Respiratory Care Currents

 Published: August 31, 2021

By: Debbie Bunch


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No Lung Damage Seen in COVID Patients Who Fully Recover

A multicenter observational study is helping answer a lingering question about people who survive a bout with COVID-19. Will they have lasting lung damage?  

The research involved analyzing lung tissue from people who had fully recovered from COVID-19 and then required surgery for unrelated lung nodules or lung cancer sometime later. Results showed no evidence of lung damage in benign lung tissue that had previously been infected with COVID-19 in any of the subjects.  

“Since the start of the pandemic, a big question has been whether COVID-19 will have long-term or permanent damage on our lungs,” said Zaid Abdelsattar, MD, MS, senior author of the study and thoracic and cardiovascular surgeon at Loyola Medicine. “This research provided us with the rare opportunity to study the asymptomatic survivors of COVID-19 and make observations to help us answer this question.” 

Previous research involving autopsy reports of patients who died of COVID-19, along with pathologic studies from those with end-stage lung disease caused by the virus, has shown a range of damage. But the authors of this study believe their results suggest people who fully recover are not likely to suffer lasting problems.  

The study was published by the Annals of Thoracic Surgery 

Three Million Asthmatics in the Line of Wildfire Smoke

Wildfire smoke may be adversely impacting three million people with asthma, report researchers from the University of Alabama in Huntsville who used satellite observations to locate the smoke in surface pollution. While much of the smoke has come from fires burning in Canada, fires in the western U.S. are also coming into play.  

“More than half of the U.S. states, especially the western U.S., have experienced significant short-term pollution increase due to wildfires,” said Zhixin (May) Xue, a second-year doctoral student in atmospheric science from China and the lead author of the research paper, which she wrote with her advisor and co-author, Dr. Sundar Christopher, a professor of atmospheric science. 

Results showed these states had 17-day mean inhalable particulate matter increases larger than 100% of the baseline value. Washington, California, Wisconsin, Colorado, and Oregon have been among the hardest hit.  

The authors suggest the northwestern U.S. experiences six to seven times more surface pollution in 24 hours than is deemed safe by the EPA.  

The was study published by Atmospheric Chemistry and Physics 


Antibiotics May Be Overused in Intubated COVID-19 Patients.

In a study supported by the NIH, investigators from Northwestern University analyzed 386 bronchoscopic bronchoalveolar lavage fluid samples from 179 COVID-19 patients with severe COVID pneumonia to help gauge the prevalence of a bacterial superinfection.  

Their results showed only 21% had a bacterial infection within 48 hours of intubation. Forty-four percent developed at least one episode of ventilator-associated pneumonia (VAP), and difficult-to-treat bacteria caused 20.8% of initial VAPs. 

Given these findings, they believe guideline-based empirical antibiotic management at intubation results in antibiotic overuse in these patients. Rapid diagnostic tests are the answer. 

“More accurate assessment other than just reviewing clinical parameters is needed to enable clinicians to avoid using antibiotics in the majority of these patients, but appropriately use antibiotics in the 20-25% who have a bacterial infection as well,” said study author Richard G. Wunderink, MD. 

The study was published by the American Journal of Respiratory and Critical Care Medicine 

Smaller Particles Would be Better

Is there room for improvement in the delivery of respiratory medications via pressurized metered-dose inhalers and dry powder inhalers? According to researchers from India and Australia, the answer is yes. 

They reached that conclusion after using computation fluid dynamics to determine how well these devices deliver drugs to the lungs. Results showed that more drug particles are deposited in the right bronchi than in the left bronchi and that the drugs should contain smaller-sized particles to enable them to reach the distal bronchi.  

“At higher flow rates, inertial impaction is found to be responsible for deposition of drug particles in the upper portion of the airways but with lesser availability of drug particles in the distal region of the airways,” said co-author Akshoy Ranjan Paul. “Additionally, at lower flow rates, there is not enough momentum to carry particles to the distal region. As a result, there should be an optimum flow rate [to achieve] maximum reach of drug particles in the distal region.” 

The research appeared in Physics of Fluids. 

Blood Test for Lung Cancer Now in the Works

Low-dose computed tomography screening is recommended for people considered at high risk of developing lung cancer, but less than 6% of those who could benefit from the screening take advantage of it. 

Nature Communications published a new study published that suggests a novel blood test might one day serve as an alternative to that testing. Researchers from Johns Hopkins worked with colleagues in Denmark and The Netherlands to screen nearly 800 high-risk individuals using an approach called DELFI, which spots unique patterns in the fragmentation of DNA shed from cancer cells in the bloodstream.  

The investigators found the DELFI test helped detect 94% of patients with cancer across stages and subtypes, including 91% of patients with earlier or less invasive stage I/II cancers and 96% of patients with more advanced stage III/IV cancers.  

A clinical trial in the U.S. is now underway to evaluate a test based on the DELFI technology in 1,700 participants, including healthy participants, those with lung cancers, and those with other types of cancer.  

“DNA fragmentation patterns provide a remarkable fingerprint for early detection of cancer that we believe could be the basis of a widely available liquid biopsy test for patients with lung cancer,” said study author Rob Scharpf, PhD, associate professor of oncology at the Johns Hopkins Kimmel Cancer Center. 

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Debbie Bunch

Debbie Bunch is an AARC contributor who writes feature articles, news stories, and other content for Newsroom, the AARC website, and associated emailed newsletters. In her spare time, she enjoys reading, traveling, photography, and spending time with her children and grandchildren. Connect with Debbie by email or on AARConnect or LinkedIn.

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