4.7 Review

From ARDS to pulmonary fibrosis: the next phase of the COVID-19 pandemic?

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Article Pathology

Fatal pulmonary fibrosis: a post-COVID-19 autopsy case

Hanna Ferlov Schwensen et al.

Summary: A Caucasian female in her 80s who died from severe pulmonary fibrosis after eliminating SARS-CoV-2 infection underwent autopsy, revealing widespread fibrosis in previously healthy lungs. The microscopic examination showed acute and organizing diffuse alveolar damage and fibrosis with honeycomb-like remodelling and bronchial metaplasia.

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Mechanical Feed-Forward Loops Contribute to Idiopathic Pulmonary Fibrosis

Margaret A. T. Freeberg et al.

Summary: Idiopathic pulmonary fibrosis is a progressive disease characterized by accumulation of extracellular matrix in lung tissue, leading to altered mechanical properties. Recent studies suggest that these changes create a feed-forward loop, contributing to fibroblast differentiation and activation. Mechanotransduction pathways, including mechanosensors like integrins and downstream transcription factors, play a role in fibrosis progression.

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Senescence of Alveolar Type 2 Cells Drives Progressive Pulmonary Fibrosis

Changfu Yao et al.

Summary: The study demonstrates that senescence of AT2 cells is sufficient to drive progressive pulmonary fibrosis, and interventions targeting p53 activation or senescence can block fibrogenesis. Early attenuation of senescence-related pathways and elimination of senescent cells are promising therapeutic approaches to prevent pulmonary fibrosis.

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2021)

Review Physiology

Healing after COVID-19: are survivors at risk for pulmonary fibrosis?

Lindsay T. McDonald

Summary: The novel SARS-CoV-2 coronavirus, responsible for COVID-19, was first reported in Wuhan, China, in December 2019, and the World Health Organization declared a pandemic by March 2020. Concerns have been raised about potential long-term effects of COVID-19 on respiratory health, but with limited data available, predictions on long-term outcomes remain speculative. Improved recognition of potential risk factors for fibrotic disease through studying previous coronavirus outbreaks is crucial in understanding the potential long-term implications of COVID-19.

AMERICAN JOURNAL OF PHYSIOLOGY-LUNG CELLULAR AND MOLECULAR PHYSIOLOGY (2021)

Review Biochemistry & Molecular Biology

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Alessandro Sette et al.

Summary: The adaptive immune system, consisting of B cells, CD4(+) T cells, and CD8(+) T cells, plays varying roles in different viral infections and vaccines. Studies are showing that CD4(+) T cells, CD8(+) T cells, and neutralizing antibodies all play a part in controlling SARS-CoV-2 in COVID-19 cases, emphasizing the importance of understanding adaptive immunity in combating the disease.
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Pulmonary function and radiological features 4 months after COVID-19: first results from the national prospective observational Swiss COVID-19 lung study

Sabina A. Guler et al.

Summary: The Swiss COVID-19 lung study investigated pulmonary sequelae of COVID-19 in 113 survivors. Severe/critical COVID-19 was associated with significant functional and radiological abnormalities 4 months after infection, potentially due to small-airway and lung parenchymal disease. Systematic follow-up for survivors needs to be evaluated to optimize care for patients recovering from COVID-19.

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Molecular markers of telomere dysfunction and senescence are common findings in the usual interstitial pneumonia pattern of lung fibrosis

Joyce S. Lee et al.

Summary: The study found that molecular markers of telomere dysfunction and senescence are pathologically expressed in both IPF and non-IPF UIP lungs, suggesting that common molecular drivers may contribute to the pathogenesis of UIP-associated pulmonary fibrosis, regardless of the clinical diagnosis.

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Article Medicine, General & Internal

6-month consequences of COVID-19 in patients discharged from hospital: a cohort study (Publication with Expression of Concern. See vol. 401, pg. 90, 2023)

Chaolin Huang et al.

