key: cord-0722282-u9fgqte6 authors: Li, Hongwei; Wu, Qian; Qin, Zhonghua; Hou, Xinwei; Zhang, Limin; Guo, Jin; Li, Yajie; Yang, Fangfei; Zhang, Yan; Wu, Qi; Li, Li; Chen, Huaiyong title: Serum levels of laminin and von Willebrand factor in COVID-19 survivors 6 months after discharge date: 2021-11-27 journal: Int J Infect Dis DOI: 10.1016/j.ijid.2021.11.032 sha: ec565036b59ddb5d983322846a0af5f4e54a5a0a doc_id: 722282 cord_uid: u9fgqte6 Objectives To evaluate clinical characteristics, pulmonary diffusion function, chest computerized tomography (CT), and serum lung cell damage indicators of coronavirus disease 2019 (COVID-19) survivors 6 months after discharge. Methods Data of COVID-19 survivors discharged from hospital between January 21, 2020 and January 11, 2021 and healthy controls were collected. Serum levels of surfactant D (SPD), the receptor for advanced glycation products (RAGE), laminin, and von Willebrand factor (vWF) were measured in healthy controls and COVID-19 survivors 6 months after discharge. The relationships between serum lung cell damage indicator levels and various parameters were explored. Results Fifty-two COVID-19 survivors (31 non-severe and 21 severe) and 30 controls were included. Serum levels of laminin in COVID-19 survivors 6 months after discharge were significantly higher than those in the controls. The increase was more significant in elderly and female patients. Serum levels of RAGE and vWF were not statistically different from those of the controls. However, 6 months after discharge, COVID-19 survivors with abnormal chest CT and those in the severe group had higher vWF levels. Conclusions COVID-19 patients had abnormal lung injury indicators 6 months after discharge. The recovery time after infection is currently unknown, and long-term observations are required. confirmed that the damage to AT2 cells and lung structures remained two 82 weeks after SARS-CoV-2 infection was treated (Shao et al., 2020) . To date, 83 there have been few reports on long-term changes of lung cell damage and 84 repair 6 months after SARS-CoV-2 infection was treated. 85 In this study, the serum levels of SPD, RAGE, laminin, and vWF in COVID-19 86 survivors were measured 6 months after discharge. By comparing clinical 87 characteristics, pulmonary diffusion function, chest computerized tomography 88 (CT) with the levels of these indicators in COVID-19 survivors 6 months after 89 discharge, an assessment can be made of the lung injury, lung regeneration, 90 and repair ability of patients who have recovered from SARS-CoV-2 infection. and lung imaging showing that the lesion had progressed significantly by > 105 50% within 24-48 h. Patients who did not meet the above criteria were 106 defined as the non-severe group. We excluded patients who died before the 107 follow-up, refused to participate in the follow-up, and left the local area and 108 could not complete the follow-up. lesions in a single lung lobe. A lung lobe without lesions was scored 0, while a 136 lung lobe with lesion area percentages was categorized into <25%, ≥25% to 137 <50%, ≥50% to <75%, and ≥75% scored 1, 2, 3, and 4, respectively. The total 138 score of the five lobe categories ranged from 0 to 20. Each CT image was 139 independently reviewed and scored by three radiologists, and the scores were 140 averaged to obtain the final score of the CT image. A score ≥1 indicated 141 abnormal chest CT, and a score of 0 indicated normal chest CT. The main symptoms were myalgia or fatigue (25%) and exertional dyspnea 177 (21%). All patients were treated with antiviral drugs during the acute infection 178 stage. The rate of corticosteroid use in patients severe COVID-19 (43%) was 179 higher than those with non-severe COVID-19 (6%) ( Table 1) . Pulmonary diffusion function tests 6 months after discharge were conducted in 181 51 patients (one patient was non-cooperative due to the presence of a 182 tracheal cannula). Seventeen patients with COVID-19 had abnormal 183 pulmonary diffuse function, including six with severe (30%) and 11 with non-184 severe COVID-19 (35.5%), although this was not significant (P=0.685) ( Table 185 S1 ). Forty-seven patients underwent chest CT (five patients refused). Eleven 187 patients presented with abnormal chest CT findings, including 10 with severe 188 (55.6%) and one with non-severe COVID-19 (3.4%) (P<0.001) ( Table 2) . Among them, six patients in the severe group showed fibrotic bands on chest 190 CT, and the difference was significant compared with non-severe COVID-19 191 patients (P=0.001) ( Table 2) . Figure 3 ). Variables, such as age, sex, symptoms, and pulmonary diffusion 216 function had no effect on serum vWF levels (Tables S2,S3,S5,S6) . 218 There were no differences in serum SPD and RAGE levels among groups with 220 different ages, sexes, disease severities, symptoms, pulmonary diffusion functions, 221 and chest CT findings (Tables S2-S7) . The role of angiopoietin-2 and surfactant protein-D levels in 450 SARS-CoV-2-related lung injury: A prospective, observational, cohort study Understanding RAGE, the 454 receptor for advanced glycation end products Evaluation of impairment/disability secondary to respiratory disorders Acute lung injury-from cannabis to COVID Age, obesity and hyperglycaemia: Activation of innate 463 immunity initiates a series of molecular interactions involving anionic surfaces 464 leading to COVID-19 morbidity and mortality. Med Hypotheses Biomarkers in acute lung injury Form and function: the laminin family of 470 heterotrimers Persistent Endotheliopathy in the Pathogenesis of Long COVID Syndrome Acute lung injury in patients with traumatic injuries: utility of a panel of 479 biomarkers for diagnosis and pathogenesis Outcome prediction in pneumonia induced ALI/ARDS by clinical 483 features and peptide patterns of BALF determined by mass spectrometry Tissue 486 distribution of ACE2 protein, the functional receptor for SARS coronavirus. A 487 first step in understanding SARS pathogenesis Fleischner Society: glossary of terms for thoracic imaging SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Impaired lung 497 regeneration after SARS-CoV-2 infection Pulmonary Manifestations of Acute Lung Injury More Than Just Diffuse Alveolar Damage Coronavirus Disease A Follow-Up Study of Lung 563 Function and Chest Computed Tomography at 6 Months after Discharge in 564 Patients with Coronavirus Disease 2019 3-month, 6-month, 9-month, 567 and 12-month respiratory outcomes in patients following COVID-19-related 568 hospitalisation: a prospective study Characteristics of and Important Lessons From the 572 COVID-19) Outbreak in China: Summary of a 573 Report of 72314 Cases From the Chinese Center for Disease Control and 574 Prevention Structural basis for the 577 recognition of SARS-CoV-2 by full-length human ACE2 Clinical course and outcomes 580 of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a 581 single-centered, retrospective, observational study 412 We would like to thank Editage (www.editage.com) for their writing support. The data used to support the findings of this study are available from the 437 corresponding author upon request.