Features of lung impairment due to COVID-19 in patients of the first wave of the pandemic (literature review)

Authors

  • Yu.I. Feshchenko SI “National institute of phthisiology and pulmonology named after F.G. Yanovsky NAMS of Ukraine” M. Amosova str., 10, Kyiv, 03038, Ukraine https://orcid.org/0000-0002-8933-8811
  • L.A. Iashyna SI “National institute of phthisiology and pulmonology named after F.G. Yanovsky NAMS of Ukraine” M. Amosova str., 10, Kyiv, 03038, Ukraine https://orcid.org/0000-0002-4264-1207
  • S.G. Opimakh SI “National institute of phthisiology and pulmonology named after F.G. Yanovsky NAMS of Ukraine” M. Amosova str., 10, Kyiv, 03038, Ukraine http://orcid.org/0000-0002-4631-2048
  • G.L. Gumeniuk SI “National institute of phthisiology and pulmonology named after F.G. Yanovsky NAMS of Ukraine” M. Amosova str., 10, Kyiv, 03038, Ukraine https://orcid.org/0000-0001-8160-7856
  • V.I. Ignatieva SI “National institute of phthisiology and pulmonology named after F.G. Yanovsky NAMS of Ukraine” M. Amosova str., 10, Kyiv, 03038, Ukraine https://orcid.org/0000-0003-0604-4349
  • M.A. Polianska SI “National institute of phthisiology and pulmonology named after F.G. Yanovsky NAMS of Ukraine” M. Amosova str., 10, Kyiv, 03038, Ukraine https://orcid.org/0000-0003-0305-7988
  • I.V. Zvol SI “National institute of phthisiology and pulmonology named after F.G. Yanovsky NAMS of Ukraine” M. Amosova str., 10, Kyiv, 03038, Ukraine http://orcid.org/0000-0001-8533-2618
  • S.M. Moskalenko SI “National institute of phthisiology and pulmonology named after F.G. Yanovsky NAMS of Ukraine” M. Amosova str., 10, Kyiv, 03038, Ukraine http://orcid.org/0000-0002-0364-2047

DOI:

https://doi.org/10.26641/2307-0404.2022.4.271118

Keywords:

COVID-19, lung impairment, inflammation, fibrosis, thrombosis

Abstract

During the COVID-19 pandemic number of patients suffering from symptoms, decreased work ability and the deterioration in quality of life for several weeks and even months after the onset of the disease is increasing. The aim of the literature review is to search and study the existing literature data regarding the lung impairment features in COVID-19, as well as the morphological and pathophysiological prerequisites for the long-term respiratory disorders in patients who have had this disease. The most common complaints of patients after acute COVID-19 are fatigue, dyspnea, cough and chest discomfort. In these cases restrictive pattern in the pulmonary function test, a reduced gas transfer and persistent changes in computed tomography often in the form of fibrosis are observed, less often in the form of bullous-emphysematous changes, bronchiectasis and pleural effusion. The main pathophysiological mechanisms of acute lung impairment in COVID-19 are direct viral toxicity, impaired function of the immune system, hyperinflammatory response, endotheliopathy, microcirculatory disorders and increased blood clotting with small and large vessels thrombosis, which can lead to pneumonia or acute respiratory distress syndrome. After the acute phase of COVID-19 the pathology of the lung can be caused by an immunogenic and hyperinflammatory response, hypercoagulability and lead to pulmonary fibrosis. The possible mechanisms of the pulmonary fibrosis are thrombotic processes, hemosiderosis, necrotic capillaritis, angiogenesis, hypoxia, cytokine storm. Thus abnormal immune response, hyperinflammation, endothelial dysfunction and excessive coagulation not only cause pneumonia or acute respiratory distress syndrome in acute COVID-19, but also may persist for a long time and contribute to pulmonary fibrosis in some patients. The causes of a longer duration and increased severity of the lung impairment in some people compared to others are the subject of current investigations.

References

Pertseva TA, Konopkina LI, Koval DS, Guba YuV. [The processes of inflammation and fibrosis in patients with chronic obstructive pulmonary disease]. Medicni perspektivi. 2020;25(4):59-65. Ukrainian. doi: https://doi.org/10.26641/2307-0404.2020.4.221229

Feshchenko YuI, Golubovska OA, Dziublyk AYa, Gavrysyuk VK, Dziublyk YaA, Liskina IV. [Pulmonary disease in COVID-19]. Ukr Pulmonol J. 2021;1:5-14. Ukrainian. doi: https://doi.org/10.31215/2306-4927-2021-29-1-5-14

