Lung Fibrosis after COVID-19
After the COVID-19 outbreak, increasing number of patients worldwide who have survived COVID-19 continue to battle the symptoms of the illness, long after they have been clinically tested negative for the disease. As we are fighting through this pandemic, the challenging part is to manage COVID-19 sequelae such as lung fibrosis after COVID-19, Mucormycosis which may vary from fatigue and bodyaches to lung fibrosis.
Lung fibrosis can be either subsequent to chronic inflammation or an idiopathic, genetically influenced and age related fibroproliferative process.Pulmonary fibrosis is a known sequele to ARDS.It has been found that 40% of patients with COVID-19 develop ARDS and 20% of ARDS cases are severe. The prevalence of post COVID-19 fibrosis will become apparent with time, but early analysis from patients with COVID-19 on hospital discharge suggests that more than a third of recovered patients develop fibrotic abnormalities. The pathological feature ARDS is diffuse alveolar damage (DAD) which is characterized by an initial acute inflammatory exudative phase with hyaline membranes, followed by an organizing phase and fibrotic phase. Duration of disease is an important determinant for lung fibrosis post ARDS.
• Dry Cough
Pulmonary fibrois is characterized by the lungs inability to reconstruct the damaged alveolar epithelium, persistence of fibroblasts, and excessive deposition of collagen and other extracellular matrices components. This is accompanied by the destruction and alteration of normal lung architecture.
Risk Factors –
The etiology of pulmonary fibrosis is multifactorial and risk of developing fibrosis increases with following factors –
• Chronic alcoholism
• Viral Infection
• Drug exposure
• Genetic predisposition
• Time period of ICU stay and Mechanical ventilation
Al-assisted chest high-resolution computed tomography (HRCT) is used to investigate the proportion of COVID-19 patients with lung fibrosis, the relationship between the degree of fibrosis and clinical classification of COVID-19, the characteristics of and risk factors for lung fibrosis and the evolution of pulmonary fibrosis after discharge.
• Steroids –
It is recommended that 20-30 mg prednisolone at discharge and tapering it on follow-up depending on the patient’s response.
• Antifibrotic agents-
• Combination therapy
• Oxygen support
• Pulmonary rehabilitation
• Anticoagulant agents
• Lung transplantation
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