Why do some people develop persistent lung sequelae after severe COVID-19? Coronavirus Disease COVID AcuteRespiratoryDistress Blood CD4 Chemokine ScienceTM imperialcollege
By Suchandrima BhowmikJan 2 2023Reviewed by Danielle Ellis, B.Sc. Although most affected individuals recover fully, a significant proportion suffers long-term health consequences. These individuals experience a wide range of symptoms, termed the post–COVID-19 syndrome. In addition, pulmonary function impairment occurs in some affected individuals; however, its mechanism is still unclear.
Recent studies have identified an increase in CD4+T and CD8+ T lymphocytes associated with myeloid inflammation in patients with post–C OVID-19 lung parenchymal abnormalities. These studies help to understand the immunological landscape following recovery from acute COVID-19 but do not comprise an appropriate control group. Moreover, they are also unable to determine the protective and susceptible pathways associated with the development of persistent lung changes.
Participants with scores from 5 to 7 were categorized as severe, and those with 1 to 3 were mild. Nasal brushings and venous blood sampling of participants took place 3 to 6 months following hospital discharge, along with answering a quality-of-life questionnaire. Those with severe disease were additionally sampled six months after visit 2. Healthy participants were also recruited as controls and were sampled only once.
Furthermore, differences in nasal transcriptomes were also observed between individuals with post–COVID-19 interstitial changes compared to those with resolution. Fifty-three genes were observed to be upregulated in such individuals, mainly including neutrophilic inflammation/inflammasome or antiviral defense pathway genes. Moreover, enrichment of "cellular response to type I interferon" and "cytokine-mediated signaling pathway" were observed in these individuals.
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