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Background: Varicella pneumonia is one of the most common and severe complications of chickenpox infection. This study aimed to describe the clinical and radiological features of varicella pneumonia in a cluster of immunocompetent adolescents. Methods: A retrospective analysis was conducted on a cohort of adolescent patients diagnosed with varicella pneumonia at Wuhan Jinyintan Hospital between February 2023 and May 2023. The clinical and imaging data were collected and analyzed. A total of 116 patients were divided into two groups by the absence (group 1, n=57) or presence (group 2, n=59) of lower respiratory symptoms for data comparison. Results: Among 116 patients (median age, 16 years; 60 males), rash (100%) was the most prevalent clinical symptom. The most common respiratory symptom and sign were fever (42.2%) and coarse breath sounds (41.4%). Chest computed tomography (CT) performed within five days of symptoms onset revealed multiple (89.7%), peripheral (51.7%), and ill-defined (73.3%) lung nodules in most patients, which gradually improved 6-10 days after symptom onset. Group 2 had higher levels of interleukin-6 (P<0.001), C-reactive protein (P=0.02), serum amyloid-A protein (P=0.002), longer hospital stays (P=0.04), more involved lung lobes (P=0.02), and a higher incidence of multiple nodules (P=0.043) than those of group 1. Conclusions: In immunocompetent adolescents, clustered varicella pneumonia often presents as mild and more uniform in clinical and radiological presentations than sporadic cases. The most common CT findings were multiple pulmonary nodules. Patients with lower respiratory symptoms exhibited more severe clinical and radiological manifestations. Generally, it is not recommended that patients undergo frequent CT scans in a short period.
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RATIONALE AND OBJECTIVES: Little is known about the long-term impact of diabetes on lung impairment in COVID-19 survivors over a three-year period. This study evaluated the long-term impact of diabetes on persistent radiological pulmonary abnormalities and lung function impairment in COVID-19 survivors over three years. MATERIALS AND METHODS: In this prospective, multicenter, cohort study, pulmonary sequelae were compared between COVID-19 survivors with and without diabetes. Serial chest CT scans, symptom questionnaires and pulmonary function tests were obtained 6 months, 12 months, 2 years and 3 years post-discharge. The independent predictors for lung dysfunction at the 3-year follow-up were analyzed. RESULTS: A total of 278 COVID-19 survivors (63 [IQR 57-69] year-old, female: 103 [37.0%]) were included. At the 3-year follow-up, individuals in the diabetes group had higher incidences of respiratory symptoms, radiological pulmonary abnormalities and pulmonary diffusion dysfunction than those in the control group. Diabetes (OR: 2.18, 95% CI: 1.04-4.59, p = 0.034), allergy (OR: 2.26, 95% CI: 1.09-4.74, p = 0.029), female (OR: 2.70, 95% CI: 1.37-5.29, p = 0.004), severe COVID-19 (OR: 4.10, 95% CI: 1.54-10.93, p = 0.005), and fibrotic-like CT changes (OR: 5.64, 95% CI: 2.28-13.98, p < 0.001) were independent predictors of pulmonary diffusion dysfunction in COVID-19 survivors. CONCLUSION: These results highlight the long-term deleterious effect of diabetes status on radiological pulmonary abnormalities and pulmonary dysfunction in COVID-19 survivors. This study provides important evidence support for long-term monitoring of lung abnormalities in COVID-19 recovery survivors with diabetes.
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We presented the construction of the ring-in-ring and Russian doll complexes on the basis of triptycene-derived carbon nanoring (TP-[12]CPP), which not only acts as a host for pillar[5]arene (P5A) but also serves as an energy donor for building Förster resonance energy transfer (FRET) systems. We also demonstrated that their hierarchical assembly processes could be efficiently monitored in real time using FRET. NMR, UV-vis and fluorescence, and mass spectroscopy analyses confirmed the successful encapsulation of the guests P5A/P5A-An by TP-[12]CPP, facilitated by C-H···π and ···π interactions, resulting in the formation of a distinct ring-in-ring complex with a binding constant of Ka = 2.23 × 104 M-1. The encapsulated P5A/P5A-An can further reverse its role to be a host for binding energy acceptors to form Russian doll complexes, as evidenced by the occurrence of FRET and mass spectroscopy analyses. The apparent binding constant of the Russian doll complexes was up to 3.6 × 104 M-1, thereby suggesting an enhanced synergistic effect. Importantly, the Russian doll complexes exhibited both intriguing one-step and sequential FRET dependent on the subcomponent P5A/P5A-An during hierarchical assembly, reminiscent of the structure and energy transfer of the light-harvesting system presented in purple bacteria.