Summary: This study aimed to investigate the long-term health consequences of discharged COVID-19 patients and associated risk factors, particularly disease severity. Patients with more severe illness during hospitalization showed more severe impaired pulmonary diffusion capacities and abnormal chest imaging manifestations, highlighting the need for targeted interventions for long-term recovery.

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Article Radiology, Nuclear Medicine & Medical Imaging

Six-month Follow-up Chest CT Findings after Severe COVID-19 Pneumonia

Xiaoyu Han et al.

Summary: The study found that over one-third of severe COVID-19 patients showed fibrotic-like changes in the lung at 6-month follow-up CT, which were associated with older age, acute respiratory distress syndrome, longer hospital stays, tachycardia, noninvasive mechanical ventilation, and higher initial chest CT score.

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Biological and Clinical Consequences of Integrin Binding via a Rogue RGD Motif in the SARS CoV-2 Spike Protein

Lee Makowski et al.

Summary: This paper proposes the hypothesis that viral binding to cell-surface integrins may contribute to the high infectivity and widespread extra-pulmonary impacts of SARS-CoV-2. The emergence of an RGD sequence in the receptor-binding domain of the spike protein is suggested to be potentially responsible for this. The interactions between virions and integrins could dysregulate signaling pathways and lead to tissue damage, with implications for various clinical outcomes.

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Article Medicine, General & Internal

Respiratory and Psychophysical Sequelae Among Patients With COVID-19 Four Months After Hospital Discharge

Mattia Bellan et al.

Summary: The study examined the prevalence of lung function, exercise function, and psychological sequelae among survivors of severe COVID-19 four months after discharge. Over half of patients experienced reduced lung capacity, one-fifth had functional impairment, and about one-fifth showed symptoms of posttraumatic stress. These findings suggest that a significant proportion of COVID-19 survivors may continue to experience respiratory, functional, or psychological issues months after hospital discharge.

JAMA NETWORK OPEN (2021)

Review Biochemistry & Molecular Biology

COVID-19 and the human innate immune system

Joachim L. Schultze et al.

Summary: The introduction of SARS-CoV-2 into the human population has led to a significant medical and economic crisis. Innate immunity plays a central role in combating the novel virus, with variability in its components contributing to the diverse disease courses observed for COVID-19. Further research into the pathophysiological mechanisms of innate immunity is crucial for the development of diagnostic markers and therapeutic strategies targeting COVID-19.
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Shared genetic etiology between idiopathic pulmonary fibrosis and COVID-19 severity

Joao Fadista et al.

Summary: There is a positive genetic correlation between IPF and COVID-19 severity, but the causal relationship between IPF and COVID-19 severity is not clear. However, one specific IPF risk gene shows a causal effect on COVID-19 severity, while another IPF risk gene appears to have a protective effect against COVID-19 hospitalization in older adults.

EBIOMEDICINE (2021)

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Sequelae in Adults at 6 Months After COVID-19 Infection

Jennifer K. Logue et al.

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Sixty-Day Outcomes Among Patients Hospitalized With COVID-19

Vineet Chopra et al.

ANNALS OF INTERNAL MEDICINE (2021)

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The spatial landscape of lung pathology during COVID-19 progression

Andre F. Rendeiro et al.

Summary: Recent studies using high-parameter imaging mass cytometry have provided insights into the cellular composition and spatial architecture of acute lung injury in humans, including injuries derived from SARS-CoV-2 infection. It was found that SARS-CoV-2 predominantly infects alveolar epithelial cells and induces a localized hyperinflammatory cell state associated with lung damage. As COVID-19 progresses, there is increased macrophage extravasation, along with increased numbers of mesenchymal cells and fibroblasts, possibly indicating attempts to repair the damaged lung tissue. The data generated help in developing a biologically interpretable landscape of lung pathology at both macroscopic and single-cell levels, providing a basis for understanding COVID-19 and lung pathology.

