Atabati Elham, Dehghani-Samani Amir, Mortazavimoghaddam Sayyed Gholamreza
Department of Internal Medicine, Faculty of Medicine, Birjand University of Medical Sciences and Health Services, Birjand, Iran.
Clinical Research Development, Vali' Asr Hospital, Birjand University of Medical Sciences and Health Services, Birjand, Iran.
Can J Respir Ther. 2020 Nov 26;56:1-9. doi: 10.29390/cjrt-2020-021. eCollection 2020.
Interstitial lung diseases (ILDs) include a broad range of diffuse parenchymal lung disorders and are characterized by diffuse parenchymal lung abnormalities leading to irreversible fibrosis. ILDs are correlated with the occurrence of pulmonary fibrosis (PF), which generally also results in pulmonary hypertension (PH). Interferons, secreted in larger amounts during viral infections, are an important possible risk factor contributing to this outcome.
In this narrative review, the role of 10 different viral infections on the generation/development of ILDs and their outcomes are described in detail. The aim of this review is to determine the probable risk that COVID-19 and other viral infections pose in the post-infection development of ILDs, PF, and PH.
Searches in PubMed (Medline), Google Scholar, Web of Science (ISI, Researcher ID, Publons), ResearchGate, Scopus, and secondary sources yielded 134 studies. After exclusion criteria, 92 studies containing the terms "Coronavirus" (COVID-19), "Interstitial Lung Diseases," "Pulmonary Fibrosis," "Pulmonary Hypertension" and "viral infections" were selected for inclusion. Selected articles were read with a focus on the roles of the 10 commonly studied viral infections on generation/intensification of ILDs and classified according to their dominant effect on the respiratory system, with a focus on each infection's effects on parenchyma of the lungs and generation and/or intensification of ILDs.
This review found that ILDs, PF, and PH can occur after a COVID-19 viral infection. Similar results are also seen in post-infection cases of other viral infections, including Epstein-Barr virus, Cytomegalovirus, Human herpesvirus-8, adenovirus, Hepatitis C, Torque-Teno (Transfusion-Transmitted) Virus, Human Immunodeficiency Virus, Severe Acute Respiratory Syndrome, and Middle East Respiratory Syndrome.
Results of current studies show probable possibility for generation and/or intensification of ILDs in COVID-19 infected patients like other studied viruses. Studies on determination of the actual prevalence of ILD, PF and PH in post-COVID-19 infected patients, follow-up studies on the prevention of ILDs in recovered COVID-19 patients, and meta-analyzed studies on pulmonary outcomes of pandemic corona viruses are strongly recommended as topics for future studies.
间质性肺疾病（ILDs）包括多种弥漫性实质性肺疾病，其特征为弥漫性实质性肺异常，可导致不可逆的纤维化。ILDs与肺纤维化（PF）的发生相关，而肺纤维化通常也会导致肺动脉高压（PH）。在病毒感染期间大量分泌的干扰素是导致这一结果的一个重要潜在风险因素。
在这篇叙述性综述中，详细描述了10种不同病毒感染在ILDs的发生/发展及其转归中的作用。本综述的目的是确定新型冠状病毒肺炎（COVID-19）和其他病毒感染在感染后发生ILDs、PF和PH的可能风险。
在PubMed（Medline）、谷歌学术、科学网（ISI、研究人员ID、Publons）、ResearchGate、Scopus以及二级来源中进行检索，共获得134项研究。经过排除标准筛选后，选取了92项包含“冠状病毒”（COVID-19）、“间质性肺疾病”、“肺纤维化”、“肺动脉高压”和“病毒感染”等术语的研究纳入。对所选文章进行阅读，重点关注10种常见研究病毒感染在ILDs发生/加重中的作用，并根据它们对呼吸系统的主要影响进行分类，重点关注每种感染对肺实质的影响以及ILDs的发生和/或加重情况。
本综述发现，COVID-19病毒感染后可发生ILDs、PF和PH。在其他病毒感染后的病例中也观察到类似结果，包括爱泼斯坦-巴尔病毒、巨细胞病毒、人类疱疹病毒8型、腺病毒、丙型肝炎病毒、Torque-Teno（输血传播）病毒、人类免疫缺陷病毒、严重急性呼吸综合征和中东呼吸综合征。
当前研究结果表明，与其他研究病毒一样，COVID-19感染患者发生ILDs的可能性较大。强烈建议将确定COVID-19感染后患者中ILD、PF和PH的实际患病率的研究、对康复的COVID-19患者预防ILDs的随访研究以及关于大流行冠状病毒肺部转归的荟萃分析研究作为未来的研究课题。