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BACKGROUND: This study aimed to evaluate the longitudinal progression of residual lung abnormalities (ground-glass opacities, reticulation and fibrotic-like changes) and pulmonary function at 3â years following coronavirus disease 2019 (COVID-19). METHODS: This prospective, longitudinal cohort study enrolled COVID-19 survivors who exhibited residual lung abnormalities upon discharge from two hospitals. Follow-up assessments were conducted at 6â months, 12â months, 2â years and 3â years post-discharge, and included pulmonary function tests, 6-min walk distance (6MWD), chest computed tomography (CT) scans and symptom questionnaires. Non-COVID-19 controls were retrospectively recruited for comparative analysis. RESULTS: 728 COVID-19 survivors and 792 controls were included. From 6â months to 3â years, there was a gradual improvement in reduced diffusing capacity of the lung for carbon monoxide (D LCO <80% predicted: 49% versus 38%; p=0.001), 6MWD (496 versus 510â m; p=0.002) and residual lung abnormalities (46% versus 36%; p<0.001), regardless of disease severity. Patients with residual lung abnormalities at 3â years more commonly had respiratory symptoms (32% versus 16%; p<0.001), lower 6MWD (494 versus 510â m; p=0.003) and abnormal D LCO (57% versus 27%; p<0.001) compared with those with complete resolution. Compared with controls, the proportions of D LCO impairment (38% versus 17%; p<0.001) and respiratory symptoms (23% versus 2.2%; p<0.001) were significantly higher in the matched COVID-19 survivors at the 3-year follow-up. CONCLUSIONS: Most patients exhibited improvement in radiological abnormalities and pulmonary function over time following COVID-19. However, more than a third continued to have persistent lung abnormalities at the 3-year mark, which were associated with respiratory symptoms and reduced diffusion capacity.
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COVID-19 , Pulmão , Testes de Função Respiratória , Tomografia Computadorizada por Raios X , Humanos , COVID-19/diagnóstico por imagem , COVID-19/fisiopatologia , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Longitudinais , Pulmão/diagnóstico por imagem , Pulmão/fisiopatologia , Estudos Prospectivos , Idoso , SARS-CoV-2 , Hospitalização/estatística & dados numéricos , Adulto , Capacidade de Difusão Pulmonar , Progressão da Doença , Teste de CaminhadaRESUMO
Chiral carbon nanohoops with both high fluorescence quantum yield and large luminescence dissymmetry factor are essential to the development of circularly polarized luminescence (CPL) materials. Herein, the rational design and synthesis of a series of highly fluorescent chiral carbon nanohoops TP-[8-13]CPPs via symmetry breaking with a chiral triptycene motif is reported. Theoretical calculations revealed that breaking the symmetry of nanohoops causes a unique size-dependent localization in the highest occupied molecular orbitals (HOMOs) and the lowest unoccupied molecular obtitals (LUMOs) as the increasing of sizes, which is sharply different from those of [n]cycloparaphenylenes. Photophysical investigations demonstrated that TP-[n]CPPs display size-dependent emissions with high fluorescence quantum yields up to 92.9% for TP-[13]CPP, which is the highest value among the reported chiral conjugated carbon nanohoops. The high fluorescence quantum yields are presumably attributed to both the unique acyclic, and radial conjugations and high radiative transition rates, which are further supported by theoretical investigations. Chiroptical studies revealed that chiral TP-[n]CPPs exhibit bright CPL with CPL brightness up to 100.5 M-1 cm-1 for TP-[11]CPP due to the high fluorescence quantum yield. Importantly, the investigations revealed the intrigued size-dependent properties of TP-[n]CPPs with regards to (chir)optical properties, which follow a nice linear relationship versus 1/n. Such a nice linear relationship is not observed in other reported conjugated nanohoops including CPPs.
