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Introduction: During the COVID-19 pandemic pulmonary rehabilitation moved to a telehealth platform and the 1-min sit-to-stand test (1minSTS) was often used instead of the 6-min walk test (6MWT) to evaluate functional exercise capacity. We sought to determine;(i) the extent to which the six-minute walk distance (6MWD) could be estimated from the number of repetitions achieved during the 1minSTS and, (ii) agreement in cardiorespiratory responses elicited collected during the tests. Method(s): Data were extracted from medical records on all people who attended the advanced lung disease service at Fiona Stanley Hospital between September 2021 and January 2022. Pulse rate and oxygen saturation (SpO 2) were measured continuously during both tests using a pulse oximeter. Symptoms were quantified using the Borg scale (0 to 10). Result(s): Data were available on 80 participants (43 males;age 64 +/- 10 years;FEV 1 1.65 +/- 0.77 L). Compared with the 6MWT, the 1minSTS resulted in a higher nadir (mean difference [MD] 4%, 95% CI 3 to 5), higher peak pulse rate (MD 8 bpm, 95% CI 5 to 11), similar intensity of dyspnoea (MD -0.3, 95% CI -0.6 to 0.1) and greater leg fatigue (MD 1.1, 95% CI 0.6 to 1.6). Of those who demonstrated severe desaturation (SpO 2 nadir <85%) on the 6MWT (n = 18), 5 and 10 were classified as moderate (SpO 2 nadir 85% to 89%) or mild desaturators (SpO 2 nadir >= 90%), respectively on the 1minSTS. The equation that represented the relationship between 6MWD and 1minSTS was: 6MWD (m) = 247 + (7 x number of transitions achieved during the 1minSTS;r 2 = 0.44). Conclusion(s): The 6MWT elicited greater desaturation, a lower peak pulse rate and greater leg fatigue than the 1minSTS. A smaller proportion of people will be classified as 'severe desaturators' using the 1minSTS test. The capacity to estimate the 6MWD using results of the 1minSTS is limited.
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The lung is the most common organ affected by sarcoidosis. Multiple tools are available to assist clinicians in assessing lung disease activity and in excluding alternative causes of respiratory symptoms. Improving outcomes in pulmonary sarcoidosis should focus on preventing disease progression and disability, and preserving quality of life, in addition to timely identification and management of complications like fibrotic pulmonary sarcoidosis. While steroids continue to be first-line therapy, other therapies with fewer long-term side-effects are available and should be considered in certain circumstances. Knowledge of common clinical features of pulmonary sarcoidosis and specific pulmonary sarcoidosis phenotypes is important for identifying patients who are more likely to benefit from treatment.Copyright © ERS 2022.
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Introduction: The occurrence of the late effects of covid-19(long-covid)is a hot issue. Detailed data on its forms within the population are still lacking. Aim(s): We want to describe the long-covid in the population of the Czech Republic(CR)in relation to the covid severity. Method(s): Prospective collection of data on consecutive patients(pts)sent by GPs to pulmonologists started since June,21. The interim analysis concerns pts enrolled by February,22. The analysis was based on data collected in Information System of Infectious Diseases of the CR, especially its long-covid module. The 44 outpatient centers cover all 14regions of the CR and represent 13% of all(343)outpatient clinics of pulmonologists, they are responsible for the care of long-covid pts in the CR. Result(s): 3.489pts have been included in the study so far. After the removal of 40%pts with significant comorbidities,1.895"healthy"post-covid individuals (50%men,69%non-smokers)remained. Only a minority of these pts with long-covid 874(46%)were hospitalized due to covid severity. Inpatients were older, more often males/obese, less likely smokers. Inpatients had more severe post-covid residual CTchanges, more frequent diffusion capacity impairment, more restrictive ventilation pattern, and more oxygen desaturation during walking. Contrary nonhospitalized pts had more cough, and obstructive ventilation pattern. Hospitalized and non-hospitalized pts did not differ in incidence of resting desaturation, dyspnea, fatigue, expectoration, and chest pain. Despite the fact that 64%of the CR population is fully vaccinated, only 25(1.3%)were vaccinated among long-covid cohort. Conclusion(s): Previously hospitalized have more severe long-covid, however, most pts had only a mild acute COVID.
