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Objective: To analyze the clinical manifestations, diagnostic methods and treatment process of the patients with non-Hodgkin's lymphoma complicated with human coronavirus(HCoV)-HKU1 pneumonia and improve the clinical medical staff's awareness of the disease, and to reduce the occurrence of clinical adverse events. Method(s): The clinical data of a patient with non-Hodgkin's lymphoma complicated with HCoV-HKU1 pneumonia with hot flashes and night sweats, dry cough and dry throat as the main clinical features who were hospitalized in the hospital in January 2021 were analyzed, and the relevant literatures were reviewed and the clinical manifestations and diagnosis of HCoV-HKU1 were analyzed. Result(s): The female patient was admitted to the hospital due to diagnosed non-Hodgkin's lymphoma for more than 2 months. The physical examination results showed Karnofsky score was 90 points;there was no palpable enlargement of systemic superfical lymph nodes;mild tenderness in the right lower abdomen, no rebound tenderness, and slightly thicker breath sounds in both lungs were found, and a few moist rales were heard in both lower lungs. The chest CT results showed diffuse exudative foci in both lungs, and the number of white blood cells in the urine analysis was 158 muL-1;next generation sequencing technique(NGS) was used the detect the bronchoalveolar lavage fluid, and HCoV-HKU1 pneumonia was diagnosed. At admission, the patient had symptoms such as dull pain in the right lower abdomen, nighttime cough, and night sweats;antiviral treatment with oseltamivir was ineffective. After treatment with Compound Sulfamethoxazole Tablets and Lianhua Qingwen Granules, the respiratory symptoms of the patient disappeared. The re-examination chest CT results showed the exudation was absorbed. Conclusion(s): The clinical symptoms of the patients with non-Hodgkin's lymphoma complicated with HCoV-HKU1 pneumonia are non-specific. When the diffuse shadow changes in the lungs are found in clinic, and the new coronavirus nucleic acid test is negative, attention should still be paid to the possibility of other HCoV infections. The NGS can efficiently screen the infectious pathogens, which is beneficial to guide the diagnosis and treatment of pulmonary infectious diseases more accurately.Copyright © 2023 Jilin University Press. All rights reserved.
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The article presents current data on the prevalence of vitamin D deficiency and criteria for its deficiency in children in different countries. Vitamin D is recognized as one of the most important vitamins involved in many biochemical processes in the body. Its active metabolites play a key role in calcium absorption, bone mineralization and promote phosphate and magnesium metabolism. At the same time, in addition to affecting mineral metabolism, there is a wide range of conditions in which vitamin D also plays a preventive role. Vitamin D has been shown to play a vital role in innate immunity maintenance and is important in prevention of several diseases, including infections, autoimmune diseases, certain forms of cancer, type 1 and 2 diabetes, and cardiovascular diseases. Vitamin D is of particular importance for newborns and young children. This vitamin is involved in important physiological regulatory processes such as bone metabolism, lung development, maturation of the immune system and differentiation of the nervous system. Vitamin D deficiency increases risks of neonatal sepsis, necrotizing enterocolitis, respiratory distress syndrome, and bronchopulmonary dysplasia. Adequate intake of vitamin D and calcium during childhood can reduce the risk of osteoporosis and other diseases associated with vitamin D deficiency in adults. Recently, vitamin D deficiency has shown to be a potential risk factor for COVID-19 propensity. It has been established that to date most scientific pediatric societies have recognized the need to prevent vitamin D deficiency in healthy children of all ages, but data on the dosage of vitamin D in its prophylactic use differ. Most scientific societies recommend an average of 400-600 IU per day of vitamin D for prophylactic purposes. The analysis of published data shows the need to follow a strategy based on an individual approach, taking into account physiological characteristics, individual requirements and lifestyle.Copyright © 2021 University of Tartu Press. All rights reserved.
