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Early COVID-19 lockdown in Greece and idiopathic pulmonary fibrosis: a beneficial “impact” beyond any expectation

Spyros A. Papiris, Demosthenes Bouros, Katerina Markopoulou, Lykourgos Kolilekas, Andriana I. Papaioannou, Vasilios Tzilas, Argyrios Tzouvelekis, Eva Fouka, Despoina Papakosta, Zoe Daniil, Paschalis Steiropoulos, Athina Gogali, Ilias C. Papanikolaou, Areti Xyfteri, Aggeliki Haritou, Ioanna Korbila, Ioannis P. Tomos, Stylianos Loukides, Rita Bellelli, Georgia Kounti, Christina Rampiadou, Theodoros Karampitsakos, Ilias Dimeas, Paraskevi Kirgou, Andromachi Bompoki, Eirini Vasarmidi, Konstantinos Loverdos, Elvira-Markela Antonogiannaki, Myrto Blizou, Evangelos Bouros, Konstantinos Kagouridis, Maria Maniati, Anna Karakatsani, Katerina M. Antoniou, Effrosyni D. Manali
European Respiratory Journal 2021 57: 2003111; DOI: 10.1183/13993003.03111-2020
Spyros A. Papiris
12nd Pulmonary Medicine Dept, General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Demosthenes Bouros
2First Academic Dept of Pneumonology, Hospital for Diseases of the Chest “Sotiria”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
3Iatriko Medical Center, Athens, Greece
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  • ORCID record for Demosthenes Bouros
Katerina Markopoulou
4Pulmonary Dept, “G Papanikolaou” General Hospital, Thessaloniki, Greece
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Lykourgos Kolilekas
57th Pulmonary Dept, Athens Chest Hospital “Sotiria”, Athens Greece
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Andriana I. Papaioannou
12nd Pulmonary Medicine Dept, General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Vasilios Tzilas
3Iatriko Medical Center, Athens, Greece
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Argyrios Tzouvelekis
6Dept of Respiratory Medicine, General Hospital of Patras, University of Patras, Patra, Greece
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Eva Fouka
7A Dept of Pulmonary Medicine, Aristotle University of Thessaloniki, “G. Papanikolaou” Hospital, Thessaloniki, Greece
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Despoina Papakosta
7A Dept of Pulmonary Medicine, Aristotle University of Thessaloniki, “G. Papanikolaou” Hospital, Thessaloniki, Greece
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Zoe Daniil
8Dept of Respiratory Medicine, Medical School, University of Thessaly, Larissa, Greece
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Paschalis Steiropoulos
9Dept of Pneumonology, University Hospital of Alexandroupolis, Democritus University of Thrace, Komotini, Greece
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Athina Gogali
10Dept of Pneumonology, Medical School, University of Ioannina, Ioannina, Greece
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Ilias C. Papanikolaou
11Pulmonary Dept, Corfu General Hospital, Corfu, Greece
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Areti Xyfteri
12Private practice, Messini, Greece
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Aggeliki Haritou
13Private practice, Ioannina, Greece
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Ioanna Korbila
12nd Pulmonary Medicine Dept, General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Ioannis P. Tomos
12nd Pulmonary Medicine Dept, General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Stylianos Loukides
12nd Pulmonary Medicine Dept, General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Rita Bellelli
12nd Pulmonary Medicine Dept, General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Georgia Kounti
4Pulmonary Dept, “G Papanikolaou” General Hospital, Thessaloniki, Greece
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Christina Rampiadou
4Pulmonary Dept, “G Papanikolaou” General Hospital, Thessaloniki, Greece
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Theodoros Karampitsakos
6Dept of Respiratory Medicine, General Hospital of Patras, University of Patras, Patra, Greece
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Ilias Dimeas
8Dept of Respiratory Medicine, Medical School, University of Thessaly, Larissa, Greece
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Paraskevi Kirgou
8Dept of Respiratory Medicine, Medical School, University of Thessaly, Larissa, Greece
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Andromachi Bompoki
14Dept of Thoracic Medicine and Laboratory of Molecular and Cellular Pneumonology, Medical School, University of Crete, Heraklion, Crete, Greece
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Eirini Vasarmidi
14Dept of Thoracic Medicine and Laboratory of Molecular and Cellular Pneumonology, Medical School, University of Crete, Heraklion, Crete, Greece
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Konstantinos Loverdos
57th Pulmonary Dept, Athens Chest Hospital “Sotiria”, Athens Greece
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Elvira-Markela Antonogiannaki
12nd Pulmonary Medicine Dept, General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Myrto Blizou
12nd Pulmonary Medicine Dept, General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Evangelos Bouros
3Iatriko Medical Center, Athens, Greece
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Konstantinos Kagouridis
12nd Pulmonary Medicine Dept, General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Maria Maniati
12nd Pulmonary Medicine Dept, General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Anna Karakatsani
12nd Pulmonary Medicine Dept, General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Katerina M. Antoniou
14Dept of Thoracic Medicine and Laboratory of Molecular and Cellular Pneumonology, Medical School, University of Crete, Heraklion, Crete, Greece
15These authors contributed equally to this work
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Effrosyni D. Manali
12nd Pulmonary Medicine Dept, General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
15These authors contributed equally to this work
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Extract

