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Cha MJ, Solomon JJ, Lee JE, Choi H, Chae KJ, Lee KS, Lynch DA. Chronic Lung Injury after COVID-19 Pneumonia: Clinical, Radiologic, and Histopathologic Perspectives. Radiology 2024; 310:e231643. [PMID: 38193836 PMCID: PMC10831480 DOI: 10.1148/radiol.231643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/06/2023] [Accepted: 09/26/2023] [Indexed: 01/10/2024]
Abstract
With the COVID-19 pandemic having lasted more than 3 years, concerns are growing about prolonged symptoms and respiratory complications in COVID-19 survivors, collectively termed post-COVID-19 condition (PCC). Up to 50% of patients have residual symptoms and physiologic impairment, particularly dyspnea and reduced diffusion capacity. Studies have also shown that 24%-54% of patients hospitalized during the 1st year of the pandemic exhibit radiologic abnormalities, such as ground-glass opacity, reticular opacity, bronchial dilatation, and air trapping, when imaged more than 1 year after infection. In patients with persistent respiratory symptoms but normal results at chest CT, dual-energy contrast-enhanced CT, xenon 129 MRI, and low-field-strength MRI were reported to show abnormal ventilation and/or perfusion, suggesting that some lung injury may not be detectable with standard CT. Histologic patterns in post-COVID-19 lung disease include fibrosis, organizing pneumonia, and vascular abnormality, indicating that different pathologic mechanisms may contribute to PCC. Therefore, a comprehensive imaging approach is necessary to evaluate and diagnose patients with persistent post-COVID-19 symptoms. This review will focus on the long-term findings of clinical and radiologic abnormalities and describe histopathologic perspectives. It also addresses advanced imaging techniques and deep learning approaches that can be applied to COVID-19 survivors. This field remains an active area of research, and further follow-up studies are warranted for a better understanding of the chronic stage of the disease and developing a multidisciplinary approach for patient management.
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Affiliation(s)
- Min Jae Cha
- From the Department of Radiology, Chung-Ang University Hospital,
Seoul, Korea (M.J.C., H.C.); Departments of Medicine (J.J.S.) and Radiology
(K.J.C., D.A.L.), National Jewish Health, 1400 Jackson St, Denver, CO 80206;
Department of Radiology, Chonnam National University Hospital, Gwangju, Republic
of Korea (J.E.L.); Department of Radiology, Research Institute of Clinical
Medicine of Jeonbuk National University, Biomedical Research Institute of
Jeonbuk National University Hospital, Jeonju, Republic of Korea (K.J.C); and
Department of Radiology, Sungkyunkwan University School of Medicine and Samsung
ChangWon Hospital, Gyeongsangnam, Republic of Korea (K.S.L.)
| | - Joshua J. Solomon
- From the Department of Radiology, Chung-Ang University Hospital,
Seoul, Korea (M.J.C., H.C.); Departments of Medicine (J.J.S.) and Radiology
(K.J.C., D.A.L.), National Jewish Health, 1400 Jackson St, Denver, CO 80206;
Department of Radiology, Chonnam National University Hospital, Gwangju, Republic
of Korea (J.E.L.); Department of Radiology, Research Institute of Clinical
Medicine of Jeonbuk National University, Biomedical Research Institute of
Jeonbuk National University Hospital, Jeonju, Republic of Korea (K.J.C); and
Department of Radiology, Sungkyunkwan University School of Medicine and Samsung
ChangWon Hospital, Gyeongsangnam, Republic of Korea (K.S.L.)
| | - Jong Eun Lee
- From the Department of Radiology, Chung-Ang University Hospital,
Seoul, Korea (M.J.C., H.C.); Departments of Medicine (J.J.S.) and Radiology
(K.J.C., D.A.L.), National Jewish Health, 1400 Jackson St, Denver, CO 80206;
Department of Radiology, Chonnam National University Hospital, Gwangju, Republic
of Korea (J.E.L.); Department of Radiology, Research Institute of Clinical
Medicine of Jeonbuk National University, Biomedical Research Institute of
Jeonbuk National University Hospital, Jeonju, Republic of Korea (K.J.C); and
Department of Radiology, Sungkyunkwan University School of Medicine and Samsung
ChangWon Hospital, Gyeongsangnam, Republic of Korea (K.S.L.)
