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1.
Polish Annals of Medicine ; 28(2):244-249, 2021.
Article in English | EMBASE | ID: covidwho-1957648

ABSTRACT

I nt r o duc t i o n: First cases of a disease called coronavirus disease 2019 (CO-VID-19), caused by a novel virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) of the coronavirus family, were detected in December 2019. The disease is manifested by a variety of symptoms and can run a different course: from oligosymptomatic or asymptomatic to the development of acute respiratory failure and even death. Ai m: The aim of this paper is to provide critical analysis of the potential pulmonary complications after COVID-19 infection. Ma t e r i a l a nd me t ho ds: We have provided the systematic literature review based on which we have discussed the pathophysiology of COVID-19, its outco-mes, risk factors and pulmonary complications. R e s u l t s a n d d i s c u s s i o n: The organs that are most often affected by a SARS--CoV-2 infection are the lungs. An infection with this virus can lead to a severe respiratory tract illness, both in the acute phase and as a complication after a rela-tively mild case. There are numerous observations of patients convalescing from COVID-19 who suffer from the interstitial pulmonary disease with fibrosis. There are also reported cases of spontaneous pneumothorax after COVID-19. Co nc l us i o ns: It should be borne in mind that other late complications may appear with time.

2.
Vestnik Urologii ; 10(2):72-77, 2022.
Article in Russian | EMBASE | ID: covidwho-1957627

ABSTRACT

Introduction. SARS-CoV-2 causes several negative processes in the body and complicates the course of chronic somatic diseases, causing dysfunction and having a negative effect on many organs and systems of the body, including organs of the reproductive system. Objective. To study morphological changes in testicles of patients who have undergone a new coronavirus infection. Materials and methods. Objects of morphological research were testicular tissues obtained by intraoperative biopsy under intravenous anesthesia served. Material sampling was carried out in 12 patients aged 25–29 years with idiopathic infertility who underwent COVID-19. Patients showed ultrasound signs of fibrosis in the testicles, which were absent before infection with SARS-CoV-2. The biopsy was performed 12 months after COVID-19. Results. In all observations, changes were observed that are characteristic of the inflammatory process, nonbacterial autoimmune genesis. Histio-lymphocytic infiltration of testicular tissue with destruction of single tubules and parenchyma atrophy, combined with varying degrees of sclerosis, was verified. Conclusion. In testicular biopsy specimens from patients who have undergone COVID-19, an autoimmune inflammatory process is recorded, manifested by lymphocytic infiltration of testicular tissue, which was combined with varying degrees of sclerosis.

3.
American Journal of Stem Cells ; 11(3):37-55, 2022.
Article in English | EMBASE | ID: covidwho-1955743

ABSTRACT

Objective: Mesenchymal stem cells can serve as a therapeutic option for COVID-19. Their immunomodula-tory and anti-inflammatory properties can regulate the exaggerated inflammatory response and promote recovery of lung damage. Method: Phase-1, single-centre open-label, prospective clinical trial was conducted to evaluate the safety and efficacy of intravenous administration of mesenchymal stem cells derived from umbilical cord and placenta in moderate COVID-19. The study was done in 2 stages with total 20 patients. Herein, the results of stage 1 including first 10 patients receiving 100 million cells on day 1 and 4 with a follow up of 6 months have been discussed. Results: No adverse events were recorded immediately after the administration of MSCs or on follow up. There was no deterioration observed in clinical, laboratory and radiological parameters. All symptoms of the study group resolved within 10 days. Levels of inflammatory biomarkers such as NLR, CRP, IL6, ferritin and D-dimer improved in all patients after intervention along with improved oxygenation demonstrated by improvement in the SpO2/FiO2 ratio and PaO2/FiO2 ratio. None of the patients progressed to severe stage. 9 out of 10 patients were discharged within 9 days of their admission. Improvements were noted in chest x-ray and chest CT scan scores at day 7 in most patients. No post-covid fibrosis was observed on chest CT 28 days after intervention and Chest X ray after 6 months of the intervention. Conclusion: Administration of 100 million mesenchymal stem cells in combina-tion with standard treatment was found to be safe and resulted in prevention of the cytokine storm, halting of the disease progression and acceleration of recovery in moderate COVID-19. This clinical trial has been registered with the Clinical Trial Registry-India (CTRI) as CTRI/2020/08/027043. http://www.ctri.nic.in/Clinicaltrials/pmaindet2. php?trialid=43175.

