Long-COVID - pathophysiology, current concepts and future directions.

Long-COVID, an umbrella term referring to a variety of symptoms and clinical presentations, which emerge in a subset of patients after SARS-CoV-2 infection, has a significant impact on an individual's quality of life and places a substantial burden on healthcare systems worldwide, straining financial and human resources. The pathophysiology of long-COVID remains incompletely understood, though several hypotheses have been proposed to explain different aspects of this complex condition. SARS-CoV-2 persistence, direct organ damage, innate and adaptive immune system pertubation, autoimmunity, latent viruses reactivation, endothelial dysfunction, and microbiome disturbances are among the most relevant avenues for elucidating the evolution, complexity, and mechanisms of long-COVID.

Bioreactor contamination monitoring using off-gassed volatile organic compounds (VOCs).

Metabolically active cells emit volatile organic compounds (VOCs) that can be used in real time to non-invasively monitor the health of cell cultures. We utilized these naturally occurring VOCs in an adapted culture method to detect differences in culturing Chinese hamster ovary (CHO) cells with and without Staphylococcus epidermidis and Aspergillus fumigatus contaminations. The VOC emissions from the cell cultures were extracted and measured from the culture flask headspace using polydimethylsiloxane (PDMS)-coated Twisters, which were subjected to thermal desorption-gas chromatography-mass spectrometry (TD-GC-MS) analysis.

Evaluating tumour budding could improve the new grading system for lung adenocarcinoma.

Objectives: To study the prognostic significance of tumour budding (TB) compared with the grading of lung adenocarcinoma (LAC).

Materials And Methods: The postoperative haematoxylin and eosin-stained histological slices of 207 surgically treated LAC patients were retrospectively reviewed by a lung pathologist. Two groups were formed from the cohort: the high-grade TB group (≥10 buds) and low-grade TB group (0-9 buds).

Trans-bronchial forceps biopsy for COVID-19 related diffuse parenchymal lung abnormalities.

Purpose: The role of lung biopsy for evaluation of persistent chest radiographic abnormalities including secondary organizing pneumonia (OP) in COVID-19 remains uncertain. This study aimed to evaluate the diagnostic value of trans-bronchial forceps biopsy (TBFB) in patients with persistent lung abnormalities on thoracic computed tomography (CT) scan following SARS-CoV-2 infection with particular focus on cases with OP and immunocompromised (IC) patients.

Methods: Descriptive retrospective single center analysis of all TBFB performed for diffuse lung parenchymal changes after COVID-19 03-2020 to 06-2023.

Measurement of breast artery calcification using an artificial intelligence detection model and its association with major adverse cardiovascular events.

Breast artery calcification (BAC) obtained from standard mammographic images is currently under evaluation to stratify risk of major adverse cardiovascular events in women. Measuring BAC using artificial intelligence (AI) technology, we aimed to determine the relationship between BAC and coronary artery calcification (CAC) severity with Major Adverse Cardiac Events (MACE). This retrospective study included women who underwent chest computed tomography (CT) within one year of mammography.

Temporal Trends of Ischemic Stroke Risk in Patients With Incident Atrial Fibrillation Before Anticoagulation.

Background: Atrial fibrillation (AF) is a major risk factor for ischemic stroke (IS), but whether the magnitude of this risk has changed over time is unknown.

Objectives: This study sought to investigate temporal trends in IS rates in patients with incident AF before oral anticoagulant agent (OAC) therapy.

Methods: The nationwide FinACAF (Finnish Anticoagulation in Atrial Fibrillation) study covers patients with AF at all levels of care in Finland from 2007 to 2018.

Magnetic Resonance Imaging in the Assessment of the Risk of Sudden Death in Cardiac Sarcoidosis: What Is Extensive or Significant Late Gadolinium Enhancement?

Background: Cardiac sarcoidosis involves a significant but difficult-to-define risk of sudden cardiac death (SCD). Current guidelines recommend consideration of an implantable cardioverter defibrillator for patients with extensive or significant myocardial late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging. However, extensive/significant LGE is not defined.