| | - Hyewon Choi
- From the Department of Radiology, Chung-Ang University Hospital,
Seoul, Korea (M.J.C., H.C.); Departments of Medicine (J.J.S.) and Radiology
(K.J.C., D.A.L.), National Jewish Health, 1400 Jackson St, Denver, CO 80206;
Department of Radiology, Chonnam National University Hospital, Gwangju, Republic
of Korea (J.E.L.); Department of Radiology, Research Institute of Clinical
Medicine of Jeonbuk National University, Biomedical Research Institute of
Jeonbuk National University Hospital, Jeonju, Republic of Korea (K.J.C); and
Department of Radiology, Sungkyunkwan University School of Medicine and Samsung
ChangWon Hospital, Gyeongsangnam, Republic of Korea (K.S.L.)
| | - Kum Ju Chae
- From the Department of Radiology, Chung-Ang University Hospital,
Seoul, Korea (M.J.C., H.C.); Departments of Medicine (J.J.S.) and Radiology
(K.J.C., D.A.L.), National Jewish Health, 1400 Jackson St, Denver, CO 80206;
Department of Radiology, Chonnam National University Hospital, Gwangju, Republic
of Korea (J.E.L.); Department of Radiology, Research Institute of Clinical
Medicine of Jeonbuk National University, Biomedical Research Institute of
Jeonbuk National University Hospital, Jeonju, Republic of Korea (K.J.C); and
Department of Radiology, Sungkyunkwan University School of Medicine and Samsung
ChangWon Hospital, Gyeongsangnam, Republic of Korea (K.S.L.)
| | - Kyung Soo Lee
- From the Department of Radiology, Chung-Ang University Hospital,
Seoul, Korea (M.J.C., H.C.); Departments of Medicine (J.J.S.) and Radiology
(K.J.C., D.A.L.), National Jewish Health, 1400 Jackson St, Denver, CO 80206;
Department of Radiology, Chonnam National University Hospital, Gwangju, Republic
of Korea (J.E.L.); Department of Radiology, Research Institute of Clinical
Medicine of Jeonbuk National University, Biomedical Research Institute of
Jeonbuk National University Hospital, Jeonju, Republic of Korea (K.J.C); and
Department of Radiology, Sungkyunkwan University School of Medicine and Samsung
ChangWon Hospital, Gyeongsangnam, Republic of Korea (K.S.L.)
| | - David A. Lynch
- From the Department of Radiology, Chung-Ang University Hospital,
Seoul, Korea (M.J.C., H.C.); Departments of Medicine (J.J.S.) and Radiology
(K.J.C., D.A.L.), National Jewish Health, 1400 Jackson St, Denver, CO 80206;
Department of Radiology, Chonnam National University Hospital, Gwangju, Republic
of Korea (J.E.L.); Department of Radiology, Research Institute of Clinical
Medicine of Jeonbuk National University, Biomedical Research Institute of
Jeonbuk National University Hospital, Jeonju, Republic of Korea (K.J.C); and
Department of Radiology, Sungkyunkwan University School of Medicine and Samsung
ChangWon Hospital, Gyeongsangnam, Republic of Korea (K.S.L.)
