https://doi.org/10.4081/monaldi.2024.3028

Fibrotic outcomes from SARS-CoV-2 virus interstitial pneumonia

Early Access
Submitted: April 18, 2024
Accepted: September 9, 2024
Published: October 16, 2024
COVID-19 interstitial pneumonia, pulmonary fibrosis
Abstract Views: 828
PDF_EARLY VIEW: 48
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Authors

Luigi Pinto
luigi.pinto@miulli.it
Respiratory Physiopathology and Bronchial Endoscopy Unit, Ecclesiastical Entity General Regional Hospital 'F. Miulli', Acquaviva Delle Fonti (BA), Italy.
Pietro Schino
Respiratory Physiopathology and Bronchial Endoscopy Unit, Ecclesiastical Entity General Regional Hospital 'F. Miulli', Acquaviva Delle Fonti (BA), Italy.
Michele Bitetto
Respiratory Physiopathology and Bronchial Endoscopy Unit, Ecclesiastical Entity General Regional Hospital 'F. Miulli', Acquaviva Delle Fonti (BA), Italy.
Ersilia Tedeschi
Respiratory Physiopathology and Bronchial Endoscopy Unit, Ecclesiastical Entity General Regional Hospital 'F. Miulli', Acquaviva Delle Fonti (BA), Italy.
Michele Maiellari
Respiratory Physiopathology and Bronchial Endoscopy Unit, Ecclesiastical Entity General Regional Hospital 'F. Miulli', Acquaviva Delle Fonti (BA), Italy.
Giancarlo De Leo
Respiratory Physiopathology and Bronchial Endoscopy Unit, Ecclesiastical Entity General Regional Hospital 'F. Miulli', Acquaviva Delle Fonti (BA), Italy.
Elena Ludovico
Radiology Unit, Ecclesiastical Entity General Regional Hospital 'F. Miulli', Acquaviva Delle Fonti (BA), Italy.
Giovanni Larizza
Unit of Internal Medicine, Ecclesiastical Entity General Regional Hospital 'F. Miulli', Acquaviva Delle Fonti (BA), Italy.
Franco Mastroianni
Unit of Internal Medicine, Ecclesiastical Entity General Regional Hospital 'F. Miulli', Acquaviva Delle Fonti (BA), Italy.

Following the onset of the new COVID-19 pandemic, particular attention is paid to the long-term outcomes, especially concerning patients affected by the SARS-CoV-2 virus leading to interstitial pneumonia. The aim of this research is to evaluate the possible evolution over time of interstitial pneumonia into post-inflammatory fibrosing interstitial disease. This research included 42 patients admitted to the COVID ward for SARS-CoV-2 interstitial pneumonia, 10 patients with mild pneumonia and respiratory failure who were treated with O2 only, 32 patients with severe pneumonia in which O2 and non-invasive ventilation were used for respiratory assistance, and 4 patients treated with invasive mechanical ventilation. At 70±30 days, 6, 12, 24, and 36 months after discharge, the cohort of patients carried out the evaluation of inflammation indices, high-resolution computed tomography (CT) chest scans, and functional respiratory tests. The comparative analysis showed that 83.3% of patients had residual parenchymal lung disease at 36-month follow-up, with a significantly higher rate in those with severe pneumonia and more extensive disease on initial CT. Regarding the pulmonary involvement model, patients presented ground-glass opacity or peripheral parenchymal bands, or a combination of them, peri- and intralobular interstitial thickening, which may be representative of fibrotic interstitial lung disease. There is a correlation between the severity of pneumonia, the inflammatory state, the need to increase respiratory support, and the quantity and persistence of CT-related lesions. Reductions in respiratory functions and exercise capacity were observed, the latter more pronounced in patients (24%) who had contracted severe pneumonia and required ventilatory support.Pulmonary outcomes from SARS-CoV-2 respiratory infections show a wide range of radiological findings, from complete recovery to stable outcomes of thickening and distortion of the interstitial architecture. From a functional point of view, there is an impairment of the alveolar-capillary diffusion capacity and, in cases who had contracted severe pneumonia, desaturation and reduced exercise tolerance in 24% of cases at a 36-month follow-up.

