Reduced Pathogenicity of the SARS-CoV-2 Omicron Variant in Hamsters

The SARS-CoV-2 Omicron (B.1.1.529) variant has proven highly transmissible and has outcompeted the Delta variant in many regions of the world. Early reports have also suggested that Omicron may result in less severe clinical disease in humans. Here we show that Omicron is less pathogenic than prior SARS-CoV-2 variants in Syrian golden hamsters. Infection of hamsters with the SARS-CoV-2 WA1/2020, Alpha, Beta, or Delta strains led to 4-10% weight loss by day 4 and 10-17% weight loss by day 6, as expected. In contrast, infection of hamsters with two different Omicron challenge stocks did not result in any detectable weight loss, even at high challenge doses. Omicron infection still led to substantial viral replication in both the upper and lower respiratory tracts and pulmonary pathology, but with a trend towards higher viral loads in nasal turbinates and lower viral loads in lung parenchyma compared with WA1/2020 infection. These data suggest that the SARS-CoV-2 Omicron variant may result in more robust upper respiratory tract infection but less severe lower respiratory tract clinical disease compared with prior SARS-CoV-2 variants.

COVID-19 Pulmonary Pathology: The Experience of European Pulmonary Pathologists throughout the First Two Waves of the Pandemic

Autoptic studies of patients who died from COVID-19 constitute an important step forward in improving our knowledge in the pathophysiology of SARS-CoV-2 infection. Systematic analyses of lung tissue, the organ primarily targeted by the disease, were mostly performed during the first wave of the pandemic. Analyses of pathological lesions at different times offer a good opportunity to better understand the disease and how its evolution has been influenced mostly by new SARS-CoV-2 variants or the different therapeutic approaches. In this short report we summarize responses collected from a questionnaire survey that investigated important pathological data during the first two pandemic waves (spring-summer 2020; autumn-winter 2020–2021). The survey was submitted to expert lung pathologists from nine European countries involved in autoptic procedures in both pandemic waves. The frequency of each lung lesion was quite heterogeneous among the participants. However, a higher frequency of pulmonary superinfections, both bacterial and especially fungal, was observed in the second wave compared to the first. Obtaining a deeper knowledge of the pathological lesions at the basis of this complex and severe disease, which change over time, is crucial for correct patient management and treatment. Autoptic examination is a useful tool to achieve this goal.

Pulmonary comorbidity in chronic lymphoproliferative diseases: realities of the problem in the Dnipro region

The prevalence of the chronic lymphoproliferative diseases is increasing worldwide with increase of the population age. It is known that the presence of comorbidities in such patients plays an important role in predicting treatment outcomes. The aim of the work was to study the prevalence and determine the structure of respiratory symptoms and comorbid pulmonary pathology in patients with chronic lymphoproliferative diseases (CLPD) in the Dnipro region of Ukraine. After analyzing 986 cards of inpatients of the hematology department, whose average age was 65 (56; 69) years, it was determined that 9.0% of patients had at least one chronic respiratory disease, the most common among which were chronic bronchitis, chronic obstructive pulmonary disease, as well as community-acquired pneumonia. Dyspnea and tachypnea are also common among patients with CLPD without established respiratory comorbidity, cardiovascular disease, or anemia. Based on the data obtained, we can recommend a study of the respiratory function and pulse oximetry, as well as a thorough collection of anamnesis of smoking and analysis of the results of chest computed tomography in all patients with CLPD in order to identify the possible cause of shortness of breath and establish the presence of respiratory comorbidity.

