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COVID-19 is often associated with long-lasting pulmonary symptoms. Data are scarce about interstitial lung disease(ILD) in patients following COVID-19 hospitalization with persistent symptoms.We retrospectively reviewed all cases sent to pulmonary post-COVID evaluation due to persistent symptomsbetween February 2021 and February 2022 (N=318). All patients with suspected ILD (N=44) were reviewed at theMDD. Patient characteristics, symptoms, time since hospitalization, lung function, PI and PE, and 6-minutewalk test (6MWT) were evaluated.The post-COVID-ILD included more men (male: 68%, age: 64.0+/-12.3 years, time since hospitalization: 2.4+/-2.3months) with overweight (BMI 29.1+/-4.2 kg/m2). Persisting symptoms included tiredness (30%), dyspnea (20%),cough (20%), sleep disorders (20%). Spirometry confirmed a mild restrictive ventilatory pattern (FVC: 76.7+/-18.1,FEV1: 83.5+/-19.1 TLC: 85.6+/-28.1 %pred) while average PI and PE was normal. 6MWT confirmed desaturationin 41% of cases.maxmaxmaxmax Our data indicate that suspected post-COVID ILD is affecting 13.8% of symptomatic patients. Functional impairment, especially desaturation during 6MWT is an important factor when ILD is suspected. Longitudinal follow-up of these patients is in progress.
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Introduction: Lung transplant recipients (LuTX) represent a vulnerable patient population for the new SARS-CoV-2 infection (severe acute respiratory syndrome coronavirus 2). Even though many vaccines are already developed, there is a few knowledge with non-mRNA vaccines in LuTX patients. Method(s): Stable LuTX recipients at least one year after transplantation were enrolled. Patients who had new coronavirus infection were excluded. Currently available (BNT162b2-mRNA, mRNA-1273, ChAdOx1 and BBIBPCorV) vaccines were given randomly, third doses were mRNA-based vaccines. SARS-CoV-2 Spike1 IgG antibody titer was evaluated before vaccination and 2 weeks after the second and third doses. Result(s): Forty-one LuTX recipients (49% men, 48.4+/-13.8 years) received minimum 2 doses of vaccines, 19 from them vaccinated with non-mRNA vaccines. 24 patients also had third dose. Positive serology was found in 37% of the patients after the second dose and 52% from all became positive after the third vaccine. The average level of Spike1 antibody among the patients with positive serology was 1894 U/ml [range 3.29-5797 U/ml] after the third dose. Six patients vaccinated with two mRNA-based vaccine developed moderate disease in average of 178 days and 3 of them died in ICU. No serious adverse events were observed. Conclusion(s): Immunosuppression therapy may induce weaker SARS-CoV-2 response in LuTX recipients. Our data confirm that non-mRNA vaccines could be safe and effective, however immunity decreases over time, therefore third dose vaccine is a priority in transplanted patients. Further data are needed to evaluate cellular responses after all type of SARS-CoV-2 vaccinations.
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Introduction: SARS-CoV2 infection is associated with significant risk of coronavirus disease (COVID-19) and represents a significant risk factor for functional deterioration in idiopathic pulmonary fibrosis (IPF) patients. Method(s): We retrospectively reviewed all IPF patients treated at our university center for their SARS-CoV2 vaccination status starting from January 2021 in Hungary. Result(s): Total of 68 (out of treated 70 IPF patients) received minimum 2 doses of SARS-CoV2 vaccines (male 52.85%, age: 72.24 +/- 9.65 years), 20 of them were vaccinated with non-mRNA vaccines (BBIBP-CorV-Sinopharm, ChAdOx1-AstraZeneca, Gam-Covid-Vac-Sputnik and Ad26. COV2.S-Janssen), while 48 with mRNA vaccines. Majority (N=57) of patients also took a third dose: most patients received BNT162b2-mRNA-Pfizer/Biontech (58.82%), followed by BBIBP-CorV and mRNA-1273-Moderna (both 11.76 %). There were no hospitalizations for COVID-19 in the vaccinated group, regardless of the type of the vaccine received and no significant adverse event was detected. One of the non-vaccinated patients (2 women, age 70 and 73 years) died in COVID-19 pneumonia. IPF patients were mainly in a good functional state (FVC = 2.52 +/- 1.03 L;78.81 +/- 22.72%) with reduced diffusion capacity (TLCO = 5.28 +/- 2.11 mmol/kPa/min;66.28 +/- 21.58%). Conclusion(s): SARS-CoV2 vaccination is utmost important in IPF patients, and independent of vaccine type used it resulted in significantly decreased risk of COVID-19 hospitalization.