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Background: Despite limited validation data (Kalin et al Systematic Reviews 2021 Mar 16;10(1):77), the 1MSTS was widely used as a rapid exercise test to assess exertional oxygen desaturation during the COVID-19 pandemic. Aim(s): To assess the diagnostic accuracy of the 1MSTS to detect significant exertional oxygen desaturation in people with chronic respiratory disease. Method(s): 99 patients referred for pulmonary rehabilitation assessment were assessed for ambulatory oxygen requirements using a shuttle walk test according to British Thoracic Society Guidelines for Home Oxygen Use. Exertional oxygen desaturation was defined as a drop in oxygen saturations (SpO ) of >=4% with nadir <90%. 1MSTS was conducted in each participant by an assessor blinded to ambulatory oxygen assessment results. Result(s): Mean(SD) age 68.9(11.4) years, 59%COPD, 13%ILD. 21% demonstrated significant exertional oxygen desaturation. Using a drop of SpO >=4% to nadir <90% threshold, the 1MSTS only identified 6 out of 21 patients with exertional oxygen desaturation (sensitivity 29%). Simplifying the threshold to a drop in SpO of >=4% alone during 1MSTS improved sensitivity to 81% with specificity of 87%. Conclusion(s): Using a threshold of drop in SpO of >=4%, the 1MSTS test had reasonable sensitivity and specificity identifying significant exertional oxygen desaturation in patients with chronic respiratory disease.
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Background: An uncertain proportion of COVID-19 survivors may present persisting symptoms,referred to the term "Long COVID". The prevalence of exercise-induced oxygen desaturation (EID) in patients with Long COVID is still uncertain, ranging between 22% and 50%;moreover, the relationship of EID with exertional dyspnea and baseline Pulmonary Function Tests (PFTs) remains unclear. Aim(s): The study was designed to investigate the prevalence of EID in patients with "Long COVID" and assess its relationship to exertional dyspnea and PFTs. Method(s): A prospective cohort study was conducted including 194 consecutive "Long COVID" patients (M/F:132/62;age: 62.8+/-12.8 yrs) discharged from 2 university hospitals in North-Eastern Italy. At 6 month follow-up visit, patients underwent 6-min walking test (6MWT) and PFTs, including spirometry and diffusing capacity (DLco). The level of dyspnea was assessed by mMRC dyspnea scale. Result(s): Thirty-three (17%) patients showed early EID (SaO2 drop: 3.4 +/- 2.5;p<0.001) with a synchronous positive chronotropic response. Compared to non-desaturators, desaturators showed significantly reduced 6-min walk distance (420 [355-525] vs 500 [443.5-581] m;p=0.002) and DLco (70.6+/-24.7%pred vs 85.7+/-16.9%pred;p<0.001). The level of dyspnea didn't significantly differ between desaturators and non desaturators (mMRC dyspnea score: 1 [1-2] vs 1 [1-1];p=0.184). Conclusion(s): A significant proportion of survivors with "Long COVID" shows persistent oxygen desaturation during exercise which seems to be unrelated to the degree of dyspnea. 6MWT should be regularly performed after discharge from hospital to understand the extent and severity of EID and whether it may be associated with worse prognosis.
