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Pappas AG, Eleftheriou K, Vlahakos V, Magkouta SF, Riba T, Dede K, Siampani R, Kompogiorgas S, Polydora E, Papalampidou A, Loutsidi NE, Mantas N, Tavernaraki E, Exarchos D, Kalomenidis I. High Plasma Osteopontin Levels Are Associated with Serious Post-Acute-COVID-19-Related Dyspnea. J Clin Med 2024; 13:392. [PMID: 38256526 PMCID: PMC10816040 DOI: 10.3390/jcm13020392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 12/30/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
COVID-19 survivors commonly report persistent symptoms. In this observational study, we investigated the link between osteopontin (OPN) and post-acute COVID-19 symptoms and lung functional/imaging abnormalities. We recorded symptoms and lung imaging/functional data from previously hospitalized COVID-19 patients, who were followed for 4-84 weeks (122 patients/181 visits) post-symptom onset at our outpatient clinic. Circulating OPN was determined using ELISA. Plasma OPN levels were higher in symptomatic patients (compared with the asymptomatic ones); those with dyspnea (compared with those without dyspnea);those with a combination of serious symptoms, i.e., the presence of at least one of the following: dyspnea, fatigue and muscular weakness (compared with those with none of these symptoms); and those with dyspnea and m-MRC > 1 (compared with those with m-MRC = 0-1). Plasma OPN levels were inversely correlated with EQ-VAS (visual analog scale of the EQ-5D-5L health-related quality-of-life questionnaire) values. High-resolution CT or diffusion lung capacity (DLCO) findings were not related to circulating OPN. In the multiple logistic regression, the presence of symptoms, dyspnea, or the combination of serious symptoms were linked to female gender, increased BMI and pre-existing dyspnea (before the acute disease), while increased plasma OPN levels, female gender and pre-existing dyspnea with m-MRC > 1 were independently associated with severe post-COVID-19 dyspnea (m-MRC > 1). Using a correlation matrix to investigate multiple correlations between EQ-VAS, OPN and epidemiological data, we observed an inverse correlation between the OPN and EQ-VAS values. Increased circulating OPN was linked to the persistence of severe exertional dyspnea and impaired quality of life in previously hospitalized COVID-19 patients.
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Affiliation(s)
- Apostolos G. Pappas
- First Department of Critical Care and Pulmonary Medicine, “Evangelismos” General Hospital, School of Medicine, National and Kapodistrian University of Athens, 10676 Athens, Greece (T.R.); (K.D.); (A.P.); (I.K.)
| | - Konstantinos Eleftheriou
- First Department of Critical Care and Pulmonary Medicine, “Evangelismos” General Hospital, School of Medicine, National and Kapodistrian University of Athens, 10676 Athens, Greece (T.R.); (K.D.); (A.P.); (I.K.)
| | - Vassilios Vlahakos
- First Department of Critical Care and Pulmonary Medicine, “Evangelismos” General Hospital, School of Medicine, National and Kapodistrian University of Athens, 10676 Athens, Greece (T.R.); (K.D.); (A.P.); (I.K.)
| | - Sophia F. Magkouta
- “Marianthi Simou Laboratory”, First Department of Critical Care and Pulmonary Medicine, “Evangelismos” General Hospital, School of Medicine, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Theofani Riba
- First Department of Critical Care and Pulmonary Medicine, “Evangelismos” General Hospital, School of Medicine, National and Kapodistrian University of Athens, 10676 Athens, Greece (T.R.); (K.D.); (A.P.); (I.K.)
| | - Konstantina Dede
- First Department of Critical Care and Pulmonary Medicine, “Evangelismos” General Hospital, School of Medicine, National and Kapodistrian University of Athens, 10676 Athens, Greece (T.R.); (K.D.); (A.P.); (I.K.)
| | - Rafaela Siampani
- First Department of Critical Care and Pulmonary Medicine, “Evangelismos” General Hospital, School of Medicine, National and Kapodistrian University of Athens, 10676 Athens, Greece (T.R.); (K.D.); (A.P.); (I.K.)
| | - Steven Kompogiorgas
- Department of Pulmonary Medicine, “Evangelismos” General Hospital, 10676 Athens, Greece
| | - Eftychia Polydora
- First Department of Critical Care and Pulmonary Medicine, “Evangelismos” General Hospital, School of Medicine, National and Kapodistrian University of Athens, 10676 Athens, Greece (T.R.); (K.D.); (A.P.); (I.K.)
| | - Athanasia Papalampidou
- First Department of Critical Care and Pulmonary Medicine, “Evangelismos” General Hospital, School of Medicine, National and Kapodistrian University of Athens, 10676 Athens, Greece (T.R.); (K.D.); (A.P.); (I.K.)
| | - Natasa-Eleni Loutsidi
- Hematology—Lymphomas Department and Bone Marrow Transplant Unit, “Evangelismos” General Hospital, 10676 Athens, Greece;
| | - Nikolaos Mantas
- Department of CT-MRI, “Evangelismos” General Hospital, 10676 Athens, Greece (D.E.)
| | | | - Demetrios Exarchos
- Department of CT-MRI, “Evangelismos” General Hospital, 10676 Athens, Greece (D.E.)
| | - Ioannis Kalomenidis
- First Department of Critical Care and Pulmonary Medicine, “Evangelismos” General Hospital, School of Medicine, National and Kapodistrian University of Athens, 10676 Athens, Greece (T.R.); (K.D.); (A.P.); (I.K.)
