Patients at risk of pulmonary fibrosis Post Covid-19: Epidemiology, pulmonary sequelaes and humoral response

  1. Miriam Hernández Porto
  2. Teresa Delgado
  3. Armando Aguirre-Jaime
  4. María Jose Ramos
  5. Silvia Campos
  6. Orlando Acosta
  7. Ana Belén Llanos
  8. María Lecuona

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Abstract

Background

The COVID-19 pandemic is one of the greatest public health problems. Our aims were to describe epidemiological characteristics, know the amount of protective antibodies and their permanence after a COVID-19 primary infection in patients with risk of pulmonary fibrosis.

Methods

Descriptive epidemiological and follow-up study of the humoral response in patients at risk of pulmonary fibrosis Post-Covid-19 hospitalized, between March and October 2020, and who were followed up for a one year after hospital discharge.

Results

72 patients participated in the study, 52 showed pre-existing chronic comorbidities. COVID-19 clinical severity was rated in 6% mild, 58% as moderate and 36% as severe. After a year of follow-up, the forty percent had pulmonary sequelae, the most frequent (20%) was mild pulmonary fibrosis. Any case of reinfection was detected. All patients presented RBD IgG antibodies and 88% presented IgA antibodies after 8-9 months. The amount of RBD IgG was similar at 4-5 and 8-9 months post-Covid. There was no difference when level of RBD IgG according to the severity of the COVID-19 (p=0.441, p=0.594).

Conclusions

Mild pulmonary fibrosis sequelae is exceptional but was detected in a high percentage. The amount of RBD IgG is maintained throughout the convalescent phase and seems to protect against new reinfections despite of emerging viral variants. However, seems not predict the developed or not of pulmonary fibrosis.

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  1. ScreenIT

    SciScore for 10.1101/2022.03.04.22271920: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsConsent: Patient volunteers signed their informed consent and were subsequently scheduled for serum sampling at 4-5 months and 8-9 months after COVID-19 infection.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    We analyzed different antibodies; RBD-specific IgG, Nucleocapsid IgG, and Spike 1-RBD IgM antibodies determined by Abbott chemiluminescent microparticle assays (CMIA): SARS-CoV-2 IgG II Quant, SARS-CoV-2 IgG and SARS-CoV-2 IgM using the ARCHITECT i 2000 SR system, following the manufacturer’s instructions.
    RBD-specific IgG, Nucleocapsid IgG
    suggested: None
    IgM
    suggested: (LSBio (LifeSpan Cat# LS-C57175-2000, RRID:AB_10560203)
    SARS-CoV-2 IgG
    suggested: None
    IgG RBD measurements were transformed to the WHO [7] international standard BAU/mL in order to obtain comparable of antiSARS-CoV-2 antibody quantification at the international level.
    antiSARS-CoV-2
    suggested: None
    IgA Spike and IgM Nucleocapsid antibodies were determined using EUROIMMUN enzyme-linked immunosorbent assay (ELISA); Anti-SARS-CoV-2 ELISA IgA and Anti-SARS-CoV-2 NCP ELISA IgM (Euroinmmun, Lübeck, Germany) according to the manufacturer’s instructions on the Dynex DS2 ELISA System platform.
    Anti-SARS-CoV-2 ELISA IgA
    suggested: None
    Anti-SARS-CoV-2 NCP ELISA IgM
    suggested: None
    Software and Algorithms
    SentencesResources
    All hypothesis contrast tests were bilateral at a significance level p≤0.05 and the calculations involved were performed with the support of the SPSS 25.0™ statistical data processing package from IBM Co®.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There are some limitations to this study. The first one is that the sample size is small, which undermines the power of the study. On the other hand, in our study the majority of patients suffered a moderate-severe degree of severity of the disease, who were those who required follow-up by the multidisciplinary consultation, so that the humoral immune response profile cannot be applied to patients with a mild degree of severity or to asymptomatic patients. Another limitation is that even if no new reinfections were detected, these may have been asymptomatic, however, these patients have a greater neutralizing capacity thanks to the positivity of IgG and IgA. Taking these limitations into consideration, our study describes a high percentage of mild pulmonary fibrosis development in patients who presented at least one of the following conditions: persistence of pathological alterations in the chest X-ray and/or having required special ventilatory support devices during their admission.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  2. Version published to 10.1101/2022.03.04.22271920v1 on medRxiv
  3. Version published to 10.26502/acbr.50170299