Effects of pharmacotherapy on post-COVID-19 pulmonary fibrosis: Systemic review

¹ Рeoples’ Friendship University of Russia named after Patrice Lumumba (RUDN University), Moscow, 117198, Russian Federation
² State Budgetary Institution of Healthcare of the City of Moscow “City Clinical Hospital No. 24 of the Moscow City Health Department”, Moscow, 127015, Russian Federation

^* Corresponding author: baybulatova-ea@rudn.ru

Abstract

Pulmonary fibrosis is one of serious consequences of COVID-19. Its prevalence and risk factors including disease severity, length of mechanical ventilation and hospitalization were studied, but the effect of pharmacotherapy was not widely assessed. This systematic review is aimed to investigate potential effects of drugs used before and during COVID-19 on lung damage possibly leading to pulmonary fibrosis, and effects of post-COVID-19 therapy used to fight formed pulmonary fibrosis. PubMed database was searched to identify studies published in English up to February 10, 2024. The systematic search revealed a total of 580 full-text articles, of which 23 (results of clinical trials) were finally included in the analysis. Most works considering COVID-19 treatment highlighted antibiotics and corticosteroids as groups with the highest frequency of use in patients with negative clinical outcomes and respiratory function decline, suggesting possible negative effects on pulmonary fibrosis development. Pre-COVID-19 treatment revealed rituximab and chemotherapy as main drug factors associated with pulmonary fibrosis development, and post-COVID-19 therapy with antifibrotic drugs revealed discussible results. Our systematic review was an attempt to highlight possible effects of pharmacotherapy on the lung damage leading to the pulmonary fibrosis formation.