Post-infectious Pulmonary Complications: Establishing Research Priorities to Advance the Field. American Thoracic Society Workshop Report 2024 Auld+

Abstract

Continued improvements in the treatment of pulmonary infections have paradoxically resulted in a growing challenge of individuals with post-infectious pulmonary complications (PIPCs). PIPCs have been long recognized after tuberculosis but recent experiences, such as the SARS-CoV-2 pandemic, have underscored the importance of PIPCs following other lower respiratory tract infections. Independent of the causative pathogen, most available studies of pulmonary infections focus on short-term outcomes rather than long-term morbidity among survivors.

In this document, we establish a conceptual scope for PIPCs with discussion of globally significant pulmonary pathogens and an examination of how these pathogens can damage different components of the lung, resulting in a spectrum of PIPCs. We also review potential mechanisms for the transition from acute infection to PIPC, including the interplay between pathogen-mediated injury and aberrant host responses, which together result in PIPCs. Finally, we identify cross-cutting research priorities for the field to facilitate future studies to establish the incidence of PIPCs, define common mechanisms, identify therapeutic strategies, and ultimately reduce the burden of morbidity in survivors of pulmonary infections.

Paywall, https://www.atsjournals.org/doi/abs/10.1513/AnnalsATS.202406-651ST

 

This reminds me of WWI, how the standard use of helmets by some units led to more traumatic injuries, because the helmets changed outcomes from "definitely dead" to traumatic brain injury. Which led some military surgeons to advise against the use of helmets, since they appeared to cause more brain injuries than otherwise.

This is probably what's mostly behind the ever-rising costs of health care. We lowered mortality but in the process raised morbidity, amplifying the most expensive form of health care.

Despite a huge record that this problem has long been significant. It was successfully covered up for decades. When activists started lobbying research institutions to study the long-term impacts of COVID the response was a very confused "why would we do that??!"

So much work ahead to simply cover the basics.