Background: Cystic fibrosis (CF) is an autosomal, recessive genetic disorder, caused by a mutation in the cystic fibrosis transmembrane conductance receptor regulator (CFTR) gene. Dysregulated mucous production, and decreased bronchial mucociliary clearance, results in increased susceptibility to bacterial and fungal infections. Recently, nontuberculous mycobacteria (NTM) infections were identified as an emerging clinical problem in CF patients. Aim: The aim of the present study was to assess the frequency of NTM isolations in CF patients hospitalized in the pulmonary department, serving as a hospital CF center, and to describe challenges concerning the recognition of NTMLD (nontuberculous mycobacterial lung disease) in those patients. Methods: Consecutive CF patients, who were hospitalized due to pulmonary exacerbations (PEX), in a single CF center, between 2010 and 2020, were retrospectively assessed for the presence of NTM in respiratory specimens. Clinical and radiological data were retrospectively reviewed. Results: Positive respiratory specimen cultures for NTM were obtained in 11 out of 151 patients (7%), mean age—35.7 years, mean BMI—20.2 kg/m², mean FEV1—58.6% pred. Cultures and phenotyping revealed the presence of Mycobacterium avium (M. avium)—in six patients, Mycobacterium chimaera (M. chimaera) in two, Mycobacterium kansasii (M. kansasii)—in one, Mycobacterium abscessus (M. abscessus)—in one, Mycobacterium lentifavum (M. lentiflavum)—in one. Simultaneously, respiratory cultures were positive for fungi in 91% of patients: Candida albicans (C. albicans)—in 82%, Aspergillus fumigatus (A. fumigatus)—in 45%. Clinical signs of NTMLD were non—specific, chest CT indicated NTMLD in five patients only. Conclusion: Due to non-specific clinical presentation, frequent sputum cultures for NTM and analysis of serial chest CT examinations are crucial for NTMLD recognition in CF patients. Further studies concerning the predictive role of fungal pathogens for NTMLD development in CF patients are needed.

The onset of the COVID-19 pandemic allowed physicians to gain experience in lung ultrasound (LUS) during the acute phase of the disease. However, limited data are available on LUS findings during the recovery phase. The aim of this study was to evaluate the utility of LUS to assess lung involvement in patients with post-COVID-19 syndrome. This study prospectively enrolled 72 patients who underwent paired LUS and chest CT scans (112 pairs including follow-up). The most frequent CT findings were ground glass opacities (83.3%), subpleural lines (72.2%), traction bronchiectasis (37.5%), and consolidations (31.9%). LUS revealed irregular pleural lines as a common abnormality initially (56.9%), along with subpleural consolidation >2.5 mm ≤10 mm (26.5%) and B-lines (26.5%). A strong correlation was found between LUS score, calculated by artificial intelligence percentage involvement in ground glass opacities described in CT (r = 0.702, p < 0.05). LUS score was significantly higher in the group with fibrotic changes compared to the non-fibrotic group with a mean value of 19.4 ± 5.7 to 11 ± 6.6, respectively (p < 0.0001). LUS might be considered valuable for examining patients with persistent symptoms after recovering from COVID-19 pneumonia. Abnormalities identified through LUS align with CT scan findings; thus, LUS might potentially reduce the need for frequent chest CT examinations.

Acute Eosinophilic Pneumonia (AEP) is a rare idiopathic disease caused by an accumulation of eosinophils in the pulmonary alveoli and interstitial tissue of the lungs. The onset of symptoms is acute; some patients develop respiratory failure. The diagnosis is based on clinical symptoms, diffuse interstitial infiltrates in the lungs on imaging studies, and eosinophilia exceeding 25% on bronchoalveolar lavage or pleural fluid smear. Smokers are primarily at increased risk for the disease. We present a case of venous thromboembolic disease (VTE) that developed in the course of AEP in a previously healthy male smoker. Complete remission of the disease was achieved with anticoagulation therapy combined with a low dose of steroids. Surprisingly, further diagnostics revealed the presence of thrombophilia: antithrombin (AT) deficiency and increased homocysteine level. According to our knowledge, this is the first case of VTE diagnosed in the course of AEP combined with thrombophilia.

Post-COVID-19 syndrome is associated with persistent inflammation and an elevated risk of late venous thromboembolism (VTE). The role of proinflammatory cytokines has been well documented in the acute phase of the disease, but their potential role in late post-COVID-19 VTE remains unknown. What is the prevalence of VTE among symptomatic post-COVID-19 patients, and which laboratory parameters could enhance the diagnostic accuracy for VTE in these patients? Consecutive patients with objectively confirmed previous SARS-CoV-2 infection, admitted to a single department of lung diseases in a tertiary hospital due to sustained symptoms of dyspnea and/or exercise intolerance, were included. Clinical assessment and laboratory testing, including cytokine profiling (Il-1β, IL-6, IL-8, IL-10, TNF-α), PAI-1, and ferritin, were performed. VTE events (pulmonary embolism and/or deep vein thrombosis) were confirmed by standard imaging. Clinical and laboratory parameters were compared between participants with and without VTE. 108 patients: 69 (63.9%) males and 39 (36.1%) females, entered the study. VTE episodes were diagnosed in 39.8% (16.7% in the course of COVID-19 and 23.1% after the acute phase of the disease). Patients who entered the study ≤6 months and >6 months from acute COVID-19 infection were compared. Median D-dimer concentration was higher in patients with VTE that occurred within 6 months from the COVID-19 diagnosis compared to the non-VTE group (607 ng/mL vs. 428 ng/mL, borderline significance, p = 0.0595). Median_IL-8 concentration was significantly higher in those who developed VTE more than 6 months after COVID-19 compared to non-VTE patients: 10.19 pg/mL vs. 6.61 pg/mL, respectively, p = 0.048. The same was noted for TNF-α (39.02 pg/mL vs. 24 pg/mL, respectively, p = 0.011). The best diagnostic utility for VTE prediction was obtained for TNF-α concentration in symptomatic patients diagnosed >6 months from acute COVID-19 infection (ROC AUC 0.73, 95% CI 0.57–0.91). TNF-α was an independent risk factor of VTE episodes in the whole study group. Detection of elevated IL-8 and TNF-α levels later than 6 months from acute COVID-19 disease may help to identify patients at increased risk of late venous thromboembolism; nevertheless, further studies are needed to validate this observation.