Association of TNF-α, TGF-ß1, amphiregulin, IL-2, and EGFR WITH pulmonary fibrosis in COVID-19.

Pulmonary fibrosis is a well-recognized sequela associated with coronavirus disease 2019 (COVID-19), however the mechanism is yet to be clearly understood. The study was designed to evaluate the association of TNF-α, TGF- ß1, amphiregulin, IL-2, and EGFR with pulmonary fibrosis after COVID-19 pneumonia. Non-severe, severe, and critical COVID-19 pneumonia patients were included in this study after the patients agreed and gave written informed consent. Blood samples were analyzed with the ELISA method for cytokine examination. The non-contrast chest CT scan was performed after patients were discharged from hospital. Seventy-nine patients with a mean age of 54 years (57 % men, 43 % women) were fully evaluated. Pulmonary fibrosis was found in 74 patients (93.7 %). Serum levels of TGF-ß1 60.55 pg/mL (11.42-2001.16), TNF-α 13.31 pg/mL (3.54-200.32), EGFR 14.9 pg/mL(6.4-53.6), IL-2 12.41 pg/mL(11-14.13), amphiregulin 156.5 pg/mL (21.7-1234). Serum levels of TNF-α increase according to the severity of clinical classification. A significant association between serum levels of TGF-ß1, TNF- α, and pulmonary fibrosis with rs-0.247, p = 0.027; rs 0.259, p = 0.046 was found. According to this study, TNF-α and TGF-ß1 potentially participate in the process of pulmonary fibrosis in COVID-19.

Respinos: A Portable Device for Remote Vital Signs Monitoring of COVID-19 Patients.

The rapidly increasing number of COVID-19 patients has posed a massive burden on many healthcare systems worldwide. Moreover, the limited availability of diagnostic and treatment equipment makes it difficult to treat patients in the hospital. To reduce the burden and maintain the quality of care, asymptomatic patients or patients with mild symptoms are advised to self-isolate at home. However, self-isolated patients need to be continuously monitored as their health can turn into critical condition within a short time. Therefore, a portable device that can remotely monitor the condition and progression of the health of these patients is urgently needed. Here we present a portable device, called Respinos, that can monitor multiparameter vital signs including respiratory rate, heart rate, body temperature, and SpO2. It can also operate as a spirometer that measures forced vital capacity (FVC), forced expiratory volume (FEV), FEV in the first second (FEV1), and peak expiratory flow Rate (PEFR) parameters which are useful for detecting pulmonary diseases. The spirometer is designed in the form of a tube that can be ergonomically inflated by the patient, and is equipped with an accurate and disposable turbine based air flow sensor to evaluate the patient's respiratory condition. Respinos uses rechargeable batteries and wirelessly connects to a mobile application whereby the patient's condition can be monitored in real-time and consulted with doctors via chat. Extensive comparison against medical-grade reference devices showed good performance of Respinos. Overall results demonstrate the potential of Respinos for remote patient monitoring during and post pandemic.

Evolution of chest CT scan manifestations in a patient recovered from COVID-19 severe pneumonia with acute respiratory distress syndrome.

A male patient with severe pneumonia due to coronavirus disease 2019 (COVID-19) had acute respiratory distress syndrome (ARDS) which developed in the second week since the first symptoms and improved without mechanical ventilation. The patient had epilepsy as a comorbid disease and his routinely consumed antiepileptic drugs were likely to cause alterations of the immune system. Ground-glass opacity (GGO), consolidation, and reticular pattern are typical radiological features of COVID-19 pneumonia. Less common findings were septal thickening, bronchiectasis, pleural thickening, and subpleural involvement. These radiological abnormalities evolve throughout the course of the disease. In this case report, a GGO lesion was seen in thin-section CT scans on the 30th and 45th day since the onset of symptoms. The consolidation subsided with time and on the 65th day, minimal GGO was seen in CT scan without pulmonary fibrosis and bronchiectasis.