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Introduction: Lung cavitation is a rare radiological finding of COVID- 19 pneumonia associated with unfavorable outcome. Its pathogenesis is unclear and it is characterized by diffuse alveolar damage, intra-alveolar hemorrhage and necrosis of parenchymal cells. Method(s): We retrospectively reviewed the radiological findings of COVID-19 patients admitted to our ICU during the pandemic in order to identify the development of lung cavitary lesions. Result(s): From 11/2020 until 10/2022 1000 patients were admitted to our COVID-19 ICU (92% on invasive mechanical ventilation). According to our data there were three cases of lung cavity formation. The first case was a 78 years male with history of hypertension. Chest CT (Day26) showed a 11.6 cm cavity in the right middle lobe (Fig. 1). The second case was a 52 year old female with history of diabetes mellitus, obesity, hypertension and rheumatoid arthritis. Follow up chest CT (D29) revealed progressive development of multiple bilateral cavitary lesions. The third case was a 61 year old male with no medical history, who developed (D17) multiple cavitary lesions in both lower lobes, concomitant with left-sided pulmonary embolism. The presence of other well defined etiologies of cavitary lesions such as mycobacterial and fungal infections as well as neoplasmatic or autoimmune diseases had been widely excluded. However, since pulmonary cavitation is a late complication of severe COVID disease, we cannot overlook the fact that all patients suffered from superinfections by XDR Acinetobacter baumanii and/or Klebsiella pneumonia, as most of our patients with prolonged length of stay. Moreover, two of the three patients developed pneumothorax. All patients finally died. Conclusion(s): Although bacterial co-infection does not allow absolute association between cavitary formation and coronavirus disease, it seems that destructive triggers, such as bacteria or mechanical ventilation, may aggravate COVID underlying lung lesions leading to cavitation.
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Background and objectives: SARS-C0V-2 infections have varied manifestations among individuals ranging from asymptomatic or mild symptoms to severe disease and death. This study is done to look into various histopathological changes in lung, liver, and kidney tissues among Covid19 positive autopsies with cellular tropism and viral load among various organs by immunohistochemistry (IHC) for the SARS-C0V-2 viral marker. Method(s): A prospective descriptive study of core biopsies from covid19 positive autopsies from the lung, liver, and kidneys were taken from 20 cases. A routine histopathological examination of the tissues with IHC staining for SARS-CoV-2 cocktail antibodies was performed and assessed. Result(s): Histopathological changes in the lung, liver, and kidney tissues showed changes of varying severity. On IHC, in the lung, the tropism for SARS-CoV-2 was seen in pneumocytes, bronchial epithelial cells, endothelial cells, and macrophages. In the kidney, tropism was seen towards tubular epithelial cells and endothelial cells. In the liver, hepatocytes and bile duct epithelial cells were positive. Variable viral density was seen in different organs which varied from case to case. The density of the viral load was highest in the lung and lower in the kidney and least in the liver. Conclusion(s): In this study the various histopathological changes and cellular tropism of the SARS-CoV-2 among Lung, liver, and kidney tissues have been described and compared with various similar studies across the globe.Copyright © 2023 International Journal of Life Sciences Biotechnology and Pharma Research. All rights reserved.
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Introduction/Aim: Significant long-term effects on both symptomatology and respiratory function have been recognised in adult populations after COVID-19 infection, termed 'Long COVID'. These have caused loss of productivity and increased need for healthcare services. This study aimed to measure symptoms and lung function in children and adolescents after acute COVID-19 infection Methods: Between June 1 and 31 October 2021 there were 144 children admitted to hospital across the Sydney Children's Hospital Network, Australia. Of these, 63 children were referred to the respiratory clinic with symptoms of ongoing cough, shortness of breath and fatigue, 3-6 months post COVID infection. 20 of these children performed reliable lung function. For these children, body plethysmography and double diffusion testing were performed within 3-6 months of their infection. The Liverpool respiratory questionnaire and PROMIS paediatric sleep questionnaires were also administered. Result(s): Of the 20 patients tested, 7 had COVID pneumonitis requiring hospitalisation during the acute illness. 6 of the 20 patients had significant persistent symptoms as measured by the Liverpool respiratory questionnaire, while none of the children had any significant sleep symptoms. All children had preserved spirometry within normal limits. Of note, 2 children with persistent respiratory symptoms had DLNO/DLCO ratio >1.15, suggesting pulmonary vascular disease. The same two children who had elevated DLNO / DLCO had high ventilator equivalents on CPET testing suggesting increased physiological dead space ventilation. Despite this, their peak aerobic capacity was within normal limits. There were no significant differences between the alpha and delta cohorts or between children treated at home vs those requiring hospitalisation during their infection. Conclusion(s): COVID-19 may cause long-lasting effects in children. In this cohort, all children maintained spirometry results within normal limits despite significant symptoms impacting daily activities. Double diffusion testing may shed some light on lung changes leading to persistent symptomatology after COVID infection.
