Ongoing Symptoms, Formation of Interstitial Lung Disease and Follow-up Process in PostCOVID-19

Aralık 2019’da Çin’in Wuhan eyaletinden severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)’ye bağlı ciddi akut solunum hastalıkları bildirildi. Koronavirüs hastalığı- 2019 (COVID-19) ilişkili semptomlar hafif üst solunum yolu infeksiyonundan akut solunum sıkıntısı sendromu (ARDS)’na kadar çeşitli klinik farklılık gösterir. Taburculuk sonrası bazı hastalarda semptomların ve radyolojik bulguların devam ettiği görülmüştür. Hipertansiyon ve diyabet gibi komorbiditeler, erkek cinsiyet ve ileri yaş gibi risk faktörleri ciddi COVID-19 ve idiopatik pulmoner fibrosis (İPF) için ortak risk faktörleridir. Bununla birlikte, SARS-CoV-2 infeksiyonuna yakalanan İPF hastalarında, antifibrotik tedavinin rolü ve bunların devamı veya kesilmesi için bilimsel mantık tam olarak tanımlanmamıştır. COVID-19 pandemisinden edinilen veriler ile şiddetli akut solunum sendromu (SARS) ve Ortadoğu solunum sendromu (MERS) gibi önceki koronavirüs infeksiyonlarından elde edilen veriler, SARS-CoV-2 infeksiyonunu takiben önemli fibrotik değişiklikler olabileceğini düşündürmektedir. Bu makalede, COVID-19 pnömonisi sonrası devam eden semptomların sıklığı ve ortaya çıkabilecek interstisyel akciğer hastalığı sıklığından söz edildi. Ayrıca başta pulmoner fibrosis olmak üzere akciğerde meydana gelen interstisyel değişikliklerin önlenmesi ve solunum fonksiyonlarında azalma literatür ışığında tartışılmıştır.n December 2019, severe acute respiratory diseases due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) were reported from Wuhan province of China. The symptoms associated with Coronavirus Disease-2019 (COVID-19) range from mild upper respiratory tract infection to acute respiratory distress syndrome (ARDS). It was observed that symptoms and radiological findings continued in some patients after discharge. Comorbidities such as hypertension and diabetes, risk factors such as male gender and advanced age are common risk factors for severe COVID-19 and idiopathic pulmonary fibrosis (IPF). However, the role of anti fibrotictherapy and the scientific rationale for their continuation or discontinuation in IPF patients infected with SARS-CoV-2 have not been fully defined. Data from the COVID-19 pandemic and previous coronavirus infections such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) suggest that there may be significant fibrotic changes following SARS-CoV-2 infection. In this article, the frequency of on going symptoms after COVID-19 pneumonia and the frequency of interstitial lung disease that may ocur were discussed. Inaddition, the prevention of interstitial changes in the lung, especially pulmonary fibrosis, and the decrease in respiratory functions are discussed in the light of the literature

Assessment of osteoporosis using the FRAX method and the importance of vitamin D levels in COPD patients

Abstract Background The aim of this paper was to evaluate the availability of FRAX for assessing osteoporosis risk, and to demonstrate the importance of vitamin D levels in COPD patients. Methods Fourty-six males who fulfilled the COPD diagnostic criteria defined by GOLD were included. Age, race, BMI, physical activity frequency, smoking and dietary habits, age at COPD diagnosis, disease duration, fractures history, and medications use were determined. Levels of 25(OH)D were detected. BMD was measured by DXA at lumbar spine, femoral neck, and entire femur, and classified according to ISCD. FRAX score was calculated. Control group was composed of 40 non-smoker individuals without previous history of pulmonary diseases. Results 25(OH)D levels were significantly different between patients and controls. In the COPD group, a statistically significant difference in vitamin D levels was detected among the A, B, C, and D grades, while no such significant differences in FRAX scores were detected. 25(OH)D levels were significantly low in COPD patients with disease exacerbations and hospitalizations in the previous one year. No correlation was detected between vitamin D levels and the FRAX score. A positive correlation was observed between vitamin D levels and T-score. FRAX scores were higher and vitamin D levels were lower in osteoporotic COPD patients than in non-osteoporotic COPD patients. Conclusion Using FRAX for assessing osteoporosis in COPD can reduce fracture risk and allow adequate treatment. Since vitamin D levels are related to exacerbations and hospitalizations, vitamin D supplementation may be needed in COPD patients, especially in those with high FRAX scores