Post COVID-19 fibrosis, an emerging complicationof SARS-CoV-2 infection

AlHiyari, Mousa A; Ata, Fateen; Alghizzawi, Mohd Islam; Bilal, Ammara Bint I; Abdulhadi, Ahmad Salih; Yousaf, Zohaib

doi:10.1016/j.idcr.2020.e01041

Cited by 51 publications

(54 citation statements)

References 14 publications

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“…However, Townsend et al [ 51 ] did not find any correlation between the patients’ fatigue severity and their serum level of inflammatory markers. Alhiyari et al [ 61 ] noted that the patient in their case report experienced a cough for at least 4 months, and this is likely attributable to the development of pulmonary fibrosis post-COVID. Townsend et al [ 49 ], on the other hand, noted that only a small percentage of their study patients developed pulmonary fibrosis and that this does not appear to be linked with their symptom severity.…”

Section: Discussionmentioning

confidence: 99%

Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)—A Systemic Review and Comparison of Clinical Presentation and Symptomatology

2021

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Background and Objectives: Long COVID defines a series of chronic symptoms that patients may experience after resolution of acute COVID-19. Early reports from studies with patients with long COVID suggests a constellation of symptoms with similarities to another chronic medical illness—myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). A review study comparing and contrasting ME/CFS with reported symptoms of long COVID may yield mutualistic insight into the characterization and management of both conditions. Materials and Methods: A systemic literature search was conducted in MEDLINE and PsycInfo through to 31 January 2021 for studies related to long COVID symptomatology. The literature search was conducted in accordance with PRISMA methodology. Results: Twenty-one studies were included in the qualitative analysis. Long COVID symptoms reported by the included studies were compared to a list of ME/CFS symptoms compiled from multiple case definitions. Twenty-five out of 29 known ME/CFS symptoms were reported by at least one selected long COVID study. Conclusions: Early studies into long COVID symptomatology suggest many overlaps with clinical presentation of ME/CFS. The need for monitoring and treatment for patients post-COVID is evident. Advancements and standardization of long COVID research methodologies would improve the quality of future research, and may allow further investigations into the similarities and differences between long COVID and ME/CFS.

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Section: Discussionmentioning

confidence: 99%

Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)—A Systemic Review and Comparison of Clinical Presentation and Symptomatology

2021

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“…Despite a higher chance of fibrosis in intensive care patients, fibrosis has been also documented in patients who did not need artificial lung ventilation [ 17 , 18 ]. Thus, post-COVID de novo interstitial lung disease was found in a case study of five patients 92who were either asymptomatic or had very mild symptoms.…”

Section: Introductionmentioning

confidence: 99%

Lung Fibrosis after COVID-19: Treatment Prospects

et al. 2021

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At the end of 2019, a highly contagious infection began its ominous conquest of the world. It was soon discovered that the disease was caused by a novel coronavirus designated as SARS-CoV-2, and the disease was thus abbreviated to COVID-19 (COVID). The global medical community has directed its efforts not only to find effective therapies against the deadly pathogen but also to combat the concomitant complications. Two of the most common respiratory manifestations of COVID are a significant reduction in the diffusing capacity of the lungs (DLCO) and the associated pulmonary interstitial damage. One year after moderate COVID, the incidence rate of impaired DLCO and persistent lung damage still exceeds 30%, and one-third of the patients have severe DLCO impairment and fibrotic lung damage. The persistent respiratory complications may cause substantial population morbidity, long-term disability, and even death due to the lung fibrosis progression. The incidence of COVID-induced pulmonary fibrosis caused by COVID can be estimated based on a 15-year observational study of lung pathology after SARS. Most SARS patients with fibrotic lung damage recovered within the first year and then remained healthy; however, in 20% of the cases, significant fibrosis progression was found in 5–10 years. Based on these data, the incidence rate of post-COVID lung fibrosis can be estimated at 2–6% after moderate illness. What is worse, there are reasons to believe that fibrosis may become one of the major long-term complications of COVID, even in asymptomatic individuals. Currently, despite the best efforts of the global medical community, there are no treatments for COVID-induced pulmonary fibrosis. In this review, we analyze the latest data from ongoing clinical trials aimed at treating post-COVID lung fibrosis and analyze the rationale for the current drug candidates. We discuss the use of antifibrotic therapy for idiopathic pulmonary fibrosis, the IN01 vaccine, glucocorticosteroids as well as the stromal vascular fraction for the treatment and rehabilitation of patients with COVID-associated pulmonary damage.

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“…It is estimated that over a third of recovered patients develop fibrotic abnormalities upon radiological examination. As more and more patients recover, post-COVID-19 pulmonary fibrosis is already starting to be reported [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Intravenous Autologous Activated Platelet-Rich Plasma Therapy on “Profibrotic Cytokine” IL-1β Levels in Severe and Critical COVID-19 Patients: A Preliminary Study

Karina

Christoffel²,

Novariani³

et al. 2021

Scientifica

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Introduction. Elevated concentration of proinflammatory cytokines followed by hyperinflammation is one of the hallmarks of severe and critical COVID-19. In the short term, this may result in ARDS and lung injury; subsequently, this may cause pulmonary fibrosis—a disease with poor prognosis—in the long run. Among the cytokines, interleukin-1β (IL-1β) is one of the most overexpressed in COVID-19. We speculate that administration of intravenous activated autologous platelet-rich plasma (aaPRP), which contains interleukin-1 receptor antagonist (IL-1RA), would lower IL-1β levels and benefit the severe and critical COVID-19 patients. Methods. After acquiring ethical clearance, we recruited 12 adult COVID-19 patients of both sexes from the Koja Regional Hospital (Jakarta, Indonesia) ICU. After selection, seven patients were included and divided into two groups, severe and critical. In addition to three doses of aaPRP, both groups received the same treatment of antiviral, steroid, and antibiotics. Quantification of plasma IL-1β levels was performed by beads multiplex assay a day before the first aaPRP administration and a day after the second and third aaPRP administration. PaO2/FiO2 ratio and lung injury scores were evaluated a day before and a day after each aaPRP administration. Results. Severe and critical patients’ initial plasma IL-1β concentration was 4.71 pg/mL and 3.095 pg/mL, respectively. After 2 treatments with aaPRP, severe patients’ plasma IL-1β concentration decreased 12.48 pg/mL, while critical patients’ plasma IL-1β concentration increased to 18.77 pg/mL. Furthermore, after 3 aaPRP treatments, significant amelioration of patients’ PaO2/FiO2 ratio from 71.33 mmHg at baseline to 144.97 mmHg was observed ( p < 0.05 ). However, no significant improvement in lung injury score was observed in severe and critical groups. All severe patients and one critical patient recovered. Conclusion. The use of aaPRP may prevent pulmonary fibrosis in severe COVID-19 patients through the reduction of patients’ plasma IL-1β concentration and the amelioration of PaO2/FiO2 ratio.

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Post COVID-19 fibrosis, an emerging complicationof SARS-CoV-2 infection

Cited by 51 publications

References 14 publications

Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)—A Systemic Review and Comparison of Clinical Presentation and Symptomatology

Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)—A Systemic Review and Comparison of Clinical Presentation and Symptomatology

Lung Fibrosis after COVID-19: Treatment Prospects

The Effect of Intravenous Autologous Activated Platelet-Rich Plasma Therapy on “Profibrotic Cytokine” IL-1β Levels in Severe and Critical COVID-19 Patients: A Preliminary Study

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