Idiopathic pulmonary fibrosis (IPF) is an irreversibly progressive diffuse lung disease characterised by a usual interstitial pneumonia (UIP) pattern. IPF presents with an ominous prognosis with a median survival of around 5 years [1]. The development of an acute exacerbation, histologically diffuse alveolar damage (DAD) upon UIP, represents the most devastating of its complications and leads to death in the majority of patients admitted to the intensive care unit (ICU) [2–4]. Viral infections in the setting of an altered host lung microbiome are likely important triggers of acute exacerbations of IPF and subsequent acute respiratory distress syndrome (ARDS) [4, 5].

Abstract

During the lockdown, IPF patients experienced lower than expected COVID-19, suggesting that simple measures for the winter months, such as face masking, clean hands, physical distancing could be adopted as promising advances in non-pharmacological therapy https://bit.ly/2ISi2EV

Footnotes

  • Author contributions: S.A. Papiris conceived of the study, had major contribution to the analysis and interpretation of data and wrote with E.D. Manali the manuscript; D. Bouros had major contribution to the acquisition and interpretation of data for the work and revised critically this work for important intellectual content; K. Markopoulou had major contribution in the acquisition and interpretation of data for the work and revised critically this work for important intellectual content; L. Kolilekas participated in the design of the study and had major contribution to the acquisition, critical analysis and interpretation of data for the work; A.I. Papaioannou performed the statistical analysis of the data, contributed substantially to the interpretation of data for the work and drafted parts of the manuscript and the figures; V. Tzilas, A. Tzouvelekis, E. Fouka, D. Papakosta, Z. Daniil, P. Steiropoulos, A. Gogali, I.C. Papanikolaou, A. Haritou, A. Xyfteri, I. Korbila, I.P. Tomos and S. Loukides had major contribution to the acquisition and analysis of data and were responsible for the integrity of data in their centres; R. Bellelli, G. Kounti, C. Rampiadou, T. Karampitsakos, I. Dimeas, P. Kirgou, A. Bompoki, E. Vasarmidi, K. Loverdos, E-M. Antonogiannaki, M. Blizou, E. Bouros, K. Kagouridis and M. Maniati had significant contribution to the acquisition and critical analysis of data; A. Karakatsani had substantial contribution to the analysis and interpretation of data and revised critically this work for important intellectual content; K.M. Antoniou participated at the conception and design of the study, had substantial contribution to the acquisition and analysis of data and was responsible for the integrity of data in her centre; E.D. Manali had major contribution to the concept and design of the study, to the acquisition, analysis and interpretation of data, has access to all data, supervised the accuracy and integrity of any part of the work and wrote with S.A. Papiris the manuscript. All authors read and approved of the final version of the submitted publication.

  • Conflict of interest: S.A. Papiris has nothing to disclose.

  • Conflict of interest: D. Bouros has nothing to disclose.

  • Conflict of interest: K. Markopoulou has nothing to disclose.

  • Conflict of interest: L. Kolilekas has nothing to disclose.

  • Conflict of interest: A.I. Papaioannou has nothing to disclose.

  • Conflict of interest: V. Tzilas has nothing to disclose.

  • Conflict of interest: A. Tzouvelekis has received advisory fees from Boehringer Ingelheim, Hoffmann La Roche, Chiesi Hellas and Elpen Pharma outside of the submitted work, has a patent “Inhaled or aerosolized delivery of thyroid hormone to the lung as a novel therapeutic agent in fibrotic lung diseases” OCR#6368, with royalties paid.

  • Conflict of interest: E. Fouka has nothing to disclose.