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Background In the UK it is estimated that 10-15% of lung cancer cases occur in never-smokers. This study demonstrates the changes of the demographic characteristics, including the smoking status, of all the patients referred to the thoracic malignancy unit at Guy's Cancer Centre, South East London, between 2010 and 2021. Methods We included patients with a documented ICD10 diagnosis of bronchus and lung malignancy who were referred to Guy's thoracic malignancy unit from 2010 until 2021. A total of 6861 patients with a diagnosis of lung cancer were identified. We collected baseline demographic and clinical characteristics, including smoking status and socio-economic status for all the patients. Descriptive statistics were utilised to highlight the dynamic changes over the years of the referred patients. Results The number of referrals per year remained overall stable from 2010 until 2019, with a decrease in the number of referrals in 2020 and 2021, most likely due to the COVID-19 pandemic. We observed a gradual increase in the percentage of never smokers among the lung cancer patients: 5%, 8%, 10% and 13% of the referred patients were never smokers in the years 2010, 2015, 2018 and 2021 respectively. Median age remained stable across the years (range 68-71 years). Male percentage was 56%, 55%, 53% and 53% in 2010, 2015, 2018 and 2021 respectively. From the patients that we had a documented ethnic background the proportion of White/Black/Asian/Other or Mixed ethnicity remained stable across the years with a median 87%, 7%, 3%, and 3% respectively. The most common histological diagnosis was adenocarcinoma, followed by squamous cell carcinoma and small cell lung carcinoma. Conclusions The proportion of never-smoking to smoking related lung cancer has gradually increased between 2010 and 2021. There was little variability in age, sex and ethnic background. Never-smoking lung cancer is a distinct biological entity, therefore, further research should focus on the understanding of the aetiology and the risk factors leading to the development of lung cancer, in the absence of a history of tobacco exposure. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.Copyright © 2023 International Association for the Study of Lung Cancer. Published by Elsevier Inc.
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Although lung disease is the primary clinical outcome in COVID-19 patients, how SARS-CoV-2 induces lung pathology remains elusive. Here we describe a high-throughput platform to generate self-organizing and commensurate human lung buds derived from hESCs cultured on micropatterned substrates. Lung buds resemble human fetal lungs and display proximodistal patterning of alveolar and airway tissue directed by KGF. These lung buds are susceptible to infection by SARS-CoV-2 and endemic coronaviruses and can be used to track cell type-specific cytopathic effects in hundreds of lung buds in parallel. Transcriptomic comparisons of infected lung buds and postmortem tissue of COVID-19 patients identified an induction of BMP signaling pathway. BMP activity renders lung cells more susceptible to SARS-CoV-2 infection and its pharmacological inhibition impairs infection by this virus. These data highlight the rapid and scalable access to disease-relevant tissue using lung buds that recapitulate key features of human lung morphogenesis and viral infection biology.
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COVID-19 , Humans , SARS-CoV-2 , Lung , Cells, CulturedABSTRACT
Introduction: Significant long-term effects on both symptomatology and respiratory function have been recognised in adult populations after COVID-19 infection, termed 'Long COVID'. These have caused loss of productivity and increased need for healthcare services. This study aimed to measure symptoms and lung function in children and adolescents after acute COVID-19 infection. Method(s): Clinical follow up, body plethysmography, and double diffusion testing were performed on 18 children and adolescents (age 7-17 years) within 3-6 months of their infection. The Liverpool respiratory questionnaire and PROMIS paediatric sleep questionnaires were also administered. 5 patients were infected with the alpha variant, while 13 had the delta variant. Of those with the delta variant, 7 had COVID pneumonitis requiring hospitalisation during their acute illness. None had been vaccinated against COVID-19. Result(s): Most children recovered well with minimal residual symptoms, and maintained lung function within normal limits. However, 3 of the 18 children had ongoing symptoms that impacted their day-to-day activities. These included fatigue, exercise limitation, sleep impairment and persistent post-viral cough. Of these, 2 children had abnormalities on double diffusion testing, despite normal spirometry. There were no significant differences between the alpha and delta cohorts or between children treated at home vs those requiring hospitalisation. Conclusion(s): 'Long COVID' also affects paediatric populations, particularly in terms of ongoing fatigue and exercise limitation. Double diffusion testing may shed some light on lung changes leading to persistent symptomatology after COVID infection.