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2
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Cojocaru E, Cojocaru T, Pînzariu GM, Vasiliu I, Armașu I, Cojocaru C. Perspectives on Post-COVID-19 Pulmonary Fibrosis Treatment. J Pers Med 2023; 14:51. [PMID: 38248752 PMCID: PMC10817460 DOI: 10.3390/jpm14010051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/19/2023] [Accepted: 12/26/2023] [Indexed: 01/23/2024] Open
Abstract
Pulmonary fibrosis, a critical outcome of chronic inflammatory diseases, has gained prominence in the context of post-coronavirus (post-COVID-19) complications. This review delves into the multifaceted landscape of post-COVID-19 pulmonary fibrosis, elucidating the intricate molecular mechanisms underlying its pathogenesis and highlighting promising therapeutic avenues. Examining the aftermath of severe acute respiratory syndrome-2 (SARS-CoV-2) infection, the review reveals key signaling pathways implicated in the fibrotic cascade. Drawing parallels with previous coronavirus outbreaks enhances our understanding of the distinctive features of post-COVID-19 fibrosis. Antifibrotic drugs, like pirfenidone and nintedanib, take center stage; their mechanisms of action and potential applications in post-COVID-19 cases are thoroughly explored. Beyond the established treatments, this review investigates emerging therapeutic modalities, including anti-interleukin agents, immunosuppressants, and experimental compounds, like buloxybutide, saracatinib, sirolimus, and resveratrol. Emphasizing the critical importance of early intervention, this review highlights the dynamic nature of post-COVID-19 pulmonary fibrosis research. In conclusion, the synthesis of current knowledge offers a foundation for advancing our approaches to the prevention and treatment of these consequential sequelae of COVID-19.
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Affiliation(s)
- Elena Cojocaru
- Morpho-Functional Sciences II Department, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania; (E.C.); (I.V.)
| | - Tudor Cojocaru
- Faculty of Medicine, University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania; (G.M.P.); (I.A.)
| | - Giulia Mihaela Pînzariu
- Faculty of Medicine, University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania; (G.M.P.); (I.A.)
| | - Ioana Vasiliu
- Morpho-Functional Sciences II Department, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania; (E.C.); (I.V.)
| | - Ioana Armașu
- Faculty of Medicine, University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania; (G.M.P.); (I.A.)
| | - Cristian Cojocaru
- Medical III Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
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3
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Islam MA, Getz M, Macklin P, Ford Versypt AN. An agent-based modeling approach for lung fibrosis in response to COVID-19. PLoS Comput Biol 2023; 19:e1011741. [PMID: 38127835 PMCID: PMC10769079 DOI: 10.1371/journal.pcbi.1011741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 01/05/2024] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
The severity of the COVID-19 pandemic has created an emerging need to investigate the long-term effects of infection on patients. Many individuals are at risk of suffering pulmonary fibrosis due to the pathogenesis of lung injury and impairment in the healing mechanism. Fibroblasts are the central mediators of extracellular matrix (ECM) deposition during tissue regeneration, regulated by anti-inflammatory cytokines including transforming growth factor beta (TGF-β). The TGF-β-dependent accumulation of fibroblasts at the damaged site and excess fibrillar collagen deposition lead to fibrosis. We developed an open-source, multiscale tissue simulator to investigate the role of TGF-β sources in the progression of lung fibrosis after SARS-CoV-2 exposure, intracellular viral replication, infection of epithelial cells, and host immune response. Using the model, we predicted the dynamics of fibroblasts, TGF-β, and collagen deposition for 15 days post-infection in virtual lung tissue. Our results showed variation in collagen area fractions between 2% and 40% depending on the spatial behavior of the sources (stationary or mobile), the rate of activation of TGF-β, and the duration of TGF-β sources. We identified M2 macrophages as primary contributors to higher collagen area fraction. Our simulation results also predicted fibrotic outcomes even with lower collagen area fraction when spatially-localized latent TGF-β sources were active for longer times. We validated our model by comparing simulated dynamics for TGF-β, collagen area fraction, and macrophage cell population with independent experimental data from mouse models. Our results showed that partial removal of TGF-β sources changed the fibrotic patterns; in the presence of persistent TGF-β sources, partial removal of TGF-β from the ECM significantly increased collagen area fraction due to maintenance of chemotactic gradients driving fibroblast movement. The computational findings are consistent with independent experimental and clinical observations of collagen area fractions and cell population dynamics not used in developing the model. These critical insights into the activity of TGF-β sources may find applications in the current clinical trials targeting TGF-β for the resolution of lung fibrosis.
