Pulmonary Medicine/Internal Medicine
Professor Larry Herman, DMSc, MPA, PA-C, DFAAPA
Purpose: The purpose of this article is to inform outpatient medical providers about the risk factors for COVID-19-associated fibrosis and to investigate the radiologic trends for guidance in preemptive management of post-COVID-19 pulmonary fibrosis.
Method: A PubMed literature search was conducted with search terms “Post-COVID Fibrosis,” “COVID-19 sequelae”, “post-COVID-19”, and “COVID-19 pulmonary complications.” Articles were reviewed based on clinical relevance and 24 were selected.
Results: At three-month and six-month follow-up of severe post-COVID-19 patients, current literature reveals fibrotic-like changes such as ground-glass consolidation, septal thickening, and fibrotic stranding. Persistent radiologic manifestations are associated with abnormal pulmonary function and diffusion impairment, strongly resembling patterns in pulmonary fibrosis. Routine monitoring of lung function and follow-up imaging is required to prevent severe complications of permanent fibrosis.
Conclusion: Although research on the clinical course of COVID-19-associated fibrosis is limited, evidence from previous human coronaviruses raises clinical suspicion for fibrosis progression. Predictive factors for fibrosis formation include advanced age, comorbidities, and prolonged hospitalization complicated by mechanical ventilation and oxygen supplementation. Early detection of COVID-19-associated fibrosis, which leads to referral to pulmonary specialists and pulmonary rehabilitation, is critical for prognosis. Long-term, large-scale research is required to determine the long-term viability of fibrosis sequelae.
Keywords: Post-COVID-19, Post-COVID Fibrosis, COVID-19 sequelae, COVID-19 pulmonary complications
Farinha CJ. The Fickle Fate of Fibrosis: A Prospective Diagnosis of COVID-19-associated Fibrosis. Lynchburg Journal of Medical Science. 2022; 4(2).
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