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The pulmonary limitations after COVID-19 are still not completely known. Lung function test (LFT) and 6-minute walk test (6MWT) are accessible and safe tests to access them. Aim(s): To evaluate the differences between non-severe and severe COVID-19 patients regarding LFT and 6MWT. Method(s): This study included patients with previous COVID-19 assessed in Pulmonology Department at 2 hospitals during 7 months who performed LFT and 6MWT. Baseline and immediately pos-6MWT heart rate (HR), SpO2, respiratory rate (RR) and perceived symptoms using a modified BORG scale were collected. We compared nonsevere and severe patients. Result(s): We included 151 patients, 69 (45.7%) with severe disease. LFT was performed 116.8+/-68.3days and the 6MWT 129.1+/-72.3days after COVID-19, without statistical difference between groups. We documented lower %FVC (94.4+/-14.7vs101.1+/-12.6%, p=0.003), %TLC (95.4+/-15.3vs107.1+/-12.3%, p=0.000) and %DLCO (68.8+/-16.5vs78.9+/-15.9%, p=0.000) in the severe group, without statistical differences in FEV1, FEV1/FVC and KCO. The 6MWT distance (m: 426.5+/-110.9vs498.2+/-93.5m, p=0.000;%:77.3+/-16.8%vs86.1+/-13.4%, p=0.001), estimated metabolic equivalents (3.03+/-0.5vs3.4+/-0.4, p=0.000) and minimal SpO2 (92.0+/-3.3vs93.8+/-3.1%, p=0.000) were lower in the severe group. The time spent below 90%SpO2 (5.6+/-19.4vs2.6+/-13.6%, p=0.039), %age-predicted maximal HR (68.5+/-10.5vs64.9+/-8.8%, p=0.023) and initial RR (19.1+/-5.1vs18.7+/-9.3 cpm, p=0.014) were higher. We did not document differences regarding the differential (maximal-initial) HR, final RR, differential (final-initial) RR and symptoms. Conclusion(s): Severe group showed higher functional limitation, mainly in lung volumes and in submaximal exercise evaluation.
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Introduction: Since its emergence in December 2019, coronavirus disease 2019 has impacted healthcare resources causing a global public threat. His long-term complications are still being evaluated and little is known about the longterm pulmonary sequelae. Method(s): We conducted a prospective observational study at the University Hospital of Gabes. Eighty-nine patients were included. Radiological evolution was assessed at 3 and 6 months from acute presentation by chest CT. Result(s): A total of 89 patients (52% women versus 48% men ;mean age 58 years +/- 13) were studied prospectively. The extension in the initial chest CT was severe to critical in 48%. They had repeat imaging after 3 months. Among those (88,5%) had persistent parenchymal changes residual ground-glass opacification (42%) or interstitial thickening (27%), and 23 (52%) patients developed post COVID-19 fibrosis with CT evidence of fibrotic-like changes : traction bronchiectasis (29%), parenchymal bands (32%), and honeycombing (2%). Six-month follow-up CT was performed in 27 patients and showed fibrotic-like changes in the lung in 30% : traction bronchiectasis (22%), parenchymal bands (26%). These persistent radiological abnormalities in the lung at 6 months were associated with an older age > 65 years (p = 0,03), longer hospital stays > 15 days (p=0,001), and higher initial chest CT score (p=0,026). Conclusion(s): Age, initial CT scan scoring and duration of hospital care were the main predictors of fibrosis-like changes at 6 months found in our study ;further research with prolonged follow-up is needed to provide a better understanding of outcomes for COVID-19 patients.
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Introduction: Lung Ultrasound (LUS) can track interstitial changes of COVID-19 pneumonia (CP) in the acute phase. CT has been used to evaluate the development of lung fibrosis post CP but its use is associated with increased ionising radiation. Aims and Objectives: We conducted a prospective single-centre pilot to assess the utility and feasibility of using serial LUS in adult patients recovering from CP. We hypothesize that LUS may provide a safe and acceptable alternative to CT imaging for the outpatient follow-up of these patients. Method(s): 21 subjects provided consent on the day of hospital discharge (D0) and were followed up for 83 days. High-resolution CT was performed on Day 83 and correlated with LUS on Days 0/41/83. Serum Ferritin, LDH, CRP, D-Dimer (Days 0/41/83), Spirometry (Day 41/83) and Quality of Life measures (EQ-5D Day 41/83) were obtained. 3 clinicians reviewed and scored the LUS images independently;CT scoring was performed by 2 thoracic radiologists blinded to the LUS findings. Result(s): 19 subjects completed the study (10 males [52%];mean age: 52 years [range:37-74]). LUS scores were significantly lower at Days 83 and 41 compared to Day 0 (Mean = 1.5 [D83] / 2.8 [D41] / 10.9 [D0] p<0.0001). Ground glass change was the most common finding on CT at Day 83. Correlation between LUS with HRCT at Day 83 was weak (Pearson r2=0.44). However a better correlation was observed in % change of LUS scores and KCO at Day 84 compared to Day 42 (r2=0.64). Conclusion(s): LUS may be a useful point of care tool for the assessment of patients recently recovered from CP. However its role in the evaluation of post CP lung fibrosis requires further study.