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Citations

Crossref
Scopus
Google Scholar
Europe PMC
Pfortmueller CA, Spinetti T, Urman RD, et al. COVID-19-associated acute respiratory distress syndrome (CARDS): Current knowledge on pathophysiology and ICU treatment – a narrative review. Best Pract Res Clin Anaesthesiol 2021;35:351-68. DOI: https://doi.org/10.1016/j.bpa.2020.12.011
Spagnolo P, Balestro E, Aliberti S, et al. Pulmonary fibrosis secondary to COVID-19: a call to arms? Lancet Respir Med 2020;8:750-2. DOI: https://doi.org/10.1016/S2213-2600(20)30222-8
Tannia SE, Todorovic Fabrob A, de Albuquerquec A, et al. Pulmonary fibrosis secondary to COVID-19: a narrative review. Expert Rev Respir Med 2021;15:791-803. DOI: https://doi.org/10.1080/17476348.2021.1916472
Huang W, Wu Q, Chen Z, et al. The potential indicators for pulmonary fibrosis in survivors of severe COVID-19. J Infect 2021;82:e5-7. DOI: https://doi.org/10.1016/j.jinf.2020.09.027
Franks TJ, Chong P, Chui P, et al. Lung pathology of severe acute respiratory syndrome (SARS): a study of 8 autopsy cases from Singapore. Hum Pathol 2003;34:743-8. DOI: https://doi.org/10.1016/S0046-8177(03)00367-8
Hwang DM, Chamberlain DW, Poutanen SM, et al. Pulmonary pathology of severe acute respiratory syndrome in Toronto. Mod Pathol 2005;18:1-10. DOI: https://doi.org/10.1038/modpathol.3800247
Carsana L, Sonzogni A, Nasr A, et al. Pulmonary post-mortem findings in a series of COVID-19 cases from northern Italy: a two-centre descriptive study. Lancet Infect Dis 2020;20:1135-40. DOI: https://doi.org/10.1016/S1473-3099(20)30434-5
Ackermann M, Verleden SE, Kuehnel M, et al. Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in covid-19. N Engl J Med 2020;383:120-8. DOI: https://doi.org/10.1056/NEJMoa2015432
Zhang P, Li J, Liu H, et al. Long-term bone and lung consequences associated with hospital-acquired severe acute respiratory syndrome: a 15-year follow-up from a prospective cohort study. Bone Res 2020;8:8. DOI: https://doi.org/10.1038/s41413-020-00113-1
Hui DS, Wong KT, Ko FW, et al. The 1-year impact of severe acute respiratory syndrome on pulmonary function, exercise capacity, and quality of life in a cohort of survivor. Chest 2005;128:2247-61. DOI: https://doi.org/10.1378/chest.128.4.2247
World Health Organization. Clinical management of severe acute respiratory infection when COVID-19 is suspected. Available from: https://iris.who.int/handle/10665/331446.
Graham BL, Brusasco V, Burgos F, et al. 2017 ERS/ATS standards for single-breath carbon monoxide uptake in the lung. Eur Respir J 2017;49:1600016. DOI: https://doi.org/10.1183/13993003.00016-2016
Wanger J, Clausen JL, Coates A, et al. Standardization of the measurement of lung volumes. Eur Respir J 2005;26:511-22. DOI: https://doi.org/10.1183/09031936.05.00035005
Graham B, Steenbruggen I, Miller M, et al. Standardization of spirometry 2019 update. An official American thoracic society and European respiratory society technical statement. Am J Respir Crit Care Med 2019;200:e70-88. DOI: https://doi.org/10.1164/rccm.201908-1590ST
ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002;166:111-7 DOI: https://doi.org/10.1164/ajrccm.166.1.at1102
Ye T, Fan Y, Liu J, et al. Follow-up Chest CT findings from discharged patients with severe COVID-19: an 83-day observational study. Available from: https://doi.org/10.21203/rs.3.rs-27359/v1. DOI: https://doi.org/10.21203/rs.3.rs-27359/v1
Tobatabaei SMH, Rajebi H, Moahaddas F, et al. Chest CT in COVID-19 pneumonia: what are the findings in mid-term follow-up? Emerg Radiol 2020;27:711-9. DOI: https://doi.org/10.1007/s10140-020-01869-z
Han X, Fan Y, Alwalid O, et al. Six-month follow-up chest ct findings after severe COVID-19 pneumonia. Radiology 2021;299:E177-86. DOI: https://doi.org/10.1148/radiol.2021203153