4.
Pharmaceutics ; 13(12)2021 Nov 25.
Article in English | MEDLINE | ID: covidwho-1957413

ABSTRACT

Respiratory diseases contribute to a significant percentage of mortality and morbidity worldwide. The circadian rhythm is a natural biological process where our bodily functions align with the 24 h oscillation (sleep-wake cycle) process and are controlled by the circadian clock protein/gene. Disruption of the circadian rhythm could alter normal lung function. Chronotherapy is a type of therapy provided at specific time intervals based on an individual's circadian rhythm. This would allow the drug to show optimum action, and thereby modulate its pharmacokinetics to lessen unwanted or unintended effects. In this review, we deliberated on the recent advances employed in chrono-targeted therapeutics for chronic respiratory diseases.

5.
Int J Mol Sci ; 23(15)2022 Jul 26.
Article in English | MEDLINE | ID: covidwho-1957349

ABSTRACT

Pulmonary fibrosis is a consequence of the pathological accumulation of extracellular matrix (ECM), which finally leads to lung scarring. Although the pulmonary fibrogenesis is almost known, the last two years of the COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its post effects added new particularities which need to be explored. Many questions remain about how pulmonary fibrotic changes occur within the lungs of COVID-19 patients, and whether the changes will persist long term or are capable of resolving. This review brings together existing knowledge on both COVID-19 and pulmonary fibrosis, starting with the main key players in promoting pulmonary fibrosis, such as alveolar and endothelial cells, fibroblasts, lipofibroblasts, and macrophages. Further, we provide an overview of the main molecular mechanisms driving the fibrotic process in connection with Galactin-1, -3, -8, and -9, together with the currently approved and newly proposed clinical therapeutic solutions given for the treatment of fibrosis, based on their inhibition. The work underlines the particular pathways and processes that may be implicated in pulmonary fibrosis pathogenesis post-SARS-CoV-2 viral infection. The recent data suggest that galectin-1, -3, -8, and -9 could become valuable biomarkers for the diagnosis and prognosis of lung fibrosis post-COVID-19 and promising molecular targets for the development of new and original therapeutic tools to treat the disease.


Subject(s)
COVID-19 , Pulmonary Fibrosis , COVID-19/complications , Endothelial Cells/metabolism , Galectin 1 , Humans , Pandemics , Pulmonary Fibrosis/metabolism , SARS-CoV-2
6.
Cells ; 11(10)2022 05 12.
Article in English | MEDLINE | ID: covidwho-1957233

ABSTRACT

Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal lung disease with limited therapeutic options, and there is a huge unmet need for new therapies. A growing body of evidence suggests that the histone deacetylase (HDAC) family of transcriptional corepressors has emerged as crucial mediators of IPF pathogenesis. HDACs deacetylate histones and result in chromatin condensation and epigenetic repression of gene transcription. HDACs also catalyse the deacetylation of many non-histone proteins, including transcription factors, thus also leading to changes in the transcriptome and cellular signalling. Increased HDAC expression is associated with cell proliferation, cell growth and anti-apoptosis and is, thus, a salient feature of many cancers. In IPF, induction and abnormal upregulation of Class I and Class II HDAC enzymes in myofibroblast foci, as well as aberrant bronchiolar epithelium, is an eminent observation, whereas type-II alveolar epithelial cells (AECII) of IPF lungs indicate a significant depletion of many HDACs. We thus suggest that the significant imbalance of HDAC activity in IPF lungs, with a "cancer-like" increase in fibroblastic and bronchial cells versus a lack in AECII, promotes and perpetuates fibrosis. This review focuses on the mechanisms by which Class I and Class II HDACs mediate fibrogenesis and on the mechanisms by which various HDAC inhibitors reverse the deregulated epigenetic responses in IPF, supporting HDAC inhibition as promising IPF therapy.


