Although pulmonary fibrosis can occur in the absence of a clear-cut inciting agent, and without a clinically clear initial acute inflammatory phase, it is more commonly associated with severe lung injury. This may be due to respiratory infections, chronic granulomatous diseases, medications, and connective tissue disorders. Pulmonary fibrosis is associated with permanent pulmonary architectural distortion and irreversible lung dysfunction. Available clinical, radiographic, and autopsy data has indicated that pulmonary fibrosis is central to severe acute respiratory distress syndrome (SARS) and MERS pathology, and current evidence suggests that pulmonary fibrosis could also complicate infection by SARS-CoV-2. The aim of this review is to explore the current literature on the pathogenesis of lung injury in COVID-19 infection. We evaluate the evidence in support of the putative risk factors for the development of lung fibrosis in the disease and propose risk mitigation strategies. We conclude that, from the available literature, the predictors of pulmonary fibrosis in COVID-19 infection are advanced age, illness severity, length of ICU stay and mechanical ventilation, smoking and chronic alcoholism. With no proven effective targeted therapy against pulmonary fibrosis, risk reduction measures should be directed at limiting the severity of the disease and protecting the lungs from other incidental injuries.

Objective. The COVID-19 pandemic and annual influenza epidemic are responsible for thousands of deaths globally. With a similarity in clinical as well as laboratory findings, there is a need to differentiate these two conditions on chest CT scan. This paper attempts to use existing literature to draw out differences in chest CT findings in COVID-19 and influenza. Methods. A search was conducted using PubMed. 17 original studies on chest CT findings in COVID-19 and influenza were identified for full-text review and data analysis. Findings. COVID-19 and influenza share similar chest CT findings. The differences found show that COVID-19 ground-glass opacities are usually peripherally located with the lower lobes being commonly involved, while influenza has a central, peripheral, or random distribution usually affecting the five lobes. Vascular engorgement, pleural thickening, and subpleural lines were reported in COVID-19 patients. In contrast, pneumomediastinum and pneumothorax were reported only in studies on influenza. Conclusion and Relevance. COVID-19 and influenza have overlapping chest CT features with few differences which can assist in telling apart the two pathologies. Additional studies are needed to further define the differences and degree between COVID-19 and influenza.

The emergence and spread of the highly contagious novel coronavirus disease (COVID-19) have triggered the greatest public health challenge of the last century. Aside from being a primary respiratory disease, acute ischemic stroke has emerged as a complication of the disease. While current evidence shows COVID-19 could cause ischemic stroke especially in severe disease, there are similarities in the risk factors for severe COVID-19 as well as ischemic stroke, underscoring the complex relationship between these two conditions. The pandemic has created challenges for acute stroke care. Rapid assessment and time-sensitive interventions required for optimum outcomes in acute stroke care have been complicated by COVID-19 due to the need for disease transmission preventive measures. The purpose of this article is to explore the putative mechanisms of ischemic stroke in COVID-19 and the clinical characteristics of COVID-19 patients who develop ischemic stroke. In addition, we discuss the challenges of managing acute ischemic stroke in the setting of COVID-19 and review current management guidelines. We also highlighted potential areas for future research.

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Heavy metals, such as cadmium (Cd), lead (Pb) and zinc (Zn), are important environmental pollutants, particularly in urban areas with high anthropogenic pressure. The uptake and accumulation of Cd, Pb and Zn in vegetables (Amaranthus hybridus L.) grown in the valley bottom soils of some cities in southwestern Nigeria were investigated. The concentration of heavy metals in vegetable leaves ranged from 0.4 to 2.0 for Pb (CV, 33), 0.38 to 1.20 for Cd (CV, 25) and 8.2 to 30.4 for Zn (CV, 33). In the vegetable stems, the concentration ranged from 0.8 to 2.6 for Pb (CV = 33), 0.6 to 2.5for Cd (CV, 22) and 11.4 to 18.9 for Zn (CV, 35). Concentration of metals in vegetable roots ranged from 2.2 to 5.1 for Pb (CV, 33), 1.4 to 4.9 for Cd (CV, 22) and 10.2 to 29.0 for Zn (CV, 35). Transfer factors (TF) were in the range of 0.22 and 3.00, with Cd having the highest TF of 3.00. Estimated intake vegetables in µg day −1 ranged from 72 to 82 for Cd, 69 to 120 for Pb and 105 to 200 for Zn. The intakes were above the recommended minimum risks levels. Potential risks, particularly for Cd and Pb intake, exceed the daily requirement for consumers of the leafy vegetable at all the sites. The apparent influence of anthropogenic inputs from the cities to these valleys was reflected by the higher concentrations than the reference location. Food quality assurance systems in vegetables grown in urban valley bottoms need to comply with the world standard on heavy metal concentration.