Interstitial lung disease and associated fibrosis occur in a proportion of individuals who have recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection through unknown mechanisms. We studied individuals with severe coronavirus disease 2019 (COVID-19) after recovery from acute illness. Individuals with evidence of interstitial lung changes at 3 to 6 months after recovery had an up-regulated neutrophil-associated immune signature including increased chemokines, proteases, and markers of neutrophil extracellular traps that were detectable in the blood. Similar pathways were enriched in the upper airway with a concomitant increase in antiviral type I interferon signaling. Interaction analysis of the peripheral phosphoproteome identified enriched kinases critical for neutrophil inflammatory pathways. Evaluation of these individuals at 12 months after recovery indicated that a subset of the individuals had not yet achieved full normalization of radiological and functional changes. These data provide insight into mechanisms driving development of pulmonary sequelae during and after COVID-19 and provide a rational basis for development of targeted approaches to prevent long-term complications.

A single experience of respiratory paralysis can be used to establish a conditioned response (CR) to a hitherto neutral stimulus. Respiratory paralysis to those undergoing it is horrific but not painful. The CR does not extinguish but becomes stronger as time passes despite repeated extinction trials. The skeletal aspects of the response are more variable than the autonomic aspects and do not provide any constant stimulus input. The results do not fit an "anxiety-reduction" explanation for the inextinguishability of traumatically conditioned responses but suggest that these responses have characteristics not mediated by reinforcement.

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Studies using objective tests have found that two relatively independent types of thought disorder occur in patients diagnosed as “schizophrenic”. In several studies (Payne, 1961) approximately half the acute schizophrenic patients showed an extreme degree of intellectual and motor retardation, more severe than that found even among retarded depressed patients, while half suffered from overinclusive thinking, as measured by the tests used. There was a significant tendency in one study (Payne and Hewlett, 1960) for these two types of thought disorder not to occur in the same acute schizophrenic patients.

Sodium amytal has long been regarded as a physiologically inhibiting drug. It is widely used in clinical practice as a sedative and sleep-producing drug, although all of its precise pharmacological effects are not definitely established. It has also been suggested that sodium amytal produces an increase in extra-version, as manifest by an increase in communicativeness, etc. Thus Lindemann (1932) found that after receiving amytal, normal subjects report feeling of increased well-being, co-operativeness, serenity and friendship. Sodium amytal is also used for the reduction of manifest anxiety. Sargant and Slater (1954) cite many examples of its use for this purpose with neurotic subjects; they describe it as useful for “deconditioning to situations likely to produce anxiety”. Masserman (1938) reports that amytal apparently reduces the sympathetic activity in cats which normally results from faradic stimulation from the hypothalamus. It has also been shown to abolish conditioned fear responses in kittens (Bailey and Miller, 1952).The literature related to conditioning is enormous. Hilgard and Marquis (1940) alone have a 973 item reference list at the end of their book. It has been established that anxiety neurotics or anxious subjects condition better than normals (e.g. Welch and Kubis, 1947a, 1947b; Taylor, 1951; Spence and Taylor, 1953; Spence and Farber, 1953). In the terminology of Eysenck (1952, 1953), in which introversion–extraversion and neuroticism are two orthogonal dimensions, anxiety neurotics are part of the groups known as Dysthymics, i.e. they have high scores on both the introversion end of the introversion–extraversion dimension and on the dimension of neuroticism. On the other hand hysterics and psychopaths have been shown to have high scores on the extraversion end of the introversion–extraversion dimension and on the dimension of neuroticism. Figure 1 will make this clear.