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Affiliation(s)
- Mohammad Aminul Islam
- Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, New York, United States of America
| | - Michael Getz
- Department of Intelligent Systems Engineering, Indiana University, Bloomington, Indiana, United States of America
| | - Paul Macklin
- Department of Intelligent Systems Engineering, Indiana University, Bloomington, Indiana, United States of America
| | - Ashlee N. Ford Versypt
- Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, New York, United States of America
- Department of Biomedical Engineering, University at Buffalo, The State University of New York, Buffalo, New York, United States of America
- Institute for Artificial Intelligence and Data Science, University at Buffalo, The State University of New York, Buffalo, New York, United States of America
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4
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Bussani R, Zentilin L, Correa R, Colliva A, Silvestri F, Zacchigna S, Collesi C, Giacca M. Persistent SARS-CoV-2 infection in patients seemingly recovered from COVID-19. J Pathol 2023; 259:254-263. [PMID: 36651103 PMCID: PMC10107739 DOI: 10.1002/path.6035] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/27/2022] [Accepted: 11/15/2022] [Indexed: 01/19/2023]
Abstract
SARS-CoV-2 infection is clinically heterogeneous, ranging from asymptomatic to deadly. A few patients with COVID-19 appear to recover from acute viral infection but nevertheless progress in their disease and eventually die, despite persistent negativity at molecular tests for SARS-CoV-2 RNA. Here, we performed post-mortem analyses in 27 consecutive patients who had apparently recovered from COVID-19 but had progressively worsened in their clinical conditions despite repeated viral negativity in nasopharyngeal swabs or bronchioalveolar lavage for 11-300 consecutive days (average: 105.5 days). Three of these patients remained PCR-negative for over 9 months. Post-mortem analysis revealed evidence of diffuse or focal interstitial pneumonia in 23/27 (81%) patients, accompanied by extensive fibrotic substitution in 13 cases (47%). Despite apparent virological remission, lung pathology was similar to that observed in acute COVID-19 individuals, including micro- and macro-vascular thrombosis (67% of cases), vasculitis (24%), squamous metaplasia of the respiratory epithelium (30%), frequent cytological abnormalities and syncytia (67%), and the presence of dysmorphic features in the bronchial cartilage (44%). Consistent with molecular test negativity, SARS-CoV-2 antigens were not detected in the respiratory epithelium. In contrast, antibodies against both spike and nucleocapsid revealed the frequent (70%) infection of bronchial cartilage chondrocytes and para-bronchial gland epithelial cells. In a few patients (19%), we also detected positivity in vascular pericytes and endothelial cells. Quantitative RT-PCR amplification in tissue lysates confirmed the presence of viral RNA. Together, these findings indicate that SARS-CoV-2 infection can persist significantly longer than suggested by standard PCR-negative tests, with specific infection of specific cell types in the lung. Whether these persistently infected cells also play a pathogenic role in long COVID remains to be addressed. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Rossana Bussani
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Lorena Zentilin
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
| | - Ricardo Correa
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
| | - Andrea Colliva
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.,International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
| | - Furio Silvestri
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Serena Zacchigna
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.,International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
| | - Chiara Collesi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.,International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
| | - Mauro Giacca
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.,International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy.,School of Cardiovascular Medicine & Sciences, King's College London, British Heart Foundation Centre of Research Excellence, London, UK
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5
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Yan MZ, Yang M, Lai CL. Post-COVID-19 Syndrome Comprehensive Assessment: From Clinical Diagnosis to Imaging and Biochemical-Guided Diagnosis and Management. Viruses 2023; 15:v15020533. [PMID: 36851746 PMCID: PMC9964207 DOI: 10.3390/v15020533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/04/2023] [Accepted: 02/05/2023] [Indexed: 02/17/2023] Open
Abstract
The COVID-19 outbreak was first reported in 2019, causing massive morbidity and mortality. The majority of the COVID-19 patients survived and developed Post-COVID-19 Syndrome (PC19S) of varying severity. Currently, the diagnosis of PC19S is achieved through history and symptomatology that cannot be explained by an alternative diagnosis. However, the heavy reliance on subjective reporting is prone to reporting errors. Besides, there is no unified diagnostic assessment tool to classify the clinical severity of patients. This leads to significant difficulties when managing patients in terms of public resource utilization, clinical progression monitorization and rehabilitation plan formulation. This narrative review aims to review current evidence of diagnosis based on triple assessment: clinical symptomatology, biochemical analysis and imaging evidence. Further assessment tools can be developed based on triple assessment to monitor patient's clinical progression, prognosis and intervals of monitoring. It also highlights the high-risk features of patients for closer and earlier monitoring. Rehabilitation programs and related clinical trials are evaluated; however, most of them focus on cardiorespiratory fitness and psychiatric presentations such as anxiety and depression. Further research is required to establish an objective and comprehensive assessment tool to facilitate clinical management and rehabilitation plans.