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Introduction: The long-term COVID-19 effects are currently unknown. Whether and for how long symptoms extend beyond the acute phase of the disease is unresolved Aim: To determine the functional capacity of COVID-19 survivors by cardio- pulmonary exercise testing (CPET) and describe its association with dyspnoea and pulmonary function test (PFT). Methods and Results: All COVID-19 patients discharged from our tertiary care institution were enrolled in a prospective follow-up study which would assess clinical, instrumental and laboratory characteristics of COVID-19 survivors at 3months from hospital discharge (Careggi University Hospital, Florence). Clinical evaluation included: peripheral blood samples including inflammatory cytokines, pulmonary function test (functional respiratory and 6 minwalking test), lung ultrasound, ECG recording and echocardiographic exam. All patients with peripheral oxygen desaturation at 6 min-walking test (SpO2 < 92%), dyspnoea and with a history of hospitalization in critical care settings were referred for CPET. Dyspnoea was classified with the Medical Research Council (MRC) scale. From June 2020 to May 2021, 198 patients were enrolled;overall, 42% of patients presented with dyspnoea at 3 months from hospital discharge with no difference according to disease severity on hospital admission (P 1/4 0.233) Conclusion(s): At 3-months, almost 1 in 2 patients discharged for COVID-19 pneumonia presented with dyspnoea, irrespective of disease severity. We want to compare CPET and spirometry data (already performed in 110 patients), highlighting differences between ventilated patients (invasive or noninvasive) and patients admitted to the ward. The data are still being analyzed.
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Introduction: There is a lack of data on long-term sequelae of severe COVID-19 pneumonia beyond clinical followup at 6 months. Aim(s): To describe the evolution of pulmonary sequelae at 3, 6 and 12 months in severe COVID-19 survivors in terms of pulmonary function and high-resolution computed tomography (HRCT) of the chest. Method(s): 84 subjects (74% male, median age: 63 [49-70]) hospitalized for COVID-19 pneumonia (January 2021- January 2022) were evaluated at 3, 6 and 12 months after discharge with spirometry, lung diffusing capacity (DLCO), 6-minute walking test (6MWT) and HRCT. Result(s): At 3, 6 and 12 months, 64%, 70% and 80% of patients were found to have normal spirometry (FVC: 83+/-6%, 96+/-2%, 97+/-2%]);DLCO <80% was found in 66% (mean 77+/-1%), 63% (mean 74+/-2%) and 43% (mean 81+/-1%) of subjects;6MWT performance was normal in 70% (median 494 m [582-472]), 84% (median 552 m [487- 583]) and 100% (median 557 m [496-588]) of subjects. However, after 1 year of discharge, 50% of patients had persistent oxygen desaturation at the end of the 6MWT. HRCT abnormalities were detected at 3, 6 and 12 months in 87%, 60% and 43% of patients. The most prevalent HRCT patterns at 12 months were ground-glass opacities (71%), subpleural reticulation and atelectasis (35%) and bronchiectasis (10%). Conclusion(s): A high prevalence of persistent lung function and HRCT abnormalities was found in survivors of severe COVID-19 pneumonia. Evaluation at 3, 6 and 12 months showed progressively improving values of spirometry, DLCO and 6MWT over time. However, long-term HRCT anomalies and exercise-induced desaturation suggest persistent interstitial phenomena of unknown implications.
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Introduction: The 6-min walk test (6MWT) is the gold standard for assessing exercise-induced impairment of gas exchange, but it is technically challenging in a busy outpatient clinic. The aim of this study was to compare the 1-min sit-to-stand test (1STST) with the 6MWT in assessment of exercise-induced oxygen desaturation in post COVID-19 patients in an outpatient setting. Method(s): A total of 447 outpatient post COVID-19 patients were recruited from post COVID-19 clinic. Both 6MWT and 1STST (a set) were performed on the same day including pulse oxygen saturation (SpO2) recording at baseline, nadir, and recovery stage. Result(s): A total of 447 sets were performed at a mean of 160 days post discharge. Majority were in category severe (n=251, 56%), critical (n=118, 26%) and moderate (n=6, 15%). At assessment, most patients were symptomatic (mMRC > 2) n= 258, 58%. There was no significant difference between nadir SpO2 for 6MWT and 1STST (p<0.075) with Bland-Altman plots showing good agreement, p<0.593 (figure 1). There was good correlation between SpO2 and 6MWT or 1STST at baseline;R=0.592 p<0.001, nadir;R=0.456 p<0.001, and recovery;R= 0.514 p<001. 1STST had 76.8% sensitivity and 42.4% specificity to detect > 4% oxygen desaturation compared with 6MWT (table 1). There was also correlation between 6MWT distance and 1STST repetition;R=0.144 p<0.002. Conclusion(s): Both 6MWT and 1STS have good agreement on nadir SpO2 and are sensitive to detect > 4% oxygen desaturation. Therefore, 1STST is an useful screening test to detect exercise-induced oxygen desaturation during outpatient assessment.
