Background. Novel coronavirus disease 2019 (COVID-19) was discovered in December 2019 and has infected more than 80 million people worldwide, and more than 50 million people have achieved a clinical cure. In this study, the pulmonary function results of patients after clinical medicine for three months were reported. Objective. To investigate the effect of COVID-19 on lung function in patients. Methods. A retrospective analysis was performed on 56 COVID-19-infected patients who were cured after the clinical treatment at Taizhou Public Health Medical Center in Zhejiang Province from January 31, 2020, to March 10, 2020. At discharge and three months after discharge, lung function was measured, including inspiratory vital capacity (IVC), forced vital capacity (FVC), forced expiratory volume in first second (FEV1), forced expiratory volume in first second to inspiratory vital capacity (FEV1/IVC), maximum mid-expiratory flow rate (MEF), peak expiratory flow rate (PEF), and carbon monoxide dispersion (DLCO). Results. At discharge, there were 37 patients (66.1%) with pulmonary dysfunction, 22 patients (39.3%) with ventilation dysfunction, 31 cases (55.4%) with small airway dysfunction, and 16 cases (28.6%) with restricted ventilation dysfunction combined with small airway dysfunction. At 3 months after discharge, 24 of the 56 patients still had pulmonary dysfunction and all of them had small airway dysfunction, of which 10 patients (17.9%) were restricted ventilation dysfunction combined with small airway dysfunction. DLCO was measured three months after discharge. Twenty-nine patients (51.8%) had mild to moderate diffuse dysfunction. All pulmonary function indexes of 56 patients recovered gradually after 3 months after release, except FEV1/IVC, and the difference was statistically significant ( < 0.05). There were 41 patients of normal type (73.2%) and 15 patients of severe type (26.8%). Among the 15 severe patients, 8 patients (53.3%) had ventilation dysfunction at discharge, 9 patients (60%) had small airway dysfunction, 4 patients (26.7%) still had ventilation dysfunction 3 months after discharge, 7 patients (46.7%) had small airway dysfunction, and 10 patients (66.7%) had diffuse dysfunction. Among the 41 common type patients, 14 patients (34.1%) had ventilation dysfunction at discharge, 22 patients (53.7%) had small airway dysfunction, 6 patients (14.6%) still had ventilation dysfunction 3 months after discharge, 17 patients (41.5%) had small airway dysfunction, and 19 patients (46.3%) had diffuse dysfunction. Patients with severe COVID-19 had more pulmonary impairment and improved pulmonary function than normal patients. Conclusion. COVID-19 infection can cause lung function impairment, manifested as restricted ventilation dysfunction, small airway dysfunction, and diffuse dysfunction. The pulmonary function of most patients was improved 3 months after clinical cure and discharge, and some patients remained with mild to moderate diffuse dysfunction and small airway dysfunction.

PD-L1 is one of the current biomarkers for immune checkpoint inhibitor (ICI) therapy in patients with non-small-cell lung cancer. However, the expression of PD-L1 in the real world and its related influencing factors remain unclear. We want to observe the expression of PD-L1 in the real world and study the related influencing factors through the collection and analysis of clinical data. R software (version 4.0) was used to perform data analysis and the “corplot” package for correlation analysis. A total of 296 individuals (mean [SD] age, 67 [9] years; 23%female) were assessed. According to the expression amount of PD-L1, the cohort was divided into low nonexpression group ( , 26.7%), low-expression group ( , 49.3%), and high-expression group ( , 23.5%). Age, gender, underlying diseases, smoking status, and PD-L1 expression level were not statistically significant. We found that the expression of PD-L1 was correlated with serum albumin ( ) and pathological type ( ) and had a negative correlation with EGFR mutation but did not correlate with gender, age, smoking status, combined with underlying diseases, tumor stage, whether it was initially treated or not, sampling site, specimen type, specimen storage time, R-IFN, CD4, CD8, NLR, CRP, and LDH. The present findings indicated that serum albumin, pathological type, and EGFR mutations are associated with PD-L1 expression in patients with NSCLC, which may provide a new basis for individualized immunotherapy and need further study to confirm. The results of this study help to further reveal the actual expression of PD-L1 in non-small-cell lung cancer patients with real events.

Purpose. To investigate the recovery of lung function and chest imaging in patients with COVID-19 three months after clinical cure and discharge and the correlation between them. Methods. This study collected 80 patients diagnosed with 2019-nCoV infection who were discharged from the Taizhou Public Health Medical Center in Zhejiang Province between January 31, 2020, and March 10, 2020. Lung function examinations and lung CT scans were performed at discharge and three months after discharge. The dynamic changes examined at discharge and three months after discharge were observed, and their correlation was analyzed. All data collection ended on June 25, 2020. Results. Among the 80 COVID-19 patients discharged from the hospital, the rate of abnormality indicated by lung CT images was 97.5, mainly presenting as patchy shadows (95), ground-glass shadows (75), grid-like lesions, interlobular septal thickening or fiber strip shadows (30), consolidation shadows, and nodules (10 cases each). At discharge, 72 patients (90) had pulmonary dysfunction, 64 (80) had restrictive ventilatory dysfunction, and 48 (60) had small airway dysfunction. Three months after discharge, the rate of abnormality indicated by lung CT images was 12.5. Eight cases (10) showed residual patchy shadows, but the density was weak, and the scope was reduced. Two cases (2.5) showed nodular shadows. Three months after discharge, 18 patients (22.5) had residual restrictive ventilatory dysfunction, 28 patients (35) had small airway dysfunction, and 32 patients (40) had diffuse dysfunction. Moreover, patients with more severe chest imaging manifestations (bilateral lesions and ground-glass shadows combined with interstitial lesions) also had more obvious lung function impairment. Conclusion. Three months after being clinically cured, patients with COVID-19 had good chest imaging absorption and no residual fibrosis. Some patients had mild to moderate pulmonary dysfunction, mainly restricted ventilation dysfunction, small airway dysfunction, and diffuse dysfunction.