Lei P, Fan B, Mao J, et al. The progression of computed tomographic (CT) images patients with coronavirus disease (COVID-19) pneumonia. J Infect 2020;80:e30-1. DOI: https://doi.org/10.1016/j.jinf.2020.03.020
Tharaux PL, Chatziantoniou C, Fakhouri F, Dussaule JC. Angiotensin II activates collagen I gene through a mechanism involving the MAP/ER kinase pathway. Hypertension 2000;36:330-6. DOI: https://doi.org/10.1161/01.HYP.36.3.330
Costela-Ruiz VJ, Illescas-Montes R, Puerta-Puerta JM, et al. SARS-CoV-2 infection: the role of cytokines in COVID-19 disease. Cytokine Growth Factor Rev 2020;54:62-75. DOI: https://doi.org/10.1016/j.cytogfr.2020.06.001
Barkauskas CE, Cronce MJ, Rackley CR, et al. Type 2 alveolar cells are stem cells in adult lung. J Clin Invest 2013;123:3025-36. DOI: https://doi.org/10.1172/JCI68782
Winters NI, Burman A, Kropski JA, Blackwell TS. Epithelial injury and dysfunction in the pathogenesis of idiopathic pulmonary fibrosis. Am J Med Sci 2019;357:374-8. DOI: https://doi.org/10.1016/j.amjms.2019.01.010
Herold T, Jurinovic V, Arnreich C, et al. Level of IL-6 predicts respiratory failure in hospitalized symptomatic COVID-19 patients. MedRxiv 2020. Available from: https://doi.org/10.1101/2020.04.01.20047381. DOI: https://doi.org/10.1101/2020.04.01.20047381
Toraldo DM, Satriano F, Rollo RR , et al. COVID-19 IgG/IgM patterns, early IL-6 elevation and long-term radiological sequelae in 75 patients hospitalized due to interstitial pneumonia followed up from 3 to 12 months. PLoS One 202;17:e0262911. DOI: https://doi.org/10.1371/journal.pone.0262911
Zamparelli SS, Fucci V, Rea G, et al. The role of SARS-CoV-2 nucleocapsidic antigen and krebs von den lungen 6 serum levels in predicting COVID-19 pneumonia outcome. Diagnostics 2024;14:642. DOI: https://doi.org/10.3390/diagnostics14060642
Lee JS, Lee EY, Ha YJ, et al. Serum Kl-6 levels reflect the severity of interstitial lung disease associated with connective tissue disease. Arthritis Res Ther 2019;21:58. DOI: https://doi.org/10.1186/s13075-019-1835-9
D’Alessandro M, Cameli P, Refini RM, et al. Serum KL-6 concentrations as a novel biomarker of severe COVID-19. J Med Virol 2020;92:2216-20. DOI: https://doi.org/10.1002/jmv.26087
Scotto R, Pinchera B, Perna F, et al. Serum KL-6 could represent a reliable indicator of unfavourable outcome in patients with COVID-19 pneumonia. Int J Environ Res Public Health 2021;18:2078. DOI: https://doi.org/10.3390/ijerph18042078
Cabrera-Benitez NE, Laffey JG, Perotto M, et al. Mechanical ventilation-associated lung fibrosis in acute respiratory distress syndrome. Anesthesiology 2014;121:189-9. DOI: https://doi.org/10.1097/ALN.0000000000000264
Anastasio F, Barbuto S, Scarnecchia E, et al. Medium term impact of COVID19 on pulmonary function, capacity and quality of life. Eur Respir J 2021;58:2004015. DOI: https://doi.org/10.1183/13993003.04015-2020
Mo X, Jia W, Su Z, et al. Abnormal pulmonary function in COVID-19 patients at time of hospital discharge Eur Respir 2020;55:2001217. DOI: https://doi.org/10.1183/13993003.01217-2020

Ethics Approval

The research was conducted in accordance with the World Medical Association declaration of Helsinki. Approval 6439 of 04/17/2020 Interregional Ethics Committee of the Bari Polyclinic.

How to Cite

Pinto, Luigi, Pietro Schino, Michele Bitetto, Ersilia Tedeschi, Michele Maiellari, Giancarlo De Leo, Elena Ludovico, Giovanni Larizza, and Franco Mastroianni. 2024. “Fibrotic Outcomes from SARS-CoV-2 Virus Interstitial Pneumonia”. Monaldi Archives for Chest Disease, October. https://doi.org/10.4081/monaldi.2024.3028.
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