Accuracy of quality of life questionnaire as a diagnostic tool for SARS-CoV-2 pulmonary sequelae

Background: Follow-up after hospital discharge of SARS-CoV-2 survivors represents a huge burden on the healthcare system. We attempt to assess the utility of symptoms and health-related quality of life questionnaire (SF-12) to identify SARS CoV2 pulmonary sequelae.MethodsProspective, non-interventional follow-up study. A cardiopulmonary exercise test, functional respiratory test (PFT), SF12 questionnaire were performed after hospitalization at six months after the first positive PCR smear.Results41 patients were included, female (39%), mean age 57.3±13.7 years. 70% persisted with symptoms. 46% presented a maximum oxygen consumption below 80% of predicted. SF-12 physical domain score was significantly reduced in patients with altered PFT (32.7 vs. 45.9; p<0.001) and obtained the best sensitivity and specificity to identify PFT alterations (AUC 0.862, Sensitivity 85.7%, Specificity 81.5%).ConclusionsSF-12 questionnaire shows high sensitivity and specificity to detect SARS CoV2 survivors with pulmonary function alterations. (AU)

Antecedentes y objetivos: El seguimiento tras el alta hospitalaria de los supervivientes de SARS-CoV-2 representa una enorme carga para el sistema sanitario. Intentamos evaluar la utilidad de los síntomas y el cuestionario de calidad de vida (SF-12) para identificar los pacientes con secuelas pulmonares por SARS-CoV-2.Materiales y métodosEstudio de seguimiento prospectivo observacional. Después de la hospitalización, a los 6 meses del primer frotis con PCR positiva se realizaron: una prueba de esfuerzo cardiopulmonar, pruebas funcionales respiratorias (PFR) y se aplicó el cuestionario SF-12.ResultadosSe incluyó a 41 pacientes, el 39% eran mujeres, con una edad media de 57,3±13,7 años. El 70% persistía con síntomas. El 46% presentó un consumo máximo de oxígeno por debajo del 80% del predicho. La puntuación del dominio físico del SF-12 fue significativamente más baja en pacientes con PFR alteradas (32,7 vs. 45,9; p<0,001) y obtuvo la mejor sensibilidad y especificidad para identificar las alteraciones de las PFR (AUC 0,862; sensibilidad 85,7% y especificidad 81,5%).ConclusionesEl cuestionario de calidad de vida SF-12 presenta una alta sensibilidad y especificidad para detectar a los sobrevivientes de SARS-CoV-2 con alteraciones de la función pulmonar. (AU)

Circulating miR-1246 in the Progression of Chronic Obstructive Pulmonary Disease (COPD) in Patients from the BODE Cohort.

Background: COPD is characterized by a persistent inflammatory response, especially against cigarette smoke. COPD patients may develop varying degrees of emphysematous destruction of the lungs. A pathophysiological role for miRNAs in COPD has been suggested in several studies. We examined changes in microRNAs expression profile during 10 years follow-up in relation to COPD progression. Methods: Clinical and lung function parameters were registered from every subject included in the study. miRNAs expression was determined in 14 serum samples from 7 patients in two moments (4 smokers with COPD (BODE cohort) and 3 smokers without COPD) by next generation sequencing (NGS) at baseline and after 10 years follow-up. A validation study was performed by qPCR in 20 patients with COPD (13 emphysema-diagnosed by CTscan) and 10 smoker controls at baseline and after 10 years follow-up. hsa-miRNA-20a-5p and hsa-let-7d-5p were used as endogenous controls. Results: A total of 198 miRNAs (≥10TPM) were identified by NGS. Between these, hsa-miR-1246 was found significantly downregulated in COPD patients after 10 years when compared to baseline (p<0.0001, FDR=0.05). Seventy-five percent of these patients had an emphysema diagnose. In the validation analysis, when analyzed longitudinally, hsa-miR-1246 was significantly downregulated in COPD patients with emphysema after 10 years (p= 0.019). However, no association was found between the expression of miR-1246 and any other lung function parameters (FEV1, PaO2, DLCO, IC/TLC) within the follow-up period. GO and KEGG enrichment analysis revealed miR-1246 to be associated with target genes in several pathways involved in COPD/emphysema development. Conclusion: Our findings suggest that hsa-miR-1246 may act as a biomarker of emphysema in COPD. Functional analysis is guaranteed to elucidate its role in COPD.