Post-infectious Pulmonary Complications: Establishing Research Priorities to Advance the Field. An Official American Thoracic Society Workshop Report.
Sara C AuldAjay SheshadriJennifer Alexander-BrettYael AschnerAmy K BarczakMaria BasilKeira A CohenCharles Dela CruzClaire McGroderMarcos RestrepoKaren RidgeLynn SchnappKatrina TraberRichard G WunderinkDavid ZhangAssem G ZiadyEngi F AttiaJane CarterJames D ChalmersKristina CrothersCharles FeldmanBarbara E JonesNaftali KaminskiJoseph KeaneDavid LewinsohnMark MeterskyJoseph P MizgerdAlison MorrisJulio RamirezAmali E SamarasingheBashar S StaitiehCari StekJie SunScott E EvansPublished in: Annals of the American Thoracic Society (2024)
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.