ABSTRACT
Methods: in this retrospective study, we evaluated 394 patients from march 2020 to december 2020 and we enrolled43 patients who developed fibrotic lesions after 1 year from a sars cov2 pneumoniae.These patients underwent BAL (Bronchioloalveolar lavage), respiratory functional and immunological tests.At admission, 41/43 patients had GGO on chest CT scan, while 13/43 showed parenchymal consolidation. 9/43 weretreated with oxygen therapy, 14/43 with HNFC, 10/43 with NIV, 10/43 with IOT.At 12 months CT, 23/43 had persistent GGO areas and 2/43 lung consolidations. All showed new onset interstitialthickening. Result(s): no differences in lung volumes between patients who required mechanical ventilation vs those who did not;while the Dlco values were lower in mechanical ventilated patients (p=0.047).The median negativization of the nasopharyngeal molecular swab was 30 days: we didn't show differences in eitherinflammation markers and in the respiratory function parameters in those who had negativization before or after 30days. 43/394 patients showed persistence of DLco and CT scan alterations. We submitted these patients to BAL in order to quantify whether there was inflammation of the lung. Median lymphocytes on BAL was 10%, while median serum lymphocytes was 31.4%. Only 4/43 patients had BAL lymphocytosis greater than 30%. We treated these 4 patients with systemic steroid therapy as an organizing pneumoniae. Conclusion(s): patients who were hospitalized with respiratory failure due to Covid 19, 10% had TC and respiratory functional changes after one year and 10% of these, had lymphocytic inflammation in the BAL, treated with steroid. Further studies are needed.
ABSTRACT
Background and Aim: High percentage of patients who had COVID- 19 are still symptomatic after several months post infection, but the long-term outcomes are not yet well known. The long-term outcomes and, in particular, the cardiac sequelae of COVID-19 are not completely known. Aim of this study was to provide new insights into cardiovascular dysfunction in “long Covid” patients. Materials and Methods: In this multicenter prospective study, subjects were collected from “long Covid” ambulatories from june 2021 to august 2021. Evaluation comprehended a blood sample, ECG, cardiac US, 24-h BP monitoring at baseline and after three months. Primary endpoint was to estimate the prevalence of cardiac involvement in these subjects and define their clinical prognosis. Results: 215 “Long Covid” patients were enrolled (120 F, 95 M, mean age 58,9±6,7). Control group was composed of patients without diagnosis of LONG COVID, with no significant differences of age, sex, comorbidities and drugs (130 subjects, 77 F, 53 M, mean age 54,7±7,8). Cardiac involvement was found in 12,3% in “long Covid” group at the baseline, 9,9% at 3rd month. Significant differences were showed in CRP and ADMA values, left ventricular global longitudinal strain, BP and HR variability. A “non-dipping” blood pressure pattern was found in almost 25,7% in the “long Covid” group at the baseline and in 19,8% at the 3rd month. Conclusions: “Long covid” subjects seems to show a cardiovascular involvement more than other COVID-19 patients. Further studies will be needed to define the duration of these signs and early preventive interventions.
ABSTRACT
At present, the time-frame used for the quarantine of individuals with coronavirus disease 2019 (COVID-19) is the entire duration of symptoms plus 14 days after symptom recovery; however, no data have been reported specifically for healthcare workers (HCWs). In the study population of 142 HCWs with COVID-19, the mean time for viral clearance was 31.8 days. Asymptomatic subjects cleared the virus more quickly than symptomatic subjects (22 vs 34.2 days; P<0.0001). The presence of fever at the time of diagnosis was associated with a longer time to viral clearance (relative risk 11.45, 95% confidence interval 8.66-14.25; P<0.0001). These findings may have a significant impact on healthcare strategies for the future management of the COVID-19 pandemic.