Subject(s)
Histone Deacetylases , Idiopathic Pulmonary Fibrosis , Fibroblasts/metabolism , Histone Deacetylase Inhibitors/pharmacology , Histone Deacetylase Inhibitors/therapeutic use , Histone Deacetylases/metabolism , Histones/metabolism , Humans , Idiopathic Pulmonary Fibrosis/pathology , Transcription Factors/metabolism
7.
Pharmacol Ther ; 237: 108249, 2022 Jul 22.
Article in English | MEDLINE | ID: covidwho-1956290

ABSTRACT

Fine control over chloride homeostasis in the lung is required to maintain membrane excitability, transepithelial transport as well as intra- and extracellular ion and water homeostasis. Over the last decades, a growing number of chloride channels and transporters have been identified in the cells of the pulmonary vasculature and the respiratory tract. The importance of these proteins is underpinned by the fact that impairment of their physiological function is associated with functional dysregulation, structural remodeling, or hereditary diseases of the lung. This paper reviews the field of chloride channels and transporters in the lung and discusses chloride channels in disease processes such as viral infections including SARS-CoV- 2, pulmonary arterial hypertension and cystic fibrosis. Although chloride channels have become a hot research topic in recent years, remarkably few of them have been targeted by pharmacological agents. As such, we complement the putative pathophysiological role of chloride channels here with a summary of their therapeutic potential.

8.
J Cyst Fibros ; 2022 Jul 22.
Article in English | MEDLINE | ID: covidwho-1956193

ABSTRACT

Better health and longer survival for many people with cystic fibrosis (PwCF) compels the continued evolution of the CF care model. Designed to deliver specialized care for a complex chronic condition, the model is organized around interdisciplinary healthcare teams at dedicated care centers. Introduction of CFTR modulators and the COVID-19 pandemic have catalyzed the model's evolution. Many PwCF on modulator therapies are experiencing better health and considering changes in their daily care routines. Some of the growing number of adults with CF are experiencing age-associated co-morbidities, requiring coordination with new specialists. The pandemic accelerated the use of telehealth, revealing tradeoffs from new configurations of care delivery. Herein we review the implications of these recent shifts and offer recommendations to improve the quality of care coordinated across the interdisciplinary teams and an expanding field of subspecialists, while supporting the ability of the patient to take on greater responsibility in disease management.

9.
Annals of Thoracic Medicine ; 17(3):137-144, 2022.
Article in English | ProQuest Central | ID: covidwho-1954267

ABSTRACT

Post-COVID lung impairment and diseases are major public health concern in the pandemic of COVID-19. Multiple etiological factors can lead to post-COVID respiratory symptoms, with post COVID fibrosis or diffuse parenchymal lung disease being the major concern. We searched PubMed database for English literature related to post-COVID lung disease and we summarized the existing evidence on radiological, physiological, and histopathological aspects of post-COVID lung diseases. We suggest a guidance on the evaluation of these patients and highlight management considerations including general care, pulmonary rehabilitation, and lung transplantation. We also explain gaps in knowledge and awaited ongoing research results, especially in the field of drug therapies including corticosteroids and antifibrotics.