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Affiliation(s)
- Michael Zhipeng Yan
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
- Correspondence: (M.Z.Y.); (C.-L.L.)
| | - Ming Yang
- Department of Ophthalmology, The University of Hong Kong, Hong Kong SAR, China
| | - Ching-Lung Lai
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
- Correspondence: (M.Z.Y.); (C.-L.L.)
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Kanne JP, Little BP, Schulte JJ, Haramati A, Haramati LB. Long-term Lung Abnormalities Associated with COVID-19 Pneumonia. Radiology 2022; 306:e221806. [PMID: 36040336 PMCID: PMC9462591 DOI: 10.1148/radiol.221806] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
In the 3rd year of the SARS-CoV-2 pandemic, much has been learned about the long-term effects of COVID-19 pneumonia on the lungs. Approximately one-third of patients with moderate-to-severe pneumonia, especially those requiring intensive care therapy or mechanical ventilation, have residual abnormalities at chest CT 1 year after presentation. Abnormalities range from parenchymal bands to bronchial dilation to frank fibrosis. Less is known about the long-term pulmonary vascular sequelae, but there appears to be a persistent, increased risk of venothromboembolic events in a small cohort of patients. Finally, the associated histologic abnormalities resulting from SARS-CoV-2 infection are similar to those seen in patients with other causes of acute lung injury.
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Chikwe J. Editor's Choice: Papers That May Change Your Practice. Ann Thorac Surg 2022; 114:359-363. [PMID: 35878951 DOI: 10.1016/j.athoracsur.2022.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Joanna Chikwe
- Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
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8
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Ravaglia C, Doglioni C, Chilosi M, Piciucchi S, Dubini A, Rossi G, Pedica F, Puglisi S, Donati L, Tomassetti S, Poletti V. Clinical, radiological, and pathological findings in patients with persistent lung disease following SARS-CoV-2 infection. Eur Respir J 2022; 60:13993003.02411-2021. [PMID: 35301248 PMCID: PMC8932282 DOI: 10.1183/13993003.02411-2021] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 02/13/2022] [Indexed: 12/18/2022]
Abstract
Some patients experience pulmonary sequelae after SARS-CoV-2 infection, ranging from self-limited abnormalities to major lung diseases. Morphological analysis of lung tissue may help our understanding of pathogenic mechanisms and help to provide consistent personalised management. The aim of this study was to ascertain morphological and immunomolecular features of lung tissue. Transbronchial lung cryobiopsy was carried out in patients with persistent symptoms and computed tomography suggestive of residual lung disease after recovery from SARS-CoV-2 infection. 164 patients were referred for suspected pulmonary sequelae after COVID-19; 10 patients with >5% parenchymal lung disease underwent lung biopsy. The histological pattern of lung disease was not homogeneous and three different case clusters could be identified, which was mirrored by their clinical and radiological features. Cluster 1 (“chronic fibrosing”) was characterised by post-infection progression of pre-existing interstitial pneumonias. Cluster 2 (“acute/subacute injury”) was characterised by different types and grades of lung injury, ranging from organising pneumonia and fibrosing nonspecific interstitial pneumonia to diffuse alveolar damage. Cluster 3 (“vascular changes”) was characterised by diffuse vascular increase, dilatation and distortion (capillaries and venules) within otherwise normal parenchyma. Clusters 2 and 3 had immunophenotypical changes similar to those observed in early/mild COVID-19 pneumonias (abnormal expression of STAT3 in hyperplastic pneumocytes and PD-L1, IDO and STAT3 in endothelial cells). This is the first study correlating histological/immunohistochemical patterns with clinical and radiological pictures of patients with post-COVID lung disease. Different phenotypes with potentially different underlying pathogenic mechanisms have been identified. Post-COVID lung disease is not a single entity, but includes different subtypes, each of them potentially requiring separate and different managementhttps://bit.ly/3BJDeUF
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Affiliation(s)
- Claudia Ravaglia
- Department of Thoracic Diseases, G.B. Morgagni Hospital/University of Bologna, Forlì, Italy
| | - Claudio Doglioni
- Department of Pathology, University Vita-Salute, Milan and San Raffaele Scientific Institute, Milan, Italy
| | - Marco Chilosi
- Department of Pathology, Pederzoli Hospital, Peschiera del Garda, Verona, Italy
| | - Sara Piciucchi
- Department of Radiology, G.B. Morgagni Hospital/University of Bologna, Forlì, Italy
| | - Alessandra Dubini
- Department of Pathology, G.B. Morgagni Hospital/University of Bologna, Forlì, Italy
| | - Giulio Rossi
- Department of Pathology, Fondazione Poliambulanza Istituto Ospedaliero Multispecialistico, Brescia, Italy
| | - Federica Pedica
- Department of Pathology, San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Puglisi
- Department of Thoracic Diseases, G.B. Morgagni Hospital/University of Bologna, Forlì, Italy
| | - Luca Donati
- Biostatistics and Clinical Trial Unit, Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori"-IRST S.r.l., IRCCS, Meldola, Italy
| | - Sara Tomassetti
- Department of Experimental and Clinical Medicine, Careggi University Hospital, Firenze, Italy
| | - Venerino Poletti
- Department of Thoracic Diseases, G.B. Morgagni Hospital/University of Bologna, Forlì, Italy.,DIMES, University of Bologna, Bologna, Italy.,Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
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9
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Hernández MTG, Barreda CF, Valentín NMN, Gago MGF, López MFJ. [CLINICAL FEATURES AND POSTOPERATIVE OUTCOMES OF PATIENTS UNDERGOING THORACIC SURGERY AFTER SARS-COV-2 INFECTION]. Cir Esp 2021; 100:795-798. [PMID: 34720120 PMCID: PMC8542436 DOI: 10.1016/j.ciresp.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- María Teresa Gómez Hernández
- Servicio de Cirugía Torácica. Hospital Universitario de Salamanca. Salamanca.,Instituto de Investigación Biomédica de Salamanca (IBSAL). Salamanca.,Universidad de Salamanca. Salamanca
| | | | - Nuria M Novoa Valentín
- Servicio de Cirugía Torácica. Hospital Universitario de Salamanca. Salamanca.,Instituto de Investigación Biomédica de Salamanca (IBSAL). Salamanca.,Universidad de Salamanca. Salamanca
| | - Marta G Fuentes Gago
- Servicio de Cirugía Torácica. Hospital Universitario de Salamanca. Salamanca.,Instituto de Investigación Biomédica de Salamanca (IBSAL). Salamanca.,Universidad de Salamanca. Salamanca
| | - Marcelo F Jiménez López
- Servicio de Cirugía Torácica. Hospital Universitario de Salamanca. Salamanca.,Instituto de Investigación Biomédica de Salamanca (IBSAL). Salamanca.,Universidad de Salamanca. Salamanca
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