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Current knowledge of histopathological changes in Covid-19 pneumonia is mainly based on autopsy findings. There are few data on dynamics of lung lesions in vivo after acute phase of disease. The aim of this study was to determine histopathologic changes during the long/post-Covid stage in patients who had suffered from moderate to severe Covid-19 pneumonia. Bronchoscopy with transbronchial lung biopsy was performed in patients with HRCT lesions involving >40% of lung parenchyma, at least 4 weeks after discharge. Additional criteria were restrictive pattern in lung function tests and signed informed consent. Histopathologic analyses were performed using H&E, MSB, MOVAT, TTF1, CD34 and CD68 staining. Research was approved by the Hospital Ethical Committee. Among 26 patients that met inclusion criteria, adequate biopsy samples were obtained from 24. The mean time from the onset of disease to biopsy was 13 weeks. We found 4 histopathologic patterns: diffuse alveolar damage-DAD with vascular abnormalities, nonspecific interstitial inflammation, organizing pneumonia and interstitial fibrosis in 11, 9, 2 and 2 patients, respectively. Vascular abnormalities included capillary thrombi, dilated venules and dissection of small pulmonary arteries. Given the duration of disease, DAD and vascular abnormalities were detected up to the 12 week from the onset of symptoms. All patients biopsied after 12th weeks had some degree of tissue inflammation without vascular changes. Our findings show rather slow recovery of lung tissue after Covid-19 pneumonia. Long lasting DAD with vascular abnormalities may explain prolonged dyspnea and exercise intolerance and should be taken into consideration when planning further rehabilitation.
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Background: Forcrd oscillation technique (FOT) is a non-invasive method for investigation of lung mechanics without active participation of the patient. The objectives of the study were to find out whether FOT method could be used for monitoring of covid-19 pneumonia (CVP) course and how FOT indices correlate with other, commonly used indicators of disease severity. Method(s): During the hospital stay and 3 months after the discharge from hospital repeated measurements of lung mechanics were performed with portable device Tremoflo-100 (Thorasys, Canada). Result(s): Most relevant differences between disease stages reflected the lung reactance indices - Fres and AX. Indices characterizing the airflow resistance didn't reach the significance level. Correlation analysis also was performed between FOT indices and CT score, body mass index (BMI), patients age, blood CRP and ferritin levels, duration of hospital stay and patients oxygen demand (FiO2). Significant correlations View inline were found only between the last two. The highest significance showed Fres % pred and AX % pred. Fres correlated to FiO2 with R=0,498 and p-0,0000004, but AX% with r=0,502 Conclusion(s): The study has shown that FOT method reflects the changes in lung mechanics occurring during acute phase and recovery period from covid-19 pneumonia. FOT indices correlate with patients oxygen demand and hospital stay-time.
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The problem of the non-smooth course of COVID-19 and deaths in children with severe comorbid pathology is urgent. Among all registered cases of a new coronavirus infection in the Russian Federation, children account for up to 8,6%, of which severe forms are noted, as a rule, in patients with concomitant diseases. A clinical observation of the course of a new coronavirus infection in a child with a severe form of idiopathic aplastic anemia complicated by pancytopenia is presented. COVID-19 infection caused a sharp deterioration in the child's condition. Despite the use of modern methods of therapy, there was a rapid deterioration of clinical and laboratory parameters: an increase in febrility, respiratory failure, interstitial changes in the lungs, a decrease in oxygen saturation to 70%, hemorrhagic, anemic syndromes and multiple organ failure with the development of a fatal outcome. Aplastic anemia is a factor predisposing to the severe course of COVID-19 and contributing to an unfavorable outcome.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
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The lung is the most critical organ of the respiratory system supporting gas exchange. Constant interaction with the external environment makes the lung vulnerable to injury. Thus, a deeper understanding of cellular and molecular processes underlying lung development programs and evaluation of progenitor status within the lung is an essential part of lung regenerative medicine. In this review, we aim to discuss the current understanding of lung development process and regenerative capability. We highlight the advances brought by multi-omics approaches, single-cell transcriptome, in particular, that can help us further dissect the cellular player and molecular signaling underlying those processes.
