Clinical and pulmonary function analysis in long-COVID revealed that long-term pulmonary dysfunction is associated with vascular inflammation pathways and metabolic syndrome

Introduction

Long-term pulmonary dysfunction (L-TPD) is one of the most critical manifestations of long-COVID. This lung affection has been associated with disease severity during the acute phase and the presence of previous comorbidities, however, the clinical manifestations, the concomitant consequences and the molecular pathways supporting this clinical condition remain unknown. The aim of this study was to identify and characterize L-TPD in patients with long-COVID and elucidate the main pathways and long-term consequences attributed to this condition by analyzing clinical parameters and functional tests supported by machine learning and serum proteome profiling.

Methods

Patients with L-TPD were classified according to the results of their computer-tomography (CT) scan and diffusing capacity of the lungs for carbon monoxide adjusted for hemoglobin (DLCOc) tests at 4 and 12-months post-infection.

Results

Regarding the acute phase, our data showed that L-TPD was favored in elderly patients with hypertension or insulin resistance, supported by pathways associated with vascular inflammation and chemotaxis of phagocytes, according to computer proteomics. Then, at 4-months post-infection, clinical and functional tests revealed that L-TPD patients exhibited a restrictive lung condition, impaired aerobic capacity and reduced muscular strength. At this time point, high circulating levels of platelets and CXCL9, and an inhibited FCgamma-receptor-mediated-phagocytosis due to reduced FcγRIII (CD16) expression in CD14+ monocytes was observed in patients with L-TPD. Finally, 1-year post infection, patients with L-TPD worsened metabolic syndrome and augmented body mass index in comparison with other patient groups.

Discussion

Overall, our data demonstrated that CT scan and DLCOc identified patients with L-TPD after COVID-19. This condition was associated with vascular inflammation and impair phagocytosis of virus-antibody immune complexes by reduced FcγRIII expression. In addition, we conclude that COVID-19 survivors required a personalized follow-up and adequate intervention to reduce long-term sequelae and the appearance of further metabolic diseases.

Preparation and Performance Evaluation of SPEEK/Polyaniline Composite Membrane for Direct Methanol Fuel Cell

Polymer composites comprising sulfonated poly(ether ether ketone) (SPEEK) and 10 to 50 wt% of Poly(trimellitic anhydride chloride-co-4,4′-methylenedianiline) (PTCMA) were prepared by solution casting. The effects of PTCMA concentrations on morphological, thermal and transport properties (water uptake, methanol permeability, ion exchange capacity and proton conductivity) were investigated. A morphological analysis revealed an homogenous dense microstructure for all the composites. Also, transport property tests revealed that the water uptake, methanol permeability and ion exchange capacity were enhanced by the addition of PTCMA whereas proton conductivity deteriorated. As shown by a thermogravimetric analysis, the difference between the thermal properties of the pure SPEEK and the composites was insignificant. Overall, the composites were observed to display a better global performance in terms of transport properties than pure SPEEK.

Increased skin flap viability after treatment with forskolin or with ridogrel, a thromboxane synthesis inhibitor and receptor blocker

Two ventral skin flaps were raised in each of 60 rats and viability was assessed 48 h after operation. Twenty animals served as controls and immediately preoperatively 20 received an intraperitoneal injection of either 5 mg/kg body weight ridogrel, a combined thromboxane synthesis inhibitor and receptor blocker, or 4 mg/kg forskolin, a cAMP stimulator. The mean total and surviving flap areas measured 14.3 +/- 1.4 and 10.1 +/- 3.2 cm2 respectively for the control group. In the treated groups it was 16.4 +/- 1.3 cm2 and 15.6 +/- 2.6 cm2 for ridogrel and 17.8 +/- 1.1 cm2 and 15.8 +/- 4.3 cm2 for forskolin respectively. The differences between the areas of each treated group and the control group were statistically significant (p less than 0.0001). It can be concluded that both ridogrel and forskolin afford protection against skin necrosis probably because of improved conditions in the microcirculation due to reduced platelet aggregation in the vasculature of the distal part of the flap.