Wang J, Wang B J, Yang J C, Wang M Y, Chen C, Luo G X, He W F
State Key Laboratory of Trauma, Burns, and Combined Injury, Institute of Burn Research, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing Key Laboratory for Disease Proteomics, Chongqing 400038, China.
Zhonghua Shao Shang Za Zhi. 2020 Aug 20;36(8):691-697. doi: 10.3760/cma.j.cn501120-20200307-00132.
Coronavirus disease 2019 (COVID-19) outbroke in Wuhan, China in December 2019 and the severe acute respiratory syndrome (SARS) outbroke in Guangzhou, China in 2003 were caused by highly pathogenic coronaviruses with high homology. Since the 2019 novel coronavirus is highly contagious and spreads rapidly. It has caused negative social effects and massive economic loss globaly. Currently there is no vaccine or effective drugs. Pulmonary fibrosis is a pulmonary disease with progressive fibrosis, which is the main factor leading to pulmonary dysfunction and declined quality of life in SARS survivors after recovery. Extensive epidemiological, viral immunological and current clinical evidences support the possibility that pulmonary fibrosis may be one of the major complications in COVID-19 patients. At present there is no report on the mechanism by which COVID-19 induces pulmonary fibrosis.With the existing theoretical basis, this article focuses on discussing the possible mechanism of COVID-19 sustained lung damaging, the key role of abnormal immune mechanism in the initiation and promotion of pulmonary fibrosis, and the corresponding therapeutic measures.
2019年12月在中国武汉爆发的新型冠状病毒肺炎(COVID-19)和2003年在中国广州爆发的严重急性呼吸综合征(SARS)均由具有高度同源性的高致病性冠状病毒引起。自2019年新型冠状病毒具有高度传染性且传播迅速。它已在全球范围内造成负面社会影响和巨大经济损失。目前尚无疫苗或有效药物。肺纤维化是一种具有进行性纤维化的肺部疾病,是导致SARS康复幸存者肺功能障碍和生活质量下降的主要因素。广泛的流行病学、病毒免疫学和当前临床证据支持肺纤维化可能是COVID-19患者主要并发症之一的可能性。目前尚无关于COVID-19诱导肺纤维化机制的报道。基于现有的理论基础,本文重点探讨COVID-19持续肺损伤的可能机制、异常免疫机制在肺纤维化起始和进展中的关键作用以及相应的治疗措施。