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The COVID-19 virus has caused a global emergency and has attracted the attention of healthcare professionals and the public around the world. The significant increase in the number of new cases of infection with this virus demonstrates the relevance of the search for drugs that are effective against this pathogen. The aim of this work was to evaluate the antiviral efficacy of Mefloquin® against COVID-19. The antiviral efficacy of Mefloquin® against the new pandemic virus SARS-CoV-2 was studied in in vitro experiments in Vero C1008 cell culture and in vivo on Syrian golden hamsters. The results of the study revealed that the drug Mefloquine® at a concentration of 2.0 µg ml-1, when applied after infection of cells, suppresses the reproduction of the SARS-CoV-2 virus by 1.7-1.9 lg, the inhibition rate is about 99%. When using Mefloquine, pathological changes in the lung tissue were less pronounced than in the control group. 6 days after infection, it was shown that when using Mefloquine, there was a statistically significant decrease in viral load in the lungs of infected Syrian golden hamsters, with an inhibition rate of 95.5%.
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Background: While lung cancer is a leading cause of death in the U.S., annual lung cancer screening (LCS) rates remain low at 12.7%. The WUSTL research group began a community intervention to increase LCS called I-STEP (Increasing Screening Through Engaging Primary Care Providers) to address this quality gap. A customizable Toolkit was administered to a collaborative of six hospital systems in Missouri and Illinois, encompassing LCS eligibility and follow up guidelines, navigating LCS referral, and smoking cessation. The COVID-19 pandemic prompted brief suspension of screening, with lingering effects on LCS delivery and I-STEP implementation. Method(s): This was a step-wedged cluster randomized control trial from January 2019 - March 2021. Six hospital systems sequentially entered a three-month training phase, followed by I-STEP implementation into primary care settings. Primary outcomes were mean number of screenings and mean percent change in LCS from baseline. Data were collated into a dashboard. Analyses compared outcomes within I-STEP sites pre- and post- intervention. To investigate whether I-STEP sites recovered screening numbers during the pandemic, we compared I-STEP sites to six comparator hospitals within the collaborative that did not participate in the intervention. Result(s): Mean LCS increased by 63% amongst I-STEP sites (130.8 to 212). Mean screenings increased significantly from pre- to post-intervention phases within I-STEP sites (p = 0.0272). Across I-STEP sites and comparator hospitals, mean LCS increased significantly following emergence of the pandemic in March 2020 (p = 0.0002, LSM difference -72.0, 95% CI [-100.9, -43]) - data adjusted for the three-month period in which LCS was suspended. Findings were similar for mean percent change in LCS. There was no difference in outcomes between I-STEP and comparator sites. Conclusion(s): I-STEP implementation successfully increased mean LCS from pre-intervention baseline. Findings suggest a possible effect of the I-STEP intervention in promoting increased LCS amidst the pandemic.
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Aim/Introduction: Although pulmonary findings of COVID-19 on PET/CT have been previously described, a comprehensive metabolic characterization of diagnostic lung parenchyma changes of COVID-19 pneumonia is still lacking. Our purpose is to evaluate the metabolic uptake of different tomographic signs observed in patients with incidental structural findings suggesting COVID-19 pneumonia through 18F-FDG PET/CT. Material(s) and Method(s): We retrospectively analyzed 596 PET/CT studies performed from February 21, 2020 to April 17, 2020. After excluding 37 scans (PET with non-18F-FDG tracers and brain studies), we analyzed the metabolic activity of several individual structural changes integrated and beyond CO-RADS score through SUVmax of multimodal studies with18F-FDG. Result(s): 43 patients with 18F-FDG PET/CT findings suggestive of COVID-19 pneumonia were included (mean age: 68+/-12.3 years, 22 male). SUVmax values were higher in patients with CO-RADS categories 5-6 than in those with lower, nonspecific CO-RADS categories (6.1+/-3.0 vs. 3.6+/-2.1, p=0.004). Groundglass opacities, bilaterality, consolidations, patchy distribution and crazy paving pattern were associated with higher SUVmax values in patients with CO-RADS 5-6 scores (p-values of 0.01, 0.02, 0,01, 0.002 and 0.01, respectively). SUVmax was significantly associated with a positive structural diagnosis of COVID-19 pneumonia (odds ratio=0.63, 95% confidence interval=0.41-0.90;p=0.02). The ROC curve of the regression model aimed to confirm or discard the structural diagnosis of COVID-19 pneumonia showed an AUC of 0.77 (standard error=0.072, p=0.003). Conclusion(s): Multimodal18F-FDG PET/CT is a useful tool during the incidental detection of COVID-19 pneumonia in patients referred for standard oncological and nononcological indications (43/559;7.7%). CT findings characteristic of COVID-19 pneumonia, specifically CO-RADS 5-6, were associated with higher SUVmax.