  • Conflict of interest: D. Papakosta has nothing to disclose.

  • Conflict of interest: Z. Daniil has nothing to disclose.

  • Conflict of interest: P. Steiropoulos has nothing to disclose.

  • Conflict of interest: A. Gogali has nothing to disclose.

  • Conflict of interest: I.C. Papanikolaou has nothing to disclose.

  • Conflict of interest: A. Xyfteri has nothing to disclose.

  • Conflict of interest: A. Haritou has nothing to disclose.

  • Conflict of interest: I. Korbila has nothing to disclose.

  • Conflict of interest: I.P. Tomos has nothing to disclose.

  • Conflict of interest: S. Loukides has nothing to disclose.

  • Conflict of interest: R. Bellelli has nothing to disclose.

  • Conflict of interest: G. Kounti has nothing to disclose.

  • Conflict of interest: C. Rampiadou has nothing to disclose.

  • Conflict of interest: T. Karampitsakos has nothing to disclose.

  • Conflict of interest: I. Dimeas has nothing to disclose.

  • Conflict of interest: P. Kirgou has nothing to disclose.

  • Conflict of interest: A. Bompoki has nothing to disclose.

  • Conflict of interest: E. Vasarmidi has nothing to disclose.

  • Conflict of interest: K. Loverdos has nothing to disclose.

  • Conflict of interest: E-M. Antonogiannaki has nothing to disclose.

  • Conflict of interest: M. Blizou has nothing to disclose.

  • Conflict of interest: E. Bouros has nothing to disclose.

  • Conflict of interest: K. Kagouridis has nothing to disclose.

  • Conflict of interest: M. Maniati has nothing to disclose.

  • Conflict of interest: A. Karakatsani has nothing to disclose.

  • Conflict of interest: K.M. Antoniou has nothing to disclose.

  • Conflict of interest: E.D. Manali has nothing to disclose.

  • Received August 12, 2020.
  • Accepted November 8, 2020.
  • Copyright ©ERS 2021
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Early COVID-19 lockdown in Greece and idiopathic pulmonary fibrosis: a beneficial “impact” beyond any expectation
Spyros A. Papiris, Demosthenes Bouros, Katerina Markopoulou, Lykourgos Kolilekas, Andriana I. Papaioannou, Vasilios Tzilas, Argyrios Tzouvelekis, Eva Fouka, Despoina Papakosta, Zoe Daniil, Paschalis Steiropoulos, Athina Gogali, Ilias C. Papanikolaou, Areti Xyfteri, Aggeliki Haritou, Ioanna Korbila, Ioannis P. Tomos, Stylianos Loukides, Rita Bellelli, Georgia Kounti, Christina Rampiadou, Theodoros Karampitsakos, Ilias Dimeas, Paraskevi Kirgou, Andromachi Bompoki, Eirini Vasarmidi, Konstantinos Loverdos, Elvira-Markela Antonogiannaki, Myrto Blizou, Evangelos Bouros, Konstantinos Kagouridis, Maria Maniati, Anna Karakatsani, Katerina M. Antoniou, Effrosyni D. Manali
European Respiratory Journal Mar 2021, 57 (3) 2003111; DOI: 10.1183/13993003.03111-2020

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Early COVID-19 lockdown in Greece and idiopathic pulmonary fibrosis: a beneficial “impact” beyond any expectation
Spyros A. Papiris, Demosthenes Bouros, Katerina Markopoulou, Lykourgos Kolilekas, Andriana I. Papaioannou, Vasilios Tzilas, Argyrios Tzouvelekis, Eva Fouka, Despoina Papakosta, Zoe Daniil, Paschalis Steiropoulos, Athina Gogali, Ilias C. Papanikolaou, Areti Xyfteri, Aggeliki Haritou, Ioanna Korbila, Ioannis P. Tomos, Stylianos Loukides, Rita Bellelli, Georgia Kounti, Christina Rampiadou, Theodoros Karampitsakos, Ilias Dimeas, Paraskevi Kirgou, Andromachi Bompoki, Eirini Vasarmidi, Konstantinos Loverdos, Elvira-Markela Antonogiannaki, Myrto Blizou, Evangelos Bouros, Konstantinos Kagouridis, Maria Maniati, Anna Karakatsani, Katerina M. Antoniou, Effrosyni D. Manali
European Respiratory Journal Mar 2021, 57 (3) 2003111; DOI: 10.1183/13993003.03111-2020
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