Post-COVID-19 Pulmonary Fibrosis: Novel Sequelae of the Current Pandemic

Abstract

Since the initial identification of the novel coronavirus SARS-CoV-2 in December 2019, the COVID-19 pandemic has become a leading cause of morbidity and mortality worldwide. As effective vaccines and treatments begin to emerge, it will become increasingly important to identify and proactively manage the long-term respiratory complications of severe disease. The patterns of imaging abnormalities coupled with data from prior coronavirus outbreaks suggest that patients with severe COVID-19 pneumonia are likely at an increased risk of progression to interstitial lung disease (ILD) and chronic pulmonary vascular disease. In this paper, we briefly review the definition, classification, and underlying pathophysiology of interstitial lung disease (ILD). We then review the current literature on the proposed mechanisms of lung injury in severe COVID-19 infection, and outline potential viral- and immune-mediated processes implicated in the development of post-COVID-19 pulmonary fibrosis (PCPF). Finally, we address patient-specific and iatrogenic risk factors that could lead to PCPF and discuss strategies for reducing risk of pulmonary complications/sequelae.

Long COVID-19 Syndrome: A Comprehensive Review of Its Effect on Various Organ Systems and Recommendation on Rehabilitation Plans

“…Pulmonary fibrosis is closely associated with Long COVID-19 Syndrome [24], which can be confirmed radiologically and histologically according to recent studies [25][26][27]. Their radiological findings can be further classified into parenchymal bands, irregular interfaces, reticular opacities and traction bronchiectasis with or without honeycombing [28].…”

Complicated and persistent severe COVID-19 pneumonia in a recipient of allogeneic haematopoietic stem cell transplant

“…The cytopathic effect of the virus, the prolonged hypoxia and exposure to high-flow oxygen therapy could represent the risk factors for the development of a persistent ILD in our immunosuppressed patient. 19 As new evidence on the pathophysiology of post-acute COVID-19 syndrome emerges, further clinical trials appear, including some studies with antifibrotic therapies for ILD, 21 with the aim not only to cure the acute phase of SARS-CoV-2 infection but also to prevent the serious long-term adverse effects of the disease.…”

Post-COVID-19 Sydrome and Decrease in Health-Related Quality of Life in Kidney Transplant Recipients after SARS-COV-2 Infection—A Cohort Longitudinal Study from the North of Poland

“…The most common persisting symptoms include fatigue, muscle and joint pain, shortness of breath, headache, cough, chest pain, altered smell and taste, diarrhea, cognitive impairment, anxiety, and sleep disorders. The complications may be respiratory, cardiovascular, cerebrovascular, neurological, thromboembolic, autoimmune, among others [ 1 , 2 , 3 ]. Clinicians worldwide have coined the term for the persistent cluster of these symptoms and abnormalities as “post-COVID syndrome”, which may be further sub-categorized into either acute or chronic subtypes, depending on whether symptoms extend beyond 12 weeks following the initial diagnosis [ 4 ].…”