Silva-Diaz BC, Moreno-Trujillo M, Roque-Márquez EI, Durán-Hernández RMR, Orendain-Jaime EN

Language: Spanish
References: 10
Page: 49-53
PDF size: 293.99 Kb.

ABSTRACT

Introduction: post-COVID-19 pulmonary fibrosis has been identified as a relevant complication in hospitalized patients, with significant impact on respiratory function and quality of life. Pirfenidone, an antifibrotic agent approved for idiopathic pulmonary fibrosis, may offer potential benefits in this context. Material and methods: a retrospective study was conducted in 30 patients hospitalized for COVID-19 in a secondary-level hospital. Two groups were formed: 15 patients treated with pirfenidone and 15 without antifibrotic therapy, matched by age, sex, comorbidities, and absence of vaccination. Clinical variables, tomographic evolution (EPPC), and extent of pulmonary damage (INER) were evaluated. Results: mortality was lower in the pirfenidone group (14.3 vs. 40%), as was the requirement for mechanical ventilation (33.3 vs. 66.7%), although without statistical significance. Regarding tomographic evolution, treated patients showed a higher proportion of favorable patterns, while in the untreated group fibrotic pattern and death predominated. The final INER score was lower in the pirfenidone group (12.8 ± 6.5 vs. 15.4 ± 7.0), suggesting less structural damage. Conclusion: pirfenidone showed a trend toward improved clinical and radiological outcomes in hospitalized COVID-19 patients, supporting the need for multicenter studies with larger sample sizes.

REFERENCES

1. Silva-Diaz BC, Moreno-Trujillo M, Roque-Márquez EI, Durán-Hernández RMR, Orendain-Jaime ENresults from the national prospective observational SwissCOVID-19 lung study. Eur Respir J. 2021;57(4):2003690. doi:10.1183/13993003.03690-2020.

2. Seeble J, Waterboer T, Hippchen T, Simon J, Kirchner M, LimA, et al. Persistent symptoms in adult patients 1 year aftercoronavirus disease 2019 (COVID-19): a prospective cohortstudy. Clin Infect Dis. 2022;74(7):1191-1198. doi: 10.1093/cid/ciab611.

3. Udwadia ZF, Koul PA, Richeldi L. Post-COVID lung fibrosis:the tsunami that will follow the earthquake. Lung India.2021;38(Supplement):S41-S47. doi: 10.4103/lungindia.lungindia_818_20.

4. Ferrara F, Granata G, Pelliccia C, La Porta R, Vitiello A. Theadded value of pirfenidone to fight inflammation and fibrotic stateinduced by SARS-CoV-2: anti-inflammatory and anti-fibrotictherapy could solve the lung complications of the infection? EurJ Clin Pharmacol. 2020;76(11):1615-1618. doi: 10.1007/s00228-020-02947-4.

5. Al-Kuraishy HM, Batiha GE, Faidah H, Al-Gareeb AI, Saad HM,Simal-Gandara J. Pirfenidone and post-COVID-19 pulmonaryfibrosis: invoked again for realistic goals. Inflammopharmacology.2022;30(6):2017-2026. doi: 10.1007/s10787-022-01027-6.

6. Giménez-Candela RM, González-Freire L, Veiga-VillaverdeAB, Crespo-Diz C. Efectividad y seguridad de pirfenidonaen la fibrosis pulmonar idiopática. Rev OFIL·ILAPHAR.2022;32(2):189-192. doi: 10.4321/s1699-714x2022000200012.

7. Seifirad S. Pirfenidone: a novel hypothetical treatment forCOVID-19. Med Hypotheses. 2020;144:110005. doi: 10.1016/j.mehy.2020.110005.

8. Maher TM, Corte TJ, Fischer A, Kreuter M, Lederer DJ, Molina-Molina M, et al. Pirfenidone in patients with unclassifiableprogressive fibrosing interstitial lung disease: a double-blind,randomised, placebo-controlled, phase 2 trial. Lancet RespirMed. 2020;8(2):147-157. doi: 10.1016/S2213-2600(19)30341-8.

9. Qiu Y, Ye W. Therapeutic efficacy of pirfenidone and nintedanibin pulmonary fibrosis; a systematic review and meta-analysis.Ann Thorac Med. 2025;20(3):145-152. doi: 10.4103/atm.atm_132_25.

10. Juárez-Hernández F, García-Benítez MP, Farías-Contreras JP,Rojas-Varela R, Hurtado-Duarte AM, Sotelo-Robledo R, et al.Escala tomográfica para evaluar la gravedad de COVID-19 en elInstituto Nacional de Enfermedades Respiratorias. Neumol CirTorax. 2022;81(1):6-12. doi: 10.35366/105526.