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Introduction: Acute COVID-19 infection could lead to long COVID, a heterogenous condition which includes the respiratory system. But data on long-term respiratory complications are scarce and limited especially from our part of the world. Method(s): A total of 443 post COVID-19 patients were recruited from post COVID-19 clinic. The following assessments were performed in all patients;symptoms, 6-minute-walk-test (6MWT), 1-minute-sit-to-stand-test (1STST), spirometry, and chest radiograph. Result(s): Patient's mean age was 51 (13) years old, majority were male (60%), and Malay ethnicity (73%). Majority were in category severe (n=254, 57%), critical (n=122, 28%) and moderate (n=67, 15%). Abnormal spirometry (FVC <80%) were detected in 47% (n=209) of the patients. It was associated with older age groups (54 vs 49 years old, p 0.001), longer hospital admission (17 vs 13 days, p 0.016), shorter follow-up duration (140 vs 170 days, p 0.004), more likely to have oxygen desaturation >4% during 6MWT and 1STST, OR 1.8 (1.1-2.9) and OR 1.7 (1.1-2.6) respectively, and abnormal chest radiograph, OR 3.9 (2.5-6.2) compared to those with normal spirometry findings 125 patients have full lung function test and gas transfer done which showed reduced TLC (<80%) and DLCO (<80%), and normal KCO (>80%) in majority of cases;80% (n = 100), 86.4% (n = 108) and 94% (n = 117). Conclusion(s): Abnormal spirometry findings are common among post COVID-19 patients with pneumonia and are associated with poorer respiratory outcomes;exertional oxygen desaturation and abnormal chest radiograph. Therefore, these groups of patients should be referred for spirometry assessment.
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[...]my short-lived joy was followed by crippling doubt, the weight of my title confounded by the trust placed in someone who still did not know how to order bloods. Blindsided by her unremarkable hospital stay and still so naive on the cusp of my professional career, I was surprised to review Mary for a small desaturation the day before hospital discharge. There was no flurry of cardiopulmonary resuscitation or intubation. [...]painstakingly the consultant sat and explained the capacity issues, the lack of beds, and how most people did not survive in the ICU. The absence of touch during this pandemic has been interesting;the reassurance gentle pressure can have on a hand or a shoulder was replaced by protective distance and plastic barriers.
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The issue of physical rehabilitation of post-COVID patients stays relevant up to this day. Most publications discuss inpatient rehabilitation and only few publications describe outpatient physical rehabilitation of such patients. The aim. Our study was performed to investigate efficacy of outpatient physical rehabilitation of post-COVID patients with lung injury. Methods. This was a prospective non-randomized open controlled study. All patients with COVID-19-associated lung injury were referred to supervised outpatient rehabilitation program. We analyzed 6-minute walk test (6-MWT) results, evaluation of dyspnea using Borg scale and assessment of oxygen saturation (SpO2) using pulse oxymeter before and after walking. Results. The rehabilitation group included 24 patients and the control group included 6 patients. The baseline and demographic findings did not differ significantly between the groups. The 6-minute distance (6-MWD) (p = 0.000018), heat rate at rest (p = 0.017) and after walking (p = 0.017), dyspnea after walking (p = 0.017), oxygen saturation at rest (p = 0.030) and after walking (p = 0.0021) improved significantly in the rehabilitation group and did not change significantly in the control group. At the end of the study, 6-MWD increased by 63.2 +/- 36.3 m in the rehabilitation group compared to 14.0 +/- 28.8 m in the control group (p = 0,01) and exertional dyspnea score increased by 0 (0 - 1) compared to 1 (1 - 2) in the control group (p = 0.033). Conclusion. Supervised outpatient physical rehabilitation in outpatient settings can accelerate physical recovery in post-COVID patients with lung injury. Copyright © 2022 Medical Education. All rights reserved.
