (mMRC) Dyspnea Scale, 6-min walking test health-related quality of life (HRQoL) across the three serial follow-up visits were evaluated, and compared among three groups. We performed liner regression to determine potential factors that were associated with changes of PFTs and distance walked in 6 minutes (6MWD).FindingsIn this study, 288 participants generally presented an improvement of PFTs parameters from 6 months to 1 year after infection. The scale 5-6 group displayed a significantly higher increase of PFTs compared with scale 3 and scale 4 groups (all p<0.0167), and corticosteroids therapy was identified as a protective factor for the PFTs improvement with a correlation coefficient of 2.730 (0.215-5.246) for forced vital capacity (FVC), 2.909 (0.383-5.436) for total lung capacity (TLC), and 3.299 (0.211-6.387) for diffusion capacity for carbon monoxide (DLco), respectively. From 1-year to 2-year follow-up, the PFTs parameters generally decreased, which was not observed to be associated with changes of 6MWD and HRQoL. Dyspnea (mMRC≥1) generally decreased over time (23.3% [61/262] for 6-month, 27.9% [67/240] for 1-year, 13.4% [35/261] for 2-year), and 6MWD increased continuously (500.0 m vs 505.0 m vs 525.0 m).InterpretationCorticosteroids therapy during hospitalization was a protective factor for PFTs improvement from 6 months to 1 year. The relatively fast decline trend of PFTs from 1 year to 2 years needs to be paid attention and further validated in the future follow-up study.FundingsThis work was supported by Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (CIFMS 2021-I2M-1-048) and the National Key Research and Development Program of China (2021YFC0864700).

Project description:ObjectiveDistinguishing post-COVID-19 residual abnormalities from interstitial lung abnormalities (ILA) on CT can be challenging if clinical information is limited. This study aimed to evaluate the diagnostic performance of radiologists in distinguishing post-COVID-19 residual abnormalities from ILA.MethodsThis multi-reader, multi-case study included 60 age- and sex-matched subjects with chest CT scans. There were 40 cases of ILA (20 fibrotic and 20 non-fibrotic) and 20 cases of post-COVID-19 residual abnormalities. Fifteen radiologists from multiple nations with varying levels of experience independently rated suspicion scores on a 5-point scale to distinguish post-COVID-19 residual abnormalities from fibrotic ILA or non-fibrotic ILA. Interobserver agreement was assessed using the weighted κ value, and the scores of individual readers were compared with the consensus of all readers. Receiver operating characteristic curve analysis was conducted to evaluate the diagnostic performance of suspicion scores for distinguishing post-COVID-19 residual abnormalities from ILA and for differentiating post-COVID-19 residual abnormalities from both fibrotic and non-fibrotic ILA.ResultsRadiologists' diagnostic performance for distinguishing post-COVID-19 residual abnormalities from ILA was good (area under the receiver operating characteristic curve (AUC) range, 0.67-0.92; median AUC, 0.85) with moderate agreement (κ = 0.56). The diagnostic performance for distinguishing post-COVID-19 residual abnormalities from non-fibrotic ILA was lower than that from fibrotic ILA (median AUC = 0.89 vs. AUC = 0.80, p = 0.003).ConclusionRadiologists demonstrated good diagnostic performance and moderate agreement in distinguishing post-COVID-19 residual abnormalities from ILA, but careful attention is needed to avoid misdiagnosing them as non-fibrotic ILA.Key pointsQuestion How good are radiologists at differentiating interstitial lung abnormalities (ILA) from changes related to COVID-19 infection? Findings Radiologists had a median AUC of 0.85 in distinguishing post-COVID-19 abnormalities from ILA with moderate agreement (κ = 0.56). Clinical relevance Radiologists showed good diagnostic performance and moderate agreement in distinguishing post-COVID-19 residual abnormalities from ILA; nonetheless, caution is needed in distinguishing residual abnormalities from non-fibrotic ILA.

Dataset Information

Inflammation associated with lung function abnormalities in COVID-19 survivors.

Background

Methods

Results

Conclusion

Publications

Inflammation associated with lung function abnormalities in COVID-19 survivors.

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