Pharmacotherapy and pulmonary fibrosis risk after SARS-CoV-2 infection.
Pharmacotherapy and pulmonary fibrosis risk after SARS-CoV-2 infection.
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DOI：
10.1016/j.lana.2023.100590
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发表时间：
2023-10
期刊：
影响因子：
--
通讯作者：
Zhou, Yuchi
中科院分区：
文献类型：
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作者：
Zeng, Guangting;Zhou, Yuchi
随着疫情的发展，SARS-CoV-2感染的后遗症引起了人们的关注和警惕。由于呼吸衰竭的高发生率以及重症患者需要机械通气，人们越来越关注肺部后遗症，尤其是肺纤维化。最近，Adegunsoye 等人。研究药物疗法（胺碘酮、癌症化疗、皮质类固醇和利妥昔单抗）是否与 COVID-19 后肺纤维化的发生率相关。 1 他们的研究表明，住院患者的利妥昔单抗或癌症化疗与 COVID-19 后肺纤维化的风险增加相关。虽然这项研究设计得很好，但也有一些局限性。首先，肺纤维化具有异质性，由不同的病因和危险因素引起，在分析中模糊地包含各种类型的肺纤维化可能会高估药物治疗引起的肺纤维化的发生率和风险。认识纤维化的复杂性和异质性并在临床环境中对其进行准确分类对于更好地评估风险因素是必要的。其次，现有证据表明，COVID-19感染导致肺纤维化的危险因素包括高龄、疾病严重程度、ICU住院时间和机械通气时间、吸烟和慢性酗酒。 2 然而，Adegunsoye 等人的研究纳入了住院患者群体，并未对 ICU 住院时间和机械通气时间等变量的影响进行调整，这可能导致结果出现偏差。
As the pandemic progresses, the sequelaes of SARS-CoV-2 infection are causing concern and alarm. Due to the high incidence of respiratory failure and the need for mechanical ventilation in severely ill patients, there is increasing concern about pulmonary sequelae, most notably pulmonary fibrosis. Recently, Adegunsoye et al. investigated whether pharmacotherapies (amiodarone, cancer chemotherapy, corticosteroids, and rituximab) were associated with post-COVID-19 pulmonary fibrosis incidence. 1 Their study revealed that rituximab or cancer chemotherapy in hospitalized patients was associated with increased risk for post-COVID-19 pulmonary fibrosis. While the study was well designed, it had some limitations. First, pulmonary fibrosis is heterogeneous and is caused by different etiology and risk factors, and the vague inclusion of various types of pulmonary fibrosis in the analysis may overestimate the incidence and risk of pulmonary fibrosis caused by Pharmacotherapy. Recognizing the complexity and heterogeneity of fibrosis and accurately classifying it in a clinical setting is necessary to better assess risk factors. Second, existing evidence suggests that risk factors for pulmonary fibrosis in COVID-19 infection include advanced age, severity of the disease, length of ICU stay and mechanical ventilation, smoking, and chronic alcoholism. 2 However, Adegunsoye et al.’s study included a population of hospitalized patients and did not adjust for the effects of these variables such as length of ICU stay and mechanical ventilation time, which may have contributed to a bias in the results.