10.
Front Immunol ; 13: 934264, 2022.
Article in English | MEDLINE | ID: covidwho-1952335

ABSTRACT

Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), responsible for COVID-19, has caused a global pandemic. Observational studies revealed a condition, herein called as Long-COVID syndrome (PC), that affects both moderately and severely infected patients, reducing quality-of-life. The mechanism/s underlying the onset of fibrotic-like changes in PC are still not well defined. The goal of this study was to understand the involvement of the Absent in melanoma-2 (AIM2) inflammasome in PC-associated lung fibrosis-like changes revealed by chest CT scans. Peripheral blood mononuclear cells (PBMCs) obtained from PC patients who did not develop signs of lung fibrosis were not responsive to AIM2 activation by Poly dA:dT. In sharp contrast, PBMCs from PC patients with signs of lung fibrosis were highly responsive to AIM2 activation, which induced the release of IL-1α, IFN-α and TGF-ß. The recognition of Poly dA:dT was not due to the activation of cyclic GMP-AMP (cGAMP) synthase, a stimulator of interferon response (cGAS-STING) pathways, implying a role for AIM2 in PC conditions. The release of IFN-α was caspase-1- and caspase-4-dependent when AIM2 was triggered. Instead, the release of pro-inflammatory IL-1α and pro-fibrogenic TGF-ß were inflammasome independent because the inhibition of caspase-1 and caspase-4 did not alter the levels of the two cytokines. Moreover, the responsiveness of AIM2 correlated with higher expression of the receptor in circulating CD14+ cells in PBMCs from patients with signs of lung fibrosis.


Subject(s)
COVID-19 , DNA-Binding Proteins , Pulmonary Fibrosis , COVID-19/blood , COVID-19/immunology , COVID-19/pathology , Carrier Proteins , Caspase 1/immunology , DNA-Binding Proteins/blood , DNA-Binding Proteins/immunology , Humans , Inflammasomes/blood , Inflammasomes/immunology , Interferon-alpha/metabolism , Leukocytes, Mononuclear/immunology , Pulmonary Fibrosis/blood , Pulmonary Fibrosis/immunology , Pulmonary Fibrosis/pathology , Pulmonary Fibrosis/virology , SARS-CoV-2 , Transforming Growth Factor beta/metabolism
11.
Front Immunol ; 13: 831194, 2022.
Article in English | MEDLINE | ID: covidwho-1952320

ABSTRACT

Resulting from severe inflammation and cell destruction, COVID-19 patients could develop pulmonary fibrosis (PF), which remains in the convalescent stage. Nevertheless, how immune response participates in the pathogenesis of PF progression is not well defined. To investigate that question, 12 patients with severe COVID-19 were included in the study. Peripheral mononuclear cell (PBMC) samples were collected shortly after their admission and proceeded for single-cell RNA sequencing (scRNA-seq). After 14 days of discharge, the patients were revisited for chest CT scan. PF index (FI) was computed by AI-assisted CT images. Patients were categorized into FIhi and FIlo based on median of FI. By scRNA-seq analysis, our data demonstrated that frequency of CD4+ activated T cells and Treg cells were approximately 3-fold higher in FIhi patients compared with FIlo ones (p < 0.034 for all). By dissecting the differentially expressed genes, we found an overall downregulation of IFN-responsive genes (STAT1, IRF7, ISG15, ISG20, IFIs, and IFITMs) and S100s alarmins (S100A8, S100A9, S100A12, etc.) in all T-cell clusters, and cytotoxicity-related genes (GZMB, PRF1, and GNLY) in CTLs and γδ T cells in the FIhi cohort, compared with FIlo subjects. The GSEA analysis illustrated decreased expression of genes enriched in IFN signaling, innate immune response, adaptive immune response in T cells, NK cells, and monocytes in FIhi patients compared with FIlo ones. In conclusion, these data indicated that the attenuated IFN-responsive genes and their related signaling pathways could be critical for PF progression in COVID-19 patients.


Subject(s)
COVID-19 , Pulmonary Fibrosis , Adaptive Immunity , Humans , Leukocytes , Leukocytes, Mononuclear , Pulmonary Fibrosis/genetics
12.
Hum Genomics ; 16(1): 20, 2022 06 13.
Article in English | MEDLINE | ID: covidwho-1951361

ABSTRACT

The increased resolution of single-cell RNA-sequencing technologies has led to major breakthroughs and improved our understanding of the normal and pathologic conditions of multiple tissues and organs. In the study of parenchymal lung disease, single-cell RNA-sequencing has better delineated known cell populations and identified novel cells and changes in cellular phenotypes and gene expression patterns associated with disease. In this review, we aim to highlight the advances and insights that have been made possible by applying these technologies to two seemingly very different lung diseases: fibrotic interstitial lung diseases, a group of relentlessly progressive lung diseases leading to pulmonary fibrosis, and COVID-19 pneumonia, an acute viral disease with life-threatening complications, including pulmonary fibrosis. We discuss changes in cell populations and gene expression, highlighting potential common features, such as alveolar cell epithelial injury and aberrant repair and monocyte-derived macrophage populations, as well as relevance and implications to mechanisms of disease and future directions.


