COVID-19 and interstitial lung diseases: A multifaceted look at the relationship between the two diseases

Respir Investig. 2023 Sep;61(5):601-617. doi: 10.1016/j.resinv.2023.05.007. Epub 2023 Jun 20.

Abstract

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although it has been a fatal disease for many patients, the development of treatment strategies and vaccines have progressed over the past 3 years, and our society has become able to accept COVID-19 as a manageable common disease. However, as COVID-19 sometimes causes pneumonia, post-COVID pulmonary fibrosis (PCPF), and worsening of preexisting interstitial lung diseases (ILDs), it is still a concern for pulmonary physicians. In this review, we have selected several topics regarding the relationships between ILDs and COVID-19. The pathogenesis of COVID-19-induced ILD is currently assumed based mainly on the evidence of other ILDs and has not been well elucidated specifically in the context of COVID-19. We have summarized what has been clarified to date and constructed a coherent story about the establishment and progress of the disease. We have also reviewed clinical information regarding ILDs newly induced or worsened by COVID-19 or anti-SARS-CoV-2 vaccines. Inflammatory and profibrotic responses induced by COVID-19 or vaccines have been thought to be a risk for de novo induction or worsening of ILDs, and this has been supported by the evidence obtained through clinical experience over the past 3 years. Although COVID-19 has become a mild disease in most cases, it is still worth looking back on the above-reviewed information to broaden our perspectives regarding the relationship between viral infection and ILD. As a representative etiology for severe viral pneumonia, further studies in this area are expected.

Keywords: COVID-19; Interstitial lung disease; Pulmonary fibrosis; SARS-CoV-2; Vaccine.

Publication types

  • Review

MeSH terms

  • COVID-19* / complications
  • COVID-19* / pathology
  • Humans
  • Lung / pathology
  • Lung Diseases, Interstitial* / epidemiology
  • Lung Diseases, Interstitial* / etiology
  • Lung Diseases, Interstitial* / pathology
  • Pneumonia, Viral* / complications
  • Pneumonia, Viral* / epidemiology
  • SARS-CoV-2