Feshchenko YI, Lynnyk МІ, Gumeniuk МІ, Kalabukha IA, Іgnatieva VІ, Gumeniuk GL, et al. [Diagnosis of disappearing lung syndrome as a complication of non-hospital pneumonia of viral etiology (COVID-19)]. Infusion & Chemotherapy. 2021;3:5-11. Ukrainian. doi: https://doi.org/10.32902/2663-0338-2021-3-5-11

Ambardar SR, Hightower SL, Huprikar NA, Chung KK, Singhal A, Collen JF. Post-COVID-19 Pul-monary Fibrosis: Novel Sequelae of the Current Pandemic. Journal of Clinical Medicine. 2021;10(11):2452. doi: https://doi.org/10.3390/jcm10112452

Bellan M, Soddu D, Balbo PE, et al. Respiratory and Psychophysical Sequelae Among Patients With COVID-19 Four Months After Hospital Discharge. JAMA Netw Open. 2021;4(1):e2036142. doi: https://doi.org/10.1001/jamanetworkopen.2020.36142

Borczuk AC, Salvatore SP, Seshan SV, Patel SS, Bussel JB, et al. COVID-19 pulmonary pathology: a multi-institutional autopsy cohort from Italy and New York City. Mod Pathol. 2020;33(11):2156-68. doi: https://doi.org/10.1038/s41379-020-00661-1

Chun HJ, Coutavas E, Pine A, et al. Immuno-fibrotic drivers of impaired lung function in post-acute sequelae of SARS-CoV-2 infection (PASC). Preprint. medRxiv. 2021;2021.01.31.21250870. doi: https://doi.org/10.1101/2021.01.31.21250870

Fahriani M, Ilmawan M, Fajar JK, et al. Per-sistence of long COVID symptoms in COVID-19 survivors worldwide and its potential pathogenesis – A systematic review and meta-analysis. Narra J. 2021;1(2):e36. doi: http://doi.org/10.52225/narraj.v1i2.36

Faverio P, Luppi F, Rebora P, Busnelli S, Stai-ner A, et al. Six-Month Pulmonary Impairment after Severe COVID-19: A Prospective, Multicentre Follow-Up Study. Respiration. 2021;100:1078-87. doi: https://doi.org/10.1159/000518141

Fogarty H, Townsend L, Morrin H, et al; the Irish COVID-19 Vasculopathy Study (iCVS) investigators. Persistent endotheliopathy in the pathogenesis of long COVID syndrome. J Thromb Haemost. 2021;19:2546-3. doi: https://doi.org/10.1111/jth.15490

Grosse C, Grosse A, Salzer HJF, Dünser MW, Motz R, Langer R. Analysis of cardiopulmonary findings in COVID-19 fatalities: High incidence of pulmonary artery thrombi and acute suppurative bronchopneumonia. Cardiovasc Pathol. 2020;49:107263. doi: https://doi.org/10.1016/j.carpath.2020.107263

Jiang DH, Roy DJ, Gu BJ, Hassett LC, McCoy RG. Postacute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A State-of-the-Art Review. J Am Coll Cardiol Basic Trans Science. 2021;9-10:796-811. doi: https://doi.org/10.1016/j.jacbts.2021.07.002

Konopka KE, Perry W, Huang T, Farver CF, Myers JL. Usual Interstitial Pneumonia is the Most Com-mon Finding in Surgical Lung Biopsies from Patients with Persistent Interstitial Lung Disease Following Infection with SARS-CoV-2. eClinicalMedicine; 2021. doi: https://doi.org/10.1016/j.eclinm.2021.101209

Lombardi F, Calabrese A, Iovene B. et al. Resi-dual respiratory impairment after COVID-19 pneumonia. BMC Pulm Med. 2021;21:241. doi: https://doi.org/10.1186/s12890-021-01594-4

Maltezou HC, Pavli A, Tsakris A. Post-COVID Syndrome: An Insight on Its Pathogenesis. Vaccines (Basel). 2021;9(5):497. doi: https://doi.org/10.3390/vaccines9050497

Marik PE, Iglesias J, Varon J, Kory P. A scoping review of the pathophysiology of COVID-19. Interna-tional Journal of Immunopathology and Pharmacology. 2021;35:1-16. doi: https://doi.org/10.1177/20587384211048026

Meizlish ML, Pine AB, Bishai JD, Goshua G, Nadelmann ER, et al. A neutrophil activation signature predicts critical illness and mortality in COVID-19. Blood Adv. 2021;5(5):1164-1177. doi: https://doi.org/10.1182/bloodadvances.2020003568

Mittal A, Sabharwal S, Foley R. Bullous lung disease complicating COVID-19 pneumonia. Chest. 2021;160(4):A908. doi: https://doi.org/10.1016/j.chest.2021.07.846

