A case of successful treatment of diffuse post-coronavirus pulmonary fibrosis with pirfenidone
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Ukrainian Military Medical Academy, Department of Military Therapy, Kyiv, Ukraine
Command of the Medical Forces of the Armed Forces of Ukraine, Central Medical and Evacuation Administration, Kyiv, Ukraine
Ukrainian Military Medical Academy, Department of Military General Practice and Family Medicine, Kyiv, Ukraine
National Military Medical Clinical Center ‘Main Military Clinical Hospital,’ Pulmonology Clinic, Kyiv, Ukraine
National Military Medical Clinical Center ‘Main Military Clinical Hospital,’ Therapeutic and Methodological Department, Kyiv, Ukraine
Submission date: 2023-02-09
Final revision date: 2023-05-07
Acceptance date: 2023-05-07
Online publication date: 2023-11-17
Corresponding author
Svitlana Bychkova   

Department of Military Therapy, Ukrainian Military Medical Academy, 01015, Knyaziv Ostroz’kykh, 45/1,Kyiv, Ukraine.
Pol. Ann. Med. 2023;30(2):149-152
Accumulated evidence suggests that pulmonary fibrosis is a common complication of COVID-19. Fibrotic post-coronavirus lung changes are similar to the changes found in patients with idiopathic pulmonary fibrosis.

The paper describes the outcomes of pirfenidone usage in treatment of patients with post-coronavirus pulmonary fibrosis.

Case study:
The paper presents a case study about a 51-year-old male patient, who had diffuse post-coronavirus pulmonary fibrosis with significant impairment of external respiratory function. The patient had experienced severe COVID-19 bilateral polysegmental pneumonia. In the 3rd week of the disease, multislice computed tomography detected signs of fibrosis that affected 80% of lung tissue. It was decided to start antifibrotic treatment with pirfenidone, which is usually used to treat idiopathic pulmonary fibrosis.

Results and discussion:
Pirfenidone was prescribed for 3 months according to the conventional scheme in combination with methylprednisolone. This therapy resulted in significant decrease of fibrosis scope , normalization of respiratory function and improvement of patient's quality of life. A key feature of the presented clinical case is a significant positive effect of pirfenidone in treating coronavirus-associated pulmonary fibrosis, which affected 80% of lung tissue of the patient.

Post-coronavirus pulmonary fibrosis is characterized by the severe oxygen insufficiency and requires a constant oxygen support. The treatment that included pirfenidone in combination with steroids has demonstrated convincing positive effect. It reduces post-coronavirus pulmonary fibrosis and improves lung function.

None to declare.
Ali RM, Ghonimy MB. Post-COVID-19 pneumonia lung fibrosis: a worrisome sequelae in surviving patients. Egypt J Radiol Nucl Med. 2021;52(1):1–8. https://
Romaszko-Wojtowicz A-M, Doboszyńska A. Pulmonary complications due to COVID-19 – a literature review. Pol Ann Med. 2021;28(2):244–249.
Li X, Shen C, Wang L, et al. Pulmonary fibrosis and its related factors in discharged patients with new corona virus pneumonia: a cohort study. Respir Res. 2021;22(1):1–11.
Pan F, Ye T, Sun P et al. Changes at Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19). Radiology. 2020;295(3):715–721.
George PM, Barratt SL, Condliffe R et al. Respiratory follow-up of patients with COVID-19 pneumonia. Thorax. 202;75(11):1009–1016.
George PM, Wells AU, Jenkins RG. Pulmonary fibrosis and COVID-19: the potential role for antifibrotic therapy. Lancet Respir Med. 2020;8(8):807–815.
Ruwanpura SM , Thomas BJ, Bardin PhG. Pirfenidone: Molecular Mechanisms and Potential Clinical Applications in Lung Disease. Am J Respir Cell Mol Biol. 2020; 62(4):413–422.
Wu W, Qiu L, Wu J, et al. Efficacy and safety of pirfenidone in the treatment of idiopathic pulmonary fibrosis patients: a systematic review and meta-analysis of randomised controlled trials. BMJ Open. 2021;11:e050004. bmjopen-2021-050004.
Vianello A, Molena B, Turato C. Pirfenidone improves the survival of patients with idiopathic pulmonary fibrosis hospitalized for acute exacerbation. Curr Med Res Opin. 2019;35(7):1187–1190. 10.1080/03007995.2019.1565530.
Wu C, Chen X, Cai Y, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020;180(7):934–943.
Vasarmidi E, Tsitoura E, Spandidos DA. Pulmonary fibrosis in the aftermath of the COVID-19 era (Review). Exp Ther Med. 2020;20(3):2557–2560.
Myall KJ, Mukherjee B, Castanheira AM, et al. Persistent post–COVID-19 interstitial lung disease. An observational study of corticosteroid treatment. Ann Am Thorac Soc. 2021;18(5):799–806.
Bychkova S, Bychkov O, Osyodlo G, et al. The main epidemiological and diagnostical features of chronic obstructive pulmonary disease in servicemen of the Armed Forces of Ukraine in the condition of Joined Forces Operation. Wiad Lek. 2022;75(1):176–181.
Tay MZ, Poh CM, Renia L. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol. 2020;20(6):363–374.
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