scholarly journals Changes in pulmonary microcirculation after COVID-19

2021 ◽  
Vol 31 (5) ◽  
pp. 588-597
Author(s):  
Valentina P. Zolotnitskaya ◽  
Olga N. Titova ◽  
Nataliya A. Kuzubova ◽  
Olga V. Amosova ◽  
Aleksandra A. Speranskaya
Keyword(s):  
Respiratory Diseases ◽  
Subsequent Development ◽  
Average Correlation ◽  
Alveolar Volume ◽  
Diffusion Capacity ◽  
Pulmonary Parenchyma ◽  
Coronavirus Infection ◽  
Pulmonary Microcirculation ◽  
Residual Lesions ◽  
Traction Bronchiectasis

The endothelium is a tissue most vulnerable to the SARS-CoV-2 virus. Systemic endothelial dysfunction leads to the development of endothelitis which causes the main manifestations of the disease and systemic disturbance of microcirculation in various organs. Pulmonary microcirculatory damage, the most striking clinical manifestation, was the reason to perform SPECT to detect microcirculation disorders.Aim. To assess microcirculatory changes in the lungs of patients who had no previous respiratory diseases and had a COVID-19 infection at different times from the onset of the disease.Methods. SPECT data were analyzed in 136 patients who had a proven coronavirus infection of varying severity from May 2020 to June 2021.Results. All patients showed changes in microcirculation in the lungs in the post-COVID period. The severity of microcirculation disorders had a significant correlation (rs = 0.76; p = 0.01) with the degree of damage to the pulmonary parenchyma and an average correlation (rs = 0.48; p = 0.05) with the timing of the post-COVID period and the degree of residual lesions on CT (rs = 0.49; p = 0.01). The examined patients with persistent clinical complaints had pulmonary microcirculatory lesions, which may indicate the development of vasculitis, at all stages of the post-COVID period. Despite regression of the lesions confirmed by CT in 3 to 6 months after the acute COVID-19 infection, specialists from Russian and other countries report that 30–36% of patients develop pulmonary fibrosis. Similar changes were identified in 19.1% of the examined patients in our study.Conclusion. Microcirculation disorders are detected in all patients in the post-COVID period, irrespective of the severity according to CT. Progressive decrease in microcirculation in the lower parts of the lungs, local zones of hypoperfusion with the critically low accumulation of radiopharmaceuticals, persistent areas of compaction of the lung tissue (so-called “ground glass”), reticular changes, and the development of traction bronchiectasis, a decrease in the diffusion capacity of the lungs and alveolar volume may indicate fibrotic lesions with subsequent development of virus-associated interstitial lung disease.

scholarly journals Faal Paru Difusi

2018 ◽  
Vol 4 (2) ◽  
pp. 61
Author(s):  
Alfian Nur Rosyid ◽  
Isnin Anang Marhana
Keyword(s):  
Pulmonary Fibrosis ◽  
Bronchial Obstruction ◽  
Alveolar Volume ◽  
Diffusion Capacity ◽  
Single Breath ◽  
Asthma Patients ◽  
Emphysematous Lung ◽  
Pulmonary Bleeding ◽  
Pulmonary Microcirculation ◽  
Parenchymal Disease

Diffusion capacity is useful for measuring ability of pulmonary microcirculation to transfer oxygen and carbon dioxide from alveoli to capillaries. Physiological examination of diffusion is a continuation of physiological examination of ventilation. Diffusion capacity is measured by DLCO (Diffusing capacity for Carbon Monoxide). Measurement of oxygen diffusion capacity directly is very difficult so that indirect methods are used using carbonmonoxide (DLCO). Diffusion capacity of oxygen is equivalent to DLCO multiplied by 1.23. Normal value of DLCO is 20-30 ml/minute mmHg. Some factors that affect DLCO are Hb levels, COHb in smokers, and alveolar volume. Some techniques for measuring DLCO include Steady-state, Three-equation Single-breath, Nitrogen Washout, and Intra-breath DLCO. This test is indicated in pulmonary parenchymal disease (pulmonary fibrosis, asbestosis, sarcoidosis, interstitial lung disease), cystic fibrosis, pulmonary hypertension, and pulmonary bleeding. DLCO is increased in asthma patients, obesity, polycythemia, intraalveolar bleeding, and right-left heart shunting. DLCO is decreased in emphysematous lung patients, pulmonary post resection, bronchial obstruction, multiple pulmonary embolism, anemia, idiopathic pulmonary fibrosis, asbestosis, sarcoidosis, vascular collagen disease, hypersensitive pneumonitis, and alveolar proteinosis.

