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Risk factors for clinically significant diffuse parenchymal lung abnormalities persisting after severe COVID-19 pneumonia

BACKGROUND & OBJECTIVES: The risk factors for clinically significant diffuse parenchymal lung abnormalities (CS-DPLA) persisting after severe coronavirus disease 2019 (COVID-19) pneumonia remain unclear. The present study was conducted to assess whether COVID-19 severity and other parameters are...

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Autores principales: Dhooria, Sahajal, Arora, Siddhant, Chaudhary, Shivani, Sehgal, Inderpaul Singh, Prabhakar, Nidhi, Mohammad, Nasim, Sharma, Riya, Das, Prabir, Kumar, Yashwant, Garg, Mandeep, Puri, Goverdhan Dutt, Bhalla, Ashish, Muthu, Valliappan, Prasad, Kuruswamy Thurai, Agarwal, Ritesh, Aggarwal, Ashutosh Nath
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10443720/
https://www.ncbi.nlm.nih.gov/pubmed/37322633
http://dx.doi.org/10.4103/ijmr.ijmr_2360_22
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author Dhooria, Sahajal
Arora, Siddhant
Chaudhary, Shivani
Sehgal, Inderpaul Singh
Prabhakar, Nidhi
Mohammad, Nasim
Sharma, Riya
Das, Prabir
Kumar, Yashwant
Garg, Mandeep
Puri, Goverdhan Dutt
Bhalla, Ashish
Muthu, Valliappan
Prasad, Kuruswamy Thurai
Agarwal, Ritesh
Aggarwal, Ashutosh Nath
author_facet Dhooria, Sahajal
Arora, Siddhant
Chaudhary, Shivani
Sehgal, Inderpaul Singh
Prabhakar, Nidhi
Mohammad, Nasim
Sharma, Riya
Das, Prabir
Kumar, Yashwant
Garg, Mandeep
Puri, Goverdhan Dutt
Bhalla, Ashish
Muthu, Valliappan
Prasad, Kuruswamy Thurai
Agarwal, Ritesh
Aggarwal, Ashutosh Nath
author_sort Dhooria, Sahajal
collection PubMed
description BACKGROUND & OBJECTIVES: The risk factors for clinically significant diffuse parenchymal lung abnormalities (CS-DPLA) persisting after severe coronavirus disease 2019 (COVID-19) pneumonia remain unclear. The present study was conducted to assess whether COVID-19 severity and other parameters are associated with CS-DPLA. METHODS: The study participants included patients who recovered after acute severe COVID-19 and presented with CS-DPLA at two or six month follow up and control group (without CS-DPLA). Adults volunteers without any acute illness, chronic respiratory illness and without a history of severe COVID-19 were included as healthy controls for the biomarker study. The CS-DPLA was identified as a multidimensional entity involving clinical, radiological and physiological pulmonary abnormalities. The primary exposure was the neutrophil-lymphocyte ratio (NLR). Recorded confounders included age, sex, peak lactate dehydrogenase (LDH), advanced respiratory support (ARS), length of hospital stay (LOS) and others; associations were analyzed using logistic regression. The baseline serum levels of surfactant protein D, cancer antigen 15-3 and transforming growth factor-β (TGF-β) were also compared among cases, controls and healthy volunteers. RESULTS: We identified 91/160 (56.9%) and 42/144 (29.2%) participants with CS-DPLA at two and six months, respectively. Univariate analyses revealed associations of NLR, peak LDH, ARS and LOS with CS-DPLA at two months and of NLR and LOS at six months. The NLR was not independently associated with CS-DPLA at either visit. Only LOS independently predicted CS-DPLA at two months [adjusted odds ratios (aOR) (95% confidence interval [CI]), 1.16 (1.07-1.25); P<0.001] and six months [aOR (95% CI) and 1.07 (1.01-1.12); P=0.01]. Participants with CS-DPLA at six months had higher baseline serum TGF-β levels than healthy volunteers. INTERPRETATION AND CONCLUSIONS: Longer hospital stay was observed to be the only independent predictor of CS-DPLA six months after severe COVID-19. Serum TGF-β should be evaluated further as a biomarker.
