Development of fibrosis and impairment of lung function in patients with a new coronavirus disease
https://doi.org/10.18093/0869-0189-2021-31-5-653-662
Abstract
The aim: review scientific research to find out whether the new coronavirus infection (NCI) causes fibrotic changes in the lungs and, if any, how long they persist and whether functional disorders of the respiratory system accompany them. Disruption of the functional state of the lungs in patients with severe novel coronavirus disease (COVID-19) is still seen 6 months after completion of inpatient treatment. High-resolution computed tomography (HRCT) demonstrates persistent pathological changes in the lungs, some of which are fibrosis-like. Pathomorphological features of the COVID-19 course, as well as the ability of the virus to activate connective tissue growth factor (CTGF) and enhance the signaling of transforming growth factor-beta (TGF-β), can contribute to lung tissue fibrosis. Increased titers of antinuclear autoantibodies and specific autoantibodies indirectly reveal dysregulation of the immune response leading to the progression of organizing pneumonia and fibrotic changes in the lung tissue. These increased titers can also indicate the need to prescribe immunosuppressive and antifibrotic drugs. Researchers are considering the possibility of including antifibrotic drugs in combination therapy for severe COVID-19 in the early stages of treatment in patients with risk factors for developing pulmonary fibrosis. However, further monitoring and determination of the role of antifibrotic drugs are required. Sometimes patients with COVID-19 develop severe, irreversible fibrotic lung disease, and lung transplantation is the only treatment option.
Conclusion. There is no unequivocal opinion among researchers concerning the clinical significance and further prognosis of COVID-19 so far, which is a reason for further studies.
About the Authors
Igor´ V. Leshchenko
Ural Federal State Medical University, Healthcare Ministry; Ural Federal Research Institute of Phthisiology and Pulmonology – A Branch of National Medical Research Center for Phthisiology, Pulmonology and Infectious Diseases, Healthcare Ministry; “Novaya bol’nitsa” Clinical Association Limited Liability Companies
Russian Federation
Competing Interests:
Russian Federation
Igor V. Leshсhenko, Doctor of Medicine, Professor, Department of Phthisiology, Pulmonology and Thoracic Surgery; Chief Researcher;
ul. Repina 3, Ekaterinburg, 620028;
ul. 22-go Parts’ezda 50, Ekaterinburg, 620039;
ul. Zavodskaya 29, Ekaterinburg, 620109
tel.: (343) 246-44-75
Competing Interests:
The authors declare no conflict of interest
Tatyana V. Glushkova
Ural Federal Research Institute of Phthisiology and Pulmonology – A Branch of National Medical Research Center for Phthisiology, Pulmonology and Infectious Diseases, Healthcare Ministry
Russian Federation
Competing Interests:
Russian Federation
Tatyana V. Glushkova, pulmonologist
ul. 22-go Parts’ezda 50, Ekaterinburg, 620039
tel.: (343) 333-44-33
Competing Interests:
The authors declare no conflict of interest
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Leshchenko I.V., Glushkova T.V. Development of fibrosis and impairment of lung function in patients with a new coronavirus disease. PULMONOLOGIYA. 2021;31(5):653-662. (In Russ.) https://doi.org/10.18093/0869-0189-2021-31-5-653-662
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