tetano
Editor, Senior Moderator
Eur Respir Rev
. 2021 Dec 15;30(162):210194.
doi: 10.1183/16000617.0194-2021. Print 2021 Dec 31.
Recovering from a pandemic: pulmonary fibrosis after SARS-CoV-2 infection
Ruben J Mylvaganam[SUP] 1 [/SUP], Joseph I Bailey[SUP] 2 [/SUP], Jacob I Sznajder[SUP] 2 [/SUP], Marc A Sala[SUP] 2 [/SUP], Northwestern Comprehensive COVID Center Consortium
Affiliations
Abstract
Acute manifestations of SARS-CoV-2 infection continue to impact the lives of many across the world. Post-acute sequelae of coronavirus disease 2019 (COVID-19) may affect 10-30% of survivors of COVID-19, and post-acute sequelae of COVID-19 (PASC)-pulmonary fibrosis is a long-term outcome associated with major morbidity. Data from prior coronavirus outbreaks (severe acute respiratory syndrome and Middle East respiratory syndrome) suggest that pulmonary fibrosis will contribute to long-term respiratory morbidity, suggesting that PASC-pulmonary fibrosis should be thoroughly screened for through pulmonary function testing and cross-sectional imaging. As data accumulates on the unique pathobiologic mechanisms underlying critical COVID-19, a focus on corollaries to the subacute and chronic profibrotic phenotype must be sought as well. Key aspects of acute COVID-19 pathobiology that may account for increased rates of pulmonary fibrosis include monocyte/macrophage-T-cell circuits, profibrotic RNA transcriptomics, protracted elevated levels of inflammatory cytokines, and duration of illness and ventilation. Mechanistic understanding of PASC-pulmonary fibrosis will be central in determining therapeutic options and will ultimately play a role in transplant considerations. Well-designed cohort studies and prospective clinical registries are needed. Clinicians, researchers and healthcare systems must actively address this complication of PASC to minimise disability, maximise quality of life and confront a post-COVID-19 global health crisis.
. 2021 Dec 15;30(162):210194.
doi: 10.1183/16000617.0194-2021. Print 2021 Dec 31.
Recovering from a pandemic: pulmonary fibrosis after SARS-CoV-2 infection
Ruben J Mylvaganam[SUP] 1 [/SUP], Joseph I Bailey[SUP] 2 [/SUP], Jacob I Sznajder[SUP] 2 [/SUP], Marc A Sala[SUP] 2 [/SUP], Northwestern Comprehensive COVID Center Consortium
Affiliations
- PMID: 34911696
- DOI: 10.1183/16000617.0194-2021
Abstract
Acute manifestations of SARS-CoV-2 infection continue to impact the lives of many across the world. Post-acute sequelae of coronavirus disease 2019 (COVID-19) may affect 10-30% of survivors of COVID-19, and post-acute sequelae of COVID-19 (PASC)-pulmonary fibrosis is a long-term outcome associated with major morbidity. Data from prior coronavirus outbreaks (severe acute respiratory syndrome and Middle East respiratory syndrome) suggest that pulmonary fibrosis will contribute to long-term respiratory morbidity, suggesting that PASC-pulmonary fibrosis should be thoroughly screened for through pulmonary function testing and cross-sectional imaging. As data accumulates on the unique pathobiologic mechanisms underlying critical COVID-19, a focus on corollaries to the subacute and chronic profibrotic phenotype must be sought as well. Key aspects of acute COVID-19 pathobiology that may account for increased rates of pulmonary fibrosis include monocyte/macrophage-T-cell circuits, profibrotic RNA transcriptomics, protracted elevated levels of inflammatory cytokines, and duration of illness and ventilation. Mechanistic understanding of PASC-pulmonary fibrosis will be central in determining therapeutic options and will ultimately play a role in transplant considerations. Well-designed cohort studies and prospective clinical registries are needed. Clinicians, researchers and healthcare systems must actively address this complication of PASC to minimise disability, maximise quality of life and confront a post-COVID-19 global health crisis.