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We reported the synthesis of a series of structurally diverse CPL-active molecules, in which pyrene units were installed to chiral pm/po-[2,2]PCP scaffolds either with or without a triple bond spacer for pm/po-PCP-P1 and pm/po-PCP-P2, respectively. The X-ray crystallographic analyses revealed that these pyrene-based [2,2]PCP derivatives exhibited diverse structures and crystal packings in the solid phases. The pyrene-based [2,2]PCP derivatives exhibit various (chir)optical properties in organic solutions, depending on their respective structures. In a mixture of dioxane and water, pm/po-PCP-P1 emit green excimer fluorescence, whereas pm/po-PCP-P2 emit blue one. The chiroptical investigation demonstrated that Rp-pm-PCP-P1 and Rp-pm-PCP-P2 exhibited completely opposite CD and CPL signals even they possess the same chiral Rp-[2,2]PCP core. The same argument also holds for other chiral pyrene-based [2,2]PCP derivatives. The theoretical calculation revealed that these unusual phenomena were attributed to different orientation between transition electric dipole moments and the magnetic dipole moments originating from the presence or absence of a triple bond spacer. These pyrene-based [2,2]PCP derivatives display various colours and fluorescence emissions in the solid state and PMMA films, possibly due to the different packings as observed in the crystal structure. Moreover, these compounds also can interact with perylene diimide through π-π interactions, leading to near-white fluorescence.
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The carbon nanorings, possessing a radial π system, have garnered significant attention primarily due to their size-dependent photophysical properties and the presence of a unique curved π-conjugated cavity. This is evidenced by the rapid proliferation of publications. Furthermore, the integration of building blocks into CPP skeletons can confer [n]CPPs with novel and exceptional photophysical and electronic characteristics, as well as chiral properties and host-guest interactions, thereby augmenting the diversity of [n]CPPs. Notably, the curved π surface structures and concave cavity of carbon nanorings enable them to host aromatic or non-aromatic guests with a complementarily curved surface, resulting in interesting binary or ternary complexes. This review provides a comprehensive treatment of literature reports on binary and ternary complexes, focusing on both their host-guest interactions and properties. It is important to note that the scope of this review is limited to host-guest chemistry in binary and ternary complexes based on π-conjugated carbon nanorings.
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In this study, we synthesized and reported the heterotopic bisnanohoops P5-[8,10]CPPs containing cycloparaphenylenes (CPPs) and a pillar[5]arene unit, which act not only as energy donors but also as a host for binding energy acceptors. We demonstrated that a series of elegant FRET systems could be constructed successfully through self-assembly between donors P5-[8,10]CPPs and acceptors with different emissions via host-guest interaction. These FRET systems further allow us to finely adjust the donors P5-[8,10]CPPs and acceptors (BODIPY-Br and Rh-Br) for achieving multiple color-tunable emissions, particularly white-light emission. More importantly, these host-guest complexes were successfully utilized in the fabrication of white-light fluorescent films and further integrated with a 365 nm LED lamp to create white LED devices. The findings highlight a new application of carbon nanorings in white-light emission materials, beyond the common recognition of π-conjugated molecules.
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Construction of macrocyclic hosts with a novel structure and excellent property has emerged as an intriguing undertaking for the past few years. Here, we reported the synthesis of shape-persistent triptycene-derived pillar[6]arene (TP[6]). The single crystal structure analysis revealed that the macrocyclic molecule adopts a hexagonal structure, featuring a helical and electron-rich cavity capable of encapsulating electron-deficient guests. In order to obtain chiral TP[6] from an enantiomerically pure triptycene building block, an efficient resolution of chiral triptycene was successfully developed through introducing chiral auxiliaries into triptycene skeletons. The 1H NMR and isothermal titration calorimetry investigations demonstrated that chiral TP[6] exhibited enantioselectivity toward four pairs of chiral guests containing a trimethylamino group, implying a significant promising application in area of enantioselective recognition.
