Pirfenidone: A novel hypothetical treatment for COVID-19

Seifirad, Soroush

doi:10.1016/j.mehy.2020.110005

Cited by 78 publications

(72 citation statements)

References 61 publications

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“…This has led to several proposals for consideration of antifibrotic therapies to prevent or to treat COVID -19 pneumonia. (19)(20)(21) One CT study showed imaging features of interstitial fibrosis such as interstitial thickening, air bronchograms, irregular interface, coarse reticular pattern and parenchymal bands in 44% of patients discharged after treatment for COVID-19. (17) The aim of this report is to document the evolution of DAD to the fibrosing pattern in a series of minimally invasive autopsies in thirty individuals who died from COVID-19 in Wuhan, China.…”

Section: Introductionmentioning

confidence: 99%

Progression to fibrosing diffuse alveolar damage in a series of 30 minimally invasive autopsies with COVID‐19 pneumonia in Wuhan, China

Wang

et al. 2020

Histopathology

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Aims: Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection has been deemed as a global pandemic by World Health Organization. While diffuse alveolar damage (DAD) is recognized to be the primary manifestation COVID-19 pneumonia, there has been little emphasis on the progression to the fibrosing phase of DAD. This topic is of great interest due to growing concerns regarding the potential long-term complications in prolonged survivors. Methods: Here we report a detailed histopathologic study of thirty autopsy cases with COVID-19 virus infection, based on minimally invasive autopsies performed between February to March, 2020. Results: The mean age was 69 years, with twenty (67%) males and 10 (33%) females and frequent (70.0%) underlying comorbidities. The duration of illness ranged from 16 to 82 (median=42) days. Histologically, the most common manifestation was diffuse alveolar damage (DAD) in 28 (93.3%) cases which showed predominantly acute (32%), organizing (25%), and/or fibrosing (43%) patterns. Patients with fibrosing DAD were one decade younger (p=0.034) and they had a longer duration of illness (p=0.033), hospitalization (p=0.037) and mechanical ventilation (p=0.014) compared to those with acute DAD. Patients with organizing DAD had a longer duration of illness (p=0.032) and hospitalization (p=0.023) compared to those with acute DAD. Conclusions: COVID-19 pneumonia patients who develop DAD can progress to the fibrosing pattern. While we observed fibrosing DAD in fatal cases, whether surviving patients are at risk for developing pulmonary fibrosis and the frequency of this complication will require further clinical and radiologic follow-up studies.

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Section: Introductionmentioning

confidence: 99%

Progression to fibrosing diffuse alveolar damage in a series of 30 minimally invasive autopsies with COVID‐19 pneumonia in Wuhan, China

Wang

et al. 2020

Histopathology

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“…A recent hypothesis has suggested that pirfenidone might be a potent therapeutic for the treatments of coronavirus disease because it could down-regulate ACE receptors expression, reduction of inflammation and improve oxidative stress, protect pneumocytes, and other cells from COVID-19 invasion. Although it has not yet been tried for the treatment of corona virusinfected patients [150]. Another research-based on epidemiological results and scientific literature suggested that pirfenidone could be used as monotherapy or along with other anti-inflammatory drugs to treat COVID-19 patients to avoid serious complications during viral infection [151].…”

Section: Pirfenidonementioning

confidence: 99%

A Generalized Overview of the Possible Pharmacotherapy and Treatments against SARS-CoV-2

Islam

Alam

Rajib

et al. 2021

Journal of Contemporary Studies in Epidemiology and Public Heal

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“…To date, there are antifibrotic drugs such as pirfenidone and nintedanib used with proven efficacy in the treatment of IPF. Specifically, pirfenidone is attributed to pleiotropic actions [15] (Fig. 1).…”

Section: Pharmacological Approach With Antifibrotic Therapymentioning

confidence: 99%

COVID-19 Patients with Pulmonary Fibrotic Tissue: Clinical Pharmacological Rational of Antifibrotic Therapy

Vitiello

Pelliccia

Ferrara

2020

SN Compr. Clin. Med.

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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.

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Pirfenidone: A novel hypothetical treatment for COVID-19

Cited by 78 publications

References 61 publications

Progression to fibrosing diffuse alveolar damage in a series of 30 minimally invasive autopsies with COVID‐19 pneumonia in Wuhan, China

Progression to fibrosing diffuse alveolar damage in a series of 30 minimally invasive autopsies with COVID‐19 pneumonia in Wuhan, China

A Generalized Overview of the Possible Pharmacotherapy and Treatments against SARS-CoV-2

COVID-19 Patients with Pulmonary Fibrotic Tissue: Clinical Pharmacological Rational of Antifibrotic Therapy

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