Beyond the acute infection of coronavirus disease (COVID-19), concern has arisen about long-term effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The aim of our study was to analyze if there is any biomarker of fibrogenesis in patients with COVID-19 pneumonia capable of predicting post-COVID-19 pulmonary sequelae. We conducted a multicenter, prospective, observational cohort study of patients admitted to a hospital with bilateral COVID-19 pneumonia. We classified patients into two groups according to severity, and blood sampling to measure matrix metalloproteinase 1 (MMP-1), MMP-7, periostin, and VEGF and respiratory function tests and high-resolution computed tomography were performed at 2 and 12 months after hospital discharge. A total of 135 patients were evaluated at 12 months. Their median age was 61 (interquartile range, 19) years, and 58.5% were men. We found between-group differences in age, radiological involvement, length of hospital stay, and inflammatory laboratory parameters. Differences were found between 2 and 12 months in all functional tests, including improvements in predicted forced vital capacity (98.0% vs. 103.9%; P = 0.001) and Dl CO <80% (60.9% vs. 39.7%; P = 0.001). At 12 months, 63% of patients had complete high-resolution computed tomography resolution, but fibrotic changes persisted in 29.4%. Biomarker analysis demonstrated differences at 2 months in periostin (0.8893 vs. 1.437 ng/ml; P < 0.001) and MMP-7 (8.7249 vs. 15.2181 ng/ml; P < 0.001). No differences were found at 12 months. In multivariable analysis, only 2-month periostin was associated with 12-month fibrotic changes (odds ratio, 1.0013; 95% confidence interval, 1.0006–1.00231; P = 0.003) and 12-month Dl CO impairment (odds ratio, 1.0006; 95% confidence interval, 1.0000–1.0013; P = 0.047). Our data suggest that early periostin postdischarge could predict the presence of fibrotic pulmonary changes.

Idiopathic pulmonary fibrosis is an interstitial lung disease of unknown etiology with a highly compromised prognosis and a significant mortality rate within a few years of diagnosis. Despite being idiopathic, it has been shown that telomeric shortening could play an important role in its etiopathogenesis. Mutations in telomere-related genes have been identified, but they are not always present despite telomere shortening. On the other hand, this telomeric shortening has been linked to a worse prognosis of the disease independently of other clinical factors, implying it may serve as a biomarker.

Background: Concern has risen about the effects of COVID-19 in interstitial lung disease (ILD) patients. The aim of our study was to determine clinical characteristics and prognostic factors of ILD patients admitted for COVID-19. Methods: Ancillary analysis of an international, multicenter COVID-19 registry (HOPE: Health Outcome Predictive Evaluation) was performed. The subgroup of ILD patients was selected and compared with the rest of the cohort. Results: A total of 114 patients with ILDs were evaluated. Mean ± SD age was 72.4 ± 13.6 years, and 65.8% were men. ILD patients were older, had more comorbidities, received more home oxygen therapy and more frequently had respiratory failure upon admission than non-ILD patients (all p < 0.05). In laboratory findings, ILD patients more frequently had elevated LDH, C-reactive protein, and D-dimer levels (all p < 0.05). A multivariate analysis showed that chronic kidney disease and respiratory insufficiency on admission were predictors of ventilatory support, and that older age, kidney disease and elevated LDH were predictors of death. Conclusions: Our data show that ILD patients admitted for COVID-19 are older, have more comorbidities, more frequently require ventilatory support and have higher mortality than those without ILDs. Older age, kidney disease and LDH were independent predictors of mortality in this population.

