Pulmonary fibrosis: A short- or long-term sequelae of severe COVID-19?
Pulmonary fibrosis: A short- or long-term sequelae of severe COVID-19?
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DOI：
10.1016/j.pccm.2022.12.002
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发表时间：
2023-06
期刊：
影响因子：
--
通讯作者：
Zhou, Yong
中科院分区：
文献类型：
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作者：
Zheng, Zhen;Peng, Fei;Zhou, Yong
由新型严重急性呼吸综合征（SARS）冠状病毒2（SARS-CoV-2）引起的2019冠状病毒病（COVID-19）大流行对全球医疗保健造成了巨大影响。SARS-CoV-2感染主要针对呼吸系统。尽管大多数SARS-CoV-2检测呈阳性的个体表现为轻度或无上呼吸道症状，但严重的COVID-19患者可迅速进展为急性呼吸窘迫综合征（ARDS）。ARDS相关的肺纤维化是COVID-19的公认后遗症。COVID-19后肺纤维化是否可消退、持续，甚至如在人类特发性肺纤维化（IPF）中所见的那样变得进行性，目前尚不清楚，仍然是一个争论的问题。随着针对COVID-19的有效疫苗和治疗方法的出现，现在重要的是建立我们对SARS-CoV-2感染的长期后遗症的理解，以识别有发生慢性肺纤维化风险的COVID-19幸存者，并开发有效的抗纤维化疗法。本文旨在总结COVID-19在呼吸系统的发病机制，并强调严重COVID-19中ARDS相关的肺纤维化及其潜在机制。它设想了COVID-19幸存者的长期纤维化肺部并发症，特别是在老年人群中。早期识别患者的风险发展为慢性肺纤维化和抗纤维化治疗的发展进行了讨论。
The pandemic of coronavirus disease 2019 (COVID‑19), caused by a novel severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2), has caused an enormous impact on the global healthcare. SARS-CoV-2 infection primarily targets the respiratory system. Although most individuals testing positive for SARS-CoV-2 present mild or no upper respiratory tract symptoms, patients with severe COVID-19 can rapidly progress to acute respiratory distress syndrome (ARDS). ARDS-related pulmonary fibrosis is a recognized sequelae of COVID-19. Whether post-COVID-19 lung fibrosis is resolvable, persistent, or even becomes progressive as seen in human idiopathic pulmonary fibrosis (IPF) is currently not known and remains a matter of debate. With the emergence of effective vaccines and treatments against COVID-19, it is now important to build our understanding of the long-term sequela of SARS-CoV-2 infection, to identify COVID-19 survivors who are at risk of developing chronic pulmonary fibrosis, and to develop effective anti-fibrotic therapies. The current review aims to summarize the pathogenesis of COVID-19 in the respiratory system and highlights ARDS-related lung fibrosis in severe COVID-19 and the potential mechanisms. It envisions the long-term fibrotic lung complication in COVID-19 survivors, in particular in the aged population. The early identification of patients at risk of developing chronic lung fibrosis and the development of anti-fibrotic therapies are discussed.