Case Report: Pirfenidone in the Treatment of Post-COVID-19 Pulmonary Fibrosis

Xianglin Zhou; Xianglin Zhou; Xianglin Zhou; Danhui Yang; Danhui Yang; Danhui Yang; Xianglong Kong; Chengli Wei; Chengli Wei; Chengli Wei; Siqi LvQiu; Siqi LvQiu; Siqi LvQiu; Lin Wang; Lin Wang; Lin Wang; Yongkang Lin; Yongkang Lin; Yongkang Lin; Zhilan Yin; Zhiguo Zhou; Hong Luo; Hong Luo; Hong Luo

doi:10.3389/fmed.2022.925703

Frontiers in Medicine (Jun 2022)

Case Report: Pirfenidone in the Treatment of Post-COVID-19 Pulmonary Fibrosis

Xianglin Zhou,
Xianglin Zhou,
Xianglin Zhou,
Danhui Yang,
Danhui Yang,
Danhui Yang,
Xianglong Kong,
Chengli Wei,
Chengli Wei,
Chengli Wei,
Siqi LvQiu,
Siqi LvQiu,
Siqi LvQiu,
Lin Wang,
Lin Wang,
Lin Wang,
Yongkang Lin,
Yongkang Lin,
Yongkang Lin,
Zhilan Yin,
Zhiguo Zhou,
Hong Luo,
Hong Luo,
Hong Luo

Affiliations

Xianglin Zhou: Department of Pulmonary and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, China
Xianglin Zhou: Research Unit of Respiratory Disease, Central South University, Changsha, China
Xianglin Zhou: Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, China
Danhui Yang: Department of Pulmonary and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, China
Danhui Yang: Research Unit of Respiratory Disease, Central South University, Changsha, China
Danhui Yang: Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, China
Xianglong Kong: Respiratory Medicine, The First Hospital of Changsha, Changsha, China
Chengli Wei: Department of Pulmonary and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, China
Chengli Wei: Research Unit of Respiratory Disease, Central South University, Changsha, China
Chengli Wei: Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, China
Siqi LvQiu: Department of Pulmonary and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, China
Siqi LvQiu: Research Unit of Respiratory Disease, Central South University, Changsha, China
Siqi LvQiu: Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, China
Lin Wang: Department of Pulmonary and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, China
Lin Wang: Research Unit of Respiratory Disease, Central South University, Changsha, China
Lin Wang: Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, China
Yongkang Lin: Department of Pulmonary and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, China
Yongkang Lin: Research Unit of Respiratory Disease, Central South University, Changsha, China
Yongkang Lin: Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, China
Zhilan Yin: Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
Zhiguo Zhou: Respiratory Medicine, The First Hospital of Changsha, Changsha, China
Hong Luo: Department of Pulmonary and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, China
Hong Luo: Research Unit of Respiratory Disease, Central South University, Changsha, China
Hong Luo: Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, China

DOI: https://doi.org/10.3389/fmed.2022.925703
Journal volume & issue: Vol. 9

Abstract

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BackgroundPulmonary fibrosis is one of the sequelae of the COVID-19, which seriously affects the quality of life of survivors. Currently, there are no optimal evidence based guidelines targeting this population.Case PresentationWe report a 66-year-old female patient without underlying comorbidities admitted to Changsha Public Health Center because of COVID-19. During hospitalization, she developed co-bacterial infection and acute respiratory distress syndrome, and received broad-spectrum antibacterial therapy, invasive mechanical ventilation and extracorporeal membrane oxygenation. After the acute phase, she developed post-COVID-19 pulmonary fibrosis subsequently treated with pirfenidone. Over 96 weeks after pirfenidone treatment, her modified Medical Research Council Dyspnea level improved to 2 from 4 at discharge. Her 6 minutes walk test distance, total lung capacity, and diffusion capacity for carbon monoxide all increased. Chest CT performed on 2 years after illness onset showed regressing fibrosis. The Hospital Anxiety and Depression Scale, Athens Insomnia Scale, and 36-Item Short Form Health Survey questionnaire all improved.ConclusionPost-COVID-19 pulmonary fibrosis is a challenging consequence of COVID-19, and our case suggests that pirfenidone may be an effective treatment option.

Published in Frontiers in Medicine

ISSN: 2296-858X (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Medicine (General)
Website: http://www.frontiersin.org/journals/medicine

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