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      Effects of pharmacotherapy on post-COVID-19 pulmonary fibrosis: Systemic review

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      Journal: BIO Web of Conferences
      Publisher: EDP Sciences

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          Abstract

          Pulmonary fibrosis is one of serious consequences of COVID-19. Its prevalence and risk factors including disease severity, length of mechanical ventilation and hospitalization were studied, but the effect of pharmacotherapy was not widely assessed. This systematic review is aimed to investigate potential effects of drugs used before and during COVID-19 on lung damage possibly leading to pulmonary fibrosis, and effects of post-COVID-19 therapy used to fight formed pulmonary fibrosis. PubMed database was searched to identify studies published in English up to February 10, 2024. The systematic search revealed a total of 580 full-text articles, of which 23 (results of clinical trials) were finally included in the analysis. Most works considering COVID-19 treatment highlighted antibiotics and corticosteroids as groups with the highest frequency of use in patients with negative clinical outcomes and respiratory function decline, suggesting possible negative effects on pulmonary fibrosis development. Pre-COVID-19 treatment revealed rituximab and chemotherapy as main drug factors associated with pulmonary fibrosis development, and post-COVID-19 therapy with antifibrotic drugs revealed discussible results. Our systematic review was an attempt to highlight possible effects of pharmacotherapy on the lung damage leading to the pulmonary fibrosis formation.

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          Sequelae, persistent symptomatology and outcomes after COVID-19 hospitalization: the ANCOHVID multicentre 6-month follow-up study

          Álvaro Romero-Duarte, Mario Rivera-Izquierdo, Inmaculada Guerrero-Fernández de Alba … (2021)
          Background Long-term effects of COVID-19, also called Long COVID, affect more than 10% of patients. The most severe cases (i.e. those requiring hospitalization) present a higher frequency of sequelae, but detailed information on these effects is still lacking. The objective of this study is to identify and quantify the frequency and outcomes associated with the presence of sequelae or persistent symptomatology (SPS) during the 6 months after discharge for COVID-19. Methods Retrospective observational 6-month follow-up study conducted in four hospitals of Spain. A cohort of all 969 patients who were hospitalized with PCR-confirmed SARS-CoV-2 from March 1 to April 15, 2020, was included. We collected all the SPS during the 6 months after discharge reported by patients during follow-up from primary care records. Cluster analyses were performed to validate the measures. The main outcome measures were return to the Emergency Services, hospital readmission and post-discharge death. Surviving patients’ outcomes were collected through clinical histories and primary care reports. Multiple logistic regression models were applied. Results The 797 (82.2%) patients who survived constituted the sample followed, while the rest died from COVID-19. The mean age was 63.0 years, 53.7% of them were men and 509 (63.9%) reported some sequelae during the first 6 months after discharge. These sequelae were very diverse, but the most frequent were respiratory (42.0%), systemic (36.1%), neurological (20.8%), mental health (12.2%) and infectious (7.9%) SPS, with some differences by sex. Women presented higher frequencies of headache and mental health SPS, among others. A total of 160 (20.1%) patients returned to the Emergency Services, 35 (4.4%) required hospital readmission and 8 (1.0%) died during follow-up. The main factors independently associated with the return to Emergency Services were persistent fever, dermatological SPS, arrythmia or palpitations, thoracic pain and pneumonia. Conclusions COVID-19 cases requiring hospitalization during the first wave of the pandemic developed a significant range of mid- to long-term SPS. A detailed list of symptoms and outcomes is provided in this multicentre study. Identification of possible factors associated with these SPS could be useful to optimize preventive follow-up strategies in primary care for the coming months of the pandemic. Supplementary Information The online version contains supplementary material available at 10.1186/s12916-021-02003-7.
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            The Long-Term Impact of COVID-19 Pneumonia on the Pulmonary Function of Survivors

            Ayad Mohammed Salem, Noor Al Khathlan, Abdulelah Alharbi … (2021)
            Background The sequelae of COVID-19 pneumonia on pulmonary function and airways inflammation are still an area of active research. Objective This research aimed to explore the long-term impact of COVID-19 pneumonia on the lung function after three months from recovery. Methods Fifty subjects (age 18–60 years) were recruited and classified into two groups: the control group (30 subjects) and the post-COVID-19 pneumonia group (20 patients). Pulmonary function tests, spirometry, body plethysmography [lung volumes and airway resistance (R aw )], diffusion capacity for carbon monoxide (DL CO ), and fractional exhaled nitric oxide (FeNO), were measured after at least 3 months post-recovery. Results Significant reduction in total lung capacity (TLC), forced vital capacity (FVC), forced expiratory volume (FEV 1 ), FEV 1 /FEV, and diffusing capacity for carbon monoxide (DL CO ) was observed in post-COVID-19 subjects compared to controls. Restrictive lung impairment was observed in 50% of post-COVID-19 cases (n = 10) compared to 20% in the control group (n = 6, P = 0.026). In addition, mild diffusion defect was detected in 35% (n = 7) of the post-COVID-19 group compared to 23.3% (n = 7) in the controls ( P = 0.012). Conclusion COVID-19 pneumonia has an impact on the lung functions in terms of restrictive lung impairment and mild diffusion defect after three months from recovery. Therefore, a long-term follow-up of the lung function in post-COVID-19 survivors is recommended.
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              The pathogenesis, epidemiology and biomarkers of susceptibility of pulmonary fibrosis in COVID-19 survivors.

              Andrea Vianello, Gabriella Guarnieri, Fausto Braccioni … (2022)
              Pulmonary fibrosis (PF), a pathological outcome of chronic and acute interstitial lung diseases associated to compromised wound healing, is a key component of the "post-acute COVID-19 syndrome" that may severely complicate patients' clinical course. Although inconclusive, available data suggest that more than a third of hospitalized COVID-19 patients develop lung fibrotic abnormalities after their discharge from hospital. The pathogenesis of PF in patients recovering from a severe acute case of COVID-19 is complex, and several hypotheses have been formulated to explain its development. An analysis of the data that is presently available suggests that biomarkers of susceptibility could help to identify subjects with increased probability of developing PF and may represent a means to personalize the management of COVID-19's long-term effects. Our review highlights the importance of both patient-related and disease-related contributing risk factors for PF in COVID-19 survivors and makes it definitely clear the possible use of acute phase and follow-up biomarkers for identifying the patients at greatest risk of developing this disease.
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                Author and article information

                Journal
                Title: BIO Web of Conferences
                Abbreviated Title: BIO Web Conf.
                Publisher: EDP Sciences
                ISSN (Electronic): 2117-4458
                Publication date Created: 2024
                Publication date (Electronic): April 08 2024
                Publication date (Print): 2024
                Volume: 100
                Page: 01010
                Article
                DOI: 10.1051/bioconf/202410001010
                SO-VID: 25a62ec2-7bb0-4d44-8798-ef245ffd9c12
                Copyright © © 2024
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                https://creativecommons.org/licenses/by/4.0/

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