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      Interstitial lung disease before and after COVID-19: a double threat?

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          Abstract

          Sadly, there have already been nearly 200 million confirmed cases of coronavirus disease 2019 (COVID-19) and more than 4 million deaths [1]. The true toll is certainly much higher. We have learned much about the wide spectrum of disease due to COVID-19 over the past 18 months, ranging from asymptomatic infection to severe pneumonia, respiratory failure and death [2]. There is growing concern about whether survivors of COVID-19 will have long-term pulmonary sequelae, including fibrotic interstitial lung disease (ILD) and/or manifest progressive pulmonary fibrosis [3].

          Abstract

          Pre-existing ILD and pulmonary fibrosis increases the risk to manifest severe COVID-19. Residual interstitial lung changes and sequelae have been observed in COVID-19 survivors. A closer and standardised long-term follow-up of these patients is needed. https://bit.ly/3jWBPCG

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          Clinical Characteristics of Coronavirus Disease 2019 in China

          Wei-jie Guan, Zheng-yi Ni, Yu Hu … (2020)
          Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)
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            Dexamethasone in Hospitalized Patients with Covid-19 — Preliminary Report

            Mark Peters (2020)
            Abstract Background Coronavirus disease 2019 (Covid-19) is associated with diffuse lung damage. Glucocorticoids may modulate inflammation-mediated lung injury and thereby reduce progression to respiratory failure and death. Methods In this controlled, open-label trial comparing a range of possible treatments in patients who were hospitalized with Covid-19, we randomly assigned patients to receive oral or intravenous dexamethasone (at a dose of 6 mg once daily) for up to 10 days or to receive usual care alone. The primary outcome was 28-day mortality. Here, we report the preliminary results of this comparison. Results A total of 2104 patients were assigned to receive dexamethasone and 4321 to receive usual care. Overall, 482 patients (22.9%) in the dexamethasone group and 1110 patients (25.7%) in the usual care group died within 28 days after randomization (age-adjusted rate ratio, 0.83; 95% confidence interval [CI], 0.75 to 0.93; P<0.001). The proportional and absolute between-group differences in mortality varied considerably according to the level of respiratory support that the patients were receiving at the time of randomization. In the dexamethasone group, the incidence of death was lower than that in the usual care group among patients receiving invasive mechanical ventilation (29.3% vs. 41.4%; rate ratio, 0.64; 95% CI, 0.51 to 0.81) and among those receiving oxygen without invasive mechanical ventilation (23.3% vs. 26.2%; rate ratio, 0.82; 95% CI, 0.72 to 0.94) but not among those who were receiving no respiratory support at randomization (17.8% vs. 14.0%; rate ratio, 1.19; 95% CI, 0.91 to 1.55). Conclusions In patients hospitalized with Covid-19, the use of dexamethasone resulted in lower 28-day mortality among those who were receiving either invasive mechanical ventilation or oxygen alone at randomization but not among those receiving no respiratory support. (Funded by the Medical Research Council and National Institute for Health Research and others; RECOVERY ClinicalTrials.gov number, NCT04381936; ISRCTN number, 50189673.)
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              Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

              Safiya Richardson, Jamie Hirsch, Mangala Narasimhan … (2020)
              There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID-19).
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                Author and article information

                Journal
                Journal ID (nlm-ta): Eur Respir J
                Journal ID (iso-abbrev): Eur Respir J
                Journal ID (publisher-id): ERJ
                Journal ID (hwp): erj
                Title: The European Respiratory Journal
                Publisher: European Respiratory Society
                ISSN (Print): 0903-1936
                ISSN (Electronic): 1399-3003
                Publication date Collection: December 2021
                Publication date (Electronic): 2 December 2021
                Volume: 58
                Issue: 6
                Electronic Location Identifier: 2101956
                Affiliations
                [1 ]ILD Unit, Pulmonology Dept Hospital Universitario de la Princesa, University Autonoma de Madrid, Madrid, Spain
                [2 ]University of Western Australia, Royal Perth Hospital, Perth, Australia
                [3 ]Center for Interstitial Lung Diseases, University of Washington, Seattle, WA, USA
                Author notes
                Corresponding author: Ganesh Raghu ( graghu@ 123456uw.edu )
                Article
                Publisher ID: ERJ-01956-2021
                DOI: 10.1183/13993003.01956-2021
                PMC ID: 8637181
                PubMed ID: 34857587
                SO-VID: a03ac764-6309-4449-bca0-36711100145b
                Copyright © Copyright ©The authors 2021.
                License:

                This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org

                History
                Date received : 13 July 2021
                Date accepted : 31 August 2021
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                Subject: Editorials

                ScienceOpen disciplines: Respiratory medicine
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                ScienceOpen disciplines: Respiratory medicine

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