Pharmacotherapy and pulmonary fibrosis risk after SARS-CoV-2 infection-response to Guangting Zeng and Yuchi Zhou.
Pharmacotherapy and pulmonary fibrosis risk after SARS-CoV-2 infection-response to Guangting Zeng and Yuchi Zhou.
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DOI：
10.1016/j.lana.2023.100611
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发表时间：
2023-10
期刊：
影响因子：
--
通讯作者：
Solway, Julian
中科院分区：
文献类型：
--
作者：
Adegunsoye, Ayodeji;Baccile, Rachel;Best, Thomas J.;Zaksas, Victoria;Zhang, Hui;Karnik, Rasika;Patel, Bhakti K.;Solomonides, Anthony E.;Parker, William F.;Solway, Julian
我们非常感谢曾医生和周医生的评论，其中提到COVID后肺纤维化的风险因素包括高龄，疾病严重程度，ICU住院时间，机械通气，吸烟和慢性酒精中毒，因为这与现有的证据体系完全一致。1我们的研究仅包括因COVID-19而住院的重症或危重症患者，承认与严重程度和ICU护理相关的固有偏见。然而，我们的研究设计是精心定制的，以解决这些混杂因素。我们仔细调整了高龄、合并症的严重程度和住院期间使用的治疗（remdesivir、地塞米松和IL-6抑制剂），将其纳入我们的倾向评分匹配中。2我们的假设是，药物暴露增加了COVID后肺纤维化的风险，部分原因是增加了严重急性COVID、机械通气和ARDS的风险。因此，控制急性COVID的严重程度将使我们的结果偏向零，因为这不能代表药物暴露与肺纤维化风险的总效应相关性。因此，我们在倾向评分分析中没有控制疾病的严重程度、COVID住院时间或机械通气，以便更全面地呈现药物暴露对COVID后肺纤维化的影响。此外，曾博士和周博士强调了在临床环境中准确分类肺纤维化亚型的微妙挑战。1
We greatly appreciate Dr. Zeng and Dr. Zhou for their commentary which mentions that risk factors for post-COVID pulmonary fibrosis include advanced age, disease severity, length of ICU stay, mechanical ventilation, smoking, and chronic alcoholism, as this is well-aligned with the existing body of evidence. 1 Our study exclusively encompassed severe or critically ill hospitalized patients due to COVID-19, acknowledging inherent biases tied to severity and ICU care. However, our study design was meticulously tailored to address these confounders. We carefully adjusted for advanced age, severity of comorbid diseases, and treatments used during hospitalization (remdesivir, dexamethasone, and IL-6 inhibitors) by including them in our propensity score matching. 2 Our hypothesis was that drug exposure increased the risk of post-COVID pulmonary fibrosis in part by increasing the risk of severe acute COVID, mechanical ventilation, and ARDS. Therefore, controlling for the severity of acute COVID would bias our results towards the null as this would not represent the total-effect association of drug exposure with pulmonary fibrosis risk. We thus did not control for severity of illness, length of COVID hospitalization, or mechanical ventilation in our propensity score analysis in order to more comprehensively present the effect of drug exposure on post-COVID pulmonary fibrosis. Further, Dr. Zeng and Dr. Zhou highlight the nuanced challenge of accurately classifying pulmonary fibrosis subtypes in clinical settings. 1
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影响因子：
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期刊：
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影响因子：
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作者：
Adegunsoye, Ayodeji;Baccile, Rachel;Best, Thomas J.;Zaksas, Victoria;Zhang, Hui;Karnik, Rasika;Patel, Bhakti K.;Solomonides, Anthony E.;Parker, William F.;Solway, Julian
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发表时间：
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期刊：
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影响因子：
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通讯作者：
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