POSSIBILITIES OF COMPUTED TOMOGRAPHY IN THE DIAGNOSIS OF PNEUMONIA ASSOCIATED WITH COVID-19

Актуальность проблемы быстрой и точной диагностики пневмонии, ассоциированной с covid-19, в период присвоения коронавирусной инфекции (covid-19) статуса пандемии, безусловно бесспорна. Своевременная диагностика влияет на прогноз заболевания. Цель оценить возможности КТ при выявлении пневмонии, ассоциированной с covid-19 и уточнения стадии развития пневмонии. Материал и методы. Исследования проводились на мультиспиральном компьютерном томографе SOMATOM Difinition AS (Siemens). В исследования включены пациенты, прошедшие КТ грудной полости с 01.06.2020. по 31.08.2020. из базы Центральной Городской Клинической Больницы (ЦГКБ) г.Алматы. Результаты КТ оценивали визуальным методом. Визуальную оценку осуществляли с использованием трехплоскостной реформации изображений, что позволяло определить локализацию, контуры, протяженность измененных участков легочной ткани. Результаты. По данным проведенных обследований у большинства пациентов были выявлены признаки воспалительных изменений в легких, которые оценивались рентгенологами нашей клиники с учетом уже известных на тот момент специфических паттернов, характерных для пневмонии, ассоциированной с covid-19. По результатам КТ органов грудной клетки при дифференциальной диагностике пневмонии, ассоциированной с covid-19 от другой легочной патологии. Специфичность составила 88%. Заключение. КТ органов грудной полости является высокоспецифичным методом исследования при диагностике пневмонии, ассоциированной с covid-19. The urgency of the problem of rapid and accurate diagnosis of pneumonia associated with covid-19 during the assignment of coronavirus infection (covid-19) pandemic status is certainly indisputable. Timely diagnosis affects the prognosis of the disease. The aim is to evaluate the possibilities of CT in detecting pneumonia associated with covid-19 and to clarify the stage of development of pneumonia. Material and methods. The studies were carried out on a multispiral computed tomograph SOMATOM Difinition AS (Siemens). The study included patients who underwent CT of the thoracic cavity from 01.06.2020. to 31.08.2020. from the base of the Central City Clinical Hospital (CGKB) in Almaty. CT results were evaluated by visual method. Visual assessment was carried out using a three-plane image reformation, which made it possible to determine the localization, contours, and extent of the altered areas of lung tissue. Results. According to the conducted examinations, most patients showed signs of inflammatory changes in the lungs, which were evaluated by radiologists of our clinic taking into account the specific patterns already known at that time, characteristic of pneumonia associated with covid-19. According to the results of CT of the chest organs in the differential diagnosis of pneumonia associated with covid-19 from other pulmonary pathology. The specificity was 88%. Conclusion. CT of the thoracic cavity is a highly specific method of investigation in the diagnosis of pneumonia associated with covid-19.

Haloaerosoltherapy: Mechanisms of Curative Effect and Place in the Respiratory Rehabilitation

Introduction. Management of patients with chronic pathology requires development of long-term programs with organic combinations of medicamental and non-medicamental influences. Haloaerosoltherapy is a group inhalation of rock salt aerosol with concentration of more than 2-3mg/m3 and certain dispersion (with presence of large-, medium- and small-grained aerosol) aboveground. Material and method. On the basis of literature data review and results of own researches a comprehensive description of haloaerosoltherapy, its mechanisms, available technologies, indications and effectiveness at pulmonary pathology was given. Results and discussion. Basis of haloaerosol curative influence is hyperosmolar stimulus that improves drainage function of bronchi and provides sanitizing effect, which causes further changes at local and systemic levels. This justifies haloaerosoltherapy usage as method of rehabilitation treatment. Comparison of haloaerosoltherapy and other methods of halotherapy (use of halite), in particular, "salt rooms (caves)" was made. It has been proven that "salt rooms" can be used only as spa procedure. Conclusions. Application of term "halotherapy" to all methods that use halite or underground treatment is incorrect. This determines necessity for stop using this term. It is necessary to differentiate clearly applied methods of treatment using terms that reflect the essence of therapeutic effect. Haloaerosoltherapy should be considered a method of respiratory rehabilitation with a proven mechanism of action and effectiveness. Haloaerosol is obtained using specific devices - halogenegenerators. The effectiveness of haloaerosoltherapy immediately after the course of treatment and in remote period is testified. Keywords: Respiratory rehabilitation, halotherapy, haloaerosoltherapy, speleotherapy,

