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The optimal linear combination algorithm is effective for noninvasive staging of liver fibrosis in CHB. However, linear combination has its own limitations; nonlinear methods may eventually reveal even clearer diagnostic results.

long-term evaluations of survivors of SARS, MERS, and ARDS (6,8, 12). Nevertheless, the long-term detrimental impact of these pulmonary sequalae on patient health and quality of life in survivors of ARDS is well established (13). Whether respiratory effects of COVID-19 hold similar implications has yet to be investigated. As such, our findings support long-term respiratory follow-up of mechanically ventilated patients with COVID-19. ConclusionsThe majority of invasively mechanically ventilated survivors of COVID-19 still had abnormal pulmonary function tests and residual changes on HRCT scans at 3 months after hospital discharge. Diminished diffusion capacity, diminished TLC, and fibrosis on HRCT were the dominant features. Our findings warrant intensive respiratory follow-up of mechanically ventilated patients with COVID-19. nAuthor disclosures are available with the text of this letter at www.atsjournals.org.

Aim:In this prospective study, we aimed to evaluate the efficacy and safety of tenofovir disoproxil fumarate (TDF) in Chinese chronic hepatitis B (CHB) patients after multiple nucleoside/nucleotide analog (NA) treatment failures.Methods: A total of 115 Chinese CHB patients with suboptimal response to two or more NA treatments were included in this study. All patients were changed to TDF (300 mg/day, oral administration) antiviral treatment for at least 72 weeks. Hepatitis B virus (HBV) polymerase (P) gene mutation screening for each patient was performed. In addition, virological, biochemical responses and estimated glomerular filtration rate (eGFR) of each patient at weeks 12, 24, 48 and 72 of TDF treatment were evaluated.Results: Seventy-six out of 115 patients had drugresistance mutations (R + ), including 27 with adefovir (ADV)-associated mutations (35.5%) and 49 with lamivudine (LMV)-associated mutations (64.5%). For all included patients, complete viral response (CVR) of HBV DNA (<100 IU/mL) was 57.4%, 69.6%, 74.8% and 86.1% at weeks 12, 24, 48 and 72 of TDF treatment, respectively. Alanine aminotransferase normalization and hepatitis B e-antigen seroclearance occurred in 77.3% and 23.2%, respectively, after 72-week TDF treatment. CVR at weeks 12, 24 and 48 was observed more commonly in patients with baseline HBV DNA of less than 10 6 IU/mL. There was no significant reduction of eGFR induced by the TDF treatment. Conclusion: Seventy-two-week treatment with TDF inChinese CHB patients with previously multiple NA treatment failures exhibited effective and safe outcomes, which were independent of baseline mutations conferring ADV or LMV resistance.