Pulmonary fibrosis in critically ill patients with novel coronavirus pneumonia during the convalescent stage and a proposal for early intervention

• 作者: Hai Zou Sheng-qing Li
• 来源期刊: 中国药理学报（英文版）
• 年，卷（期）: 2021,（8）
• 所属期刊栏目: Correspondence
• 页码范围: 1376-1378
• 页数: 3页
• 语种: 英文

摘要

The coronavirus disease 2019(COVID-19)outbreak poses a serious challenge to China and most countries around the world,thus the World Health Organization has declared the outbreak a public health emergency of international concern.On August 24,2020,more than 23,584,000 cases of COVID-19 had been confirmed in more than 120 countries/regions worldwide,812,519 patients had died,and 16,078,455 confirmed cases were still undergoing treatment.Most patients with COVID-19 have a good prognosis,but a small portion of patients become critically ill and even die(the cumulative mortality rate is～3.7％).Critically ill patients account for～15％of those with COVID-19,and most of them are the elderly,patients with underlying diseases or patients with obesity[1].Critically ill patients often experience dyspnea and/or hypoxemia 1 week after onset of the illness,and in severe cases,the patient can rapidly develop acute respiratory distress syndrome(ARDS),septic shock,uncorrectable metabolic acidosis,bleeding and coagulation dysfunction,and multiple organ failure.According to our clinical treatment experience,we previously proposed the"Huashan Model",which is based on supportive therapy for multiple organs supplemented with anti-inflammatory and anticoagulation therapies,for the treatment of patients with severe novel coronavirus pneumonia(NCP)[2].This model significantly improved the survival rate of critically ill NCP patients by correcting the pathophysiological state,adjusting immune system function,and promoting clearance of the virus and affected cells through symptomatic and supportive treatment.Patients with severe NCP in the convalescent stage often experience serious complications,such as multiple organ failure.In particular,prevalent pulmonary parenchymal lesions,alveolar lumen exudates,and pulmonary interstitial fibrosis can lead to poor pulmonary function in patients and seriously affect their long-term quality of life.Therefore,alleviating/reversing the process of pulmonary interstitial fibrosis,improving the pulmon-ary function of patients with severe NCP,and improving the quality of life of patients should be the focus of treatment for patients with severe NCP in the convalescent stage.