Impact of antifibrotics on post-COVID-19 lung sequelae

Respiratory problems in acute COVID-19 and post-acute COVID-19 syndrome vary greatly, potentially leading to long-term functional difficulties. Off-label usage of antifibrotics, such as pirfenidone, has emerged as a promising treatment for post-COVID interstitial lung problems. Our study aims to assess clinical and radiological lung abnormalities post-COVID-19 and the effect of antifibrotics on the outcome. A retrospective observational study examined data from 90 COVID-19 patients who completed the follow-up period in the post-COVID clinic at the Chest Department, Kasr El Ainy Hospital, from August 2020 to August 2022. Demographic data, comorbidities, exercise tolerance, and chest computed tomography (CT) results were collected 1 and 6 months after the diagnosis. Initial CT scans (1 month following hospital admission) revealed diffuse ground-glass opacities (87.8%) and reticulations (43.3%). After 6 months, 33.3% were back to normal, 41% had persistent reticulations, 22.2% had ground glass opacities, and 3.3% had bronchiectasis. CT scores improved dramatically after 6 months. No significant link was detected between CT score change and off-label use of pirfenidone. Antifibrotic therapy has a modest effect on post-COVID lung problems. One-third of patients showed reticulations as persistent radiological abnormalities, which could guide future treatment choices.