NATURE (2021)

Review Biochemistry & Molecular Biology

Post-acute COVID-19 syndrome

Ani Nalbandian et al.

Summary: SARS-CoV-2 is responsible for the COVID-19 pandemic, causing global healthcare crises. Recovery from COVID-19 may lead to persistent symptoms and long-term complications, prompting the need for multidisciplinary care and follow-up for survivors.

NATURE MEDICINE (2021)

Article Respiratory System

Pulmonary fibrosis 4 months after COVID-19 is associated with severity of illness and blood leucocyte telomere length

Claire F. McGroder et al.

Summary: Patients who underwent mechanical ventilation for severe COVID-19 are more likely to develop fibrotic-like radiographic abnormalities after hospitalisation. The severity of initial illness, duration of mechanical ventilation, lactate dehydrogenase on admission, and leucocyte telomere length are independent risk factors for these abnormalities, which are correlated with lung function, cough, and frailty measures, but not with dyspnoea.

THORAX (2021)

Article Critical Care Medicine

3-month, 6-month, 9-month, and 12-month respiratory outcomes in patients following COVID-19-related hospitalisation: a prospective study

Xiaojun Wu et al.

Summary: Most patients recovering from severe COVID-19 showed improvement in dyspnoea scores and exercise capacity over time, but a subgroup of patients still exhibited persistent physiological and radiographic changes at 12 months post-discharge. A unified pathway for respiratory follow-up is needed for COVID-19 patients.

LANCET RESPIRATORY MEDICINE (2021)

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Tissue factor upregulation is associated with SARS-CoV-2 in the lungs of COVID-19 patients

Sandeep Subrahmanian et al.

Summary: The upregulation of tissue factor (TF) expression in the lungs of COVID-19 patients may be associated with thrombus formation, which could serve as a key therapeutic target. The correlation of TF expression with SARS-CoV-2 in COVID-19 lungs raises the possibility of direct TF induction by the virus.

JOURNAL OF THROMBOSIS AND HAEMOSTASIS (2021)

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Acute respiratory distress syndrome

Nuala J. Meyer et al.

Summary: This article summarizes the epidemiology, diagnosis, and treatment of acute respiratory distress syndrome (ARDS), while also discussing the similarities and differences between ARDS caused by COVID-19 and ARDS caused by other factors.

LANCET (2021)

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Pulmonary fibrosis distal airway epithelia are dynamically and structurally dysfunctional

Ian T. Stancil et al.

Summary: Environmental and genetic risk factors affect the distal airway epithelium in idiopathic pulmonary fibrosis (IPF), but the specific role of the epithelium in the disease remains unclear. The study demonstrates that pathologic activation of the ERBB-YAP axis induces dysfunction in distal airway epithelium, leading to a pro-fibrotic phenotype in mesenchymal cells.

NATURE COMMUNICATIONS (2021)

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Distinctive features of severe SARS-CoV-2 pneumonia

G. R. Scott Budinger et al.

Summary: The COVID-19 pandemic is a major public health crisis of our generation, with severe patients expected to continue filling hospitals and intensive care units. While there are similarities in the clinical presentation and pathobiology of ARDS between pneumonia caused by SARS-CoV-2 and other respiratory pathogens, there are also unique features that could be targeted for therapeutics.

JOURNAL OF CLINICAL INVESTIGATION (2021)

Article Respiratory System

Persistent Post-COVID-19 Interstitial Lung Disease An Observational Study of Corticosteroid Treatment

Katherine Jane Myall et al.

Summary: Following SARS-CoV-2 infection, some patients develop persistent radiological inflammatory lung disease and functional deficits. Early treatment with corticosteroids is well tolerated and associated with rapid and significant improvement.

ANNALS OF THE AMERICAN THORACIC SOCIETY (2021)

Article Critical Care Medicine

Static compliance of the respiratory system in COVID-19 related ARDS: an international multicenter study

Benoit Vandenbunder et al.

