Pulmonary Hypertensive Changes Secondary to COVID-19 Pneumonia in a Chronically SARS-CoV-2-Infected Bilateral Lung Explant

2021 ◽  
pp. 106689692110642
Author(s):  
Joseph M. Rohr ◽  
Heather Strah ◽  
David Berkheim ◽  
Aleem Siddique ◽  
Stanley J. Radio ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Complex Disease ◽  
The Novel ◽  
Long Term Effects ◽  
Hypoxic Respiratory Failure ◽  
Bilateral Lung ◽  
Medial Hypertrophy ◽  
Novel Coronavirus ◽  
Chronic Course

COVID-19, the syndrome caused by the novel coronavirus SARS-CoV-2, has spread throughout the world, causing the death of at least three million people. For the over 81 million who have recovered, however, the long-term effects are only beginning to manifest. We performed a bilateral lung transplant on a 31-year-old male patient for chronic hypoxic respiratory failure, severe pulmonary hypertension and radiographically identified pulmonary fibrosis five months after an acute COVID-19 infection. The explant demonstrated moderate pulmonary vascular remodeling with intimal thickening and medial hypertrophy throughout, consistent with pulmonary hypertension. The parenchyma demonstrated an organizing lung injury in the proliferative phase, with severe fibrosis, histiocytic proliferation, type II pneumocyte hyperplasia, and alveolar loss consistent with known COVID-19 pneumonia complications. This report highlights a novel histologic finding in severe, chronic COVID-19. Although the findings in acute COVID-19 pneumonia have been well-examined at autopsy, the chronic course of this complex disease is not yet understood. The case presented herein suggests that COVID-induced pulmonary hypertension may become more common as more patients survive severe SARS-CoV-2-related pneumonia. Pulmonologists and pulmonary pathologists should be aware of this possible association and look for the clinical, radiographic, and histologic criteria in the appropriate clinical setting.

Long COVID-19

2021 ◽  
Vol 23 (3) ◽  
pp. 261-268
Author(s):  
Yulia G. Belotserkovskaya ◽  
◽  
Anna G. Romanovskikh ◽  
Igor P. Smirnov ◽  
Alexander I. Sinopalnikov ◽  
...  
Keyword(s):  
Time Frame ◽  
The Novel ◽  
Shortness Of Breath ◽  
Long Term Effects ◽  
Clinical Disorders ◽  
Persistent Fatigue ◽  
Coronavirus Infection ◽  
Long Term Consequences ◽  
Novel Coronavirus

The term “long COVID-19” describes the long-term effects of the novel coronavirus infection COVID-19. Patients with severe COVID-19 who require hospitalization, as well as those who are on outpatient treatment with mild clinical forms of the disease, often report persistent fatigue, shortness of breath, pain, cough and other respiratory and extrapulmonary symptoms for weeks and months. The generally accepted time frame that separates the duration of the acute and subacute phase of infection from the long COVID-19 is 28 days. The article describes the duration and the course of clinical disorders caused by COVID-19 and their persisting after the end of the acute phase of the disease. In addition, the current understanding of the causes of long-term consequences and the possibilities of drug and non-pharmacological correction are presented.

scholarly journals Procuring healthcare public-private partnerships (PPPs) through unsolicited proposals during the COVID-19 pandemic

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Carter B. Casady ◽  
David Baxter
Keyword(s):  
Private Sector ◽  
Ad Hoc ◽  
Public Private Partnerships ◽  
The Novel ◽  
Department Of Transportation ◽  
Long Term Effects ◽  
Public Agencies ◽  
Content Type ◽  
Novel Coronavirus

Purpose The novel coronavirus (COVID-19) pandemic has left nations around the world scrambling to procure emergency healthcare capacity, services and equipment. To meet this unprecedented demand on global healthcare systems, governments are increasingly looking to partner with the private sector via public-private partnerships (PPPs). However, the protracted procedures of traditional PPP procurements are not suitable for times of crisis. This is where unsolicited proposals (USPs) may play a pivotal role. Design/methodology/approach To explore the relevance of USPs for the current pandemic, this Viewpoint paper describes both the advantages and challenges of USPs, discusses the emergence of several PPPs to combat COVID-19 as well as some of the ad hoc processes governing current USP consideration, highlights an example of streamlined USP solicitation from Pennsylvania’s Department of Transportation and articulates a pragmatic and practical approach for encouraging and procuring healthcare USPs. Findings This Viewpoint paper concludes that USPs could play a crucial role in the COVID-19 pandemic as boundary spanners between public agencies and the private sector in the PPP procurement process. Social implications Deploying proactive and strategic healthcare PPPs at speed and scale through digital USP platforms may help mitigate the pandemic’s long-term effects. Digital USP platforms may also serve as crucial tools for effective crisis communication, decision-making and partnership. Originality/value Using the digital USP platforms proposed in this paper, infrastructure organizations can develop and maintain effective partnerships with other sector organizations prior to and during crises like COVID-19.

