Zhan X, Liu B, Tong Z H
Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
Department of Respiratory and Critical Care Medicine, Zhongnan Hospital, Wuhan University, Wuhan 430071, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2020 Sep 12;43(9):728-732. doi: 10.3760/cma.j.cn112147-20200317-00359.
The novel coronavirus pneumonia (COVID-19) has been well controlled in China. Most of the COVID-19 patients were having postinflammatory pulmonary fibrosis (PPF) on the follow-up CT scan when discharged, and complaining about exertional dyspnea of different levels, presenting with an UIP (usual interstitial pneumonia) pattern or NSIP (non-specific interstitial pneumonia) pattern on the CT scans. Will the PPF get improved or stay stable, or progress? Such questions could only be answered by follow-up and monitoring of the pulmonary function. At the same time, we should learn from the lessons on pulmonary function loss of the SARS patients and MERS patients, some of whom had persistent impaired lung function after discharge. Pirfenidone and Nintedanib had been approved for the treatment of idiopathic pulmonary fibrosis(IPF), showing effectiveness on non-IPF pulmonary fibrosis as well. However, there are no studies about the application on PPF resulting from viral pneumonia. Given the follow-up status of SARS patients and MERS patients, and the PPF of COVID-19 patients, we should be careful about the discharged patients with a close follow-up, and further studies on PPF of COVID-19 are needed.
新型冠状病毒肺炎(COVID-19)在中国已得到有效控制。大多数COVID-19患者出院时在随访CT扫描中出现炎症后肺纤维化(PPF),并伴有不同程度的运动性呼吸困难,CT扫描表现为寻常型间质性肺炎(UIP)或非特异性间质性肺炎(NSIP)模式。PPF会改善、保持稳定还是进展?此类问题只能通过对肺功能的随访和监测来回答。同时,我们应吸取SARS患者和MERS患者肺功能丧失的教训,他们中的一些人出院后肺功能持续受损。吡非尼酮和尼达尼布已被批准用于治疗特发性肺纤维化(IPF),对非IPF肺纤维化也显示出有效性。然而,尚无关于其在病毒性肺炎所致PPF应用的研究。鉴于SARS患者和MERS患者的随访情况以及COVID-19患者的PPF,我们应对出院患者进行密切随访,并需要对COVID-19的PPF进行进一步研究。