Tofacitinib and pirfenidone as rescue therapies for severe COVID-19 in a patient with previously stable interstitial lung disease associated with Sjögren syndrome.

Coronavirus disease 2019 (COVID-19) can lead to pulmonary fibrosis due to the inflammatory process in the lung, resulting in a series of respiratory consequences. Patients with underlying systemic diseases or pre-existing pulmonary diseases are particularly at risk of severe respiratory distress and persistent pulmonary abnormalities. Pirfenidone, a well-known anti-fibrotic agent recognized for its therapeutic effect on idiopathic pulmonary fibrosis, could be a feasible option in severe COVID-19 cases given the similar pathophysiological features shared with interstitial lung diseases. In this paper, we share our experience of early administration of pirfenidone in combination with tofacitinib in a 61-year-old female patient with severe COVID-19 pneumonia. Pirfenidone was initiated because of persistent dependence on high-flow oxygen support and even the requirement for mechanical ventilation due to disease progression after initial standard COVID-19 treatment. The patient was successfully extubated 15 days after the initiation of pirfenidone, and 13 days after extubation, she was completely weaned off supplemental oxygen. A series of chest radiographs and computed tomography scans demonstrated notable improvements in her lung condition. We propose a strategy of using pirfenidone plus tofacitinib as a rescue therapy in the management of patients with severe COVID-19.

Stable reflective state induced by a disturbed planar texture in surface-treatment-free chiral nematic liquid crystals.

Chiral nematic liquid crystals possess a one-dimensional periodic helical structure and are one of the oldest known materials with the ability of selective reflection of light. Their helix orientation, determining their optical properties, can be changed by a variety of stimuli, and it is also dominated by the surface treatment, ratio of the elastic constants and cell thickness. Here, we present a simple method to realize an angular independence reflective state, induced by a stable disturbed planar texture, in a surface-treatment-free chiral nematic liquid crystal cell. The scattering state caused by the defect-rich focal-conic texture can be electrically tuned to the reflective state from the disturbed planar texture in a very short time, and vice versa. These two optical conditions are both stable states in the null field until the next trigger. We find that the disturbed planar texture in the chiral nematic can provide a 100° viewing angle without reflected wavelength shift. The gray level of the reflected intensity can be tuned via application of the voltage pulses. Moreover, in this work, we discuss the effect of the chiral concentration on stabilizing the disturbed planar texture. When the chiral concentration is higher to induce the blue phases, the change in the texture of the ChNLCs after removing the strong electric field can stop at the disturbed planar texture with high reflectivity. In this work, the optical performance and the bistability based on the disturbed planar texture exhibits great potential for many applications, such as tunable filters, see-through/reflective displays and large-area smart windows.