scholarly journals Coronavirus infection and gut microbiota

2021 ◽  
Vol 102 (4) ◽  
pp. 518-527
Author(s):  
D D Safina ◽  
S R Abdulkhakov
Keyword(s):  
Gastrointestinal Tract ◽  
Gut Microbiota ◽  
Viral Infections ◽  
Subsequent Development ◽  
Upper Respiratory Tract ◽  
Therapeutic Approaches ◽  
Coronavirus Infection ◽  
Upper Respiratory ◽  
Treatment Of Infection ◽  
Tract Disorder

At present time, a number of questions regarding the pathophysiological characteristics and therapeutic approaches to the treatment of the new coronavirus infection COVID-19 remain unresolved. In some cases, patients with COVID-19 may experience symptoms of gastrointestinal tract disorder. According to the literature, the new SARS-CoV-2 coronavirus can replicate in the gastrointestinal tract and may affect the gut microbiota. The article aims to review studies about the possible relationship between the gut microbiota condition and the course of COVID-19 infection, as well as to consider the gut microbiota as a potential therapeutic target and probiotic drugs as possible therapeutic agents in the treatment of viral infections, including COVID-19 infection. It is known that gut microbiota condition is one of the factors determining the susceptibility and features of the bodys response to various infectious agents, possibly including the COVID-19 infection. Currently published studies demonstrate a possible relationship between the gut microbiota condition and the course of COVID-19 infection, however, to confirm this hypothesis, additional studies are required, which will allow to make more unambiguous conclusions with subsequent development of new approaches to the prevention and treatment of infection. Potentially a lot of hope in this direction is inspired by the results of probiotics studies, which showed that their use may reduce the frequency and severity of viral infections of the upper respiratory tract. However, currently, there is insufficient data to extrapolate the results of these studies to COVID-19 patients.

scholarly journals Vitamin D for the protection of immune system

2020 ◽  
pp. 38-41
Author(s):  
Irina Shirokova ◽  
◽  
Julia Prozherina ◽  
Keyword(s):  
Vitamin D ◽  
Immune System ◽  
Respiratory Diseases ◽  
Viral Infections ◽  
Acquired Immunity ◽  
Wide Range ◽  
Important Regulator ◽  
Coronavirus Infection

Vitamin D is the most important regulator of innate and acquired immunity. Due to a wide range of beneficial properties, it affects viral infections, reducing the risk of influenza and other respiratory diseases. Moreover, some research works showed that vitamin D can be used to help fight coronavirus infection.

scholarly journals The Effect of an Olympic Distance Triathlon on Pulmonary Diffusing Capacity and its Recovery 24 Hours Later

2021 ◽  
Vol 80 (1) ◽  
pp. 83-92
Author(s):  
Alain Boussana ◽  
Olivier Galy ◽  
Daniel Le Gallais ◽  
Olivier Hue
Keyword(s):  
Vital Capacity ◽  
Maximal Exercise ◽  
Volume Ratio ◽  
Forced Expiratory Volume ◽  
Breath Holding ◽  
Alveolar Volume ◽  
Diffusion Capacity ◽  
Forced Expiratory Flow ◽  
Pulmonary Diffusion Capacity ◽  
T Values

Abstract The Olympic distance triathlon includes maximal exercise bouts with transitions between the activities. This study investigated the effect of an Olympic distance triathlon (1.5-km swim, 40-km bike, 10-km run) on pulmonary diffusion capacity (DLCO). In nine male triathletes (age: 24 ± 4.7 years), we measured DLCO and calculated the DLCO to alveolar volume ratio (DLCO/VA) and performed spirometry testing before a triathlon (pre-T), 2 hours after the race (post-T), and the day following the race (post-T-24 h). DLCO was measured using the 9-s breath-holding method. We found that (1) DLCO decreased significantly between pre- and post-T values (38.52 ± 5.44 vs. 35.92 ± 6.63 ml∙min-1∙mmHg-1) (p < 0.01) and returned to baseline at post-T-24 h (38.52 ± 5.44 vs. 37.24 ± 6.76 ml∙min-1∙mmHg-1, p > 0.05); (2) DLCO/VA was similar at the pre-, post- and post-T-24 h DLCO comparisons; and (3) forced expiratory volume in the first second (FEV1) and mean forced expiratory flow during the middle half of vital capacity (FEF25-75%) significantly decreased between pre- and post-T and between pre- and post-T-24-h (p < 0.02). In conclusion, a significant reduction in DLCO and DLCO/VA 2 hours after the triathlon suggests the presence of pulmonary interstitial oedema. Both values returned to baseline 24 hours after the race, which reflects possible mild and transient pulmonary oedema with minimal physiological significance.

