The Complex Association between COPD and COVID-19.

Chronic obstructive pulmonary disease (COPD) is significant cause of morbidity and mortality worldwide. There is mounting evidence suggesting that COPD patients are at increased risk of severe COVID-19 outcomes; however, it remains unclear whether they are more susceptible to acquiring SARS-CoV-2 infection. In this comprehensive review, we aim to provide an up-to-date perspective of the intricate relationship between COPD and COVID-19. We conducted a thorough review of the literature to examine the evidence regarding the susceptibility of COPD patients to COVID-19 infection and the severity of their disease outcomes. While most studies have found that pre-existing COPD is associated with worse COVID-19 outcomes, some have yielded conflicting results. We also discuss confounding factors such as cigarette smoking, inhaled corticosteroids, and socioeconomic and genetic factors that may influence this association. Furthermore, we review acute COVID-19 management, treatment, rehabilitation, and recovery in COPD patients and how public health measures impact their care. In conclusion, while the association between COPD and COVID-19 is complex and requires further investigation, this review highlights the need for careful management of COPD patients during the pandemic to minimize the risk of severe COVID-19 outcomes.

Rationale of Using Common Antifibrotic Therapy in Post COVID Fibrosis

Different mechanisms of lung injury in COVID-19 have been described, like viral to immune-mediated mechanisms. Lung injury can be either subsequent to chronic inflammation or an idiopathic and genetically influenced process. Pulmonary fibrosis can occur with acute lung injury & a known sequela to ARDS. However, persistent radiological abnormalities after ARDS are of little clinical significance and have dwindled with protective lung ventilation. Pulmonary fibrosis is associated with permanent pulmonary architectural distortion and irreversible lung dysfunction. Available clinical, radiographic, and autopsy data has indicated that pulmonary fibrosis is central to severe acute respiratory distress syndrome (SARS) and MERS pathology, and current evidence suggests that pulmonary fibrosis could also complicate infection by SARS-CoV-2 The aim of this review is to explore the current literature on the pathogenesis of lung injury in COVID-19 infection, its risk factors & to find out the possible effective therapy within the existing medication. After literature review, we conclude that, currently there are no approved therapies for SARS COV2. Trials are based on drugs that are already approved for other diseases, have acceptable safety profiles or have been effective in animal studies against the other two highly pathogenic coronaviruses. Apart from the potent use of antivirals to reduce the viral effects, the use of antifibrotic therapies could also be under consideration based on the pulmonary fibrotic disease observed after COVID-19 recovery. Pirfenidone and Nintedanib are the two approved anti fibrotic drugs for Idiopathic Pulmonary Fibrosis (IPF). Despite having different modes of action, both are effective in attenuating the rate of lung function decline and are widely considered to improve life expectancy.

Reinfection with SARS-CoV-2 after 152 Days: A Case Report

Background: In general, reinfection means a person was infected (got sick) once, recovered, and then later became infected again. Based on what we know from similar viruses, some reinfections are expected. We are still learning more about COVID-19. Ongoing COVID-19 studies will help us to understand.The degree of protective immunity conferred by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently unknown. As such, the possibility of reinfection with SARS-CoV-2 is not well understood. Here we describe presentation and investigations of two instances of SARS-CoV-2 infection in the same individual. Methodology : A 38-year-old man who is a resident of Dhaka city , Engineer by profession presented to doctors on two occasions with symptoms of viral infection. First time at a community testing event in June, 2020, and a second time to Evercare hospital at the mid November , 2020. Nasopharyngeal swabs were obtained from the patient at each presentation and twice during follow-up. RT PCR testing was done to confirm SARS-CoV-2 infection. CXR P/A view was performed in 1st time of Covid infection & HRCT of chest was performed during his stay at Evercare hospitals Findings: The patient had two positive tests for SARS-CoV-2, the first on June 20th, 2020, and the second on November 18th 2020, separated by two negative tests done during follow-up in July, 2020. The second infection was symptomatically more severe than the first with remarkable radiological changes of Chest in high resolution CT scanning . Interpretation: Two subsequent negative RT PCR after 1st positive with clinically asymptomatic period after 2 weeks of mild symptoms was observed in our patient . About 5 months later he was Covid19 positive again with moderate symptoms. These findings suggest that the patient was infected by SARS-CoV- 2 on two separate occasions probably by genetically distinct virus. Thus, previous exposure to SARS-CoV- 2 might not guarantee total immunity in all cases. All individuals, whether previously diagnosed with COVID- 19 or not, should take identical precautions to avoid infection with SARS-CoV-2. The implications of reinfections could be relevant for vaccine development and application.