tetano
Editor, Senior Moderator
Arch Bronconeumol
. 2021 Sep 3.
doi: 10.1016/j.arbres.2021.08.014. Online ahead of print.
Lung Function, Radiological Findings and Biomarkers of Fibrogenesis in a Cohort of COVID-19 Patients Six Months After Hospital Discharge
Belen Safont[SUP] 1 [/SUP], Julia Tarraso[SUP] 1 [/SUP], Enrique Rodriguez-Borja[SUP] 2 [/SUP], Estrella Fernández-Fabrellas[SUP] 3 [/SUP], Jose N Sancho-Chust[SUP] 4 [/SUP], Virginia Molina[SUP] 5 [/SUP], Cecilia Lopez-Ramirez[SUP] 6 [/SUP], Amaia Lope-Martinez[SUP] 2 [/SUP], Luis Cabanes[SUP] 7 [/SUP], Ada Luz Andreu[SUP] 8 [/SUP], Susana Herrera[SUP] 9 [/SUP], Carolina Lahosa[SUP] 10 [/SUP], Jose Antonio Ros[SUP] 11 [/SUP], Juan Luis Rodriguez-Hermosa[SUP] 12 [/SUP], Joan B Soriano[SUP] 13 14 [/SUP], Ines Moret-Tatay[SUP] 15 [/SUP], Juan Antonio Carbonell-Asins[SUP] 16 [/SUP], Alba Mulet[SUP] 1 [/SUP], Jaime Signes-Costa[SUP] 1 [/SUP]
Affiliations
Abstract
in English, Spanish
Introduction: Impairment in pulmonary function tests and radiological abnormalities are a major concern in COVID-19 survivors. Our aim is to evaluate functional respiratory parameters, changes in chest CT, and correlation with peripheral blood biomarkers involved in lung fibrosis at two and six months after SARS-CoV-2 pneumonia.
Methods: COVID-FIBROTIC (clinicaltrials.gov NCT04409275) is a multicenter prospective observational cohort study aimed to evaluate discharged patients. Pulmonary function tests, circulating serum biomarkers, chest radiography and chest CT were performed at outpatient visits.
Results: In total, 313, aged 61.12 ± 12.26 years, out of 481 included patients were available. The proportion of patients with DLCO < 80% was 54.6% and 47% at 60 and 180 days. Associated factors with diffusion impairment at 6 months were female sex (OR: 2.97, 95%CI 1.74-5.06, p = 0.001), age (OR: 1.03, 95% CI: 1.01-1.05, p = 0.005), and peak RALE score (OR: 1.22, 95% CI 1.06-1.40, p = 0.005). Patients with altered lung diffusion showed higher levels of MMP-7 (11.54 ± 8.96 vs 6.71 ± 4.25, p = 0.001), and periostin (1.11 ± 0.07 vs 0.84 ± 0.40, p = 0.001). 226 patients underwent CT scan, of whom 149 (66%) had radiological sequelae of COVID-19. In severe patients, 68.35% had ground glass opacities and 38.46% had parenchymal bands. Early fibrotic changes were associated with higher levels of MMP7 (13.20 ± 9.20 vs 7.92 ± 6.32, p = 0.001), MMP1 (10.40 ± 8.21 vs 6.97 ± 8.89, p = 0.023), and periostin (1.36 ± 0.93 vs 0.87 ± 0.39, p = 0.001).
Conclusion: Almost half of patients with moderate or severe COVID-19 pneumonia had impaired pulmonary diffusion six months after discharge. Severe patients showed fibrotic lesions in CT scan and elevated serum biomarkers involved in pulmonary fibrosis.
Keywords: 6-MWT, 6 minute-walk test; ARDS, acute respiratory distress syndrome; BMI, body mass index; COPD, chronic obstructive pulmonary disease; COVID-19 sequelae; COVID-19, coronavirus disease 2019; CT, computed tomography; Chest CT; DLCO, diffusing capacity for carbon monoxide; Fibrotic changes; GGO, ground-glass opacity; HFNC, high flow nasal cannula oxygen; ILD, interstitial lung disease; IMV, mechanical ventilation; Interstitial lung disease; Lung diffusion; MMP, matrix metalloproteinases; NIV, non-invasive ventilation; RALE, radiographic assessment of lung edema; RT-PCR, reverse transcriptase-polymerase chain reaction; SARS, severe acute respiratory syndrome; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; Serum biomarkers; VEGF, vascular endothelial growth factor; mMRC, modified British Medical Research Council; sEGFR, soluble epidermal growth factor receptor.