The incidence of respiratory diseases during the pandemic of the new coronavirus infection COVID-19 in the Russian Federation

Vrach ◽  
2021 ◽  
Vol 32 (11) ◽  
pp. 11-17
Author(s):  
A. Shastin ◽  
T. Bushueva ◽  
V. Gazimova ◽  
T. Obukhova ◽  
A. Zhdanov
Keyword(s):  
Russian Federation ◽  
Respiratory Diseases ◽  
Coronavirus Infection ◽  
The Russian Federation

scholarly journals High Frequency of Viral Co-Detections in Acute Bronchiolitis

Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 990
Author(s):  
Hortense Petat ◽  
Vincent Gajdos ◽  
François Angoulvant ◽  
Pierre-Olivier Vidalain ◽  
Sandrine Corbet ◽  
...  
Keyword(s):  
Respiratory Diseases ◽  
Virus Detection ◽  
Public Health Issue ◽  
Chronic Obstructive ◽  
Acute Bronchiolitis ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Diseases ◽  
Coronavirus Infection ◽  
Syncytial Virus

Over two years (2012–2014), 719 nasopharyngeal samples were collected from 6-week- to 12-month-old infants presenting at the emergency department with moderate to severe acute bronchiolitis. Viral testing was performed, and we found that 98% of samples were positive, including 90% for respiratory syncytial virus, 34% for human rhino virus, and 55% for viral co-detections, with a predominance of RSV/HRV co-infections (30%). Interestingly, we found that the risk of being infected by HRV is higher in the absence of RSV, suggesting interferences or exclusion mechanisms between these two viruses. Conversely, coronavirus infection had no impact on the likelihood of co-infection involving HRV and RSV. Bronchiolitis is the leading cause of hospitalizations in infants before 12 months of age, and many questions about its role in later chronic respiratory diseases (asthma and chronic obstructive pulmonary disease) exist. The role of virus detection and the burden of viral codetections need to be further explored, in order to understand the physiopathology of chronic respiratory diseases, a major public health issue.

scholarly journals Cough in the post COVID period: clinical examples

2021 ◽  
Vol 31 (3) ◽  
pp. 375-382
Author(s):  
O. V. Fesenko
Keyword(s):  
Post Infection ◽  
Spontaneous Pneumothorax ◽  
Protective Factor ◽  
Respiratory Control ◽  
Hyperventilation Syndrome ◽  
Chronic Lung Diseases ◽  
Wide Range ◽  
Coronavirus Infection ◽  
Mechanisms Of Development ◽  
Traction Bronchiectasis

Among the extensive list of manifestations of post COVID syndrome, cough is often found. Most researchers interpret its character as post infection. In some patients, post infection cough becomes productive, and combined mucoactive therapy is required for effective treatment. Since the onset of the pandemic, clinical descriptions of spontaneous pneumothorax have accumulated in the literature. The risk of this complication is present even in patients who are not burdened with chronic lung diseases, as well as those who are breathing spontaneously. The study of the mechanisms of development of spontaneous pneumothorax in COVID-19 is necessary for the development of further therapeutic and preventive measures. Traction bronchiectasis occurs in 27 – 52.5% of cases of new coronavirus infection. Changes in the structure of the bronchi predispose to chronic cough and recurrent infections. Respiratory viral infection has been considered in the past as a trigger for bronchial asthma. There is controversy over the new coronavirus. Asthma has been suggested as a protective factor in COVID-19, due to the specific inflammation profile that protects patients. In some patients who have had COVID-19, the cough is due to hyperventilation syndrome. To explain it, a hypothesis of impaired respiratory control was proposed. The paper presents clinical examples illustrating a wide range of pathological conditions accompanied by cough. Possible relationships between cough and previous coronavirus infection are discussed.

scholarly journals THORACIC SURGICAL TREATMENT IN PATIENTS WITH CORONAVIRUS INFECTION

2021 ◽  
Vol 29 (3) ◽  
pp. 31-35
Author(s):  
M. S. Opanasenko ◽  
◽  
B. M. Konik ◽  
S. M. Belokon ◽  
O. V. Tereshkovich ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pleural Empyema ◽  
Radical Resection ◽  
Severe Condition ◽  
Cardiovascular Failure ◽  
Significant Area ◽  
Pulmonary Parenchyma ◽  
Coronavirus Infection ◽  
Timely Treatment

