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Recovering from a pandemic: pulmonary fibrosis after SARS-CoV-2 infection

Acute manifestations of SARS-CoV-2 infection continue to impact the lives of many across the world. Post-acute sequelae of coronavirus disease 2019 (COVID-19) may affect 10–30% of survivors of COVID-19, and post-acute sequelae of COVID-19 (PASC)-pulmonary fibrosis is a long-term outcome associated w...

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Autores principales: Mylvaganam, Ruben J., Bailey, Joseph I., Sznajder, Jacob I., Sala, Marc A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Respiratory Society 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8674935/
https://www.ncbi.nlm.nih.gov/pubmed/34911696
http://dx.doi.org/10.1183/16000617.0194-2021
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author Mylvaganam, Ruben J.
Bailey, Joseph I.
Sznajder, Jacob I.
Sala, Marc A.
author_facet Mylvaganam, Ruben J.
Bailey, Joseph I.
Sznajder, Jacob I.
Sala, Marc A.
author_sort Mylvaganam, Ruben J.
collection PubMed
description Acute manifestations of SARS-CoV-2 infection continue to impact the lives of many across the world. Post-acute sequelae of coronavirus disease 2019 (COVID-19) may affect 10–30% of survivors of COVID-19, and post-acute sequelae of COVID-19 (PASC)-pulmonary fibrosis is a long-term outcome associated with major morbidity. Data from prior coronavirus outbreaks (severe acute respiratory syndrome and Middle East respiratory syndrome) suggest that pulmonary fibrosis will contribute to long-term respiratory morbidity, suggesting that PASC-pulmonary fibrosis should be thoroughly screened for through pulmonary function testing and cross-sectional imaging. As data accumulates on the unique pathobiologic mechanisms underlying critical COVID-19, a focus on corollaries to the subacute and chronic profibrotic phenotype must be sought as well. Key aspects of acute COVID-19 pathobiology that may account for increased rates of pulmonary fibrosis include monocyte/macrophage–T-cell circuits, profibrotic RNA transcriptomics, protracted elevated levels of inflammatory cytokines, and duration of illness and ventilation. Mechanistic understanding of PASC-pulmonary fibrosis will be central in determining therapeutic options and will ultimately play a role in transplant considerations. Well-designed cohort studies and prospective clinical registries are needed. Clinicians, researchers and healthcare systems must actively address this complication of PASC to minimise disability, maximise quality of life and confront a post-COVID-19 global health crisis.
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spelling pubmed-86749352021-12-17 Recovering from a pandemic: pulmonary fibrosis after SARS-CoV-2 infection Mylvaganam, Ruben J. Bailey, Joseph I. Sznajder, Jacob I. Sala, Marc A. Eur Respir Rev COVID-19 Reviews Acute manifestations of SARS-CoV-2 infection continue to impact the lives of many across the world. Post-acute sequelae of coronavirus disease 2019 (COVID-19) may affect 10–30% of survivors of COVID-19, and post-acute sequelae of COVID-19 (PASC)-pulmonary fibrosis is a long-term outcome associated with major morbidity. Data from prior coronavirus outbreaks (severe acute respiratory syndrome and Middle East respiratory syndrome) suggest that pulmonary fibrosis will contribute to long-term respiratory morbidity, suggesting that PASC-pulmonary fibrosis should be thoroughly screened for through pulmonary function testing and cross-sectional imaging. As data accumulates on the unique pathobiologic mechanisms underlying critical COVID-19, a focus on corollaries to the subacute and chronic profibrotic phenotype must be sought as well. Key aspects of acute COVID-19 pathobiology that may account for increased rates of pulmonary fibrosis include monocyte/macrophage–T-cell circuits, profibrotic RNA transcriptomics, protracted elevated levels of inflammatory cytokines, and duration of illness and ventilation. Mechanistic understanding of PASC-pulmonary fibrosis will be central in determining therapeutic options and will ultimately play a role in transplant considerations. Well-designed cohort studies and prospective clinical registries are needed. Clinicians, researchers and healthcare systems must actively address this complication of PASC to minimise disability, maximise quality of life and confront a post-COVID-19 global health crisis. European Respiratory Society 2021-12-15 /pmc/articles/PMC8674935/ /pubmed/34911696 http://dx.doi.org/10.1183/16000617.0194-2021 Text en Copyright ©The authors 2021 https://creativecommons.org/licenses/by-nc/4.0/This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org (mailto:permissions@ersnet.org)
spellingShingle COVID-19 Reviews
Mylvaganam, Ruben J.
Bailey, Joseph I.
Sznajder, Jacob I.
Sala, Marc A.
Recovering from a pandemic: pulmonary fibrosis after SARS-CoV-2 infection
title Recovering from a pandemic: pulmonary fibrosis after SARS-CoV-2 infection
title_full Recovering from a pandemic: pulmonary fibrosis after SARS-CoV-2 infection
title_fullStr Recovering from a pandemic: pulmonary fibrosis after SARS-CoV-2 infection
title_full_unstemmed Recovering from a pandemic: pulmonary fibrosis after SARS-CoV-2 infection
title_short Recovering from a pandemic: pulmonary fibrosis after SARS-CoV-2 infection
title_sort recovering from a pandemic: pulmonary fibrosis after sars-cov-2 infection
topic COVID-19 Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8674935/
https://www.ncbi.nlm.nih.gov/pubmed/34911696
http://dx.doi.org/10.1183/16000617.0194-2021
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