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We report the synthesis and chiroptical properties of novel chiral carbon nanorings Sp-/Rp-[12]PCPP containing a planar chiral [2.2]PCP unit, and demonstrate that Sp-/Rp-[12]PCPP can not only host crown ether 18-Crown-6 to form ring-in-ring complexes with a binding constant 3.35×103 â M-1 , but also accommodate the complexes of 18-Crown-6 and S/R-protonated amines to form homochiral S@Sp-/R@Rp- and heterochiral S@Rp-/R@Sp- ternary complexes, displaying significantly larger binding constants of up to 3.31×105 â M-1 depending on the chiral guests. Importantly, homochiral S@Sp-/R@Rp- ternary complexes exhibit an enhanced CD signal, while the heterochiral S@Rp-/R@Sp- ones have a constant CD signal compared with the chiral carbon nanorings, respectively, which suggests that homochiral S@Sp-/R@Rp- ternary complexes display a highly narcissistic chiral self-recognition for S/R-protonated chiral amines, respectively. Finally, the chiral ternary complexes can be further applied to determine the ee values of chiral guests. The findings highlight a new application of carbon nanorings in supramolecular sensors, beyond the common recognition of π-conjugated molecules.
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The construction of efficient artificial light-harvesting systems (ALHSs) is of vital importance in utilizing solar energy. Herein, we report the non-covalent syntheses of double helicates PCP-TPy1/2 and Rp,Rp-PCP-TPy1/2 by metal-coordination interaction and their applications in ALHSs and white light-emitting diode (LED) device. All double helicates exhibit significant aggregation-induced emission in tetrahydrofuran/water (1:9, v/v) solvent. The aggregated double helicates can be used to construct one-step or sequential ALHSs with fluorescent dyes Eosin Y (EsY) and Nile red (NiR) with the energy transfer efficiency up to 89.3%. Impressively, the PMMA film of PCP-TPy1 shows white-light emission when doped 0.075% NiR, the solid of double helicates (Rp,Rp-) PCP-TPy2 can be used as the additive of a blue LED bulb to achieve white-light emission. In this work, we provided a general method for the preparation of novel double helicates and explored their applications in ALHSs and fluorescent materials, which will promote future construction and application of helicates as emissive devices.
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We report herein the regioselective synthesis of all-carbon lemniscular nanohoops bis-po-CC and bis-pm-TC by the rational control of ring closures at the different positions of planar chiral tetrasubstituted [2.2]paracyclophane. Topological analyses reveal that bis-pm-TC is topologically chiral while bis-po-CC is topologically achiral. X-ray crystal analysis demonstrates that bis-pm-TC adopts a lemniscular conformation with a contiguous conjugation. CD and CPL measurements further reveal that the chiroptical properties of bis-pm-TC are obviously different from those of bis-po-CC due to their different topological chiralities.
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OBJECTIVES: To compare the clinical characteristics and chest CT findings of patients infected with Omicron and Delta variants and the original strain of COVID-19. METHODS: A total of 503 patients infected with the original strain (245 cases), Delta variant (90 cases), and Omicron variant (168 cases) were retrospectively analyzed. The differences in clinical severity and chest CT findings were analyzed. We also compared the infection severity of patients with different vaccination statuses and quantified pneumonia by a deep-learning approach. RESULTS: The rate of severe disease decreased significantly from the original strain to the Delta variant and Omicron variant (27% vs. 10% vs. 4.8%, p < 0.001). In the Omicron group, 44% (73/168) of CT scans were categorized as abnormal compared with 81% (73/90) in the Delta group and 96% (235/245, p < 0.05) in the original group. Trends of a gradual decrease in total CT score, lesion volume, and lesion CT value of AI evaluation were observed across the groups (p < 0.001 for all). Omicron patients who received the booster vaccine had less clinical severity (p = 0.015) and lower lung involvement rate than those without the booster vaccine (36% vs. 57%, p = 0.009). CONCLUSIONS: Compared with the original strain and Delta variant, the Omicron variant had less clinical severity and less lung injury on CT scans.