Subject(s)
COVID-19 , Pulmonary Fibrosis , COVID-19/genetics , Humans , Lung/pathology , Pulmonary Fibrosis/genetics , Pulmonary Fibrosis/pathology , RNA , Single-Cell Analysis
13.
Arch Dis Child ; 107(8): 752-754, 2022 08.
Article in English | MEDLINE | ID: covidwho-1950043

ABSTRACT

OBJECTIVE: To investigate the validity and home use of a personal ultrasonic spirometer. METHODS: Supervised spirometry was performed using laboratory equipment and a personal ultrasonic spirometer. In addition, the ability of children to perform acceptable spirometry during supervised telehealth appointments at home was assessed. RESULTS: 59 children completed spirometry on both devices. There was high between-device intraclass correlation coefficient (ICC) for forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC): ICC 0.991 (95% CI 0.985 to 0.995) and 0.989 (95% CI 0.981 to 0.993), respectively. Bland-Altman analysis revealed mean bias and limits of agreement of -0.01 (-0.22 to 0.24) L for FEV1 and -0.02 (-0.30 to 0.33) L for FVC. 125 of 140 (89%) supervised telehealth spirometry sessions were acceptable. CONCLUSION: There was excellent reliability in between-device measurements; however, the limits of agreement were wide. Therefore, caution is needed if the device is used interchangeably with laboratory equipment. High success rates of telehealth spirometry sessions indicate the device is suitable for this application.


Subject(s)
Telemedicine , Ultrasonics , Child , Forced Expiratory Volume , Humans , Reproducibility of Results , Spirometry , Vital Capacity
14.
Latin American Journal of Pharmacy ; 41(Special Issue):183-188, 2022.
Article in English | EMBASE | ID: covidwho-1935249

ABSTRACT

Pneumonia is a serious complication of the new coronavirus infection, also known as COVID-19. Patients if risk groups who require ICU care and mechanical ventilation are at the highest risk to develop lung fibrosis. This review analyzes the use of cytostatic agents such as cyclophosphamide with his proven efficacy against lung fibrosis of various etiologies and considers its potential effectiveness in the treatment of post-Covid pulmonary fibrosis.

15.
INDIAN JOURNAL OF RESPIRATORY CARE ; 11(2):183-186, 2022.
Article in English | Web of Science | ID: covidwho-1939204

ABSTRACT

Progressive lung fibrosis, an enduring complication of COVID-19, affects lung function adversely, fatigue levels, exercise tolerance, and health-related quality of life, affecting more than 50% of the confirmed cases. Furthermore, the number of post-COVID survivors is steadily increasing, stipulating a need for early, safe, and effective post-COVID pulmonary rehabilitation (PR). A 62-year-old male diagnosed with viral pneumonitis with severe lung fibrosis post-COVID infection exhibited severe exercise intolerance during hospitalization. An 8-week supervised, structured PR program led to early weaning from oxygen support and improved patient's functional outcomes. Amelioration in the patient's clinical status was demonstrated by a 50% reduction in his fatigue levels and a three-fold change in his functional capacity. This case study highlights the importance of early initiation of PR in optimizing patient's health status and reducing any further functional limitations.

