Pulmonary long-term consequences of COVID-19 infections after hospital discharge

Objectives: COVID-19 survivors are reporting residual abnormalities after discharge from the hospital. Limited information is available about this stage of recovery or the lingering effects of the virus on pulmonary function and inflammation. The aim of this study was to describe lung function and to identify biomarkers in serum and induced sputum samples from patients recovering from COVID-19 hospitalisation. Methods: Patients admitted to Spanish hospitals with laboratory-confirmed COVID-19 infection by a real-time PCR (RT-PCR) assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were recruited for this study. Each hospital screened their lists of discharged patients at least 45 days after symptom onset. SARS-CoV-2-infected patients were divided into mild/moderate and severe disease groups according to the severity of their symptoms during hospitalisation. Patients’ epidemiological and medical histories, comorbidities, chronic treatments, and laboratory parameters were evaluated. Pulmonary function tests, the standardised 6-minute walk test (6 MWT) and chest computed tomography (CT) were also performed. The levels of proteases, their inhibitors, and shed receptors were measured in serum and induced sputum samples. Results: A total of 100 patients with respiratory function tests were included in this study. The median number of days after the onset of symptoms was 104 (IQR 89.25, 126.75). COVID-19 was severe in 47% (47/100) of patients. CT was normal in 48% (48/100) of patients. Lung function was normal (FEV1 ≥80%, FVC ≥80%, FEV1/FVC ≥0.7, and diffusing capacity for carbon monoxide [DLCO] ≥80%) in 92% (92/100), 94% (94/100), 100% (100/100) and 48% (48/100) of patients, respectively. Multivariate analysis showed that a DLCO <80% (OR 5.92; 95%CI 2.28-15.37; p <0.0001) and a lower serum LDH level (OR 0.98; 95%CI 0.97-0.99) were associated with the severe disease group of SARS-CoV-2 during hospital stay. Conclusions: A diffusion deficit (DLCO <80%) was still present after hospital discharge and was associated with the most severe SARS-CoV-2 cases

Simulium (Hearlea) Vargas, Mart nez Palacios, &amp; D az N jera (Diptera: Simuliidae): Taxonomic revision and cladistic analysis

FIGURE 10. Distribution of Simulium (Hearlea).Published as part of Coscarón, S., Esquivel, D.R. Miranda, Moulton, J.K., Arias, C.L. Coscarón- & Bernal, S. Ibañez, 2004, Simulium (Hearlea) Vargas, Martínez Palacios, & Díaz Nájera (Diptera: Simuliidae): Taxonomic revision and cladistic analysis, pp. 1-52 in Zootaxa 396 on page 47, DOI: 10.11646/zootaxa.396.1.1, http://zenodo.org/record/522742

Simulium (Hearlea) paracarolinae Coscarón & Esquivel & Moulton & Arias & Bernal 2004, n. sp.

Simulium (Hearlea) paracarolinae Coscarón, n. sp. Figs. 8I–L, 9B, C. Larva: Length (mature), 7.0– 8.5 mm. Coloration light brown yellowish (in alcohol). Cephalic apotome light brown, darkened basally, with darkened median longitudinal stripe on basal one­third and 1+1 small submedian spots near midline. Labral fan with 44–48 primary rays. Medial antennal article with 4 pseudoannulations (Fig. 8K). Ratio of antennal articles = 1:1.6:1.0 (proximal: medial: distal). Postgenal cleft subtriangular, without anteromedian incision (Fig. 8I). Ratio of hypostoma/hypostomal bridge = 1.2. Hypostoma with median tooth longer than others; 11–12 lateral and 2 discal setae per side. Mandible with internal teeth arranged in 3–4 rows of 6–8 teeth; 2 marginal teeth, second one very small (Fig. 8L); lateral process elongated, stout, and curved. Lateral sclerite of thoracic proleg with 42–46 teeth. Anal sclerite with ventral struts heavily sclerotized, relatively short, not encircling posterior circlet although enclosing approximately 1/3 of it; accessory plates comprised of 1+1 well sclerotized, dorsolateral conical plates covered with small setae (Figs. 9B, C [ds]). Segment VIII lacking ventrolateral papillae. Posterior circlet with 398– 400 rows of 42–48 hooks. Rectal papillae trilobed, with 6–7 lobules per lobe (18–21 total), the median lobe largest. Material examined: Guatemala: Solala, Atitlan, Santa Alicia, Finca Monte de Oro, río Catarata, (12 K, 36 B), Holotype larva and Paratype 1 larva, 24 March 1951, H. Dalmat (AMNH); same locality, 6 larvae, 22 February 1945, (AMNH); unknown locality XXII, 3 lots: (5 larvae), (1 larva), (7 larvae, 2 larvae on slides) (AMNH); XVII, 2 lots (2 larvae in slide) (MLP). Discussion: Larval morphology permits differentiation of S. paracarolinae from all other known species. The presence of accessory plates on the anal sclerite and a curved anterior hypostomal margin place this species into the S. carolinae group, for which the larva is known for all species. Although the larva cannot be completely ruled out from being the unknown larva of S. nigricorne, pupal morphology suggests the latter species corresponds to a group having different larval characters, such as absence of accessory plates on the distal abdomen, straight anterior hypostomal margin, distinct mandible morphology, and postgenal cleft. The closest species is S. carolinae, but its anal sclerite ventral struts completely encircle the posterior circlet and has 2+2 dorsolateral accessory plates.Published as part of Coscarón, S., Esquivel, D. R. Miranda, Moulton, J. K., Arias, C. L. Coscarón- & Bernal, S. Ibañez, 2004, Simulium (Hearlea) Vargas, Martínez Palacios, & Díaz Nájera (Diptera: Simuliidae): Taxonomic revision and cladistic analysis, pp. 1-52 in Zootaxa 396 on page 32, DOI: 10.11646/zootaxa.396.1.1, http://zenodo.org/record/522742