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Introduction: Significant portion of the patients manifest symptoms, like coughing, dyspnoea, fatigue, exercise intolerance, sleep disorders or neuropsychological symptoms in post-COVID condition. It has influence on patients' quality of life and workability. Pulmonary rehabilitation (PR) has favourable effect on the cardiovascular system, metabolism, respiratory and peripheral muscles, lung mechanics and psychological condition of the patient. Aim(s): Our aim was to assess the effectiveness of a post-COVID PR program in terms of the improvement of patients' functional condition and quality of life. Method(s): 50 patients were involved (female:male=26:24, age 55+/-12 years, BMI: 31+/-8 kg/m2) at the Department of Pulmonology, Semmelweis University, Budapest, Hungary. At the onset of the program we measured lung function, 6-minute walking distance (6MWD), chest wall expansion (CWE), lung function and quality of life (EQ5D and postCovid Functional Scale (PCFS). The post-COVID rehabilitation included controlled breathing techniques, chest wall mobilization, strengthening of respiratory and peripheral muscle, endurance training for cycle and treadmill, dietetic, psychological health assessment and counselling. Result(s): Rehabilitation resulted in improvement in 6MWD (496.16 (80-780) vs. 526.32 (328-744) m;p<0.05), CWE (39.4 (15.2-98.9) vs. 47.4 (20.1-100.5) cm;p<0.05) and quality of life (EQ5D, PCFS). Statistically significant improvement was detected in IVC and FVC. No side effect was observed related to the PR program. Conclusion(s): There is an urgent need of an available PR for patients who suffer from post-COVID pulmonary symptoms to avoid serious medical, social and economic complications and it is safe for the patients.
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Aerosol particles proved to play a key role in airborne transmission of SARS-CoV-2 viruses. Therefore, their size-fractionated collection and analysis is invaluable. However, aerosol sampling in COVID departments is not straightforward, especially in the sub-500-nm size range. In this study, particle number concentrations were measured with high temporal resolution using an optical particle counter, and several 8 h daytime sample sets were collected simultaneously on gelatin filters with cascade impactors in two different hospital wards during both alpha and delta variants of concern periods. Due to the large number (152) of size-fractionated samples, SARS-CoV-2 RNA copies could be statistically analyzed over a wide range of aerosol particle diameters (70-10 µm). Our results revealed that SARS-CoV-2 RNA is most likely to exist in particles with 0.5-4 µm aerodynamic diameter, but also in ultrafine particles. Correlation analysis of particulate matter (PM) and RNA copies highlighted the importance of indoor medical activity. It was found that the daily maximum increment of PM mass concentration correlated the most with the number concentration of SARS-CoV-2 RNA in the corresponding size fractions. Our results suggest that particle resuspension from surrounding surfaces is an important source of SARS-CoV-2 RNA present in the air of hospital rooms.