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spelling pubmed-104437202023-08-23 Risk factors for clinically significant diffuse parenchymal lung abnormalities persisting after severe COVID-19 pneumonia Dhooria, Sahajal Arora, Siddhant Chaudhary, Shivani Sehgal, Inderpaul Singh Prabhakar, Nidhi Mohammad, Nasim Sharma, Riya Das, Prabir Kumar, Yashwant Garg, Mandeep Puri, Goverdhan Dutt Bhalla, Ashish Muthu, Valliappan Prasad, Kuruswamy Thurai Agarwal, Ritesh Aggarwal, Ashutosh Nath Indian J Med Res Practice: Original Article BACKGROUND & OBJECTIVES: The risk factors for clinically significant diffuse parenchymal lung abnormalities (CS-DPLA) persisting after severe coronavirus disease 2019 (COVID-19) pneumonia remain unclear. The present study was conducted to assess whether COVID-19 severity and other parameters are associated with CS-DPLA. METHODS: The study participants included patients who recovered after acute severe COVID-19 and presented with CS-DPLA at two or six month follow up and control group (without CS-DPLA). Adults volunteers without any acute illness, chronic respiratory illness and without a history of severe COVID-19 were included as healthy controls for the biomarker study. The CS-DPLA was identified as a multidimensional entity involving clinical, radiological and physiological pulmonary abnormalities. The primary exposure was the neutrophil-lymphocyte ratio (NLR). Recorded confounders included age, sex, peak lactate dehydrogenase (LDH), advanced respiratory support (ARS), length of hospital stay (LOS) and others; associations were analyzed using logistic regression. The baseline serum levels of surfactant protein D, cancer antigen 15-3 and transforming growth factor-β (TGF-β) were also compared among cases, controls and healthy volunteers. RESULTS: We identified 91/160 (56.9%) and 42/144 (29.2%) participants with CS-DPLA at two and six months, respectively. Univariate analyses revealed associations of NLR, peak LDH, ARS and LOS with CS-DPLA at two months and of NLR and LOS at six months. The NLR was not independently associated with CS-DPLA at either visit. Only LOS independently predicted CS-DPLA at two months [adjusted odds ratios (aOR) (95% confidence interval [CI]), 1.16 (1.07-1.25); P<0.001] and six months [aOR (95% CI) and 1.07 (1.01-1.12); P=0.01]. Participants with CS-DPLA at six months had higher baseline serum TGF-β levels than healthy volunteers. INTERPRETATION AND CONCLUSIONS: Longer hospital stay was observed to be the only independent predictor of CS-DPLA six months after severe COVID-19. Serum TGF-β should be evaluated further as a biomarker. Wolters Kluwer - Medknow 2023-05 2023-06-20 /pmc/articles/PMC10443720/ /pubmed/37322633 http://dx.doi.org/10.4103/ijmr.ijmr_2360_22 Text en Copyright: © 2023 Indian Journal of Medical Research https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Practice: Original Article
Dhooria, Sahajal
Arora, Siddhant
Chaudhary, Shivani
Sehgal, Inderpaul Singh
Prabhakar, Nidhi
Mohammad, Nasim
Sharma, Riya
Das, Prabir
Kumar, Yashwant
Garg, Mandeep
Puri, Goverdhan Dutt
Bhalla, Ashish
Muthu, Valliappan
Prasad, Kuruswamy Thurai
Agarwal, Ritesh
Aggarwal, Ashutosh Nath
Risk factors for clinically significant diffuse parenchymal lung abnormalities persisting after severe COVID-19 pneumonia
title Risk factors for clinically significant diffuse parenchymal lung abnormalities persisting after severe COVID-19 pneumonia
title_full Risk factors for clinically significant diffuse parenchymal lung abnormalities persisting after severe COVID-19 pneumonia
title_fullStr Risk factors for clinically significant diffuse parenchymal lung abnormalities persisting after severe COVID-19 pneumonia
title_full_unstemmed Risk factors for clinically significant diffuse parenchymal lung abnormalities persisting after severe COVID-19 pneumonia
title_short Risk factors for clinically significant diffuse parenchymal lung abnormalities persisting after severe COVID-19 pneumonia
title_sort risk factors for clinically significant diffuse parenchymal lung abnormalities persisting after severe covid-19 pneumonia
topic Practice: Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10443720/
https://www.ncbi.nlm.nih.gov/pubmed/37322633
http://dx.doi.org/10.4103/ijmr.ijmr_2360_22
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