Simulium (Hearlea) contrerense Diaz Najera & Vulcano

Simulium (Hearlea) contrerense Díaz Nájera & Vulcano Simulium (Hearlea) contrerense Díaz Nájera & Vulcano, 1962: 94–99, Figs. 15–45. (Description derived from Díaz Nájera & Vulcano, 1962). Female: General coloration blackish. Scutum velvety blackish, with 1+1 silvery vittae not adjoining anteriorly with 1+1 submedian silvery triangular spots; lateral and posterior borders silvery pruinose. Abdomen brownish, with posterior margins of tergites yellowish. Basal portion of cibarium concave medially, without wrinkled margin and with thickened rim. Genitalia similar to those of S. capricorne. Male: Wing length, 5 mm. General coloration blackish. Scutum velvety black, bordered with whitish pruinose and clothed in golden pile. Scutellum brown, with light brown posterior margin. Abdominal tergites black, with yellowish hairs. Sc haired. Genitalia as in S. capricorne. Ventral plate with prominent median carina. Pupa: Length (basal), 7 mm; dorsal, 6 mm; gill, 3.5 mm. Cocoon shoe shaped, gradually elevated, closed basally on anterior 1/4, compactly woven, not reinforced along anterior margin. Thorax with 5 simple trichomes per side. Gill inflated, with 2 major branches; dorsal branch stout, subglobulose, tapered distally, sclerotized and wrinkled dorsally, ventral branch membranous and translucent ventrally, with subconical lateral prominence, and subannulations; ventrolateral branch small, thin, and curved medially. Larva: Length, 12 mm. Head brownish, body yellowish gray, without ventral papillae. Labral fan with 42 primary rays. Hypostoma with 15–17 lateral setae per side and 4+4 discal setae. Mandible with 6–7 internal and 2 marginal teeth. Ratio of antennal articles = 1:2.2:1.9 (proximal: medial: distal). Postgenal cleft subtriangular. Posterior circlet with 185 rows of ca. 16 hooks. Rectal papillae trilobed, with 20–23 lobules per lobe (60–66 total), the dorsal lobe largest. Distribution: México: México, 3000 m and D. F. Discussion: The peculiar gill, with its inflated dorsal and ventral branches membraneous and translucent ventrally, distinguishes this species from all others. Simulium juarezi has a somewhat similar gill, but only its medial branch is markedly inflated.Published as part of Coscarón, S., Esquivel, D. R. Miranda, Moulton, J. K., Arias, C. L. Coscarón- & Bernal, S. Ibañez, 2004, Simulium (Hearlea) Vargas, Martínez Palacios, & Díaz Nájera (Diptera: Simuliidae): Taxonomic revision and cladistic analysis, pp. 1-52 in Zootaxa 396 on page 17, DOI: 10.11646/zootaxa.396.1.1, http://zenodo.org/record/522742

