Usefulness of Pirfenidone in Covid Lung: A Case Series

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  •   Abdul Basit Ibne Momen

  •   Farhana Khan

  •   Sadia Saber

  •   Amrin Sultana

  •   Rafa Faaria Alam

  •   Sheikh Golam Raihan

  •   Mohammad Monower Hossain

  •   Md Tarek Alam

Abstract

The year 2020 has been plagued by the COVID‑19 pandemic that has resulted in an additional 1,800,000 deaths worldwide. Many patients who recover from Covid-19 later present with shortness of breath and fibrosis of the lungs, while some take a long time to recover from the initial infection. A drug such as pirfenidone, which has been used for the treatment of idiopathic pulmonary fibrosis, could offer additional benefits by reverting pulmonary fibrotic damage. Here we describe a case series of five patients where addition of this drug showed marked improvement in symptoms and radiological findings. Apart from the efforts regarding understanding the pathophysiology of this new disease, we must also evaluate the proportion of patients that develop chronic lung disease due to fibrosis following COVID-19 recovery. Certainly, more attention should be given to new studies to determine the actual benefit of pirfenidone in patients with pulmonary fibrosis as a result of Covid-19 infection.


Keywords: COVID-19, Pirfenidone, Pulmonary Fibrosis

References

Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS‐CoV2 may play a role in the respiratory failure of COVID‐19 patients. Journal of medical virology. 2020 Jun;92(6):552-5. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, Niu P, Zhan F, Ma X, Wang D, Xu W, Wu G, Gao GF, Tan W, China Novel Coronavirus Investigating and Research Team (2020) A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 382:727–733.

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DSC, du B, Li LJ, Zeng G, Yuen KY, Chen RC, Tang CL, Wang T, Chen PY, Xiang J, Li SY, Wang JL, Liang ZJ, Peng YX, Wei L, Liu Y, Hu YH, Peng P, Wang JM, Liu JY, Chen Z, Li G, Zheng ZJ, Qiu SQ, Luo J, Ye CJ, Zhu SY, Zhong NS, China Medical Treatment Expert Group for Covid-19 (2020) Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 382:1708–1720

King CS, Nathan SD. Idiopathic pulmonary fibrosis: effects and optimal management of comorbidities. The Lancet Respiratory Medicine. 2017 Jan 1;5(1):72-84.

Maher TM, Corte TJ, Fischer A, Kreuter M, Lederer DJ, Molina-Molina M, Axmann J, Kirchgaessler KU, Samara K, Gilberg F, Cottin V. Pirfenidone in patients with unclassifiable progressive fibrosing interstitial lung disease: a double-blind, randomised, placebo-controlled, phase 2 trial. The Lancet Respiratory Medicine. 2020 Feb 1;8(2):147-57.

Yang Y, Ye Y, Lin X, Wu K, Yu M. Inhibition of pirfenidone on TGF-beta2 induced proliferation, migration and epithlial-mesenchymal transition of human lens epithelial cells line SRA01/04. PloS one. 2013 Feb 21;8(2): e56837.

Lancaster LH, de Andrade JA, Zibrak JD, Padilla ML, Albera C, Nathan SD, Wijsenbeek MS, Stauffer JL, Kirchgaessler KU, Costabel U. Pirfenidone safety and adverse event management in idiopathic pulmonary fibrosis. European respiratory review. 2017 Dec 31;26(146).

George PM, Wells AU, Jenkins RG. Pulmonary fibrosis and COVID-19: the potential role for antifibrotic therapy. The Lancet Respiratory Medicine. 2020 May 15.

Ferrara F, Granata G, Pelliccia C, La Porta R, Vitiello A. The added value of pirfenidone to fight inflammation and fibrotic state induced by SARS-CoV-2. European Journal of Clinical Pharmacology. 2020 Nov;76(11):1615-8.

Li Y, Li H, Liu S, Pan P, Su X, Tan H, Wu D, Zhang L, Song C, Dai M, Li Q. Pirfenidone ameliorates lipopolysaccharide-induced pulmonary inflammation and fibrosis by blocking NLRP3 inflammasome activation. Molecular immunology. 2018 Jul 1; 99:134-44.

Saha A, Vaidya PJ, Chavhan VB, Achlerkar A, Leuppi JD, Chhajed PN. Combined pirfenidone, azithromycin and prednisolone in post-H1N1 ARDS pulmonary fibrosis. Sarcoidosis, Vasculitis, and Diffuse Lung Diseases. 2018;35(1):85.

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How to Cite
Momen, A. B. I., Khan, F., Saber, S., Sultana, A., Alam, R. F., Raihan, S. G., Hossain, M. M., & Alam, M. T. (2021). Usefulness of Pirfenidone in Covid Lung: A Case Series. European Journal of Medical and Health Sciences, 3(1), 24–26. https://doi.org/10.24018/ejmed.2021.3.1.670

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