. 2021 Sep 3.
doi: 10.1016/j.arbres.2021.08.014. Online ahead of print.
Lung Function, Radiological Findings and Biomarkers of Fibrogenesis in a Cohort of COVID-19 Patients Six Months After Hospital Discharge
Belen Safont[SUP] 1 [/SUP], Julia Tarraso[SUP] 1 [/SUP], Enrique Rodriguez-Borja[SUP] 2 [/SUP], Estrella Fernández-Fabrellas[SUP] 3 [/SUP], Jose N Sancho-Chust[SUP] 4 [/SUP], Virginia Molina[SUP] 5 [/SUP], Cecilia Lopez-Ramirez[SUP] 6 [/SUP], Amaia Lope-Martinez[SUP] 2 [/SUP], Luis Cabanes[SUP] 7 [/SUP], Ada Luz Andreu[SUP] 8 [/SUP], Susana Herrera[SUP] 9 [/SUP], Carolina Lahosa[SUP] 10 [/SUP], Jose Antonio Ros[SUP] 11 [/SUP], Juan Luis Rodriguez-Hermosa[SUP] 12 [/SUP], Joan B Soriano[SUP] 13 14 [/SUP], Ines Moret-Tatay[SUP] 15 [/SUP], Juan Antonio Carbonell-Asins[SUP] 16 [/SUP], Alba Mulet[SUP] 1 [/SUP], Jaime Signes-Costa[SUP] 1 [/SUP]
Affiliations
- PMID: 34497426
- PMCID: PMC8414844
- DOI: 10.1016/j.arbres.2021.08.014
Abstract
in English, Spanish
Introduction: Impairment in pulmonary function tests and radiological abnormalities are a major concern in COVID-19 survivors. Our aim is to evaluate functional respiratory parameters, changes in chest CT, and correlation with peripheral blood biomarkers involved in lung fibrosis at two and six months after SARS-CoV-2 pneumonia.
Methods: COVID-FIBROTIC (clinicaltrials.gov NCT04409275) is a multicenter prospective observational cohort study aimed to evaluate discharged patients. Pulmonary function tests, circulating serum biomarkers, chest radiography and chest CT were performed at outpatient visits.
Results: In total, 313, aged 61.12 ± 12.26 years, out of 481 included patients were available. The proportion of patients with DLCO < 80% was 54.6% and 47% at 60 and 180 days. Associated factors with diffusion impairment at 6 months were female sex (OR: 2.97, 95%CI 1.74-5.06, p = 0.001), age (OR: 1.03, 95% CI: 1.01-1.05, p = 0.005), and peak RALE score (OR: 1.22, 95% CI 1.06-1.40, p = 0.005). Patients with altered lung diffusion showed higher levels of MMP-7 (11.54 ± 8.96 vs 6.71 ± 4.25, p = 0.001), and periostin (1.11 ± 0.07 vs 0.84 ± 0.40, p = 0.001). 226 patients underwent CT scan, of whom 149 (66%) had radiological sequelae of COVID-19. In severe patients, 68.35% had ground glass opacities and 38.46% had parenchymal bands. Early fibrotic changes were associated with higher levels of MMP7 (13.20 ± 9.20 vs 7.92 ± 6.32, p = 0.001), MMP1 (10.40 ± 8.21 vs 6.97 ± 8.89, p = 0.023), and periostin (1.36 ± 0.93 vs 0.87 ± 0.39, p = 0.001).
Conclusion: Almost half of patients with moderate or severe COVID-19 pneumonia had impaired pulmonary diffusion six months after discharge. Severe patients showed fibrotic lesions in CT scan and elevated serum biomarkers involved in pulmonary fibrosis.
Keywords: 6-MWT, 6 minute-walk test; ARDS, acute respiratory distress syndrome; BMI, body mass index; COPD, chronic obstructive pulmonary disease; COVID-19 sequelae; COVID-19, coronavirus disease 2019; CT, computed tomography; Chest CT; DLCO, diffusing capacity for carbon monoxide; Fibrotic changes; GGO, ground-glass opacity; HFNC, high flow nasal cannula oxygen; ILD, interstitial lung disease; IMV, mechanical ventilation; Interstitial lung disease; Lung diffusion; MMP, matrix metalloproteinases; NIV, non-invasive ventilation; RALE, radiographic assessment of lung edema; RT-PCR, reverse transcriptase-polymerase chain reaction; SARS, severe acute respiratory syndrome; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; Serum biomarkers; VEGF, vascular endothelial growth factor; mMRC, modified British Medical Research Council; sEGFR, soluble epidermal growth factor receptor.