On March 11, 2020, the World Health Organization declared Coronavirus Disease 2019 (COVID-19) a pandemic. Till now, it affected 452.4 million (Spain, 11.18 million) persons all over the world with a total of 6.04 million of deaths (Spain, 100,992). It is observed that 75% of hospitalized COVID-19 patients have at least one COVID-19 associated comorbidity. It was shown that people with underlying chronic illnesses are more likely to get it and grow seriously ill. Individuals with COVID-19 who have a past medical history of cardiovascular disorder, cancer, obesity, chronic lung disease, diabetes, or neurological disease had the worst prognosis and are more likely to develop acute respiratory distress syndrome or pneumonia. COVID-19 can affect the respiratory system in a variety of ways and across a spectrum of levels of disease severity, depending on a person's immune system, age and comorbidities. Symptoms can range from mild, such as cough, shortness of breath and fever, to critical disease, including respiratory failure, shock and multi-organ system failure. So, COVID-19 infection can cause overall worsening of these previous respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), interstitial lung disease, etc. This review aims to provide information on the impact of the COVID-19 disease on pre-existing lung comorbidities. 

https://doi.org/10.1016/j.arbres.2022.03.011

Short and Long-Term Impact of COVID-19 Infection on Previous Respiratory Diseases

Bronchiectasis is a debilitating chronic suppurative airway disease that confers a substantial burden globally. Despite the notable prevalence, research on bronchiectasis in mainland China remains in its infancy. Nevertheless, there has been a significant leap in the quantity and quality of research, which has contributed to the ever-improving clinical practice. A nationwide collaborative platform has been established to foster multicentre studies, which will help increase the level of evidence further. Here, we summarise the status quo of clinical management and consider the research priorities for bronchiectasis that have been published previously. We also highlight the efforts of the Chinese medical communities to outline the core tasks that need to be addressed within the next decade. The remarkable progress made in bronchiectasis research has revolutionised clinical practice in mainland China https://bit.ly/3K8kQYr

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Research advances and clinical management of bronchiectasis: Chinese perspective

The respiratory system is the main target of the novel coronavirus infection (COVID19) spread by the SARS-CoV-2 virus. The interim guidelines of the Ministry of Health of the Russian Federation “Prevention, diagnosis and treatment of a new coronavirus infection (COVID-19)” (14th version of December 27, 2021) discuss pneumonia in COVID-19 in detail. The issues of the course of other respiratory diseases (chronic obstructive pulmonary disease-COPD, bronchial asthma) are considered in them very briefly. Other diseases and pathological conditions of the respiratory organs are ignored. The federal clinical guidelines Bronchial Asthma, Chronic Obstructive Pulmonary Disease, Community-Acquired Pneumonia in Adults published in 2021 do not discuss the  course of  these diseases in  the context of  the COVID-19  pandemic. A  search was made for  literature on the association of major diseases and pathological conditions of the respiratory organs with the new coronavirus infection COVID-19 in the electronic search engines PubMed and Scopus. The literature sources found indicate that the new coronavirus infection COVID-19 certainly has a specific, often negative, effect on the respiratory system as a whole, and in particular, on certain respiratory diseases and pathological conditions. However, this influence is sometimes ambiguous. Thus, patients with COPD, along with patients with arterial hypertension, diabetes mellitus, and other cardiovascular and cerebrovascular diseases, belong to a vulnerable group of the population during the COVID-19 pandemic, but there was a decrease in the frequency of  exacerbations of  COPD during the  pandemic, especially hospitalizations. due to severe exacerbations. A  number of meta-analyses and systematic reviews have shown that the risk of contracting COVID-19 in people with asthma is lower than in  people without asthma. There is no association between asthma and a  more severe course and worse prognosis of COVID-19. The relationship of diseases/pathological conditions of the respiratory system and COVID-19, therefore, requires further study and clarification.