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Background Information on pulmonary sequelae and pulmonary function 2 years after recovery from SARS-CoV-2 infection is lacking. Purpose To longitudinally assess changes in chest CT abnormalities and pulmonary function in individuals after SARS-CoV-2 infection. Materials and Methods In this prospective study, participants discharged from the hospital after SARS-CoV-2 infection from January 20 to March 10, 2020, were considered for enrollment. Participants without chest CT scans at admission or with complete resolution of lung abnormalities at discharge were excluded. Serial chest CT scans and pulmonary function test results were obtained 6 months (June 20 to August 31, 2020), 12 months (December 20, 2020, to February 3, 2021), and 2 years (November 16, 2021, to January 10, 2022) after symptom onset. The term interstitial lung abnormality (ILA) and two subcategories, fibrotic ILAs and nonfibrotic ILAs, were used to describe residual CT abnormalities on follow-up CT scans. Differences between groups were compared with the χ2 test, Fisher exact test, or independent samples t test. Results Overall, 144 participants (median age, 60 years [range, 27-80 years]; 79 men) were included. On 2-year follow-up CT scans, 39% of participants (56 of 144) had ILAs, including 23% (33 of 144) with fibrotic ILAs and 16% (23 of 144) with nonfibrotic ILAs. The remaining 88 of 144 participants (61%) showed complete radiologic resolution. Over 2 years, the incidence of ILAs gradually decreased (54%, 42%, and 39% of participants at 6 months, 12 months, and 2 years, respectively; P < .001). Respiratory symptoms (34% vs 15%, P = .007) and abnormal diffusing capacity of lung for carbon monoxide (43% vs 20%, P = .004) occurred more frequently in participants with ILAs than in those with complete radiologic resolution. Conclusion More than one-third of participants had persistent interstitial lung abnormalities 2 years after COVID-19 infection, which were associated with respiratory symptoms and decreased diffusion pulmonary function. Chinese Clinical Trial Registry no. ChiCTR2000038609 © RSNA, 2023 Supplemental material is available for this article. See also the editorial by van Beek in this issue.
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COVID-19 , Humanos , Masculino , Pessoa de Meia-Idade , COVID-19/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Estudos Prospectivos , SARS-CoV-2 , Tomografia Computadorizada por Raios X/métodosRESUMO
We evaluated pulmonary sequelae in COVID-19 survivors by quantitative inspiratory-expiratory chest CT (QCT) and explored abnormal pulmonary diffusion risk factors at the 6-month follow-up. This retrospective study enrolled 205 COVID-19 survivors with baseline CT data and QCT scans at 6-month follow-up. Patients without follow-up pulmonary function tests were excluded. All subjects were divided into group 1 (carbon monoxide diffusion capacity [DLCO] < 80% predicted, n = 88) and group 2 (DLCO ≥ 80% predicted, n = 117). Clinical characteristics and lung radiological changes were recorded. Semiquantitative total CT score (0-25) was calculated by adding five lobes scores (0-5) according to the range of lesion involvement (0: no involvement; 1: < 5%; 2: 5-25%; 3: 26-50%; 4: 51-75%; 5: > 75%). Data was analyzed by two-sample t-test, Spearman test, etc. 29% survivors showed air trapping by follow-up QCT. Semiquantitative CT score and QCT parameter of air trapping in group 1 were significantly greater than group 2 (p < 0.001). Decreased DLCO was negatively correlated with the follow-up CT score for ground-glass opacity (r = - 0.246, p = 0.003), reticulation (r = - 0.206, p = 0.002), air trapping (r = - 0.220, p = 0.002) and relative lung volume changes (r = - 0.265, p = 0.001). COVID-19 survivors with lung diffusion deficits at 6-month follow-up tended to develop air trapping, possibly due to small-airway impairment.