Summary: In COVID-19-related ARDS, Crs does not seem to have a significant impact on patient outcomes, while plateau pressure may be associated with the chance of breathing independently. In some patients, a decrease in Crs between day 1 and day 14 is observed, but this change does not affect the outcome on day 28.

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Article Critical Care Medicine

Genome-Wide Association Study of Susceptibility to Idiopathic Pulmonary Fibrosis

Richard J. Allen et al.

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2020)

Article Critical Care Medicine

Recommended Reading from the University of Michigan Pulmonary and Critical Care Fellowship Program

Leigh M Cagino et al.

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2020)

Review Biochemistry & Molecular Biology

Regulated Necrosis in Pulmonary Disease A Focus on Necroptosis and Ferroptosis

Shunsuke Minagawa et al.

AMERICAN JOURNAL OF RESPIRATORY CELL AND MOLECULAR BIOLOGY (2020)

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Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China

Dawei Wang et al.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2020)

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Clinical Characteristics of Coronavirus Disease 2019 in China

W. Guan et al.

NEW ENGLAND JOURNAL OF MEDICINE (2020)

Review Hematology

Hematological findings and complications of COVID-19

Evangelos Terpos et al.

AMERICAN JOURNAL OF HEMATOLOGY (2020)

Letter Critical Care Medicine

COVID-19 Does Not Lead to a Typical Acute Respiratory Distress Syndrome

Luciano Gattinoni et al.

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Christian J. A. Sigrist et al.

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Maria C. Basil et al.

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Obesity in Patients Younger Than 60 Years Is a Risk Factor for COVID-19 Hospital Admission

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Clemens K. Probst et al.

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Xiaoneng Mo et al.

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Stijn E. Verleden et al.

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Lida Hariri et al.

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Parag Goyal et al.

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Gisli Jenkins

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Heterogeneity of Acute Respiratory Distress Syndrome in COVID-19: Typical or Not?

Jason H. Maley et al.

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COVID-19-related Acute Respiratory Distress Syndrome: Not So Atypical

Lieuwe D. J. Bos

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Sara Y. Tartof et al.

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Alice Huertas et al.

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Robert Verity et al.

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Resequencing Study Confirms That Host Defense and Cell Senescence Gene Variants Contribute to the Risk of Idiopathic Pulmonary Fibrosis

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Marissa J. Schafer et al.

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Targeting of the pulmonary capillary vascular niche promotes lung alveolar repair and ameliorates fibrosis

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Article Physiology

Mechanosignaling through YAP and TAZ drives fibroblast activation and fibrosis

Fei Liu et al.

AMERICAN JOURNAL OF PHYSIOLOGY-LUNG CELLULAR AND MOLECULAR PHYSIOLOGY (2015)

Article Biochemistry & Molecular Biology

Alveolar Derecruitment and Collapse Induration as Crucial Mechanisms in Lung Injury and Fibrosis

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Jonathan A. Kropski et al.

EUROPEAN RESPIRATORY JOURNAL (2015)

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MUC5B promoter polymorphism in Japanese patients with idiopathic pulmonary fibrosis

Yasushi Horimasu et al.

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Lineage-negative progenitors mobilize to regenerate lung epithelium after major injury

Andrew E. Vaughan et al.

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Ivana V. Yang et al.

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Ellen L. Burnham et al.

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Talmadge E. King et al.

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Luca Richeldi et al.

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Arnaud W. Thille et al.

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Matrices of Physiologic Stiffness Potently Inactivate Idiopathic Pulmonary Fibrosis Fibroblasts

Aleksandar Marinkovic et al.

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Targeted Injury of Type II Alveolar Epithelial Cells Induces Pulmonary Fibrosis

Thomas H. Sisson et al.

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Partial inhibition of integrin alpha v beta 6 prevents pulmonary fibrosis without exacerbating inflammation

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Telomere shortening in familial and sporadic pulmonary fibrosis

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