Long-Term Outcomes in Acute Respiratory Distress Syndrome

Palakshappa, Jessica A.; Krall, J.T.W.; Belfield, L.; Files, D. Clark

doi:10.1016/j.ccc.2021.05.010

Cited by 17 publications

(6 citation statements)

References 133 publications

(142 reference statements)

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“…There was a significant resolution of diffuse alveolar damage and atelectasis after cytomix-licensed MSC administration, showing that preactivated MSCs can restore lung structure even in the setting of established untreated infection. This is a promising result of MSC therapy and would contribute to positive long-term outcomes in ARDS patients who can suffer the ongoing effects of lung fibrosis and poor oxygen diffusion impairment (reviewed in [28]).…”

Section: Discussionmentioning

confidence: 99%

Multiple Dosing and Preactivation of Mesenchymal Stromal Cells Enhance Efficacy in Established Pneumonia Induced by Antimicrobial-Resistant Klebsiella pneumoniae in Rodents

Byrnes

Masterson

Gonzales

et al. 2023

IJMS

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Antimicrobial-resistant (AMR) bacteria, such as Klebsiella species, are an increasingly common cause of hospital-acquired pneumonia, resulting in high mortality and morbidity. Harnessing the host immune response to AMR bacterial infection using mesenchymal stem cells (MSCs) is a promising approach to bypass bacterial AMR mechanisms. The administration of single doses of naïve MSCs to ARDS clinical trial patient cohorts has been shown to be safe, although efficacy is unclear. The study tested whether repeated MSC dosing and/or preactivation, would attenuate AMR Klebsiella pneumonia-induced established pneumonia. Rat models of established K. pneumoniae-induced pneumonia were randomised to receive intravenous naïve or cytomix-preactivated umbilical cord MSCs as a single dose at 24 h post pneumonia induction with or without a subsequent dose at 48 h. Physiological indices, bronchoalveolar lavage (BAL), and tissues were obtained at 72 h post pneumonia induction. A single dose of naïve MSCs was largely ineffective, whereas two doses of MSCs were effective in attenuating Klebsiella pneumosepsis, improving lung compliance and oxygenation, while reducing bacteria and injury in the lung. Cytomix-preactivated MSCs were superior to naïve MSCs. BAL neutrophil counts and activation were reduced, and apoptosis increased. MSC therapy reduced cytotoxic BAL T cells, and increased CD4+/CD8+ ratios. Systemically, granulocytes, classical monocytes, and the CD4+/CD8+ ratio were reduced, and nonclassical monocytes were increased. Repeated doses of MSCs—particularly preactivated MSCs—enhance their therapeutic potential in a clinically relevant model of established AMR K. pneumoniae-induced pneumosepsis.

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Section: Discussionmentioning

confidence: 99%

Multiple Dosing and Preactivation of Mesenchymal Stromal Cells Enhance Efficacy in Established Pneumonia Induced by Antimicrobial-Resistant Klebsiella pneumoniae in Rodents

Byrnes

Masterson

Gonzales

et al. 2023

IJMS

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“…According to Palakshappa et al (2021) , ARDS survivors recovered their lung capacity 6–12 months after hospital discharge, but suffered from long term physical, cognitive, and mental impairments. Since there is increase in ARDS incidence with COVID-19, it is important to re-evaluate the severity and lasting of post COVID 19 symptoms for an additional year.…”

Section: Discussionmentioning

confidence: 99%

The long-term effects of COVID-19 on pulmonary status and quality of life

Alahmari,

Krishna,

Jose

et al. 2023

PeerJ

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Background Few studies have looked at how SARS-CoV-2 affects pulmonary function, exercise capacity, and health-related quality of life over time. The purpose of this study was to evaluate these characteristics in post COVID-19 subjects 1 year after recovery. Methods The study included two groups. The case group included post COVID-19 subjects who had recovered after a year, and the control group included healthy participants who had never tested positive for COVID-19. Results The study screened 90 participants, 42 of whom met the eligibility criteria. The findings revealed that the majority of post COVID-19 subjects had relatively normal lung function 1-year post-recovery. A significant reduction in DLCO (B/P%) was observed in the case group vs. control. The exercise capacity test revealed a clinically significant difference in distance walked and a significant difference in the dyspnea post-walk test in the case group compared to the control group. The case group’s health-related quality of life domain scores were significantly affected in terms of energy/fatigue, general health, and physical function. Conclusions The post COVID-19 subjects were shown to have well-preserved lung function after 1 year. However, some degree of impairment in diffusion capacity, exercise capacity, and health-related quality of life remained.

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“…Adjusted odds ratio (OR) and 95% confidence interval (95%CI) for the risk of subsequent hospitalization for a personality disorder of different types over the 12-month period after initial hospital discharge, for patients hospitalized for COVID-19 versus those hospitalized for another reason, in all adult patients hospitalized in metropolitan France the first half of 2020: Model 7, stratified by age categories (18-39, 40-59, 60-74, and 75þ) using fully-adjusted analysis. 18 specifically, the higher risk may not be related to COVID-19 hospitalization per se, but to selection bias: patients with a psychiatric history were at a higher risk of COVID-19 hospitalization, as a psychiatric history was the risk factor most strongly associated with subsequent hospitalization for a psychiatric disorder. Both hypotheses, that is, COVID-19 hospitalization as a risk factor for hospitalization for a psychiatric disorder, and vice-versa, may explain the association, and may not be mutually exclusive.…”

Section: Discussionmentioning

confidence: 99%

“…Data on the emergence of psychiatric symptoms after hospitalization for COVID-19 highlight the prevalence of several disorders including posttraumatic stress symptoms, anxiety, and depression, which can continue up to 6 months after discharge [6,[15][16][17]. This is especially true for persons with severe COVID-19 infection who have acute respiratory distress syndrome and require therapy in an intensive care unit (ICU) [18,19]. A systematic review performed several years before the COVID-19 pandemic found that nearly 30% of ICU patients had significant depressive symptoms during the first year after hospital discharge [20].…”

Section: Introductionmentioning

confidence: 99%