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COVID-19 , COVID-19/diagnóstico por imagem , Seguimentos , Humanos , Pulmão/diagnóstico por imagem , Estudos Retrospectivos , Sobreviventes , Tomografia Computadorizada por Raios XRESUMO
Structural designs combining cycloparaphenylenes (CPPs) backbone with planar chiral [2.2]paracyclophane ([2.2]PCP) lead to optical-active chiral macrocycles with intriguing properties. X-ray crystal analysis revealed aesthetic necklace-shaped structures and size-dependent packages with long-range channels. The macrocycles exhibit unique photophysical properties with high fluorescence quantum yield of up to 82 %, and the fluorescent color varies with ring size. In addition, size-dependent chiroptical properties with moderately large CPL dissymmetry factor of 10-3 and CPL brightness in the range of 30-40â M-1 cm-1 were observed.
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T-cell reduction is an important characteristic of coronavirus disease 2019 (COVID-19), and its immunopathology is a subject of debate. It may be due to the direct effect of the virus on T-cell exhaustion or indirectly due to T cells redistributing to the lungs. HIV/AIDS naturally served as a T-cell exhaustion disease model for recognizing how the immune system works in the course of COVID-19. In this study, we collected the clinical charts, T-lymphocyte analysis, and chest CT of HIV patients with laboratory-confirmed COVID-19 infection who were admitted to Jin Yin-tan Hospital (Wuhan, China). The median age of the 21 patients was 47 years [interquartile range (IQR) = 40-50 years] and the median CD4 T-cell count was 183 cells/µl (IQR = 96-289 cells/µl). Eleven HIV patients were in the non-AIDS stage and 10 were in the AIDS stage. Nine patients received antiretroviral treatment (ART) and 12 patients did not receive any treatment. Compared to the reported mortality rate (nearly 4%-10%) and severity rate (up to 20%-40%) among COVID-19 patients in hospital, a benign duration with 0% severity and mortality rates was shown by 21 HIV/AIDS patients. The severity rates of COVID-19 were comparable between non-AIDS (median CD4 = 287 cells/µl) and AIDS (median CD4 = 97 cells/µl) patients, despite some of the AIDS patients having baseline lung injury stimulated by HIV: 7 patients (33%) were mild (five in the non-AIDS group and two in the AIDS group) and 14 patients (67%) were moderate (six in the non-AIDS group and eight in the AIDS group). More importantly, we found that a reduction in T-cell number positively correlates with the serum levels of interleukin 6 (IL-6) and C-reactive protein (CRP), which is contrary to the reported findings on the immune response of COVID-19 patients (lower CD4 T-cell counts with higher levels of IL-6 and CRP). In HIV/AIDS, a compromised immune system with lower CD4 T-cell counts might waive the clinical symptoms and inflammatory responses, which suggests lymphocyte redistribution as an immunopathology leading to lymphopenia in COVID-19.
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COVID-19 , Infecções por HIV , Adulto , Antirretrovirais , Linfócitos T CD4-Positivos , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Humanos , Contagem de Linfócitos , Pessoa de Meia-Idade , SARS-CoV-2RESUMO
BACKGROUND: The full range of long-term health consequences of COVID-19 in patients who are discharged from hospital is largely unclear. The aim of our study was to comprehensively compare consequences between 6 months and 12 months after symptom onset among hospital survivors with COVID-19. METHODS: We undertook an ambidirectional cohort study of COVID-19 survivors who had been discharged from Jin Yin-tan Hospital (Wuhan, China) between Jan 7 and May 29, 2020. At 6-month and 12-month follow-up visit, survivors were interviewed with questionnaires on symptoms and health-related quality of life (HRQoL), and received a physical examination, a 6-min walking test, and laboratory tests. They were required to report their health-care use after discharge and work status at the 12-month visit. Survivors who had completed pulmonary function tests or had lung radiographic abnormality at 6 months were given the corresponding tests at 12 months. Non-COVID-19 participants (controls) matched for age, sex, and comorbidities were interviewed and completed questionnaires to assess prevalent symptoms and HRQoL. The primary outcomes were symptoms, modified British Medical Research Council (mMRC) score, HRQoL, and distance walked in 6 min (6MWD). Multivariable adjusted logistic regression models were used to evaluate the risk factors of 12-month outcomes. FINDINGS: 1276 COVID-19 survivors