Simulium (Hearlea) dalmati Vargas & Diaz Najera

Simulium (Hearlea) dalmati Vargas & Díaz Nájera Figs. 5J–M Simulium (Hearlea) dalmati Vargas & Díaz Nájera, 1948: 337–341, Figs. 47–56; 1955: 166, 169, 170, 171, 173, 290, Figs. 99–106; Díaz Nájera & Vulcano, 1962: 93, 122, Figs. 46–50. Female: (Derived from Vargas & Díaz Nájera, 1948). Wing length, 3.5 mm. General coloration blackish, with golden pilosity. Scutum black with 1+1 silvery vittae, joining anteriorly with 1+1 silvery subtriangular spots. Legs yellowish, with apices of femora, tibiae, and tarsomeres black. Basal portion of cibarium smooth, with anterior margin thickened, gradually elevated sublaterally. Sc haired. Genitalia as in S. capricorne. Male: Wing length, 3 mm. Coloration similar to that of female. Scutum black, with grayish pruinosity on anterior 1/3 interrupted medially. Sc with scarce hairs. Hind basitarsus 3.6 times longer than wide Ventral plate with short, haired, median carina. Pupa: (Fig. 5J). Cocoon slipper shaped, coarsely woven, anterior margin reinforced. Length (at base), 5 mm. Gill (Figs. 5K–M) inflated, annulated, comprised of 3 branches; medial and ventral branches subequal in size; dorsal branch 0.4 mm, 1/4 or less length of other branches, directed posteromedially, accuminate apically (Fig. 5K); medial branch 1.4 mm, subcylindrical, capitate, directed anterolaterally, with 3–4 small apical protuberances (Fig. 5K); ventral branch 1.3 mm, laterally compressed, curved anteromedially, blunt apically, with one or more small apical protuberances (Fig. 5L). Frontoclypeus and thorax with few, iregularly sized granules. Larva: Length, 9 mm. Coloration grayish green; cephalic apotome without headspots, slightly darkened mediobasally. Labral fan with 42–44 primary rays. Antenna as long as stalk of labral fan, median article with 2 whitish subannulations. Mandible with strong curvature on superíor side, with 6 internal and 2 marginal teeth, the last well developed. Ratio of antennal articles = 1:1.3–1.4:1.0–1.1 (proximal: medial: distal). Postgenal cleft gradually curved, with narrow apical incision. Hypostoma with anterior margin straight, 11–13 lateral setae per side, and 3+3 discal setae; median tooth longer than others; ratio of hypostoma/hypostomal bridge = 0.8. Posterior circlet with 144 rows of 21–23 hooks. Rectal papillae 18–24 lobules, consisting of large dorsal and 5–7 smaller ventral lobules per lobe. Material examined: México, Veracruz, Cumbres de Alcutzingo, 1 pharate male, 1 larva (on slides), 2 pupae and 4 larvae, 31 August 1948, Cordova, (MLP) leg. INDRE. Distribution: México, Veracruz. Discussion: The female is very similar to S. delatorrei and S. larvispinosum. The pupa is structurally close to S. canadense and S. burchi, but S. canadense has a slipper­shaped cocoon and S. burchi has a more anterodorsally directed, more finely woven cocoon. The larva is similar to that of S. ethelae, but the latter has 36–39 lobules (versus 18–24) on the rectal papillae. The larva of S. delatorrei is also similar but has 114 rows of hooks (versus 144) on the posterior circlet and 7–9 (versus 11–13) lateral hypostomal setae per side. Female of S. contrerense is very close, but silvery vittae of scutum not adjoining anteriorly, and the pupa gill has only 2 branches.Published as part of Coscarón, S., Esquivel, D. R. Miranda, Moulton, J. K., Arias, C. L. Coscarón- & Bernal, S. Ibañez, 2004, Simulium (Hearlea) Vargas, Martínez Palacios, & Díaz Nájera (Diptera: Simuliidae): Taxonomic revision and cladistic analysis, pp. 1-52 in Zootaxa 396 on page 18, DOI: 10.11646/zootaxa.396.1.1, http://zenodo.org/record/522742

