ABSTRACT
Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has showed to cause long-term pulmonary sequelae. Objects: The aim of this study was to evaluate the consequences on pulmonary function of the SARS-CoV-2 infection related to the severity of the disease and exercise tolerance. Method(s): a retrospective cohort study was performed at the "Policlinico Tor Vergata" Academic hospital (Rome, Italy) where 75 patients evaluated in the post-COVID outpatient clinics at the Respiratory units were included in the study. Complete pulmonary function tests, 6-minute walk tests and persistence of symptoms were evaluated. Result(s): among the 75 subjects, 23 were mild, 16 moderate, 26 severe and 10 very severe based on the WHO classification. Very severe patients had a lower FVC (100+/-10%pr) compared to the others groups (116+/-16%pr, 116+/-13%pr, 122+/-20%pr from mild to severe;p<0,05) and a lower TLC (94+/-13%pr) compared to the others (102+/-10%pr, 108+/-15%pr, 108+/-12%pr from mild to severe;p<0,05). DL'co and DL'co/VA were similar among groups. At the 6MWT, distance, basal and nadir SpO2 were similar among groups, but all groups presented a significant decrease of SpO2 from basal to the nadir (Basal SpO2: 97,0+/-1,0% vs Nadir SpO2: 93,6+/-2,7%, p.<0,01). A positive correlation was found between desaturation and delta SpO2 (basal-nadir) (R: 0.29, p<0,05) and the Distance Desaturation Product (R: 0.39, p<0,01). Conclusion(s): These results showed that, although the PFTs are within the normal range, there is a restrictive spirometric pattern in very severe subjects. Moreover, the only persistent pathological sequalae of SARS-CoV-2 infection were a mild desaturation at 6MWT, despite the severity.
ABSTRACT
Introduction: Pulmonary function can be affected in Long COVID Syndrome as long-term health consequences caused by SARS CoV2 infection. Objects: The aim of the study was to evaluate the consequences of SARS-CoV-2 infection on pulmonary function, exercise tolerance and muscle strength in healthy middle age outpatients. Method(s): a retrospective cohort study was carried out at the long-COVID outpatient clinics after 3 month from the last negative PCR test. Pulmonary function tests, diffusion of carbon monoxide (Dlco), 6 Minute Walk Test (6MWT), Handgrip Test (HT), and One Minute Sit to Stand Test (1'STS) were perfomed and only in symptomatic patients chest HRCT was carried out. Subjects included were divided according to age, BMI positive HRCT for pneumonia and comorbidities. Result(s): 89 males and 4 female (age: 49,49 +/- 9,1yrs) were included. Subjects older than 50 yrs or with a positive HRCT had a significantly (p<0,05) lower FVC, DLco, and 6MWT distance compared to younger subjects or subjects with negative or no HRCT. Subjects with a greater BMI (>30) had similar lung function compared to the group with a BMI<=30, but a significantly lower distance at the 6MWT (509m vs 570m, p.<0,05), a lower nadir saturation and a lower number of repetition at the 1'STS. In the all group, the DLco, %pr positively correlates with number of repetition at the 1'STS, the distance at the 6MWT and the strength at the HG. Conclusion(s): These results showed that BMI has an impact on exercise tolerance impairment, age and CT pulmonary involvement due to SARS-CoV-2 infection lead to a spirometric restrictive pattern, while DLco correlates with an impaired exercise tolerance, regardless of the exercise modalities.
ABSTRACT
SUMMARY: At the beginning of Sars-Cov 2 pandemic, in the absence of "targeted" therapies, the national health authorities have introduced some measures aimed at reducing the spread of infection in the community (lockdown, social distancing, personal protective equipment (PPE), personal hygiene and disinfection of living environments). All the containment measures have led to both positive and negative effects in patients with allergic diseases. We believe that further studies should be undertaken to investigate the possible correlations between SARS-CoV-2 infection and allergy, from a broader perspective. In particular, the risk factors for the development of undesirable effects should be investigated, especially in healthcare professionals forced to use PPE and sanitizing agents for a long time. However, since the COVID-19 pandemic probably will not be short-lived, the use of such protective aids will necessarily be widespread even in the general population. Therefore, further studies on the materials used for the production of PPE and sanitizing agents would be necessary to reduce their sensitizing and, in some cases, toxic potential.
ABSTRACT
Neutrophils, which are among the first immune cells to respond to both infection and injury, when activated can release pre-stored serine proteases such as neutrophil elastase, cathepsin G and proteinase 3. An abundant release of these proteolytic enzymes in the alveolar compartment as well as the airways can trigger collateral pulmonary tissue damage. Indeed, much of the tissue destruction that characterizes non-cystic fibrosis bronchiectasis appears to be caused by serine proteases. The transitory pharmacological inhibition of bone marrow dipeptidyl peptidase 1 (DPP1), which converts neutrophil proteolytic enzymes into their mature active form, is a therapeutic possibility to decrease the constitutively produced serine protease pool of neutrophils. Brensocatib (also called INS-1007 or AZD-7986) is a potent reversible DPP1 inhibitor that has been successfully evaluated in a phase II trial as a treatment for non-cystic fibrosis bronchiectasis and, consequently, has been granted breakthrough therapy designation by the U.S. Food and Drug Administration and Priority Medicines (PRIME) designation by the European Medicines Agency.
Subject(s)
COVID-19 , Rhinitis, Allergic, Seasonal , Communicable Disease Control , Humans , Masks , Pandemics , SARS-CoV-2 , Self ReportABSTRACT
To date, there is still a paucity of data from Phase III trials concerning the efficacy of vaccines against COVID-19. Furthermore, no studies investigated the variables that may modulate the efficacy of vaccination. The aim of this analysis was to assess whether there are modifying factors that may potentially influence the clinical efficacy of COVID-19 vaccines. A quantitative synthesis of data from Phase III trials was performed via pairwise and network meta-analyses, along with meta-regression analysis. Data from Phase III trials are currently available only for AZD1222, BNT162b2, mRNA-1237, and Sputnik V. Vaccination resulted to be generally effective (90.0%, 95%CI 72.6-96.4;p < 0.001), although the efficacy of AZD1222 (62.1%) introduced a significant level of heterogeneity in the meta-analysis (I<sup>2</sup> 92.17%, p < 0.001). No significant modifying factors resulted from the meta-regression analysis. However, considering the mRNA-based vaccines, a trend toward significance (p = 0.081) resulted for age. The network meta-analysis provided the following rank of effectiveness: BNT162b2 mRNA-1273 > Sputnik V >> AZD1222. In conclusion, no modifying factors seem to modulate the efficacy of vaccines against COVID-19. This quantitative synthesis will need to be updated as soon as further clinical results on the efficacy profile are available from Phase III trials for further licensed COVID-19 vaccines.
ABSTRACT
Objective: Coronavirus disease 2019 (COVID-19) represents a novel pneumonia leading to severe acute respiratory syndrome (SARS). Recent studies documented that SARS-Coronavirus2 (SARS-CoV2), responsible for COVID-19, can affect the nervous system. The aim of the present observational study was to prospectively assess subjective neurological symptoms (sNS) in patients with SARS-CoV2 infection.