COVID-19 Patients with Pulmonary Fibrotic Tissue: Clinical Pharmacological Rational of Antifibrotic Therapy.
Antonio VitielloChiara PellicciaFrancesco FerraraPublished in: SN comprehensive clinical medicine (2020)
In December 2019, the first data emerged from Wuhan, China, of a serious acute respiratory disease caused by a new coronavirus, SARS-CoV-2 (COVID-19). In a short time, the health emergency became a global pandemic. To date, there are about 18.8 million infected people and about 700,000 deaths. There are currently no effective vaccines, and treatments are mostly experimental. The symptoms associated with COVID-19 are different, ranging from mild upper respiratory tract symptoms to severe acute respiratory distress syndrome (SARS). Data from previous coronavirus outbreaks such as SARS-CoV (2003 outbreak) and emerging epidemiological data from the current global COVID-19 pandemic suggest that there could be substantial tissue fibrotic consequences following SARS-CoV-2 infection, responsible for severe and in some cases fatal lung lesions. Some data show that even patients cured of viral infection have lung fibrotic tissue residues responsible for incorrect respiratory function even after healing. The role of antifibrotic drug therapy in patients with ongoing SARS-CoV-2 infection or in patients cured of residual pulmonary fibrosis is still to be defined and unclear; the scientific rationale for initiating, continuing, or discontinuing therapy is poorly defined. In this article, we describe the advantages of antifibrotic therapy in patients with ongoing SARS-CoV-2 viral infection to prevent the worsening and aggravation of the clinical situation, and the advantages it could have in the role of preventing pulmonary fibrosis after SARS-CoV-2 infection, and in accelerating the complete healing process.
Keyphrases
- sars cov
- respiratory syndrome coronavirus
- pulmonary fibrosis
- end stage renal disease
- coronavirus disease
- acute respiratory distress syndrome
- electronic health record
- chronic kidney disease
- healthcare
- public health
- ejection fraction
- newly diagnosed
- respiratory tract
- big data
- systemic sclerosis
- clinical trial
- machine learning
- idiopathic pulmonary fibrosis
- drug induced
- extracorporeal membrane oxygenation
- mental health
- liver failure
- social media
- mechanical ventilation
- artificial intelligence
- mesenchymal stem cells
- replacement therapy
- patient reported
- depressive symptoms
- smoking cessation
- hepatitis b virus