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Background: Although Remdesivir has been evaluated for the treatment of coronavirus disease 2019 (COVID-19), few study has yet shown effective mortality reduction. It might be because, in almost all those studies, remdesivir therapy was started beyond 7th days from the onset of symptoms when the active viral replications have already gone. Methods: This study reviewed the effectiveness of early remdesivir therapy during viral phase of COVID-19 and safety of its administration at home or community care during the outbreak of COVID-19 from July to September 2021 in Myanmar. We retrospectively reviewed clinical records of 204 high risk COVID-19 patients who had received remdesivir therapy within 7 days from the onset of illness and before oxygen desaturation. Findings: All patients received remdesivir therapy according to standard five days course of 200 mg loading dose on day 1, followed by 100 mg daily for up to 4 additional days. Out of 204 patients, 60.75% (124/204) were aged 60 years and above with comorbidity; 21.1% (43/204) aged under 60 years with comorbidity and 18.1% (37/204) were aged more than 60 years old without comorbidity. The patients who received RDSV therapy within 1-4 days and within 5-7 days were 50.5% (103/204) and 49.5% (101/204) respectively. All patients survived to 21 days without ICU admission or mechanical ventilation. Eighty six percent of patients had no hypoxia and only five percent had moderate to severe hypoxia, requiring oxygen. Those who received RDSV therapy within 1 to 4 days from the onset of symptoms had significantly lower rate of hypoxia compared to those who received remdesivir therapy on 5 to 7 days. After RDSV therapy, increased lymphocyte count and decreased CPR were observed in 74.5% (152/204) and 52.9% (108/204) of the patients respectively. There was no report of major adverse events. Conclusion: Remdesivir, if given within first 4 days from the onset of symptoms, is the most effective strategy for prevention of oxygen desaturation, further progression of COVID-19 and death although it is still beneficial if given later, days 5 to 7. It is a safe drug to be prescribed in hospital at home care. It may be cost-benefit if high-risk group of patients with COVID-19 were selected for early remdesivir therapy in the community.
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SESSION TITLE: Long COVID: It Can Take Your Breath Away SESSION TYPE: Original Investigations PRESENTED ON: 10/16/2022 10:30 am - 11:30 am PURPOSE: Dyspnea is a common complaint in survivors of severe COVID-19 pneumonia, which may originate from intrinsic lung injury, diaphragmatic weakness, or other etiologies. Point-of-care ultrasound has revolutionized evaluation of acute respiratory failure in inpatient settings. Ultrasound however has seldomly been employed in ambulatory practice. We report on the use of thoracic ultrasound in evaluating dyspnea in survivors of critically ill COVID-19 pneumonia in a Post-ICU clinic. We aimed to determine how thoracic ultrasound (comprised of the lung ultrasound score (LUS) and diaphragm excursion during inspiration) correlate with patient-reported dyspnea (per the Borg Dyspnea Scale) during 6-minute walk test (6MWT). We hypothesize higher LUS and lower diaphragm excursion will correlate with severity of dyspnea. METHODS: Single-center cross-sectional study of survivors of critically ill COVID-19 pneumonia (requiring high-flow nasal cannula, or invasive- or non-invasive mechanical ventilation) seen in our Post-ICU clinic. All patients underwent standardized scanning protocols to compute LUS and diaphgram excursion (at quiet and deep inspiration). Pearson correlations were performed to detect association between LUS and diaphragm excursion with dyspnea at rest and exertion during 6MWT. RESULTS: Between 1/15/21-1/15/22, we enrolled n=45 patients. Average age was 61.5±13.9 years, 57.7% were male, with average BMI of 32.3±7.2. Higher LUS correlated significantly with dyspnea, at rest (r = +0.41, p = <0.01) and at exertion (r = +0.40, p = <0.01). Higher LUS correlated significantly with lower oxygen saturation during 6MWT (r = -0.55, p = <0.01) and lower 6MWT distance (r = -0.44, p = <0.01). Diaphragm excursion (on quiet and deep inspiration), correlated significantly with 6MWT distance (r = +0.33, p = 0.05;r = +0.37, p = 0.03), but did not correlate with dyspnea at rest or exertion. CONCLUSIONS: Higher LUS correlated positively and significantly with patient-reported dyspnea, both