scholarly journals Drug Repurposing for Prevention and Treatment of COVID-19: A Clinical Landscape

Discoveries ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e121
Author(s):  
Md. Shahadat Hossain ◽  
◽  
Ithmam Hami ◽  
Md. Sad Salabi Sawrav ◽  
Md. Fazley Rabbi ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Treatment Plan ◽  
Drug Repurposing ◽  
The Novel ◽  
Long Term Effects ◽  
Novel Therapy ◽  
Worldwide Distribution ◽  
The World ◽  
Novel Coronavirus

SARS-CoV-2, the novel coronavirus strain responsible for the current pandemic of COVID-19, has rendered the entire humanity suffering. Several months have passed since the pandemic has struck. However, the world is still looking for an effective treatment plan to battle the viral infection. The first vaccine just received emergency approval in December 2020 for use in USA and UK. These are excellent news, however, the worldwide distribution of such vaccine, the possibility of virus mutation and the lack of data regarding the long-term effects of such vaccines are a significant concern. In addition, although remdesivir was recently approved by the FDA to be used as a clinical drug against COVID-19, it hasn’t stood out yet as a proven form of therapeutics. Such inability to produce a novel therapy has caused enough inconveniences for the affected people worldwide. Repurposing the already available drugs to fight against the virus seems to be a reasonable option amidst such uncertainty. Given the vast collection of potential treatment candidates to be explored against COVID-19, there is a decent chance that a success in this regard will serve the intermediary purpose of clinically treating the infection until a COVID-19 vaccine is widely distributed worldwide and will be able to treat COVID-19 patients that do not adequately respond to vaccines. Such treatments may prove very useful in future coronavirus outbreaks too. Proper research into these repurposing treatments may yield a certain insight into the field of novel treatment production as well. This review study accumulates a relevant set of information about drugs and vaccines against COVID-19, in terms of their repurposing properties and the specific phases of clinical trials they are undergoing across the world. A potential timeline is also suggested to estimate when an effective result can be expected from the ongoing clinical trials for a better anticipation of the drug landscape. This study will hopefully help accelerate investment of resources into development and discovery of drugs and vaccines against the infection.

scholarly journals Optimal control strategies on COVID-19 infection to bolster the efficacy of vaccination in India

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ashutosh Rajput ◽  
Mohammad Sajid ◽  
Tanvi ◽  
Chandra Shekhar ◽  
Rajiv Aggarwal
Keyword(s):  
Optimal Control ◽  
Control Strategies ◽  
Real Data ◽  
Vaccination Rate ◽  
Transmission Dynamics ◽  
The Novel ◽  
Long Term Effects ◽  
Precautionary Measures ◽  
Novel Coronavirus

AbstractThe Novel Coronavirus which emerged in India on January/30/2020 has become a catastrophe to the country on the basis of health and economy. Due to rapid variations in the transmission of COVID-19, an accurate prediction to determine the long term effects is infeasible. This paper has introduced a nonlinear mathematical model to interpret the transmission dynamics of COVID-19 infection along with providing vaccination in the precedence. To minimize the level of infection and treatment burden, the optimal control strategies are carried out by using the Pontryagin’s Maximum Principle. The data validation has been done by correlating the estimated number of infectives with the real data of India for the month of March/2021. Corresponding to the model, the basic reproduction number $${\mathcal {R}}_0$$ R 0 is introduced to understand the transmission dynamics of COVID-19. To justify the significance of parameters we determined the sensitivity analysis of $${\mathcal {R}}_0$$ R 0 using the parameters value. In the numerical simulations, we concluded that reducing $${\mathcal {R}}_0$$ R 0 below unity is not sufficient enough to eradicate the COVID-19 disease and thus, it is required to increase the vaccination rate and its efficacy by motivating individuals to take precautionary measures.

