COVID-19 pandemic has been associated with a high short-term morbidity and mortality, on the long-term, COVID-19 complications may lead to a major impact on the community and the health care the pulmonary sequelae are expected to rise significantly in the future. The lungs are the main organs affected by COVID-19. A wide variety of long-term respiratory complications secondary to COVID-19 have been described ranging from persistent symptoms and radiological changes to an impaired respiratory physiology, vascular complications and pulmonary fibrosis. Despite all of that, the respiratory sequalae post-acute SARS-CoV-2 infection has not been fully explored until now. Furthermore, the main treatment for most of the COVID-19 respiratory complications is still symptomatic and supportive care. In this review article we shed the light on the post COVID-19 complications based on the latest available evidence, focusing on pulmonary fibrosis, treatment directions, and recommendations to the physicians.
Objectives The primary objective is to determine the prevalence of SARS-COV-2 antibodies persistence among HCWs and specifically among asymptomatic HCW. A secondary objective is to determine the duration of persistent SARS-CoV-2 antibodies post infection and factors affecting this duration. The findings are expected to open the door for further research into the role of SARS-CoV-2 antibodies during the current COVID-19 pandemic. Methodology HCWs were divided into high, intermediate, and low risk based on their type and location of work. All participants filled a questionnaire. Blood samples were obtained for SARS-CoV-2 IgG/total antibodies. A documented SARS-CoV-2 PCR or Anti-SARS-CoV-2 IgG/total antibodies defined the primary outcome. The probability of persistence of antibody was calculated using the Kaplan-Meier estimator. Logistic and Cox regression were used where appropriate. Results A total of 1,111 HCWs were included. The median age 37 years ( IQR: 31–43). More than half (67.2%) were females. The primary outcome was seen in 373 (33.6%) participants with a median age of 36 years ( IQR: 29 - 41). Only 37.2% of those with documented positive SARS-CoV-2 PCR had reactive serology, while only 16.2% of those with reactive serology had documented positive SARS-CoV-2 PCR. Male gender (OR 0.44, P < 0.001) and older age (OR 0.98, P < 0.019) were associated with a lower risk of acquiring SARS-COV-2 infection. The probability of persistent SARS-COV-2 antibodies at six months was 60.2% (95% CI: 49.5% - 73.1%). Omani had a higher probability of losing the antibody than others (HR 2.63, P = 0.021). Conclusion We report a high prevalence of anti-SARS-CoV-2 antibodies among HCWs in Oman, specifically among asymptomatic HCWs. Community was the most likely source of infection. Therefore, the society must adhere to the roles and regulations set to reduce the risk of transmission. We demonstrate a high percentage of seroconversion post initial infection, and the persistence of SARS-COV-2 antibodies at six months in more than half of those previously infected. We demonstrated a new interesting finding of fast decline of SARS-CoV2 antibody levels over time among different nationalities and this requires further research.
Lung cancer is the leading cause of cancer-related death worldwide among both men and women. Although advances in therapy have been made, the 5-year survival rates for lung cancer remain poor, ranging from 10% to 20%. One of the main reasons is late presentation, as only 25% of patients are amenable to cure at the time of presentation. Therefore, the emphasis on lung cancer screening (LCS) is growing with the current evidence that has shown benefits with low-dose computed tomography scan of the chest in high-risk populations. LCS remains a debated topic in Gulf Cooperation Council (GCC) countries, possibly due to a lack of local experience. In this article, we explore the rationale and give recommendations on the best approach for LCS in GCC.
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