Background: This study aimed to examine the prognostic value of pericoronary adipose tissue (PCAT) attenuation at three months after transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis (AS) and obstructive coronary artery disease (CAD). Methods: This retrospective study included 226 patients with both obstructive CAD and AS who underwent TAVR. PCAT attenuation was measured three months post-TAVR using coronary computed tomography angiogram (CCTA) images. Univariable and multivariable Cox regression analyses were conducted to evaluate the association between PCAT attenuation and major adverse cardiac events (MACEs). Results: Of the 226 patients, 37 experienced MACEs during a median follow-up period of 1.5 years. High PCAT attenuation was significantly associated with MACEs (–65.3 Hounsfield units (HU) vs. –71.6 HU; p < 0.01). The optimal PCAT attenuation threshold of –67.5 HU, determined by receiver operating characteristic (ROC) curve analysis, showed 84% sensitivity and 75% specificity (area under the curve (AUC) = 0.88) for predicting MACEs. Multivariable Cox regression confirmed that higher PCAT attenuation was independently associated with an increased risk of MACEs (hazard ratio (HR) = 1.83, 95% confidence interval (CI): 1.44–2.32; p < 0.01). Inclusion of PCAT attenuation increased the C-index from 0.41 to 0.82 (p = 0.01) and the net reclassification improvement (NRI) by 0.55 (95% CI: 0.34–0.78; p = 0.01). Conclusions: PCAT attenuation was independently associated with the risk of MACEs in post-TAVR patients with obstructive CAD and AS, suggesting the potential utility of PCAT attenuation for risk stratification.

Background: Skeletal muscle depletion predicts poor outcomes in gastrointestinal cancers, but whether volumetric three-dimensional (3D) body composition adds anything over the standard two-dimensional (2D) single-slice approach in colorectal cancer (CRC) patients receiving chemoradiotherapy is unclear. We quantified CT-derived sarcopenia and directly compared 2D and 3D body composition metrics from a fully automated deep learning pipeline. Methods: We retrospectively analyzed 368 patients with CRC. Body composition was quantified automatically from CT using SMAT-BC, a pipeline combining TotalSegmentator-based vertebral localization with an nnU-Net Residual Encoder XL network incorporating a Transformer bottleneck for four-class tissue segmentation. Single-slice L3 (2D) and L1–L5 volumetric (3D) indices were derived. The primary endpoint was overall survival (OS); recurrence-free survival (RFS) was secondary. Cox proportional hazards models with bootstrap optimism correction were used. Measurement reproducibility was assessed in 25 external TCGA-COAD cases. Results: Sarcopenia was strongly associated with both overall and recurrence-free survival (unadjusted OS HR 2.16, 95% CI 1.55–3.00; unadjusted RFS HR 1.83, 95% CI 1.36–2.47; both raw p < 0.001; adjusted OS HR 1.89, 95% CI 1.57–2.28; adjusted RFS HR 1.44, 95% CI 1.22–1.70; FDR-adjusted p < 0.0001 for both). L3 single-slice indices were strongly correlated with volumetric indices (r = 0.91 for muscle index) and added discriminant value over the clinical model for overall survival (optimism-corrected C-index: clinical 0.602 (95% CI 0.578–0.626), clinical + 2D 0.631 (95% CI 0.609–0.654), clinical + 3D 0.599 (95% CI 0.574–0.624); DeLong p = 0.002 for clinical + 2D vs. clinical, FDR-adjusted p = 0.006). The 2D- and 3D-augmented models yielded overlapping bootstrap confidence intervals and were not clinically meaningfully different in this cohort (OS ΔC = +0.032, 95% CI +0.013 to +0.051; FDR-adjusted p = 0.006; RFS ΔC = +0.008, 95% CI −0.011 to +0.027; FDR-adjusted p = 0.612). Conclusions: Automated CT-derived sarcopenia is an independent predictor of survival in CRC patients receiving chemoradiotherapy. In our cohort, single-slice L3 measurement matched or exceeded volumetric discrimination, but the 2D- and 3D-augmented models yielded overlapping bootstrap confidence intervals for both endpoints: for overall survival, the DeLong FDR-adjusted p value for the 2D-versus-3D contrast was 0.006, and 0.612 for recurrence-free survival. Because no non-inferiority margin was pre-specified, the 2D–3D comparison is presented as exploratory, and we make no formal claim of non-inferiority or equivalence for either endpoint. The findings support single-slice L3 measurement as an efficient biomarker for risk stratification but warrant external validation in larger prospectively designed cohorts.