at rest and during exertion. Higher LUS significantly correlated with more exertional oxygen desaturation during 6MWT and lower 6MWT distance. While diaphragm excursion did not correlate with dyspnea, higher excursion (on quiet and deep inspiration) did correlate positively and significantly with 6MWT distance. CLINICAL IMPLICATIONS: Higher LUS reflect severity of lung injury following viral pneumonia in post-COVID-19 patients. LUS may thus predict which patients will desaturate during exertion, and which patients may require prolonged oxygen support during recovery. Hypoxemia from post-viral lung injury may limit exercise capacity, thus LUS may also guide clinicians in determining the role of physical or pulmonary rehabilitation. Diaphragm excursion correlated with 6MWT distance, and thus may provide insight for clinicians into the capacity of a patient's extra-pulmonary respiratory system in relation to patient exercise tolerance. DISCLOSURES: No relevant relationships by Seth Congdon No relevant relationships by Gerardo Eman No relevant relationships by Benjamin Galen no disclosure on file for Aluko Hope;No relevant relationships by Marjan Islam No relevant relationships by Shwe Synn
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The objectives of this study were to determine the biological characteristics of diabetic patients who have been diagnosed with COVID-19 and to estimate the risk of death in these patients. The study included 285 COVID-19 individuals whose diagnosis was confirmed by PCR and/or on the basis of typical signs and radiological findings (CT). Patients admitted to the Infectiology Service of Ali Boushaba Public Hospitalier Khenchela, during the year 2020. The data was collected from 1 January to 30 June 2021. The average age of patients diagnosed with COVID-19 in the enumerated population is 62.53 + 16.65 years. A male predominance was noted, with a sex ratio of men to women in the range of 1,29. Old diabetic patients account for 48.80 % of our sample patient. The PCR was positive in 87% of diabetic cases, the oxygen desaturation was 64.7%, and the pulmonary affliction was important or critical in 28.8% and 18.7%, respectively. A wide range of biological abnormalities was found in diabetic patients, including high CRP in 95.7% of cases, hyperglycemia in 64%, hyperleucocytose in 26.6% of cases, D-dimer elevation in 56% of cases, and hypoprothrombinemia in 21.6% of cases. A high rate of urea and hypo-creatinemia were found in 36.70% and 12% of patients, respectively. As well as high rates of ASAL and ALAT in 28.80% and 26.60% of patients, respectively. In diabetics a mortality rate of 22.3% was noted. With the exception of glycemia and ALAT, the differences in percentages of these parameters based on the presence of diabetes are statistically insignificant. Furthermore, the diabetic is unrelated to the clinical outcome of the patients. Due to the high number of infections, biological changes, and deaths among diabetics infected with COVID19, it is necessary to consider good care of care of these patients in order to reduce morbidity and mortality rates.
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The aim. The presented material reflects the results of studies by Russian specialists conducted under the auspices of the Russian Respiratory Society over the past 15 years. The article also includes the main provisions set out in the III Guidelines for dyspnea. A significant part of the manual is devoted to the recent achievements in studying neurophysiological processes in the brain structures during the development of dyspnea. These achievements were driven by image-diagnosis methods. An important aspect of this series of works for the clinical practice was identifying dyspnea domains and developing the instruments to assess severity. Results. Analysis of the data on dyspnea from the clinical practice showed a highly heterogenic clinical picture, which must be taken into account in the management of individual patients. A diagnostic algorithm for long-term follow-up of patients with dyspnea syndrome is also discussed. The attention of doctors is drawn to the features of dyspnea during COVID-19;the disproportion between the sensory perception of respiratory discomfort and the degree of oxygen desaturation is emphasized. Conclusion. It was concluded that in the Russian-speaking environment of patients, doctors should actively use a verbal characteristic of dyspnea – the “language of dyspnea”. © 2021 Medical Education. All rights reserved.