completed both visits. The median age of patients was 59·0 years (IQR 49·0-67·0) and 681 (53%) were men. The median follow-up time was 185·0 days (IQR 175·0-198·0) for the 6-month visit and 349·0 days (337·0-361·0) for the 12-month visit after symptom onset. The proportion of patients with at least one sequelae symptom decreased from 68% (831/1227) at 6 months to 49% (620/1272) at 12 months (p<0·0001). The proportion of patients with dyspnoea, characterised by mMRC score of 1 or more, slightly increased from 26% (313/1185) at 6-month visit to 30% (380/1271) at 12-month visit (p=0·014). Additionally, more patients had anxiety or depression at 12-month visit (26% [331/1271] at 12-month visit vs 23% [274/1187] at 6-month visit; p=0·015). No significant difference on 6MWD was observed between 6 months and 12 months. 88% (422/479) of patients who were employed before COVID-19 had returned to their original work at 12 months. Compared with men, women had an odds ratio of 1·43 (95% CI 1·04-1·96) for fatigue or muscle weakness, 2·00 (1·48-2·69) for anxiety or depression, and 2·97 (1·50-5·88) for diffusion impairment. Matched COVID-19 survivors at 12 months had more problems with mobility, pain or discomfort, and anxiety or depression, and had more prevalent symptoms than did controls. INTERPRETATION: Most COVID-19 survivors had a good physical and functional recovery during 1-year follow-up, and had returned to their original work and life. The health status in our cohort of COVID-19 survivors at 12 months was still lower than that in the control population. FUNDING: Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, the National Natural Science Foundation of China, the National Key Research and Development Program of China, Major Projects of National Science and Technology on New Drug Creation and Development of Pulmonary Tuberculosis, the China Evergrande Group, Jack Ma Foundation, Sino Biopharmaceutical, Ping An Insurance (Group), and New Sunshine Charity Foundation.
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COVID-19/complicações , Sobreviventes , Idoso , Ansiedade/etiologia , COVID-19/fisiopatologia , COVID-19/psicologia , Depressão/etiologia , Tolerância ao Exercício , Fadiga/etiologia , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Pulmão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Debilidade Muscular/etiologia , Qualidade de Vida , SARS-CoV-2 , Teste de CaminhadaAssuntos
COVID-19/complicações , Fibrose Pulmonar/diagnóstico por imagem , Fibrose Pulmonar/etiologia , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Feminino , Seguimentos , Humanos , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , SARS-CoV-2RESUMO
ABSTRACT: We aimed to investigate the relationship of radiological features and the corresponding pulmonary pathology of patients with Coronavirus Disease (COVID-19) pneumonia.In this multicenter study, serial chest CT and radiographic images from 9 patients (51-85âyears old, 56% male) were reviewed and analyzed. Postmortem lungs were sampled and studied from these autopsies, with a special focus on several corresponding sites based on imaging features.The predominant pattern of pulmonary injury in these 9 cases was diffuse alveolar damage (DAD) and interstitial inflammation. Moreover, acute fibrinous exudates, organization, inflammatory cell infiltration, hyaline membranes, pulmonary edema, pneumocyte hyperplasia, and fibrosis were all observed. The histopathology features varied according to the site and severity of each lesion. In most of the 9 cases, opacities started from a subpleural area and peripheral structures were more severely damaged based on gross views and pathological examinations. Fibrosis could occur in early stages of infection and this was supported by radiological and pathological findings. The radiological features of COVID-19 pneumonia, at the critically ill stage, were diffuse ground-glass opacities with consolidation, interstitial thickening, and fibrous stripes, which was based in the fibrous tissue proliferation in the alveolar and interlobular septa, and filled alveoli with organizing exudation. Fungal and bacterial co-infections were also observed in 6 cases.Typical imaging features can be correlated with underlying pathological findings. Combining assessments of imaging features with pathological findings therefore can enhance our understanding of the histopathological mechanism of COVID-19 pneumonia, and facilitate early radiological diagnosis and prognosis estimation of COVID-19 pneumonia, which has important implications for the development of clinical targeted treatments and research related to COVID-19 pneumonia.