Lung Fibrosis Sequelae After Recovery from COVID-19 Infection

Susanto, Agus Dwi; Triyoga, Paulus Arka; Isbaniah, Fathiyah; Aulya, Fairuz; Cendikiawan, Hans; Zaron, Ferdynand; Aryanti, Intan; Irbah, Sarah Naura; Hidayat, Moulid

doi:10.3855/jidc.13686

Cited by 9 publications

(6 citation statements)

References 9 publications

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“…These can contribute to persistent lung damage, including the recovery period after discharge, and may eventually lead to PF ( John et al., 2021 ). The pathogenesis of PF in COVID-19 have been discussed in several studies ( John et al., 2021 ; Susanto et al., 2021 ; Xiang et al., 2022 ) and alveolar epithelial cell injury during lung infection with SARS-CoV-2 are reported to be the major cause for the occurrence of PF since they lead to infiltration of fibroblasts and inflammatory cells, resulting in the release of pro-fibrotic factors ( Martinez et al., 2017 ). Meanwhile, 83% of type II alveolar cells express angiotensin-converting enzyme 2 (ACE2), which is the primary receptor for SARS-CoV-2 and may partly explain alveolar epithelial cell injury ( Umemura et al., 2021 ; Bui et al., 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Pulmonary fibrosis in patients with COVID-19: A retrospective study

Deng

Song³

et al. 2022

Front. Cell. Infect. Microbiol.

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BackgroundCoronavirus disease 2019 (COVID-19) pandemic has caused substantial threats to people’s physical health and lives, claiming the lives of over 6 million people worldwide. Although the mortality rate of COVID-19 is very low, many survivors may have different degrees and various sequelae. Previous studies have shown that pulmonary fibrosis (PF) were common on discharged COVID-19 patients, and PF itself is a poor prognostic factor.Methods227 COVID-19 hospitalized patients’ clinical and laboratory data from the first 15 days following admission were collected in this retrospective study. Groups were based on with or without PF of COVID-19. Categorical variables were compared with the chi-square test or Fisher’s exact test. Continuous variables were tested by Wilcoxon rank-sum test for the non-normal distribution. Spearman correlations were used to assess the correlations between PF with clinic parameters of multiple time points. Univariate and multivariate logistic regression were used to analyze for risk factors of COVID-19 patients with pulmonary fibrosis.ResultsSixty cases of COVID-19 patients were diagnosed with PF. Compared with 167 non-PF patients, those with PF were older and had higher proportions of fever, shortness of breath, hemoptysis, abdominal pain, hypertension, cardiovascular, diabetes, high flow nasal cannula (HFNC), severe disease, and virus shedding duration. Furthermore, the correlation analysis between PF and clinic parameters showed that PF were positively related to the C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), and negatively correlated with hemoglobin (HGB) and albumin (ALB) at all time points in the first 15 days after admission. Moreover, We found that PF were significantly correlated with coagulation indexes prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib) and fibrinolysis index D-Dimer at some phases. In addition, Univariate logistic regression analyses showed that age, fever, shortness of breath, hemoptysis, hypertension, cardiovascular, diabetes, HFNC, severe disease were the risk factors of COVID-19 patients with PF. However, multivariate logistic regression showed that age was the risk factor of COVID-19 patients with PF.ConclusionCombining various factors, advanced age is an independent risk factor of COVID-19 patients with PF. PF was significantly related with clinic parameter of inflammation/coagulopathy/fibrinolysis.

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Section: Introductionmentioning

confidence: 99%

Pulmonary fibrosis in patients with COVID-19: A retrospective study

Deng

Song³

et al. 2022

Front. Cell. Infect. Microbiol.

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“…In this case, a CT thorax scan post resolution of symptoms demonstrated that the acute lung damage initially observed had fully resolved. The long-term effects of COVID-19 on pulmonary function remain relatively unexplored (15). By the completion of 1-year follow-up, no chronic fibrosis was detected on imaging in this kidney transplant recipient.…”

Section: Discussionmentioning

confidence: 89%

Long-Term Clinical and Immunological Impact of Severe COVID-19 on a Living Kidney Transplant Recipient – A Case Report

Qiu

Huang

et al. 2021

Front. Immunol.