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Background & Aim: The wide gap in severe Covid-19 management is increasingly addressed by mesenchymal cell (MSC) therapies, despite studies that failed to show significant efficacy in ARDS. To improve the therapeutic utility of MSCs in ARDS, Bonus BioGroup developed MesenCure: An allogeneic adipose-derived MSC product professionalized by a combination of culture conditions enhancing the cells’ potency and stability, producing unique transcriptomic, proteomic, and morphological signatures. Up to 100k fresh MesenCure doses with a shelf life sufficient for global supply can be produced from a single donor under 20 PDLs, further preventing potency loss due to cryopreservation and culture aging. Based on preclinical data presented during ISCT2021, demonstrating MesenCure’s advantages over non-professionalized MSCs, and its safety in a Phase I study, Bonus BioGroup initiated a multi-center Phase II trial in severe Covid-19 patients that was recently concluded. Methods, Results & Conclusion: The Phase II trial included 50 severe Covid-19 patients suffering from diffuse pneumonia and oxygen desaturation treated with up to 3 MesenCure doses (1.5x106 cells/kg on days 1, 3, and 5), on top of the Standard of Care (SoC), and 150 similar severe control patients treated by the SoC only and stratified according to gender, age, and comorbidities. A substantial 68% reduction in the mortality rate of the test patients was measured (Fig. 1A, p<0.05), along with a 57% drop in their risk of intubation relative to the control (Fig. 2A, p<0.05). Over 50% of the patients treated with MesenCure were released from the hospital within two days after treatment, and a 38% reduction was measured in the hospital length of stay (LoS) of patients having LoS>7 days (Fig. 1C, p<0.01). Starting from a similar baseline as the control, the median CRP and CK levels of the test patients, after MesenCure treatment, ended 52% (p<0.0001) and 33% (p<0.01) lower than their respective control levels. As shown in Fig. 2 [Figure Presented] Fig. 1 ( 25). (A) Mortality rates among test and control patients at Visit 8 (one month after the first MesenCure dose or the equivalent time points for the control). (B) Test and control patients’ risk of deteriorating to mechanical ventilation. (C) Average hospital length of stay (LoS) of patients having LoS > 7 days. Two-sided p values were calculated using the Fisher Exact test (A and B) or t-test (C). [Figure Presented Fig. 2 ( 25). (A) CRP and (B) CK levels measured at Visit 6, the earliest of two weeks after the first MesenCure dose (Visit 2) or upon hospital release, or the equivalent time points for the control. The test and control groups started from similar median CRP and CK levels. (C) Changes in control and test patients’ LDH levels from Visit 1 (screening) to Visit 6. (D) Area of test patients’ diffuse pneumonia during Visits 1, 6, and 8 (one month after Visit 2). (E) Blood oxygen saturation measured during test patients visits 1, 2-4 (upon or before receiving the first to third MesenCure dose), Visit 5 (the earliest of one week after Visit 2 or upon hospital release), and Visit 6. (F) Test patients’ blood lymphocytes levels (absolute) across Visits 1 and 6. Charts are presented as box-and-whiskers (according to the Tukey method). p values were calculated using the Mann-Whitney test (A, B, and C), Dunn’s multiple comparisons (D and E), or the Wilcoxon test (F). the more profound improvements in inflammatory and tissue damage markers observed in test patients were accompanied by a rapid recovery in pneumonia, respiratory functions, and lymphopenia, emphasizing MesenCure’s powerful effect. In conclusion, we show that MesenCure saves patients’ lives and accelerates their healing, possibly reducing the risk of long-term damages while freeing ICU beds allowing better care for other patients, and reducing the burden associated with hospitalization and additional long-term healthcare costs.