New coronavirus infection (COVID-19) and respiratory diseases / pathological conditions

The objective: to evaluate functional and radiological data of the respiratory system assessment in patients with impaired lung diffusion capacity in the post-COVID period.Subjects and Methods. Clinical, functional and radiological data were analyzed and compared in the patients divided into two groups according to the degree of lung diffusion capacity (LDC) impairment measured by carbon monoxide (Dlco) after 180 (135–196) days from the onset of acute symptoms of COVID-19: Group 1 included patients with Dlco of 80–60%, and Group 2 included patients with Dlco less than 60%. The lung functions were assessed by spirometry, body plethysmography and the Dlco level measurement. The data of CT scans of patients performed in the acute period of COVID-19, after 93 (89–103) days and 180 (135–196) days from the onset of acute symptoms were analyzed.Results. The patients of Group 2 developed a severe form of COVID-19 statistically significantly more often, they required high-flow oxygen therapy (HFO) and stayed in the intensive care unit (ICU): 13/20 (65%), 11/20 (55%), 10/20 (50%) versus 8/24(33,3%), 2/24 (8,3%) and 3/24 (13,5%) in the patients of Group 2, respectively. The level of Dlco (%) after 93 (89–103) days and 180 (135–196) days in Groups 1 and 2 made 66 (64–71) and 71 (67–73) versus 45 (41–53) and 51(47–58), respectively (p<0,05). Honeycombing changes in the lungs were detected by chest CT only in the patients of Group 2 – 16.7% on 93 (89–103) and 180 (135–196) days of observation, respectively.Conclusion. A severe form of COVID-19, stay in the ICU and additional oxygen support are the factors indicating an unfavorable functional state of the respiratory system and presence of irreversible changes in the lung tissue in the post-COVID period.

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Functional and Radiological Assessment of the Respiratory System in Patients with Impaired Lung Diffusion Capacity in the Post-COVID Period

Bronchiectasis (BE) has been linked to past viral infections such as influenza, measles, or adenovirus. Two years ago, a new pandemic viral infection severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) broke out and it still persists today, and a significant proportion of surviving patients have radiological and clinical sequelae, including BE. Our aim was to thoroughly review the information available in the literature on the bidirectional relationship between SARS-CoV-2 infection and the development of BE, as well as the impact of this infection on patients already suffering from BE. Available information indicates that only a small percentage of patients in the acute phase of coronavirus disease 2019 (COVID-19) pneumonia develop BE, although the latter is recognized as one of the radiological sequelae of COVID-19 pneumonia, especially when it is caused by traction. The severity of the initial pneumonia is the main risk factor for the development of future BE, but during the COVID-19 pandemic, exacerbations in BE patients were reduced by approximately 50%. Finally, the impact of BE on the prognosis of patients with COVID-19 pneumonia is not yet known. 

Bronchiectasis and COVID-19 infection: a two-way street

A total of 115 convalescent inpatients with COVID-19 were enrolled. According to the results of scans of lung lesions via computed tomography (CT), the patients were divided into mild, moderate, and severe groups. The clinical data of the patients were collected, including age, gender, finger pulse oxygen pressure, ventricular rate, body temperature, etc. The correlation between the clinical indicators and the lesions of high-resolution CT (HRCT) and bronchiectasis was analyzed. Among the 115 patients, 82 had no bronchiectasis and 33 had bronchiectasis. The bronchodilation-prone layers mainly included the left and right lower lobe of the lung. The probability of branching in the inflamed area was greater than that in the noninflamed area in patients with COVID-19. There were significant differences in gender, CT lesion range, and number of incidents of bronchiectasis between noninflamed and inflamed areas (P < 0.05). Moreover, there were significant differences in age, total proportion of CT lesions, volume of CT lesions, and total number of patients with bronchiectasis among the three groups (P < 0.05). CT lesion range was positively correlated with the total number of patients with bronchiectasis and patient age (respectively, r = 0.186, P < 0.05; r = 0.029, P < 0.05). The lesion range in HRCT images of lungs in patients with COVID-19 is correlated with bronchodilation. The larger the lesion, the higher the probability of bronchiectasis and the more incidents of bronchiectasis.

Clinical study of pulmonary CT lesions and associated bronchiectasis in 115 convalescent patients with novel coronavirus pneumonia (COVID-19) in China.

Kaiping Mao

Papers

Clinical study of pulmonary CT lesions and associated bronchiectasis in 115 convalescent patients with novel coronavirus pneumonia (COVID-19) in China.