Simulium (Hearlea) gorirossiae Vargas & Diaz Najera

Simulium (Hearlea) gorirossiae Vargas & Díaz Nájera Figs. 1D, 6F, G, 8D–G, 9D–F. Simulium (Hearlea) gorirossii Vargas & Díaz Nájera, 1957: 199–202, Figs. 143–151; Díaz Nájera & Vulcano, 1962: 92: Figs. 67–71. Female: Wing length, 3.2 mm. Coloration blackish. Head dark brown, with frons and clypeus silvery pollinose. Scutum velvety black with 1+1 silvery vittae adjoined with submedian anterior subtriangular silvery spots; laterally bordered by narrow whitish gray pruinose band adjoining whitish prescutellar area. Abdomen blackish. Fronto­ocular triangle about as long as wide; cibarium with basal portion as in S. larvispinosum, with hyaline internal margin and 1+1 small rounded submedian processes. Sc bare. Genitalia typical for subgenus, with cercus rectangular, flattened distally, anal lobe with a transversal tegumentary fold and very haired apically; gonapophysis subtriangular, with blunt apex similar to that of S. larvispinosum. Male: Wing length, 3.0 mm. Scutum velvety black with anterior 1/3 pruinose, continued by narrow band bordering laterally and meeting with whitish gray pruinose prescutellar area. Abdomen blackish. Sc bare. Genitalia similar to those of S. larvispinosum, except ventral plate more elevated medially. Pupa: Length: basal, 2.4–2.7 mm; dorsal, 1.5–1.7 mm. Cocoon slipper shaped, open anteriorly, thickly woven, with narrow, ragged rim along anterior margin. Clypeus and thoracic dorsum with few to abundant, small, accuminate platelets and simple, stout, trichomes. Gill similar to that of S. larvispinosum, but with large apical lobe of medial branch narrower and dorsal branch more elongate, basally sclerotized, and apically curved; in dorsal view, submedial accuminate branches of major (medial) branch splayed laterally (Figs. 6F, G). Abdominal tergite X lacking terminal spines. Larva: Length, 6.5–7.0 mm. General coloration light yellowish gray. Cephalic apotome uniformly colored, slightly darkened basally (Fig. 8D). Labral fan with 50–52 primary rays. Antenna longer than stalk of labral fan; ratio of antennal articles = 1:1.4:0.7 (proximal: medial: distal); medial article pseudosegmented (Figure 8E). Mandible with outer margin strong curved (Fig. 8F); internal teeth arrangeded in two rows of 4 teeth, with first and second teeth very curved, 2 marginal teeth, and one robust and long lateral tooth, 1/3 of which surpasses inner margin of mandible (Fig. 8G). Hypostoma with anterior margin as in S. larvispinosum, with prominent median tooth and intermediate teeth longer than corner teeth; 14–21 lateral setae per side. Postgenal cleft deep, without anterior accuminate incision; ratio of hypostoma/hypostomal bridge = 0.9–1.1. Ratio of antennal articles = 1:1.3–1.6:0.9 (proximal: medial: distal). Prothoracic proleg lateral sclerite comb with 47– 55 teeth. Abdominal segment VIII with 1+1 ventrolateral, apically sclerotized papillae (Figs. 9D, F [vp]). Anal sclerite with ventral struts projected distally encircling posterior circlet, bordered laterally by heavily sclerotized, spinous accessory plates composed of the following: 2+2 conical dorsolateral projections [dd]; 1+1 flattened, expanded, ventrolateral plates with accuminate projections (Fig. 9D [vl]), abundant accuminate tubercles, and sparse minute trichomes; and 1+1 dorsolateral, irregularly bordered, elongate plates positioned diagonally to lateral lobes of rectal papillae (Figs. 9E [df]). Posterior circlet with 272–282 rows of 30–35 hooks. Rectal papillae trilobed, with 6–10 lobules per lobe (18–30 total). Material examined: Mexico: Paratypes Chiapas, Mariscal, 1 female, 1 male, III­1946, col. A. Díaz Nájera (INDRE). Guatemala: Sololá, Atitlán, río Catarata, Sta. Alicia, Fca. Monte de Oro, several larvae and 1 pupa, 24 March 1951 (USNM); río Santa Anita, Fca. Monte de Oro, abundant larvae, 22 February 1945 (AMNH); XXII, without locality 32 larvae, 3 pupae; another lot: 6 pupae; another lot: 10 larvae, (AMNH). Distribution: México, Chiapas and Veracruz; Guatemala, Sololá. Discussion: Simulium (Hearlea) gorirossiae, S. larvispinosum, S. menchacai, S. carolinae, S. johnson, and S. temascalense are very similar but can be distinguished by subtle differences in the pupal gill and accessory plates of the larval anal sclerite.Published as part of Coscarón, S., Esquivel, D. R. Miranda, Moulton, J. K., Arias, C. L. Coscarón- & Bernal, S. Ibañez, 2004, Simulium (Hearlea) Vargas, Martínez Palacios, & Díaz Nájera (Diptera: Simuliidae): Taxonomic revision and cladistic analysis, pp. 1-52 in Zootaxa 396 on pages 26-28, DOI: 10.11646/zootaxa.396.1.1, http://zenodo.org/record/522742