16.
Journal of Hypertension ; 40:e170, 2022.
Article in English | EMBASE | ID: covidwho-1937712

ABSTRACT

Objective: The patient was a 59-year-old man who was referred to the hospital due to shortness of breath due to increased activity, accompanied by cough, weakness, and lethargy. The patient also had a history of diabetes, hypertension, hyperlipidemia, and asthma. The patient also underwent cardiac stenting last year. LCX and LAD stenting Design and method: He had a continuous pan-systolic murmur on cardiac examination diagnosed with valvular dysfunction. Severe aortic regurgitation was reported on echo. The patient underwent a CT scan of the lungs and a PCR test to rule out Covid-19, which was negative. Finally, the patient was diagnosed with severe aortic regurgitation and underwent aortic valve replacement surgery. Echocardiography was performed before the operation, and the diagnosis was confirmed. Results: Echocardiography was performed postoperatively, which showed good valve function and no valve leakage. From the 5th day after the operation, the patient developed fever and increased leukocytosis. Suspected of having Covid19 and accordingly underwent PCR test, the test result was positive;the patient underwent a CT scan of the lungs. After that, he was transferred to the corona ICU. The patient was treated with Remdesivir, and after two weeks, his PCR was negative, and he was almost ready to be discharged. The patient had completed the entire course of treatment and developed pulmonary fibrosis due to Covid disease, but suddenly, after two weeks from the onset of the illness, she developed severe shortness of breath, which led to intubation. We find severe pulmonary fibrosis in the re-CT scan, especially in the left lung, where the entire left lung had fibrosis. Prednisolone was started at a dose of 50 mg three times a day. The patient was intubated for ten days, then gradually removed from the device. Now the patient is extubated and ready for discharge. Conclusions: Risk factors such as Past cardiac surgery and present cardiac intervention with diabetes mellitus increase the risk of developing lung failure in these Covid19 patients. Elective intubation is better than emergency intubation in patients with comorbidities. Corticosteroids can be effective in treating pulmonary insufficiency.

17.
J Clin Med ; 11(14)2022 Jul 13.
Article in English | MEDLINE | ID: covidwho-1938853

ABSTRACT

SARS-CoV-2 may lead to a large spectrum of respiratory manifestations, including pulmonary sequelae. We conducted a single-center longitudinal study of survivors from severe COVID-19 cases who underwent a chest CT during hospitalization (CTH). Three months after being discharged, these patients were evaluated by a clinical examination, pulmonary function tests and a chest-CT scan (CTFU). Sixty-two patients were enrolled. At follow-up, 27% complained of exertional dyspnoea and 12% of cough. Dyspnoeic patients had a lower forced expiratory flow (FEF)25-75 (p = 0.015), while a CT scan (p = 0.016 showed that patients with cough had a higher extent of bronchiectasis. Lung volumes and diffusion of carbon monoxide (DLCO) at follow-up were lower in patients who had been invasively ventilated, which correlated inversely with the length of hospitalization and ground-glass extension at CTH. At follow-up, 14.5% of patients had a complete radiological resolution, while 85.5% presented persistence of ground-glass opacities, and 46.7% showed fibrotic-like alterations. Residual ground-glass at CTFU was related to the length of hospitalization (r = 0.48; p = 0.0002) and to the need for mechanical ventilation or high flow oxygen (p = 0.01) during the acute phase. In conclusion, although patients at three months from discharge showed functional impairment and radiological abnormalities, which correlated with a prolonged hospital stay and need for mechanical ventilation, the persistence of respiratory symptoms was related not to parenchymal but rather to airway sequelae.

18.
Int J Mol Sci ; 21(15)2020 Jul 22.
Article in English | MEDLINE | ID: covidwho-1934093

ABSTRACT

Tissue injury and inflammatory response trigger the development of fibrosis in various diseases. It has been recognized that both innate and adaptive immune cells are important players with multifaceted functions in fibrogenesis. The activated immune cells produce various cytokines, modulate the differentiation and functions of myofibroblasts via diverse molecular mechanisms, and regulate fibrotic development. The immune cells exhibit differential functions during different stages of fibrotic diseases. In this review, we summarized recent advances in understanding the roles of immune cells in regulating fibrotic development and immune-based therapies in different disorders and discuss the underlying molecular mechanisms with a focus on mTOR and JAK-STAT signaling pathways.