Assessment of Mortality and Morbidity in Covid patients with Previous Pulmonary Pathology of SKZH/CMH

Aim: To study the severity of symptoms, rates of mortality and morbidity in COVID patients with and without previous pulmonary pathology. Methodology: The cohort study consisted of 244 patients and nearly all the individuals had underlying diseases. Data collection forms included demographic data, medical history, history of exposure to infection, symptoms, signs, laboratory findings, HRCT results, treatment measures especially history of corticosteroid use, and duration of illness. Results: In 244 patients, 180 patients were having the pulmonary pathology and other 64 were having no pulmonary pathology. 77.2% (139/180) of the patients showed severe symptoms in the previous pulmonary pathology while 21.8% (10/64) showed severe symptoms in the group with no pulmonary pathology. 16.1% (29/180) patients died because of COVID and were also having pulmonary pathology. While 10.9% (7/64) patients died in the group having no pulmonary pathology. Conclusion: In this study, 16.1% patients died of COVID with pulmonary pathology. While 10.9% patients died having no pulmonary pathology. 77.2% of the patients showed severe symptoms with previous pulmonary pathology while 21.8% showed severe symptoms with no pulmonary pathology. Keywords: Covid-19, Mortality, morbidity

ChAdOx1 nCoV-19 (AZD1222) protects Syrian hamsters against SARS-CoV-2 B.1.351 and B.1.1.7

We investigated ChAdOx1 nCoV-19 (AZD1222) vaccine efficacy against SARS-CoV-2 variants of concern (VOCs) B.1.1.7 and B.1.351 in Syrian hamsters. We previously showed protection against SARS-CoV-2 disease and pneumonia in hamsters vaccinated with a single dose of ChAdOx1 nCoV-19. Here, we observe a 9.5-fold reduction of virus neutralizing antibody titer in vaccinated hamster sera against B.1.351 compared to B.1.1.7. Vaccinated hamsters challenged with B.1.1.7 or B.1.351 do not lose weight compared to control animals. In contrast to control animals, the lungs of vaccinated animals do not show any gross lesions. Minimal to no viral subgenomic RNA (sgRNA) and no infectious virus can be detected in lungs of vaccinated animals. Histopathological evaluation shows extensive pulmonary pathology caused by B.1.1.7 or B.1.351 replication in the control animals, but none in the vaccinated animals. These data demonstrate the effectiveness of the ChAdOx1 nCoV-19 vaccine against clinical disease caused by B.1.1.7 or B.1.351 VOCs.

Multiple subpleural cysts in the lungs in a child with Down’s syndrome

Down’ssyndrome is the most common chromosomal abnormality in live births. Due to the complete or partialtrisomy of chromosome 21the Down’s syndrome causes cognitive impairment, dysmorphic features and congenital mal formations. Pulmonary disease is the most common cause of death in patients with Down’s syndrome. The article highlights the pulmonological problems of the patients, and it also describes a clinical case of a child with Down’s syndrome with pulmonary pathology.

Contralateral pneumothorax after central line placement in COVID-19 positive patients

Contralateral pneumothorax after percutaneous central venous catheter placement has not been previously reported. Three patients who required intubation and mechanical ventilation for acute respiratory failure due to COVID-19 were identified with a new pneumothorax on routine post-placement chest roentgenogram on the side opposite the catheter placement. Retrospective review of charts, radiographs, and laboratory studies. No causative relationship was identified between the percutaneous placement of the central venous catheters and the subsequent pneumothoraces identified on the contralateral side, other than the presence of active COVID-19 viral pneumonia. The timing of the contralateral pneumothoraces were coincidental the placement of the central venous catheters. We believe these pneumothoraces were a consequence of the pulmonary pathology of the COVID-19 virus.