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The long-term effects of coronavirus disease 2019 (COVID- 19) pneumonia on the lungs and pulmonary circulation require further characterization. We assessed progression of pathophysiological pulmonary changes during 1 year of follow-up of patients who had been hospitalized because of COVID-19. After discharge, recruited patients had up to four MRI examinations at a median of 6 (n=9), 12 (n=9), 25 (n=7) and 52 (n=3) weeks. Lung MRI examinations included: ultra-short echo time (UTE), dynamic contrastenhanced (DCE) lung perfusion, 129Xe diffusion weighted (DW-MRI), 129Xe ventilation and 129Xe 3D dissolved phase imaging. Nine patients (age 56 +/-9 years;six male) were recruited. Ventilation defect percentage and whole lung coefficient of variation of lung ventilation decreased significantly at 25 weeks (visit 3) compared with visit 1 at 6 weeks (p=0.010 and p=0.048). The UTE imaging indicated no evidence of lung scarring, and DW-MRI indicated normal lung microstructure across all visits. Dissolved phase xenon imaging showed that RBC:TP increased significantly at visits 2 and 3 compared with visit 1 (p=0.048). Median RBC:TP was abnormally low at all visits compared with reference age- and sex-matched data. An individual's RBC:TP was associated significantly and positively with an increase in their pulmonary blood volume (p=0.026). For patients with 52-week data available, one showed a continued improvement in RBC:TP;however, two of the patients maintained a low RBC:TP. In patients recovering from COVID-19, xenon gas transfer improves alongside pulmonary blood volume. Further work is needed to establish the proportion of post-COVID-19 patients who have longer-term impairment in xenon transfer and to correlate changes in lung MRI parameters with symptoms, lung function tests and other imaging modalities. Persistent impairment of xenon transfer might represent a physiological mechanism underlying ongoing symptoms in some patients and might indicate damage to the pulmonary microcirculation.
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Background. Passive immune therapies may be useful in mitigating severe COVID-19. The hamster model has been successfully used to study efficacy of COVID-19 treatments. Our objective with this research is to demonstrate initial efficacy of a new polyclonal ovine Fab raised against the SARS-CoV-2 spike protein (PR020) as a treatment for COVID-19. Methods. Hamsters were treated with PR020 via intraperitoneal route at a dose of 120 mg/kg or a vehicle control once every 24 hours for 8 days, starting 1 day prior to viral challenge with Victoria/1/2020 SARS-CoV-2. Sampling to detect viral RNA and clinical observations were taken throughout the challenge phase. Necropsy occurred 1 day following the last dose of PR020, and tissues were assessed for histopathology and viral RNA. Results. Hamsters receiving vehicle alone lost weight more rapidly than the PR020 group (Figure 1, p< 0.05 day 4 onward). Clinical illness scores for the PR020 group were lower compared to control animals (Figure 2, p< 0.05 day 3 onward). While viral shedding assessed by throat swab did not differ between groups, viral RNA levels in lung tissue was significantly lower in PR020-treated animals (Figure 3, p< 0.05). PR020-treated animals also showed significantly less pathological changes in the lung compared to controls (Figure 4, p=0.0022). (Figure Presented) Conclusion. Treatment with PR020 resulted in a positive clinical outcome (e.g. less weight loss and lower clinical signs). While treatment appeared to have little effect in the nasopharynx, there was a positive effect in the lower respiratory tract, with substantially less viral RNA in the lungs of the group given PR020 and a decrease in the lung histopathology, including consolidation.