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Papalampidou A, Bibaki E, Boutlas S, Pantazopoulos I, Athanasiou N, Moylan M, Vlachakos V, Grigoropoulos V, Eleftheriou K, Daniil Z, Gourgoulianis K, Kalomenidis I, Zakynthinos S, Ischaki E. Nasal high-flow oxygen versus noninvasive ventilation in acute exacerbation of COPD: protocol for a randomised noninferiority clinical trial. ERJ Open Res 2020; 6:00114-2020. [PMID: 33123554 PMCID: PMC7569159 DOI: 10.1183/23120541.00114-2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 08/10/2020] [Indexed: 12/11/2022] Open
Abstract
Background Noninvasive ventilation (NIV) is considered as the first-line treatment for acute exacerbation of COPD (AECOPD) complicated by respiratory acidosis. Recent studies demonstrate a role of nasal high-flow oxygen (NHF) in AECOPD as an alternative treatment in patients intolerant to NIV or with contraindications to it. Aim The study aimed to evaluate whether NHF respiratory support is noninferior compared to NIV in respect to treatment failure, defined as need for intubation or change to alternative treatment group, in patients with AECOPD and mild-to-moderate acute or acute-on-chronic hypercapnic respiratory failure. Methods We designed a multicentre, prospective, randomised trial on patients with AECOPD, who have pH<7.35 but >7.25 and PaCO2 >45 mmHg, in whom NIV is indicated as a first-line treatment. According to power analysis, 498 participants will be required for establishing noninferiority of NHF compared to NIV. Patients will be randomly assigned to receive NIV or NHF. Treatment will be adjusted to maintain SpO2 between 88%–92% for both groups. Arterial blood gases, respiratory variables, comfort, dyspnoea score and any pulmonary or extrapulmonary complications will be assessed at baseline, before treatment initiation, and at 1, 2, 4, 6, 12, 24, 48 h, then once daily from day 3 to patient discharge, intubation or death. Conclusion Given the increasing number of studies demonstrating the physiological effects of NHF in COPD patients, we hypothesise that NHF respiratory support will be noninferior to NIV in patients with AECOPD and mild-to-moderate acute or acute on chronic hypercapnic respiratory failure. Nasal high-flow oxygen could be an effective alternative to NIV respiratory support for patients with mild-to-moderate #AECOPD, especially for those who do not tolerate or have contraindications for NIVhttps://bit.ly/3bgxDYx
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Affiliation(s)
- Athanasia Papalampidou
- First Dept of Critical Care Medicine and Pulmonary Services, Medical School of Athens, Evangelismos Hospital, Athens, Greece.,Both authors contributed equally to this manuscript
| | - Eleni Bibaki
- Respiratory Dept, Venizelio General Hospital, Athens, Greece.,Both authors contributed equally to this manuscript
| | - Stylianos Boutlas
- Dept of Respiratory Medicine, School of Medicine, University of Thessaly, Larissa, Greece
| | | | | | - Melanie Moylan
- Dept of Epidemiology and Biostatistics, Auckland University of Technology, Auckland, New Zealand
| | - Vasileios Vlachakos
- First Dept of Critical Care Medicine and Pulmonary Services, Medical School of Athens, Evangelismos Hospital, Athens, Greece
| | - Vasileios Grigoropoulos
- First Dept of Critical Care Medicine and Pulmonary Services, Medical School of Athens, Evangelismos Hospital, Athens, Greece
| | - Konstantinos Eleftheriou
- First Dept of Critical Care Medicine and Pulmonary Services, Medical School of Athens, Evangelismos Hospital, Athens, Greece
| | - Zoe Daniil
- Dept of Respiratory Medicine, School of Medicine, University of Thessaly, Larissa, Greece
| | | | - Ioannis Kalomenidis
- First Dept of Critical Care Medicine and Pulmonary Services, Medical School of Athens, Evangelismos Hospital, Athens, Greece
| | - Spyros Zakynthinos
- First Dept of Critical Care Medicine and Pulmonary Services, Medical School of Athens, Evangelismos Hospital, Athens, Greece
| | - Eleni Ischaki
- First Dept of Critical Care Medicine and Pulmonary Services, Medical School of Athens, Evangelismos Hospital, Athens, Greece
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Kipourou M, Nτinapogias E, Papalampidou A, Eftychidis I, Mpikas C, Michailopoulos P, Savvaki A, Georgopoulos C, Katsoulis K. AB019. Hereditary methemoglobinemia case: estimation of tissue oxygenation. Ann Transl Med 2016. [DOI: 10.21037/atm.2016.ab019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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