2024-01-08 22:45:46
During the COVID-19 pandemic, various types of sequelae were identified on a sustained basis in patients recovered from SARS-CoV-2. To refer to this phenomenon, researchers have used the terminology of post-acute COVID-19, post-COVID-19 syndrome or long COVID-19. Likewise, to be classified as such, the symptoms must not be attributable to other causes.
Among the identified symptoms, several pulmonary manifestations have been reported. For example, alteration in computed tomography (CT) after infection has been associated with the need for invasive mechanical ventilation during the acute phase of the disease, while a reduction in the diffusing capacity of carbon monoxide (DLCO) It is one of the most reported lung function alterations 6 months after COVID-19. Likewise, severe acute COVID-19 has been associated with an increased risk of long-term pulmonary sequelae, including lung structural abnormalities and impaired O2 diffusion.
A study carried out by a team including, among others, Estefanía Nova-Lamperti and Sergio Sanhueza, both from the University of Concepción in Chile, Mauricio Hernández, from the MELISA Institute in San Pedro de la Paz, Chile, and Gonzalo Labarca from the University Harvard in the United States, aimed to identify the sequelae associated with long-term pulmonary dysfunction (L-TPD) in patients with COVID-19. The researchers specifically carried out a prospective translational clinical study, focused on clinical characteristics such as comorbidities, mental health, physical health, fatigue, cardiopulmonary functions, among others.
The cohort of this study consisted of 60 subjects who had COVID-19 (mild, moderate or severe), who were evaluated according to the results of their CT scan and DLCOc examination at 4 months after infection, to identify patients with long-term pulmonary dysfunction (L-TPD).
Subsequently, once L-TPD was confirmed, the main parameters that supported this condition during the acute phase of the pathology and 4 months after infection were identified, in addition to the concomitant long-term consequences at 12 months after infection. by COVID-19.
Part of the equipment used at the MELISA Institute. (Photo: MELISA Institute)
Regarding the research methodology, Dr. Gonzalo Labarca indicated that a prospective translational clinical study was carried out in a fairly complex time, such as the beginning of the pandemic. Likewise, “the focus of the study was to see the consequences between the third and fourth month, and after a year after the acute infection. We focused on clinical characteristics such as comorbidities, mental health, physical health, fatigue, cardiopulmonary functions and in-depth sleep study (considering a priori that these systems were going to be significantly altered). Curiously, this was the case, and both for the first evaluation and the one carried out after a year, we found a high percentage of symptoms, in addition to metabolic dysfunction, insulin insufficiency and diabetes that occurred over time, which gave us “It shed light on what the clinical consequences of COVID were,” he added.
For Mauricio Hernández, proteomics was a fundamental tool in carrying out this research: “In our laboratory we have developed a robust methodology for the massive analysis of serum and plasma, which undoubtedly positions us as one of the most important research centers. capacity at the Latin American level. Thanks to this, we were able to obtain valuable information that allowed us to describe, from an immunological and systemic point of view, how the patients evolved over time, which was consistent with the data obtained clinically.”
This research concluded that long-term pulmonary dysfunction is associated with advanced age, having experienced acute respiratory distress, and the presence of hypertension and insulin resistance. Regarding these findings, Dr. Nova-Lamperti pointed out that “we realized that patients who maintain lung damage presented a hypoxic state, even up to 12 months post infection, greater systemic inflammation that affected the endothelial barrier, reduced response of phagocytosis mediated by Fc receptors and an increase in metabolic syndrome and insulin resistance. This is why individuals with LONG-COVID must have a treatment defined by multidisciplinary teams that seek the patient’s gradual recovery through physical exercise, mental health therapy and nutritional intervention.”
The study is titled “Clinical and pulmonary function analysis in long-term COVID revealed that long-term pulmonary dysfunction is associated with vascular inflammation pathways and metabolic syndrome”. And it has been published in the academic journal Frontiers in Medicine. (Source: MELISA Institute)
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