The SARS-CoV-2 coronavirus is responsible for the COVID-19 pandemic resulting in a global health emergency. Given its rapid spread and high number of infected individuals, a diagnostic tool for a rapid, simple, and cost-effective detection was essential. In this work, we developed a COVID-19 diagnostic test, that incorporates a human internal control, based on the Reverse Transcription Loop-Mediated Isothermal Amplification (RT-LAMP). When working with synthetic SARS-CoV-2 RNA, the optimized RT-LAMP assay has a sensitivity of 10 viral copies and can be detected by fluorescence in less than 15 min or by the naked eye in 25 min using colorimetric RT-LAMP. To avoid the RNA extraction step, a pre-treatment of the sample was optimized. Subsequently, a validation was performed on 268 trypsin treated samples (including nasopharyngeal, buccal, and nasal exudates) and amplified with colorimetric RT-LAMP to evaluate its sensitivity and specificity in comparison with RT-qPCR of extracted samples. The validation results showed a sensitivity and specificity of 100% for samples with Ct ≤ 30. The rapid, simple, and inexpensive RT-LAMP SARS-CoV-2 extraction-free procedure developed may be an alternative test that could be applied for the detection of SARS-CoV-2 or adapted to detect other viruses present in saliva or nasopharyngeal samples with higher sensitivity and specificity of the antibody test.

Coronavirus disease 2019 (COVID‐19) global pandemic has affected more than 600 million people up to date. The symptomatology and severity of COVID‐19 are very broad, and there are still concerns about the long‐term sequelae that it can have on discharged patients. The development of pulmonary fibrotic sequelae after this infection is especially worrying. Our aim was to determine if there was a metabolomic signature that could predict the development of pulmonary fibrotic sequelae. It is a multicenter prospective observation subcohort based on the COVID‐FIBROTIC study. A metabolomic analysis was performed by nuclear magnetic resonance (NMR) on serum samples from patients admitted with bilateral COVID‐19 pneumonia collected 2 months after hospital discharge. One year after admission, clinical, functional and radiological data were collected from these same patients. Finally, 109 patients (mean age 57.68 [DS14.03], 65.13% male) were available. Fibrotic sequelae 1 year after COVID‐19 disease were found in 33% of them. Based on the NMR analysis of the serum samples, it was possible to distinguish with 80.82% of sensitivity, 72.22% of specificity and 0.83 of an area under the curve (AUC) value which patients would have radiological signs of pulmonary fibrotic pattern 1 year after sample collection. According to the metabolites participating in the discriminative model and the univariate statistics, glucose, valine, and fatty acids (═CH–CH2–CH═) were suggested as potential biomarkers of the development of pulmonary fibrotic sequelae after COVID‐19. Trial Registration Number: clinicaltrials.gov NCT04409275 (June 1, 2020).

Background: Sarcoidosis is a highly heterogeneous disease, leading to differences in clinical practices across countries. This study aimed to identify similarities and differences in diagnostic, therapeutic, and follow-up practices for sarcoidosis across European coun-tries. Methods: Within the Joint Action on REspiratory Diseases (JARED) project, we conducted a multinational, cross-sectional study using a key informant expert survey. The structured survey comprised 48 questions on adult sarcoidosis diagnostics and management. Rep-resentatives of all 15 JARED project countries completed the electronic survey. Results: Sarcoidosis and/or interstitial lung disease centres are present in 12 countries, but only 7 have national guidelines for diagnosis and treatment. In most countries, bron-choscopy with bronchoalveolar lavage and endobronchial ultrasound-guided lymph node biopsy are performed. The use of bronchoscopic lung biopsies, particularly cryo-biopsies, varies considerably. To assess the extent and activity of the disease, almost all countries perform extended pulmonary function testing, but there are variations in the use of hypercalcaemia and hypercalciuria tests. Positron emission tomography is used routinely only in 4 countries. Around half of the patients are treated with corticosteroids. In most cases, treatment is initiated when an organ other than the lungs is affected or when severe pulmonary function impairment is present. The follow-up intervals range from 1 to 12 months. The monitoring strategies vary based on the radiological stage of sarcoidosis or the severity of the disease. Conclusions: Our survey highlights substantial variation in sarcoidosis management across Europe, underscoring the need for updated, evidence-based recommendations on diagnostic strategies, treatment initiation and duration, and long-term follow-up.