Antenatal Steroids Enhance Long-Term Neonatal Lung Outcomes and are Associated with Placental Alterations in Experimental Chorioamnionitis.

Intrauterine inflammation from chorioamnionitis (CA) is associated with placental dysfunction and increased risk of bronchopulmonary dysplasia (BPD), the chronic lung disease of prematurity. Antenatal steroid (ANS) treatment improves early respiratory outcomes for premature infants. However, it remains unclear whether ANS improve long-term respiratory outcomes, and whether these effects are mediated through improvement of placental dysfunction and/or direct impact on the fetal lung.

A Comparative Pharmacokinetics Study of Orally and Intranasally Administered 8-Nitro-1,3-benzothiazin-4-one (BTZ043) Amorphous Drug Nanoparticles.

BTZ043 is an 8-nitro-1,3-benzothiazin-4-one with potency against multidrug-resistant . Low solubility and hepatic metabolism are linked to poor oral bioavailability. Amorphous drug nanoparticles (ADN) were formulated to improve the bioavailability.

Understanding rare genetic variants within the terminal pathway of complement system in preeclampsia.

Preeclampsia is a common multifactorial disease of pregnancy. Dysregulation of complement activation is among emerging candidates responsible for disease pathogenesis. In a targeted exomic sequencing study of 609 women with preeclampsia and 2092 non-preeclamptic controls, we identified 14 variants within nine genes coding for components of the membrane attack complex (MAC, C5b-9) that are associated with preeclampsia.

Early career member highlights from the 22nd ERS Lung Science Conference: development of chronic lung diseases - from life-spanning mechanisms to preventive therapy.

https://bit.ly/4cbMjpS.

The Value of Repeat 5-HIAA Measurements as a Predictor of Carcinoid Heart Disease: A Prospective 5-Year Follow-Up Study in Patients with Small Intestinal Neuroendocrine Tumors.

Small intestinal neuroendocrine tumors (SI-NETs) are characterized by carcinoid syndrome and carcinoid heart disease (CHD). The aim of the present study was to identify early risk markers for carcinoid heart disease and survival in a prospective median-term follow-up setting. We measured 5-HIAA and cumulative 5-HIAA exposure (Cum-5-HIAA) based on repeated measurements, proBNP, vascular function, hepatic tumor load, and transthoracic echocardiography (TTE) at baseline and during the median 5-year follow-up.

Synchrotron-Based Phase-Contrast Micro-CT Combined With Histology to Decipher Differences Between Hereditary and Sporadic Pediatric Pulmonary Veno-Occlusive Disease.

Pulmonary veno-occlusive disease (PVOD) is a lethal variant of pulmonary hypertension. The degree of pulmonary arterial involvement varies. Here, we compare two PVOD patients who were transplanted at 8 years of age, whereof one is a homozygous mutation carrier.

HHV-6B, HHV-7, and B19V Are Frequently Found DNA Viruses in the Human Thymus but Show No Definitive Link with Myasthenia Gravis.

Myasthenia gravis (MG) is a rare autoimmune disorder characterised by muscle weakness resulting from autoantibody-mediated disruption of the neuromuscular junction. Notably, it is also frequently associated with thymic pathology. This study explores the relationship between MG and DNA viruses in the thymus, employing targeted NGS and qPCR to analyse thymic tissue samples from both MG patients and healthy controls.

Tuberculosis in adult migrants in Europe: a TBnet consensus statement.

Introduction: Global migration has increased in recent decades due to war, conflict, persecutions, and natural disasters, but also secondary to increased opportunities related to work or study. Migrants' risk of tuberculosis (TB) differs by reasons for migration, socioeconomic status, mode of travel and TB risk in transit, TB incidence and healthcare provision in country of origin. Despite advances in TB care for migrants and new treatment strategies, decisions for the management of migrants at risk of TB often rely on expert opinions, rather than clinical evidence.

