Acute lung injury—from cannabis to COVID

Beasley, Mary Beth

doi:10.1038/s41379-021-00915-6

Cited by 15 publications

(12 citation statements)

References 85 publications

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“…DAD is described as progressing over a traditionally defined timeframe across three successive phases of presumably decreasing reversibility: exudative (first 7 days from onset), organizing (7-21 days), and fibrotic (beyond 21 days). 25 Autopsy studies of H1N1 influenza in the US suggest rapid progression to fatal DAD with antemortem duration of illness centered on 7-8 days 26 , 27 with phases of DAD observed at their expected time points: average time in hospital for deaths with exudative DAD was only 3.4 days, for deaths with progression to organizing DAD average time in hospital was 11.7 days, and for deaths with development of fibrosing DAD average time in hospital was 31.5 days. The microscopic chronology in COVID may be very different as indicated by at least one lung autopsy study performed in China.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal membrane oxygenation in COVID-19 compared to other etiologies of acute respiratory failure: A single-center experience

Yaqoob¹,

Greenberg²,

Huang³

et al. 2023

Heart & Lung

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Section: Discussionmentioning

confidence: 99%

Extracorporeal membrane oxygenation in COVID-19 compared to other etiologies of acute respiratory failure: A single-center experience

Yaqoob¹,

Greenberg²,

Huang³

et al. 2023

Heart & Lung

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“…Otherwise, the profile of clinical characteristics and comorbidities was similar between the early and late mortality groups, with all patients showing evidence of hypoxemia based on oxygen saturation or partial pressure of oxygen (Supplemental Table 1). Histopathological assessment of the postmortem examinations (Figure 1A) revealed JCI Insight 2022;7(11):e157608 https://doi.org/10.1172/jci.insight.157608 patterns of ALI (see Methods) (11,28), predominately DAD in 81.25% of the late COVID-19 mortality cases (13/16 cases) and 25% in the early COVID-19 mortality cases (2/8 cases) (Figure 1B). In 75% of the early mortality cases, signs of vascular congestion and capillary proliferation were observed (Supplemental Table 1 and Figure 1A) consistent with previous reports (11,13).…”

Section: Histopathology Of Early and Late Covid-19 Mortality From An ...mentioning

confidence: 99%

“…The main histological classification was based on presence or absence of ALI. ALI was diagnosed by presence of DAD or fibrin, affecting more than 1 slide and at least 5% of the slide area (11,28). Presence of vascular congestion and hemangiomatosis-like change was also analyzed (11).…”

Section: Covid-19 Case Definition and Sample Collectionmentioning

confidence: 99%

Immune and epithelial determinants of age-related risk and alveolar injury in fatal COVID-19

Chait¹,

Yilmaz²,

Shakil³

et al. 2022

JCI Insight

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“…Although many autopsy-studies of patients who died with ARDS report a two-to 5-fold increase of the weight of both lungs, they mainly concentrate on histology findings especially on DAD,presence of hyaline membranes and microthrombi in the capillary, the question of the sequence of events however is seldom addressed (153)(154)(155)(156)(157)(158)(159).…”

Section: Acute Respiratory Distress Syndrome (Ards):definition and Po...mentioning

confidence: 99%

SARS-CoV-2-Infection (COVID-19): Clinical Course and Cause(s) of Death

Ramadori¹

2022

Preprint

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Two years after first patients approached the emergency rooms of hospitals in Wuhan becouse of respiratory distress,thousend of SARS-CoV-2 infected persons continue to die every day worldwide.SARS-CoV-2-infected patients undergo a process of dehydration and malnutrition before they develop respiratory problems and approach the emergency room of a hospital.This is,in many cases, the consequence of high fever which causes massive loss of fluids. In addition loss of appetite, is responsible for the deficit of protein intake.Most of the virus-infected patients admitted to the emergency room are therefore hypovolemic and hypoproteinemic and suffer of respiratory distress accompanied by ground grass opacities at CT-scan of the lungs.Critically ill patients are treated following the guidelines for treatment of septic shock but with &bdquo;conservative“ fluid replacement and administration of diuretics to assure sufficient hourly urine production. The combination of conservative fluid administration with reduced protein content in the enterally administered diet, together with administration of diuretics, has severe hemodynamic consequenses in mostly aged,dehydrated,critically ill patients. Many of them will develop acute kidney injury in the next 24 hours.In most of the cases, patients continue to loose weight by loosing skeletal muscle mass. Ischemic damage in the lung capillaries is responsible for the acute respiratory distreass syndrome (ARDS) and for the hallmark of autoptic findings,diffuse alveolar damage (DAD) characterized by hyaline membrane formation,fluid invasion of the alveoli recruitment of some inflammatory cells and progressive arrest of blood flow in the pulmonary vessels.The consequence is progressive congestion , increase of lung weight and progressive hypoxia (progressive severity of ARDS).Sequestration of blood in the lungs worsen hypovolemia and ischemia in different organs.This is most probably responsible for recruitment of inflammatory cells and for persistance of elevated serum levels of positive acute-phase markers and of hypoalbuminemia. Autoptic studies have been performed mostly in patients who died in the ICU after SARS-CoV-2-infection because of progessive ARDS.In those patients, tubulus epithelium necrosis in the kidney is a frequent finding as it has been the case in the first SARS-CoV-1 pandemic.In the death certification charts, many times weeks after first symptoms have started ,cardiac arrest is the cause of death after respitatory insufficiency.Replacement therapy with sufficient amount of fluid and albumin should be part of the early individualized life-saving supportive measures avoiding mechanical ventilation.

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Acute lung injury—from cannabis to COVID

Cited by 15 publications

References 85 publications

Extracorporeal membrane oxygenation in COVID-19 compared to other etiologies of acute respiratory failure: A single-center experience

Extracorporeal membrane oxygenation in COVID-19 compared to other etiologies of acute respiratory failure: A single-center experience

Immune and epithelial determinants of age-related risk and alveolar injury in fatal COVID-19

SARS-CoV-2-Infection (COVID-19): Clinical Course and Cause(s) of Death

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