Praktické lekárnictvo 4/2023

COVID-19 and the lung: from interstitial pneumonia to pulmonary fibrosis

The novel coronavirus-induced disease led to a pandemic that poses a global threat to human health. The most common cause of hospitalisation for COVID-19 is interstitial pneumonia that may be complicated by Acute Respiratory Distress Syndrome (ARDS). The monitoring of patients who have recovered from COVID-associated pneumonia demonstrates that the significant reduction in diffuse lung capacity and associated fi brotic signs in the lung parenchyma are factors associated with a negative prognosis. Thus, the longterm consequences of COVID-19 appear crucial. Risk factors, histopathological characterization, prevalence, and management of post- COVID-19 pulmonary fibrosis are poorly understood. This review addresses underlying pathobiological mechanisms and the possible predictors which might lead to the development of fibrotic lung remodeling. Potential therapeutic modalities include anti-fibrotic drugs, prolonged use of corticosteroids, other anti-inflammatory and immunosuppressive drugs, spironolactone, azithromycine, with further multiple novel compounds under investigation.

Keywords: SARS-CoV-2, interstitial pneumonia, post-COVID-19 pulmonary fibrosis, anti-fibrotic drugs