Case Report: Pirfenidone in the Treatment of Post-COVID-19 Pulmonary Fibrosis

Xianglin Zhou; Danhui Yang; Xianglong Kong; Chengli Wei; Siqi LvQiu; Lin Wang; Yongkang Lin; Zhilan Yin; Zhiguo Zhou; Hong Luo

doi:10.3389/fmed.2022.925703

Case Report: Pirfenidone in the Treatment of Post-COVID-19 Pulmonary Fibrosis

Front Med (Lausanne). 2022 Jun 6:9:925703. doi: 10.3389/fmed.2022.925703. eCollection 2022.

Authors

Xianglin Zhou^{1

2

3}, Danhui Yang^{1

2

3}, Xianglong Kong⁴, Chengli Wei^{1

2

3}, Siqi LvQiu^{1

2

3}, Lin Wang^{1

2

3}, Yongkang Lin^{1

2

3}, Zhilan Yin⁵, Zhiguo Zhou⁴, Hong Luo^{1

2

3}

Affiliations

¹ Department of Pulmonary and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, China.
² Research Unit of Respiratory Disease, Central South University, Changsha, China.
³ Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, China.
⁴ Respiratory Medicine, The First Hospital of Changsha, Changsha, China.
⁵ Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China.

Abstract

Background: Pulmonary fibrosis is one of the sequelae of the COVID-19, which seriously affects the quality of life of survivors. Currently, there are no optimal evidence based guidelines targeting this population.

Case presentation: We report a 66-year-old female patient without underlying comorbidities admitted to Changsha Public Health Center because of COVID-19. During hospitalization, she developed co-bacterial infection and acute respiratory distress syndrome, and received broad-spectrum antibacterial therapy, invasive mechanical ventilation and extracorporeal membrane oxygenation. After the acute phase, she developed post-COVID-19 pulmonary fibrosis subsequently treated with pirfenidone. Over 96 weeks after pirfenidone treatment, her modified Medical Research Council Dyspnea level improved to 2 from 4 at discharge. Her 6 minutes walk test distance, total lung capacity, and diffusion capacity for carbon monoxide all increased. Chest CT performed on 2 years after illness onset showed regressing fibrosis. The Hospital Anxiety and Depression Scale, Athens Insomnia Scale, and 36-Item Short Form Health Survey questionnaire all improved.

Conclusion: Post-COVID-19 pulmonary fibrosis is a challenging consequence of COVID-19, and our case suggests that pirfenidone may be an effective treatment option.

Keywords: long COVID; pirfenidone; post-COVID-19; pulmonary fibrosis; sequelae.

Publication types

Case Reports