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The long-term impact of COVID-19 on transplant recipients remains unknown. We describe the case of a 30-year-old male kidney transplant recipient from Wuhan, China that was treated for severe COVID-19 in February 2020. He suffered an acute lung and renal injury and required systemic treatment including adjustment of his immunosuppressant regime. He was followed up to 1-year after discharge. No chronic lung fibrosis or deterioration of his pulmonary function was observed. Despite COVID-19 mediated damage to his renal tubular cells, no transplant rejection occurred. His immunological profile demonstrated both cellular anti-SARS-CoV-2 reactivity and specific humoral immunity, indicating that it is beneficial for the transplanted patients to be immunized with SARS-CoV-2 virus vaccine. This case will help guide clinical decision making for immunocompromised individuals that become infected with SARS-CoV-2.

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“…Though it gives rise to various types of symptoms such as fatigue, myalgia, psychological issue, and rare neurological and cardiologic complications, dyspnea is one of the commonest symptoms [6][7][8][9]. Patients suffering from COVID pneumonia also show lung fibrosis later, even after recovery from COVID-19 [16,17]. It can lead to altered lung functions, dyspnea, and reduced exercise and work capacity.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Persistence of Dyspnea and Change in Health-Related Quality of Life in Patients With COVID-19 After Discharge

Biswas¹,

Pandey²,

Ghosh³

et al. 2022

Cureus

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IntroductionCoronavirus disease 2019 (COVID-19) is a deadly virus affecting multiple organ systems, predominantly the respiratory system. Dyspnea along with the deterioration of health-related quality of life (HRQoL) is common in COVID-19 patients discharged from a dedicated Coronavirus disease (COVID) hospital. Very few studies in India used HRQoL for the assessment of COVID-19 patients after discharge. Our article aims to assess the factors associated with the persistence of dyspnea and HRQoL in discharged patients of COVID-19. MethodsA total of 48 patients were included in this prospective observational study. Ethical approval from Institutional Ethics Committee was obtained before the enrolment of patients. Patients having dyspnea at exertion and during discharge were selected for this study. Modified Medical Research Council (mMRC) scale and modified Borg scale were used for assessing dyspnea on activity, and Saint George's Respiratory Questionnaire (SGRQ) was used to assess HRQoL. Data were collected on the day of discharge (D0) and after 60 days (D60) post-discharge. The significance of changes in parameters from D0 to D60 was evaluated by paired t-test. ResultsThe mean mMRC, modified Borg, and SGRQ scores at D0 were 2.38±0.98, 3.15±2.12, and 45.36±27.32, respectively, which were improved to 0.94±0.86, 0.94±1.27, and 19.22±18.96 at D60. Age showed significant positive correlations with initial modified Borg (r=0.292, p=0.044) and SGRQ (r=0.332, p=0.021) scores. Body mass index showed significant positive correlations with initial mMRC (r=0.352, p=0.014) and SGRQ (r=0.419, p=0.003) scores. ConclusionOur study showed that on discharge, many COVID patients have impaired HRQoL. Many of them also have dyspnea on exertion. With the early institution of standard pulmonary rehabilitation protocol, symptoms and HRQoL improves rapidly in a month. Different influencing factors were identified. Long-term follow-up with a bigger sample size is needed to formulate a management strategy for these patients.

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Lung Fibrosis Sequelae After Recovery from COVID-19 Infection

Cited by 9 publications

References 9 publications

Pulmonary fibrosis in patients with COVID-19: A retrospective study

Pulmonary fibrosis in patients with COVID-19: A retrospective study

Long-Term Clinical and Immunological Impact of Severe COVID-19 on a Living Kidney Transplant Recipient – A Case Report

Factors Associated With Persistence of Dyspnea and Change in Health-Related Quality of Life in Patients With COVID-19 After Discharge

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