Bronchial asthma - a risk factor or not for the frequency and severity of COVID-19, where are we? [Bulgarian]

Introduction: The pandemic of a new strain of corona virus - SARS-CoV-2, which occurred at the end of 2019, caused the appearance of a new disease (Covid-19) in over 500 million people worldwide, and over 6 million died. This infection is often clinically manifested as lung complications. Bronchial asthma is a chronic pulmonary disease, which was considered to be a serious risk factor for more frequent and more severe infection with this virus. The aim of this study was to define the role of bronchial asthma as a risk factor for frequency and severity of COVID-19 infection. Materials and methods: The study is retrospective, for the period from April 1, 2020, to December 31, 2021, and includes 356 patients with bronchial asthma, 256 of whom (72%) females and 100 (28%) males, middle age 58.5 (+or- 15.8) years. The infected, hospitalized and deceased patients with COVID-19 and bronchial asthma were included. Data is collected from an outpatient practice database in Pleven, Bulgaria, and is statistically processed with Statgraphics 19.

Dynamic changes in chest CT images over 167 days in 11 patients with COVID-19: a case series and literature review

Background: Recently, CT findings have been widely reported to be associated with the clinical severity of COVID-19. However, few studies have reported the correlation between CT findings and long-term outcomes in patients with COVID-19. Case presentation: Herein, we conducted a 167 day long-term follow-up of CT examination on 11 patients with COVID-19 to evaluate their long-term prognosis, particularly in severe cases. We found that the course of COVID-19 can be divided into four stages according to the characteristics of CT images: (1) early stage (1-4 days), with chest CT showing quasi-circular ground-glass shadows and fine mesh shadows;(2) progressive stage (5-10 days), showing lesion spread through the axial interstitium along the bronchi and gradual diffusion to the whole lung;(3) recovery stage (11-74 days), showing gradual absorption of the fibre cord, ground-glass, and consolidation shadows;and (4) normal stage (74 days later), indicating no serious permanent lung injuries. Conclusions: Our data indicate that chest CT can enable early detection of COVID-19 and determination of the different stages of COVID-19. Furthermore, mild cases tended to have better prognosis, whereas severe cases still showed cord-like fibrosis in the lungs in follow-up at the 167th day after symptom onset.

Impact of COVID-19 on the relapse and reawakening of dormant tumor cells in breast cancer

Worldwide, the study shows that breast cancer is one of the major cancer responsible for women death. All the effective therapies - immune-modulator therapy, chemo-radiation and cell targeted therapies can worsen the body immune system which majorly affects the lungs and these women with weak immune system and bronchi problems are more susceptible to major complications if they are exposed to COVID-19. In start of pandemic, it was difficult for healthcare system to manage the surgeries, scans and therapies of cancer patients without let them exposed to SARCoV-2, leads to delay in their treatment which can even more worsen condition for the patient. SARCoV-2 triggers the IL-6 release by the formation of neutrophil extracellular trap which can increase the complications in the breast cancer patient as well as it can also reactivate the relapsed dormant breast cancer cells. So, after seeing the condition of patients doctors decided that they can treat the patients by taking all measuring safety precautions during the admission to the hospital and found Anti-IL-6 receptor (tocilizumab) neutrophils inhibitor (alvestat) and JAK1/JAK2 inhibitors (baricitinib) effective and vaccines are also available in international market considering them safe and efficient for patient with breast cancer history or maybe undergoing in treatment.

Clinical features of 51 patients with corona virus disease 2019

Objective: To investigate the clinical characteristics of corona virus disease 2019 (COVID-19) patients in Wuhan City, and the correlation between inflammatory factors and severity.

Anatomical variants identified on chest computed tomography of 1000+ COVID-19 patients from an open-access dataset.

Chest computed tomography (CT) has been the preferred imaging modality during the pandemic owing to its sensitivity in detecting COVID-19 infections. Recently, a large number of COVID-19 imaging datasets have been deposited in public databases, leading to rapid advances in COVID-19 research. However, the application of these datasets beyond COVID-19-related research has been little explored. The authors believe that they could be used in anatomical research to elucidate the link between anatomy and disease and to study disease-related alterations to normal anatomy. Therefore, the present study was designed to investigate the prevalence of six well-known anatomical variants in the thorax using open-access CT images obtained from over 1000 Iranian COVID-19 patients aged between 6 and 89 years (60.9% male and 39.1% female). In brief, we found that the azygos lobe, tracheal bronchus, and cardiac bronchus were present in 0.8%, 0.2%, and 0% of the patients, respectively. Variations of the sternum, including sternal foramen, episternal ossicles, and sternalis muscle, were observed in 9.6%, 2.9%, and 1.5%, respectively. We believe anatomists could benefit from using open-access datasets as raw materials for research because these datasets are freely accessible and are abundant, though further research is needed to evaluate the uses of other datasets from different body regions and imaging modalities. Radiologists should also be aware of these common anatomical variants when examining lung CTs, especially since the use of this imaging modality has increased during the pandemic.