Subject(s)
Adaptive Immunity , Fibrosis/immunology , Immunity, Innate , Signal Transduction/immunology , Animals , B-Lymphocytes/immunology , Cytokines/metabolism , Dendritic Cells/immunology , Fibrosis/pathology , Fibrosis/therapy , Humans , Lymphopoiesis/immunology , Macrophages/immunology , Myofibroblasts/metabolism , Neutrophils/immunology , T-Lymphocytes/immunology
19.
Physiotherapy Practice and Research ; 43(1):17-25, 2022.
Article in English | Scopus | ID: covidwho-1933553

ABSTRACT

BACKGROUND PURPOSE: Pulmonary fibrosis (PF) is a debilitating, incurable disease. Strategies to optimise health-related quality of life and minimise symptom impact are advocated. Available treatment options such as pulmonary rehabilitation have been severely disrupted due to COVID-19. This feasibility study explored the clinical efficacy and acceptability of an online singing and breathing retraining programme (SingStrong) for people with PF. METHODS: The weekly online programme conducted over 12 weeks was comprised of 45-minute classes of mindfulness, breathing retraining, vocal exercises and singing conducted by a trained vocal coach. People with PF were invited to participate and sessions were recorded for non-attenders. Demographic data were collected, and the St Georges Respiratory Questionnaire (SGRQ) and Idiopathic PF Patient Reported Outcome measure (IPF-PROM) were administered. The questionnaire also invited participants to provide feedback on the utility, enjoyability and main pros/cons of the intervention. Participation in the research element of the programme was not required to attend the weekly classes. RESULTS: Of 24 participants recruited, data from 15 (mean (Standard Deviation) age of 66 (8.7);male: n = 8) who completed both pre and post-intervention questionnaires were analysed. Statistically significant improvements were recorded in the IPF-PROM (p = 0.019) and self-reported quality of life (p = 0.028). Class attendance by study participants and the broader PF group cumulatively, increased from 14 to 25 participants between weeks 1 and 12. Qualitatively, strong satisfaction with classes and improved efficacy in self-management of lung health, in particular breathlessness, were reported. CONCLUSIONS: Singing and breathing retraining interventions may endow biopsychosocial benefits for people with PF, in the presence of modest objective clinical gains. Singing programmes are popular and may provide helpful adjuncts to existing clinical strategies such as pulmonary rehabilitation. © 2022 - IOS Press. All rights reserved.

20.
Pathobiology ; : 1-8, 2022 Jul 14.
Article in English | MEDLINE | ID: covidwho-1932873

ABSTRACT

The incidence, presentation, and predisposing factors of post-acute sequelae of COVID-19 (PASC) are currently poorly understood. Lung explants may provide a rare insight into terminal SARS-CoV-2-associated lung damage and its pathophysiology. A 62-year-old man presented with progressively worsening respiratory symptoms after recovering from mild COVID-19 3 months earlier. No underlying pulmonary comorbidities were reported. A chest CT revealed bilateral extensive ground-glass and reticular opacities, suspicious of pulmonary fibrosis. Despite initial high-dose glucocorticoid therapy, the interstitial lung disease progressed, and after exhausting all viable therapeutic options, bilateral lung transplantation was successfully conducted. Histological analysis revealed extensive end-stage interstitial fibrosis with diffuse dendriform ossification and bronchiolar and transitional cell metaplasia. Signs of interstitial remodeling such as an increased interstitial collagen deposition, a pathological accumulation of CD163+/CD206+ M2-polarized macrophages with an increased expression of phosphorylated ERK, and an increased density of CD105+ newly formed capillaries were observed. qRT-PCR and immunohistochemistry for SARS-CoV-2 N-protein in the endothelium of medium-sized vessels confirmed a persistence of SARS-CoV-2. Our findings highlight a highly unusual presentation of SARS-CoV-2-associated lung fibrosis, implying that incomplete viral clearance in the vascular compartment may play a vital pathophysiological role in the development of PASC.

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