Simulium (Hearlea) menchacai Vargas & Diaz Najera

Simulium (Hearlea) menchacai Vargas & Díaz Nájera Figs. 6J, K Simulium (Hearlea) menchacai Vargas & Díaz Nájera, 1957: 208–210, Figs. 170–178; Díaz Nájera & Vulcano, 1962: 101–102, Figs. 85–88. Female: Wing length, 3.5 mm. General coloration blackish. Thorax blackish brown; scutum with abundant appressed silvery pilosity that somewhat obscures submedian silvery stripes; vittae not adjoining 1+1 anterior subtrapezoidal silvery spots; scutellum brownish, metanotum and pleurae blackish; legs yellowish brown. Abdomen mostly brownish, with tergites II–IV pale. Fronto­ocular triangle about as long as high. Metathoracic basitarsus 0.5–1.1 times longer than broad. Cibarium wrinkled, with anterior margin thickened, translucent, medially concave, without lateral subovoidal prominences; Sc with 15–17 setae. Genitalia as in S. larvispinosum. Male: Wing length, 3.0 mm. Coloration blackish; scutum velvety black with anterior area whitish. Sc with 2–3 trichomes. Hind basitarsus 3.0–3.1 times longer than broad. Genitalia similar to those of S. larvispinosum. Pupa: Length: basal, 3.5 mm; dorsal, 3.0 mm. Cocoon slipper shaped, loosely woven, closed basally, with reinforced anterior margin coarse and slightly projected dorsolaterally. Gill well sclerotized, cylindrical, comprised of 9–10 terminal branches; 3 primary gill branches: dorsal one short, oriented posteriorly, and curved with rounded apex; median branch short, with 3 secondary branches of approximately equal length; dorsal secondary branch bifurcated basally, median secondary branch subdivided apically into 3 branches, third secondary branch also with 3 subdivided branches, although on different plane; primary ventral branch curved and longer than other three main branches (Figs. 6J–K). Secondary branches are apically accuminated. Frontoclypeus smooth, with robust spiniform setae, frontal ones divergent and superíor ones very long. Thorax with abundant, small, rounded granules. Larva: (Diagnosis derived from Vargas & Díaz Nájera, 1957 and also from Díaz Nájera & Vulcano, 1962). Length (mature), 7.5–8.0 mm. Coloration dark greenish. Cephalic apotome homogeneously pigmented, without discernible headspots. Labral fan with 50–55 primary rays. Hypostoma with anterior margin curved and 15–17 lateral setae per side. Postgenal cleft dome shaped, with anteromedian incision. Anal sclerite, accesory plates and ventrolateral papillae similar to those of S. gorirossiae, but with ventrolateral plates having shorter, more anteriorly directed accuminate projections. Posterior circlet with ca. 310 rows of hooks. Rectal papillae trilobed, with 6–12 lobules per lobe (18–36 total). Material examined: México: Oaxaca, Cerro San Felipe del Agua, 2 pharate female and 1 pharate male (on slide), 3 pupae, 13 May 1962, Reyes & Vulcano (MLP) leg. INDRE. Distribution: México: Oaxaca. Discussion: The larva is very close to those of S. gorirossiae and temascalense, based upon similar anal sclerite and accessory plates morphology, and presence of ventrolateral papillae on the larva. However, the peculiar form and disposition of the pupal gill branches permits their separation.Published as part of Coscarón, S., Esquivel, D. R. Miranda, Moulton, J. K., Arias, C. L. Coscarón- & Bernal, S. Ibañez, 2004, Simulium (Hearlea) Vargas, Martínez Palacios, & Díaz Nájera (Diptera: Simuliidae): Taxonomic revision and cladistic analysis, pp. 1-52 in Zootaxa 396 on pages 31-32, DOI: 10.11646/zootaxa.396.1.1, http://zenodo.org/record/522742