Abstract
Objectives: Severe stages of COVID-19 infection have been associated with the excessive discharge of pro-inflammatory mediators such as cytokines, resulting in lung deterioration, which progresses rapidly to lung fibrosis leading to acute respiratory distress syndrome. In this investigation, the efficacy and safety of the novel antifibrotic and anti-inflammatory agent, Pirfenidone, were assessed in COVID-19 patients with pulmonary fibrosis secondary to cytokine storm. In this randomized controlled study, we assigned 100 adult COVID-19 patients cytokine storm and admitted to the intensive care isolation unit into either pirfenidone added to the standard therapy (n = 47), or the standard protocol only (n = 53). High-resolution computed tomography of the chest was performed in all patients to evaluate fibrotic lesions and their progression. The results showed that the percentage of patients who developed pulmonary fibrosis during cytokine storm onset in the pirfenidone group relative to the standard group was 29.8% and 35.8%, respectively, with no significant difference between the two groups; while there was a significant increase in the proportion of patients discharged from the isolation unit with pulmonary fibrosis without progression in fibrotic lesions in the pirfenidone group compared to the standard group (21.3% and 5.7%, respectively). Furthermore, there was a significant difference concerning liver enzyme elevation and GIT disturbance incidences in the studied groups (p = 0.006 and 0.01, respectively). Our findings show that Pirfenidone inhibits fibrosis advancement in COVID-19 patients with pulmonary fibrosis and is associated with hepatotoxicity and GI distress. It may be beneficial in patients with mild to moderate COVID-19-induced pulmonary fibrosis; however, additional research is necessary.
Funder
Deanship of Scientific Research at Jouf University
Subject
Health Information Management,Health Informatics,Health Policy,Leadership and Management
Reference44 articles.
1. Schaalan, M., Warda, A.E.A., Osman, S.M., Fathy, S., Sarhan, R.M., Boshra, M.S., Sarhan, N., Gaber, S., and Ali, A.M.A. (2022). The Impact of Sociodemographic, Nutritional, and Health Factors on the Incidence and Complications of COVID-19 in Egypt: A Cross-Sectional Study. Viruses, 14.
2. Pirfenidone: A novel hypothetical treatment for COVID-19;Med. Hypotheses,2020
3. The COVID-19 pandemic;Crit. Rev. Clin. Lab. Sci.,2020
4. Incidence of ARDS and outcomes in hospitalized patients with COVID-19: A global literature survey;Crit. Care,2020
5. Comparison of Hospitalized Patients With ARDS Caused by COVID-19 and H1N1;Chest,2020
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