Efficacy of Pirfenidone as Antifibrotic Agent in Patients with Post Covid Fibrosis

Abstract

Backkground: Due to repeated respiratory infections induced by the coronavirus, pulmonary fibrosis develops over time. Life's quality is negatively impacted. Pirfenidone may be essential in avoiding serious lung problems because it has anti-fibrotic properties. Objective: This study aimed at prevention of the damage produced by post covid-19 fibrosis and avoiding long term complications. Methods: This study enrolled 50 adult patients with post covid fibrosis without chest diseases history, who were randomly chosen from Chest Outpatient Clinic, Zagazig University. They were divided into 2 groups. One group received pirfenidone and prednisolone and the other received prednisolone. Demographics and laboratory parameters were evaluated. Forced vital capacity (FVC), baseline oxygen saturation (SpO2), 6-minute walk distance test (6MWT), King's brief interstitial lung diseases (K-BILD) and CT severity score (CSS) were performed at the first visit, after one and three months. Results: Each group included 25 patients with a mean age of 47.1 ± 8.7 and 49.3 ± 13.7 years. There were statistically non-significant differences between both groups as regards age, sex, comorbidities and period from acute infection of COVID-19. At the first visit, there were statistically non-significant differences as regards FVC, SpO2, 6MWT, K-BILD and CSS. There were statistically significant differences as regards K-BILD and CSS and highly significant as regards 6MWT after one month of treatment. After 3 months, there were highly statistically significant differences as regards all parameters, which were all higher among pirfenidone + prednisolone group. Conclusion: Antifibrotic medications as pirfenidone can reduce fibrotic changes and enhance patients' quality of life who have post-COVID-19 fibrosis.