Pneumofibrosis after COVID-19: accumulated knowledge and lingering questions

Pneumofibrosis after COVID-19: accumulated knowledge and lingering questions

O.N. Titova, N.A. Kuzubova, A.G. Kozyrev

Pavlov First Saint-Petersburg State Medical University, St. Petersburg 

One of the serious consequences of the new coronavirus infection (COVID-19) is the development of pneumofibrosis. The incidence assessment of this complication is hampered by the lack of clear diagnostic criteria, which, in turn, is a consequence of the general consensus absence on the duration after the COVID-19 acute phase at which pulmonary changes should be considered fibrotic rather than inflammatory. The formation of post-COVID pneumofibrosis occurs due to various pathogenetic mechanisms. Risk factors include elderly age, comorbidities, severe COVID-19 with significant pulmonary involvement, the need for intensive care and mechanical ventilation. Currently, there is no data indicating that post-COVID pneumofibrosis is capable of progressing, but it may lead to the onset or exacerbation of other interstitial lung diseases, which are also accompanied by the pneumofibrosis development. The prevention of post-COVID pneumofibrosis is primarily based on effective treatment of the viral infection, including the use of anti-inflammatory agents. The administration of antifibrotic drugs (nintedanib, pirfenidone) at the stage of established fibrotic pulmonary changes, which are currently used in the therapy of idiopathic pulmonary fibrosis, is under discussion.

Keywords: COVID-19, post-COVID pneumofibrosis, idiopathic pulmonary fibrosis, nintedanib, pirfenidone, antifibrotic drug.

For citation: Titova O.N., Kuzubova N.A., Kozyrev A.G. Pneumofibrosis after COVID-19: accumulated knowledge and lingering questions. RMJ. 2024;1:25–29.