scholarly journals Outpatient management of heart valve disease following the COVID-19 pandemic: implications for present and future care

Heart ◽  
2020 ◽  
Vol 106 (20) ◽  
pp. 1549-1554 ◽  
Author(s):  
Benoy Nalin Shah ◽  
Dominik Schlosshan ◽  
Hannah Zelie Ruth McConkey ◽  
Mamta Heena Buch ◽  
Andrew John Marshall ◽  
...  
Keyword(s):  
Heart Valve ◽  
Waiting Times ◽  
Severe Disease ◽  
Valve Disease ◽  
Heart Valve Disease ◽  
The Novel ◽  
Future Care ◽  
Novel Coronavirus

The established processes for ensuring safe outpatient surveillance of patients with known heart valve disease (HVD), echocardiography for patients referred with new murmurs and timely delivery of surgical or transcatheter treatment for patients with severe disease have all been significantly impacted by the novel coronavirus pandemic. This has created a large backlog of work and upstaging of disease with consequent increases in risk and cost of treatment and potential for worse long-term outcomes. As countries emerge from lockdown but with COVID-19 endemic in society, precautions remain that restrict ‘normal’ practice. In this article, we propose a methodology for restructuring services for patients with HVD and provide recommendations pertaining to frequency of follow-up and use of echocardiography at present. It will be almost impossible to practice exactly as we did prior to the pandemic; thus, it is essential to prioritise patients with the greatest clinical need, such as those with symptomatic severe HVD. Local procedural waiting times will need to be considered, in addition to usual clinical characteristics in determining whether patients requiring intervention would be better suited having surgical or transcatheter treatment. We present guidance on the identification of stable patients with HVD that could have follow-up deferred safely and suggest certain patients that could be discharged from follow-up if waiting lists are triaged with appropriate clinical input. Finally, we propose that novel models of working enforced by the pandemic—such as increased use of virtual clinics—should be further developed and evaluated.

scholarly journals The coronavirus in the MENA region: Enhancing turbulence or mitigating conflicts?

European View ◽  
2020 ◽  
Vol 19 (2) ◽  
pp. 206-211
Author(s):  
Magnus Norell
Keyword(s):  
Middle East ◽  
The Novel ◽  
Crisis Preparedness ◽  
Mena Region ◽  
Existing Problems ◽  
Regional Conflicts ◽  
Current Trends ◽  
Short And Long Term ◽  
Novel Coronavirus

The novel coronavirus (COVID-19) pandemic has affected the countries in the Middle East and North Africa (MENA) region in different ways, and the varying political structures, economic conditions and civil-crisis preparedness of the states in this region have resulted in it being handled in a variety of ways too. Even if it is difficult to assess how the crisis has affected the MENA region in more detail due to the region’s general volatility and ongoing conflicts in Libya and Syria, current trends have so far not shown a diminution in regional conflicts. Nor have the pandemic’s consequences in the Middle East lessened Europe’s problems with the region. Thus the article argues that COVID-19 has not really led to a decrease in the conflicts and wars plaguing the MENA region, and that, therefore, the effects for Europe—both short- and long-term—will still be felt, as existing problems will continue to affect Europe.

Long-Term Effects of Cicletanine on Secondary Pulmonary Hypertension

1998 ◽  
Vol 31 (3) ◽  
pp. 364-371 ◽  
Author(s):  
Alain Saadjian ◽  
François Philip-Joët ◽  
Franck Paganelli ◽  
Alain Arnaud ◽  
Samuel Levy
Keyword(s):  
Pulmonary Hypertension ◽  
Long Term Effects ◽  
Secondary Pulmonary Hypertension

scholarly journals Primary Pulmonary Hypertension: Improved Long-Term Effects and Survival With Continuous Intravenous Epoprostenol Infusion

1997 ◽  
Vol 30 (2) ◽  
pp. 343-349 ◽  
Author(s):  
Shelley M Shapiro ◽  
Ronald J Oudiz ◽  
Tiesheng Cao ◽  
Matthew A Romano ◽  
X.Joy Beckmann ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Primary Pulmonary Hypertension ◽  
Long Term Effects
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