Myall KJ, Mukherjee B, Castanheira AM, et al. Persistent Post-COVID-19 Interstitial Lung Disease. An Observational Study of Corticosteroid Treatment. Ann Am Thorac Soc. 2021;18(5):799-806. doi: https://doi.org/10.1513/AnnalsATS.202008-1002OC

Nalbandian A, Sehgal K, Gupta A, et al. Post-acute COVID-19 syndrome. Nat Med. 2021;27:601-15. doi: https://doi.org/10.1038/s41591-021-01283-z

Pandey P, Agarwal S, Rajkumar. Lung pathology in COVID-19: A systematic review. Int J App Basic Med Res. 2020;10:226-3. doi: https://doi.org/10.4103/ijabmr.IJABMR_381_20

Rendeiro AF, Ravichandran H, Bram Y, et al. The spatial landscape of lung pathology during COVID-19 progression. Nature. 2021;593:564-9. doi: https://doi.org/10.1038/s41586-021-03475-6

Reno C, Sanmarchi F, Stoto MA, Fantini MP, Lenzi J, Golinelli D. The impact of health policies and vaccine rollout on the COVID-19 pandemic waves in Italy. Health Policy and Technology. 2022;100604. doi: https://doi.org/10.1016/j.hlpt.2022.100604

Salem AM, Al Khathlan N, Alharbi AF, Algha-mdi T, AlDuilej S, Alghamdi M, et al. The Long-Term Impact of COVID-19 Pneumonia on the Pulmonary Function of Survivors. Int J Gen Med. 2021;14:3271-80. doi: https://doi.org/10.2147/IJGM.S319436

Shah W, Hillman T, Playford ED, Hishmeh L. Managing the long term effects of COVID-19: summary of NICE, SIGN, and RCGP rapid guideline. BMJ. 2021;372:n136. doi: https://doi.org/10.1136/bmj.n136

Siddiqui S, Brightling CE. Pathological disease in the lung periphery after acute COVID-19. Lancet Respir Med. 2021;9(10):1089-90. doi: https://doi.org/10.1016/S2213-2600(21)00378-7

Solomon JJ, Heyman B, Ko JP, Condos R, Lynch DA. CT of Post-Acute Lung Complications of COVID-19. Radiology. 2021;301(2):E383-95. doi: https://doi.org/10.1148/radiol.2021211396

Stockley JA, Alhuthail EA, Coney AM, et al. Lung function and breathing patterns in hospitalised COVID-19 survivors: a review of post-COVID-19 Clinics. Respir Res. 2021;22:255. doi: https://doi.org/10.1186/s12931-021-01834-5

Wild JM, Porter JC, Molyneaux PL, et al. Under-standing the burden of interstitial lung disease post-COVID-19: the UK Interstitial Lung Disease-Long COVID Study (UKILD-Long COVID). BMJ Open Respir Res. 2021;8(1):e001049. doi: https://doi.org/10.1136/bmjresp-2021-001049

Wu Q, Zhong L, Li H, Guo J, Li Y, et al. A Fol¬low-Up Study of Lung Function and Chest Computed Tomography at 6 Months after Discharge in Patients with Coronavirus Disease 2019. Canadian Respiratory Journal. 2021;6692409. doi: https://doi.org/10.1155/2021/6692409

Zawbaa HM, Osama H, El-Gendy A, et al. Effect of mutation and vaccination on spread, severity, and mortality of COVID-19 disease. J Med Virol. 2021;94:197-204. doi: https://doi.org/10.1002/jmv.27293

Zayet S, Zahra H, Royer P-Y, Tipirdamaz C, Mer-cier J, Gendrin V, et al. Post-COVID-19 Syndrome: Nine Months after SARS-CoV-2 Infection in a Cohort of 354 Patients: Data from the First Wave of COVID-19 in Nord Franche-Comté Hospital, France. Microorganisms. 2021;9(8):1719. doi: https://doi.org/10.3390/microorganisms9081719

Zhang S, Bai W, Yue J, et al. Eight months fol¬low-up study on pulmonary function, lung radiographic, and related physiological characteristics in COVID-19 survivors. Sci Rep. 2021;11:13854. doi: https://doi.org/10.1038/s41598-021-93191-y

Published

2022-12-29

How to Cite

1.
Feshchenko Y, Iashyna L, Opimakh S, Gumeniuk G, Ignatieva V, Polianska M, Zvol I, Moskalenko S. Features of lung impairment due to COVID-19 in patients of the first wave of the pandemic (literature review). Med. perspekt. [Internet]. 2022Dec.29 [cited 2024Mar.29];27(4):20-6. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/271118

Issue

Section

THEORETICAL MEDICINE