THORACIC SURGICAL TREATMENT IN PATIENTS WITH CORONAVIRUS INFECTION M. S. Opanasenko, B. M. Konik, S. M. Belokon, O. V. Tereshkovich, S. M. Shalagai, L. I. Levanda, M. I. Kalinichenko, V. I. Lysenko, M. U. Shamrai, A. M. Stepanyuk, O. D. Shestakova Abstract Aim. To familiarize physicians of different specialties with thoracic pathology in patients with coronavirus infection (COVID-19). Materials and methods. Since the beginning of the COVID-19 pandemic 63 patients were treated at the department of surgical treatment of tuberculosis and NLD, complicated by purulent-septic infections: 47 (74.6%) — with various complications of coronavirus infection, and 16 (25.4%) — COVID-19 and conditions, requiring thoracic surgery, not associated with COVID-19. Results. Pleural empyema was the most common bacterial complication — 18 (28.5%) cases. Only 6 (9.5%) patients were diagnosed with broncho-pleural fistula, while 12 (19.6%) patients already had a functioning broncho-pleural fistula at the stage of hospitalization. In 15 (23.8%) patients, the destructive cavities remained on admission, and only 3 (4.7%) had isolated pleural empyema without destruction of pulmonary parenchyma (complete scarring of abscesses). 17 (26.9%) patients with empyema underwent videothoracoscopic (VATS) drainage of the pleural cavity with polydrainage and the use of long-term active aspiration in the postoperative period. In 1 (1.5%) case, due to the extremely severe condition of the patient, only drainage of both pleural cavities was performed. 1 (1.5%) patient with bilateral pleural empyema died of progressive respiratory and cardiovascular failure. Nonspecific exudative pleurisy was diagnosed in 8 (12.6%) patients after coronavirus infection. Spontaneous pneumothorax without development of pleural empyema was diagnosed in 7 (11.1%) patients and in 3 (4.7%) cases pneumo hemothorax occurred. in 2 (3.1%) cases there was a need for parietal pleurectomy (there was a significant area of detachment of the visceral pleura and the impossibility of imposing intracorporeal sutures). All patients were discharged from the hospital with recovery. 6 (9,5 %) patients with necrotizing pneumonia comprised a challenging group of patients with large, treatment-resistant cavities. In 4 (6.3%) cases antibacterial therapy was ineffective, so transthoracic cavity drainage was performed. All 6 patients underwent radical resection interventions following long pre-operative period: 3 (4.7%) cases - pleurolobectomy, 2 (3.1%) — sublobar resection and 1 (1.5%) - resection of the 6th segment of right lung). Conclusions. Pulmonary purulent-destructive COVID-19 complications may occur much more rarely if timely treatment was used. Videothoracoscopic intervention is a preferred option of treatment of these conditions. Key words: COVID-19, thoracic pathology pneumohemothorax, pleurodesis. Ukr. Pulmonol. J. 2021;29(3):31–35:

The role of functional research of the respiratory system in assessing the effectiveness of rehabilitation of patients after COVID-19

MedAlliance ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 82-88
Keyword(s):  
Medical Rehabilitation ◽  
Functional Tests ◽  
Alveolar Volume ◽  
Lung Diffusion ◽  
Diffusion Capacity ◽  
Discharge From Hospital ◽  
Observational Descriptive Study ◽  
Eq Vas

SummaryCOVID-19 is a disease with manifestations ranging from asymptomatic to interstitial pneumonia associated with severe acute respiratory syndrome. The aim of the study isto assess the dynamics of the parameters of the pulmo-nary functional tests (PFTs), dyspnea, quality of life in the process of medical rehabilitation (MR) in the early recov-ery period after COVID-19. Materials and methods. An observational descriptive study was performed. 30 pa-tients were examined, median age 46 years, males (90%). The median of computed tomography (CT) abnormalities in the acute period was 52.5%. Before MR most patients had post-inflammatorychanges in the lungs. The medians of primary PFTs including spirometry, body plethysmog-raphy, diffusion test 15 days after discharge from hospital. The severity of dyspnea (mMRC) and qua lity of life (QoL, EQ-VAS) were also evaluated. Individual MR programs were designed taking into accountcase history, clinical picture, PFTs data. Results. Before MR, on average, all PFTs parameters were within the normal range, except for impaired lung diffusion capacity (83% of cases). 12 (40%) had restrictive, 3 (10%) — obstructive, and 1 — mixed type of ventilation disorders. The severity of dyspnea was 1–2, QoL was reduced. After MR, a statistically significant increase in SVC, FVC, FEV1, FEV1/SVC, МMEF25–75%, transfer factor CO (DLCO) and alveolar volume (VA) was revealed. The average increase in SVC, FVC, FEV1, DLCO and VA was 4.5% (150 ml), 6,4% (270 ml), 7% (323 ml), 5.5% (1.7 ml/min/mmHg) and 5.8% (380 ml), respectively. There was also a statistically significant reduction in dyspnea, and an improvement in QoL. Conclusion. Improvement in lung function, reduction of dyspnea, improvement in QoL indi-cates the effectiveness of MR after COVID-19

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