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Recovering from a pandemic: pulmonary fibrosis after SARS-CoV-2 infection

Authors :
Ruben J. Mylvaganam
Joseph I. Bailey
Jacob I. Sznajder
Marc A. Sala
Source :
European Respiratory Review, Vol 30, Iss 162 (2021)
Publication Year :
2021
Publisher :
European Respiratory Society, 2021.

Abstract

Acute manifestations of SARS-CoV-2 infection continue to impact the lives of many across the world. Post-acute sequelae of coronavirus disease 2019 (COVID-19) may affect 10–30% of survivors of COVID-19, and post-acute sequelae of COVID-19 (PASC)-pulmonary fibrosis is a long-term outcome associated with major morbidity. Data from prior coronavirus outbreaks (severe acute respiratory syndrome and Middle East respiratory syndrome) suggest that pulmonary fibrosis will contribute to long-term respiratory morbidity, suggesting that PASC-pulmonary fibrosis should be thoroughly screened for through pulmonary function testing and cross-sectional imaging. As data accumulates on the unique pathobiologic mechanisms underlying critical COVID-19, a focus on corollaries to the subacute and chronic profibrotic phenotype must be sought as well. Key aspects of acute COVID-19 pathobiology that may account for increased rates of pulmonary fibrosis include monocyte/macrophage–T-cell circuits, profibrotic RNA transcriptomics, protracted elevated levels of inflammatory cytokines, and duration of illness and ventilation. Mechanistic understanding of PASC-pulmonary fibrosis will be central in determining therapeutic options and will ultimately play a role in transplant considerations. Well-designed cohort studies and prospective clinical registries are needed. Clinicians, researchers and healthcare systems must actively address this complication of PASC to minimise disability, maximise quality of life and confront a post-COVID-19 global health crisis.

Details

Language :
English
ISSN :
09059180 and 16000617
Volume :
30
Issue :
162
Database :
Directory of Open Access Journals
Journal :
European Respiratory Review
Publication Type :
Academic Journal
Accession number :
edsdoj.1cc8f997338a49899877af9c8609a66f
Document Type :
article
Full Text :
https://doi.org/10.1183/16000617.0194-2021