Subject(s)
COVID-19 , Humans , RNA, Viral/genetics , SARS-CoV-2/genetics , Respiratory Aerosols and Droplets , Hospitals , Particulate MatterABSTRACT
Aim/Introduction: The novel coronavirus disease (COVID-19) is caused by the respiratory infection of SARS-CoV-2 virus and is characterized by a multisystemic inflammation, presenting with a wide spectrum of symptoms. 18F-fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG-PET/CT) is a promising imaging method in the evaluation of acute-phase and late changes in the central nervous system. Material(s) and Method(s): A single-centre, prospective clinical study (COMPOSIT study) was initiated where FDG-PET/CT was performed in adult COVID-19 patients during acute, infective state and 3 months later. Brain FDG-PET images were evaluated with a software utilizing a built-in, age-matched normal database and the degree of the differences (Z-scores) were investigated at the two imaging timepoints. Result(s): We present the data of 36 patients (14 women, 22 men), with a mean age of 52 years (42-75 years). In the acute, infective state, the majority of the patients presented with diffuse, significant cortical hypometabolism whereas at 3 months followup, the involved regions showed a marked and often complete metabolic normalization. The most common regions with residual hypometabolism at 3 monts were the medial prefrontal and medial temporal regions and the anterior cingulate. Also, these regions showed the proportionally lowest rates of normalization. Hypometabolism was the least frequent in the cerebellum at the acute, infective state and its FDG-uptake showed a nomalization in all but one case. Conclusion(s): Residual hypometabolism is common in the areas encompassing the orbitofrontal cortex and the limbic system while the cerebellar cortex was relatively spared. However, our study is limited by the corticosteroid-effect in the scans performed at the acute, infective state and furthermore, the fact that no metabolic data is available of the patients before SARS-CoV-2 infection.
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Aim/Introduction: The novel coronavirus disease (COVID-19) is caused by the respiratory infection of SARS-CoV-2 virus and is characterized by a multisystemic inflammation, presenting with a wide spectrum of symptoms. 18F-fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG-PET/CT) is a promising imaging method in the evaluation of acute-phase and late changes in the central nervous system. Material(s) and Method(s): A single-centre, prospective clinical study (COMPOSIT study) was initiated where FDG-PET/CT was performed in adult COVID-19 patients during acute, infective state and 3 months later. Brain FDG-PET images were evaluated with a software utilizing a built-in, age-matched normal database and the degree of the differences (Z-scores) were investigated at the two imaging timepoints. Result(s): We present the data of 36 patients (14 women, 22 men), with a mean age of 52 years (42-75 years). In the acute, infective state, the majority of the patients presented with diffuse, significant cortical hypometabolism whereas at 3 months followup, the involved regions showed a marked and often complete metabolic normalization. The most common regions with residual hypometabolism at 3 monts were the medial prefrontal and medial temporal regions and the anterior cingulate. Also, these regions showed the proportionally lowest rates of normalization. Hypometabolism was the least frequent in the cerebellum at the acute, infective state and its FDG-uptake showed a nomalization in all but one case. Conclusion(s): Residual hypometabolism is common in the areas encompassing the orbitofrontal cortex and the limbic system while the cerebellar cortex was relatively spared. However, our study is limited by the corticosteroid-effect in the scans performed at the acute, infective state and furthermore, the fact that no metabolic data is available of the patients before SARS-CoV-2 infection.
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This study aims to verify associated factors with trait and state anxiety in professional soccer teams during the COVID-19 epidemic. The sample was composed of 529 athletes, coaches, and professional soccer teams' physical trainers during the COVID-19 epidemic. From this amount, 214 were classified with trait-anxiety, and 315 were classified with state-anxiety using the State-Trait Anxiety Inventory (STAI). This study is an epidemiological and cross-sectional study. We applied an observational method, and we performed a remote measurement. The measurement was made via online questionnaires in male and female individuals working on soccer teams (soccer professionals or athletes) who could be affected by anxiety during social isolation in the COVID-19 epidemic. Each questionnaire was composed of sociodemographic questions, self-perceived performance, and State-Trait Anxiety Inventory (STAI). Descriptive data are presented as percentage/absolute frequency. Factor analysis was used to reduce many variables into fewer factors of each anxiety group (state and trait) to verify which variables are associated with the COVID-19 pandemic anxiety state, p≤.05. Factor analysis of the trait anxiety group indicated a significant correlation (p≤ 0001). The trait anxiety group's components correlated 0.43 and 0.84, while the state anxiety demonstrated a correlation between 0.52 and 0.996. The present results highlight the importance of cognitive behavior therapy for professional soccer teams. Its core is cognitive restructuring using the ABC model (antecedents-behavior-consequences). Mental errors and maladaptive behaviors are identified and worked upon considering sociodemographic factors such as gender and schooling levels. © JPES.