Persistent pulmonary pathology after COVID-19 is associated with high viral load, weak antibody response, and high levels of matrix metalloproteinase-9

• Published in: Scientific reports
• Main Authors: Lerum, Tøri Vigeland, Maltzahn, Niklas, Aukrust, Pål, Trøseid, Marius, Nezvalova-Henriksen, Katerina, Kåsine, Trine, Dyrhol-Riise, Anne Ma, Stiksrud, Birgitte, Haugli, Mette, Blomberg, Bjørn, Kittang, Bård Reiakvam, Johannessen, Asgeir, Hannula, Raisa, Aballi, Saad, Kildal, Anders Benjamin, Eiken, Ragnhild, Dahl, Tuva Børresdatter, Lund-Johansen, Fridtjof, Müller, Fredrik, Rivero, Jezabel Rodriguez, Meltzer, Carin, Einvik, Gunnar, Ueland, Thor, Olsen, Inge Christoffer, Barratt-Due, Andreas, Aaløkken, Trond Mogens, Skjønsberg, Ole Henning
• Format: Journal Article
• Language: Norwegian
• Published: Nature Portfolio 2021
• ISSN: 2045-2322; 2045-2322

The association between pulmonary sequelae and markers of disease severity, as well as pro-fibrotic mediators, were studied in 108 patients 3 months after hospital admission for COVID-19. The COPD assessment test (CAT-score), spirometry, diffusion capacity of the lungs (DLCO), and chest-CT were performed at 23 Norwegian hospitals included in the NOR-SOLIDARITY trial, an open-labelled, randomised clinical trial, investigating the efficacy of remdesivir and hydroxychloroquine (HCQ). Thirty-eight percent had a CAT-score ≥ 10. DLCO was below the lower limit of normal in 29.6%. Ground-glass opacities were present in 39.8% on chest-CT, parenchymal bands were found in 41.7%. At admission, low pO2/FiO2 ratio, ICU treatment, high viral load, and low antibody levels, were predictors of a poorer pulmonary outcome after 3 months. High levels of matrix metalloproteinase (MMP)-9 during hospitalisation and at 3 months were associated with persistent CT-findings. Except for a negative effect of remdesivir on CAT-score, we found no effect of remdesivir or HCQ on long-term pulmonary outcomes. Three months after hospital admission for COVID-19, a high prevalence of respiratory symptoms, reduced DLCO, and persistent CT-findings was observed. Low pO2/FiO2 ratio, ICU-admission, high viral load, low antibody levels, and high levels of MMP-9 were associated with a worse pulmonary outcome.