Inhaled Water and Salt Suppress Respiratory Droplet Generation and COVID-19 Incidence and Death on US Coastlines

Dry air alters salt and water balance in the upper airways and increases the risks of COVID-19 among other respiratory diseases. We explored whether such upper airway variations in salt and water balance might alter respiratory droplet generation and potentially contribute to observed impacts of airway hydration on respiratory disease. In a randomized 4-arm study of 21 healthy human subjects we found that the breathing of humid air, the wearing of cotton masks, and the delivery of (sodium, calcium, and magnesium chloride) salt droplets sized to deposit in the nose, trachea, and main bronchi similarly reduce the exhalation of respiratory droplets by approximately 50% (P < 0.05) within 10 minutes following hydration. Respiratory droplet generation returns to relatively high baseline levels within 60–90 minutes on return to dry air in all cases other than on exposure to divalent (calcium and magnesium) salts, where suppression continues for 4–5 hours. We also found via a preliminary ecological regression analysis of COVID-19 cases in the United States between January 2020 and March 2021 that exposure to elevated airborne salt on (Gulf and Pacific) US coastlines appears to suppress by approximately 25%–30% (P < 0.05) COVID-19 incidence and deaths per capita relative to inland counties — accounting for ten potential confounding environmental, physiological, and behavioral variables including humidity. We conclude that the hydration of the upper airways by exposure to humidity, the wearing of masks, or the breathing of airborne salts that deposit in the upper airways diminish respiratory droplet generation and may reduce the risks of COVID-19 incidence and symptoms.

Temporospatial characterization of the bronchus associated lymphoid tissue (BALT) of the one humped camel (Camelus dromedarius).

BACKGROUND: Bronchial-associated lymphoid tissue (BALT) is responsible for the local immune response of the lung against airborne infections. The structure of this tissue varies according to species and age. AIM: The aim of this study was to describe the possible age-related structural variation of the BALT of the one humped camel. MATERIAL AND METHODS: Fresh specimens from both lungs of 15 clinically healthy male camels (10 months-12 years) were studied with light and electron microscopes. RESULTS: The BALT in the camel was variable from few lymphocytes to well-organized lymphoid tissue with a clear germinal center. The BALT of the bronchi is a constant lymphoid tissue in young and adult camels which may be of the large size with clear germinal center in response to repeated immune reaction and involutes in old age. The BALT of the bronchioles may be induced and develops mainly due to an immune reaction and showed great morphological variations and observed in different ages. High endothelial venules were associated with BALT in the bronchi but not with that of the bronchioles. The BALT-associated epithelium was tall pseudostratified columnar ciliated epithelium with goblet cells in the extrapulmonary bronchi changed to pseudostratified columnar ciliated epithelium mucous secreting cells in the intrapulmonary bronchi and simple columnar ciliated to simple cuboidal epithelium with Clara cells without goblet cells or mucous secreting cells in the bronchioles. CONCLUSIONS: The BALT of the bronchi is a constant lymphoid tissue in young and adult camels and involutes in old age. The BALT of the bronchioles may be induced and develops mainly due to an immune reaction and observed in different ages.

Tomographic findings in bronchial atresia.

OBJECTIVE: To evaluate computed tomography (CT) findings in 23 patients with bronchial atresia. MATERIALS AND METHODS: The CT images were reviewed by two radiologists who reached decisions by consensus. We included only patients who presented with abnormalities on CT and in whom the diagnosis had been confirmed by pathological examination of the surgical specimen (if the lesion was resected). The CT scans were assessed in order to identify the main findings and to map the distribution of the lesions (i.e., to determine whether the pulmonary involvement was unilateral or bilateral). RESULTS: The main CT finding was the combination of bronchocele and hyperinflation of the distal lung. That combination was observed in all of the patients. The lesions were unilateral in all 23 cases, being seen predominantly in the left upper lobe, followed by the right lower lobe, right upper lobe, middle lobe, and left lower lobe. CONCLUSION: The diagnosis of bronchial atresia can be reliably made on the basis of a finding of bronchocele accompanied by hyperinflation of the adjacent lung parenchyma.

OBJETIVO: Analisar os achados na tomografia computadorizada (TC) de tórax de 23 pacientes com atresia brônquica. MATERIAIS E MÉTODOS: As imagens de TC foram avaliadas por dois observadores e os casos discordantes foram resolvidos por consenso. Os critérios de inclusão foram a presença de anormalidades na TC compatíveis com atresia brônquica e/ou diagnóstico confirmado por exame anatomopatológico das peças cirúrgicas para os pacientes submetidos a ressecção cirúrgica. As TCs foram avaliadas quanto aos principais achados de imagem, à distribuição das lesões, ao envolvimento pulmonar unilateral ou bilateral. RESULTADOS: Os principais achados na TC foram a presença de broncocele, hiperinsuflação do parênquima pulmonar ou ambos. A combinação desses achados foi encontrada em todos os pacientes. Em relação à distribuição, o envolvimento foi unilateral nos 23 casos. Quando se consideraram os lobos mais acometidos, o lobo superior esquerdo foi o mais acometido, seguido do lobo inferior direito, lobo superior direito, lobo médio e lobo inferior esquerdo. CONCLUSÃO: O diagnóstico de atresia brônquica pode ser feito em presença de broncocele associada com hiperinsuflação do parênquima pulmonar adjacente.