How cardiac computed tomography angiography and positron emission tomography play complementary roles in a Practice's business model.

Cardiovascular imaging is fundamental and crucial for providing accurate diagnosis and guiding treatment. There are unique clinical benefits and uses of Cardiac CT as well as cardiac PET. There have been advances in cardiac PET as well as Cardiac CT which have led to novel applications.

Riociguat in pulmonary arterial hypertension: Application of the 4-strata COMPERA 2.0 risk assessment tool in the PATENT studies.

Background: Risk stratification is an essential part of evaluating disease severity in patients with pulmonary arterial hypertension (PAH). This study applied the 4-strata COMPERA 2.0 risk model to the Phase 3 PATENT-1/2 studies of riociguat.

ATP citrate lyase drives vascular remodeling in systemic and pulmonary vascular diseases through metabolic and epigenetic changes.

ATP citrate lyase (ACLY), a crucial enzyme in de novo lipid synthesis and histone acetylation, plays a key role in regulating vascular smooth muscle cell (VSMC) proliferation and survival. We found that human coronary and pulmonary artery tissues had up-regulated ACLY expression during vascular remodeling in coronary artery disease and pulmonary arterial hypertension. Pharmacological and genetic inhibition of ACLY in human primary cultured VSMCs isolated from the coronary arteries of patients with coronary artery diseases and from the distal pulmonary arteries of patients with pulmonary arterial hypertension resulted in reduced cellular proliferation and migration and increased susceptibility to apoptosis.

SPARCL1 and NT-proBNP as biomarkers of right ventricular-to-pulmonary artery uncoupling in pulmonary hypertension.

Aims: SPARCL1 was recently identified as a biomarker of right ventricular (RV) maladaptation in patients with pulmonary hypertension (PH), and N-terminal pro-brain natriuretic protein (NT-proBNP) is an established biomarker of RV failure in PH. The present study investigated whether NT-proBNP and SPARCL1 concentrations are associated with load-independent parameters of RV function and RV-to-pulmonary artery (RV-PA) coupling as measured using invasive pressure-volume (PV) loops in the RV.

Methods: SPARCL1 and NT-proBNP were measured in the plasma of patients with idiopathic pulmonary artery hypertension (IPAH, n = 73).

Association of Patients' Knowledge on the Disease and Its Management with Indicators of Disease Severity and Individual Characteristics in Patients with Chronic Obstructive Pulmonary Disease (COPD): Results from COSYCONET 2.

Background: In patients with chronic diseases, including those with chronic obstructive pulmonary disease (COPD), knowledge on the disease and its self-management is considered as relevant for improving disease control and long-term outcome. We studied to which extent components of knowledge depended on potential predictors, such as participation in educational programs and disease severity. For example, the perception of exacerbations or GOLD grade might modulate the content and reliability of COPD understanding.

Efficacy and Safety of Sotatercept Across Ranges of Cardiac Index in Patients with Pulmonary Arterial Hypertension: A Pooled Analysis of PULSAR and STELLAR.

Background: This analysis compared effects of the activin signaling inhibitor, sotatercept, across pulmonary arterial hypertension (PAH) subgroups stratified by baseline cardiac index (CI).

Methods: Pooled data from PULSAR (N=106; NCT03496207) and STELLAR (N=323; NCT04576988) were analyzed using two different CI thresholds, < and ≥ 2.0 L/min/m or 2.

The accuracy and adequacy of rapid on-site evaluation conducted by trained pulmonologist on transbronchial needle aspiration samples: A systemic review and meta-analysis.

Introduction: The effective deployment of rapid on-site cytologic evaluation (ROSE) requires the availability of a cytologist/pathologist. Several studies investigated the capability of trained pulmonologists to assess the adequacy and validity of transbronchial needle aspiration (TBNA) samples. This study aimed to determine the validity and adequacy of ROSE by pulmonologists (P-ROSE).