Department of Respiratory and Critical Care Medicine, West China School of Medicine and West China Hospital, Sichuan University, Chengdu, China.
Clinical Trial Center, National Medical Products Administration Key Laboratory for Clinical Research and Evaluation of Innovative Drugs, West China Hospital, Sichuan University, Chengdu, China.
Int J Infect Dis. 2024 Oct;147:107193. doi: 10.1016/j.ijid.2024.107193. Epub 2024 Jul 31.
The impact of anti-fibrotic medications on pulmonary fibrosis caused by COVID-19 remains inconclusive and lacks systematic investigation. This study assessed the efficacy of anti-fibrotic drugs in addressing post-COVID-19 lung fibrosis.
We searched PubMed, Web of Science, Embase, and the Cochrane Library until June 15, 2024. The meta-analysis was performed using Review Manager. Heterogeneity was evaluated utilizing I statistic, and publication bias was assessed via funnel plots.
The study (CRD42024552847) included 7 trials with 496 participants. No significant differences were observed in chest CT score (SMD = -0.60, 95% CI: -1.33 to 0.12, P = 0.10), length of hospital stay (MD = -1.34, 95% CI: -4.39 to 1.70, P = 0.39), and mortality (OR = 0.91, 95% CI: 0.50 to 1.64, P = 0.75) between anti-fibrosis and standard treatment groups. Notable improvements in pulmonary function were observed with anti-fibrotic drugs, as indicated by FEV1%pred (MD = 23.95, 95% CI: 12.24 to 35.67, P < 0.0001) and FEV1/FVC (MD = 18.17, 95% CI: 11.96 to 24.38, P < 0.00001).
Anti-fibrotic medications may help reduce fibrotic lesions and improve pulmonary function in post-COVID-19 pulmonary fibrosis, but their practical use is currently based more on theory than on solid medical evidence. Currently, in clinical practice, the use of anti-fibrotic drugs in these patients primarily relies on empirical treatment. Further clinical studies are imperative to bolster its credibility for future applications.
抗纤维化药物对 COVID-19 引起的肺纤维化的影响仍不确定，缺乏系统研究。本研究评估了抗纤维化药物治疗 COVID-19 后肺纤维化的疗效。
我们检索了 PubMed、Web of Science、Embase 和 Cochrane Library，检索时间截至 2024 年 6 月 15 日。使用 Review Manager 进行荟萃分析。使用 I ² 统计评估异质性，并通过漏斗图评估发表偏倚。
该研究（CRD42024552847）纳入了 7 项试验，共 496 名参与者。抗纤维化组与标准治疗组在胸部 CT 评分（SMD=-0.60，95%CI：-1.33 至 0.12，P=0.10）、住院时间（MD=-1.34，95%CI：-4.39 至 1.70，P=0.39）和死亡率（OR=0.91，95%CI：0.50 至 1.64，P=0.75）方面无显著差异。抗纤维化药物治疗后肺功能显著改善，FEV1%pred（MD=23.95，95%CI：12.24 至 35.67，P<0.0001）和 FEV1/FVC（MD=18.17，95%CI：11.96 至 24.38，P<0.00001）。
抗纤维化药物可能有助于减少 COVID-19 后肺纤维化的纤维化病变并改善肺功能，但目前其实际应用更多地基于理论而非确凿的医学证据。目前，在临床实践中，这些患者使用抗纤维化药物主要基于经验治疗。为了提高其在未来应用中的可信度，迫切需要进一步的临床研究。
