My husband has signs of lung fibrosis. How should it be treated?

Question

Hello doctor,

My husband is a person with diabetes and was discharged from the hospital after COVID treatment one and a half months ago. His computed tomography (CT) showed early fibrosis at the time of admission. The doctor advised us to repeat the CT after around a month. We got it done today, and I am attaching the reports, which do not look good. I am very tensed. He took anti-fibrotic medicine for a month even after discharge. Can you please check and guide us on the best possible treatment?

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern. According to the HRCT (high-resolution computed tomography) of the chest report (attachment removed to protect the patient's identity), some scattered areas of fibrosis in both lungs and prominent mediastinal lymph nodes are seen. Ground glass opacities were seen in the previous CT scan, indicating that COVID-19 pneumonia has been resolved or cured. Now, fibrosis is seen in the bilateral lungs as a complication or consequence of COVID-19 infection. Considering the huge number of patients affected by COVID-19, even rare complications like post-COVID fibrosis will have major health effects at the population level. Currently, no proven options are available for the treatment of post-inflammatory COVID-19 pulmonary fibrosis. It has been proposed that prolonged use of antiviral agents, anti-inflammatory drugs, and anti-fibrotic drugs, along with or without antibiotics like tablet Azithromycin, may diminish the probability of further development of lung fibrosis. Breathing exercises like blowing balloons every day at home with respiratory physiotherapy may help improve a patient's respiratory problems with fibrotic lungs to some extent.

I hope this helps.

Please feel free to reach out in case of further queries.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

His first HRCT of the chest report (attachment removed to protect the patient's identity) is provided. It shows that he had COVID pneumonia, and now it has subsided or cured, but post-COVID pulmonary fibrosis has already started to develop despite taking anti-fibrotic drugs.

Recent high-resolution computed tomography (HRCT) of the lung shows mediastinal lymph nodes, which were not present in his previous CT scan. It may result from various underlying conditions like COPD (chronic obstructive pulmonary disorder), heart failure, sarcoidosis, pneumoconiosis, granulomatous disease, carcinoma, etc. CT (computed tomography) guided FNAC (fine needle aspiration cytology) or biopsy and bronchoscopy can confirm the underlying etiology of the mediastinal lymph nodes.

The life expectancy of patients with fibrosis is five years at best after diagnosis. However, early detection of the disease is the key to slowing progression and increasing disease prognosis. The treatment will aim to stop the disease progression first. Corticosteroids, bronchodilators, antivirals, antibiotics, etc., along with anti-fibrotic drugs, can be given for improvement.

The anti-fibrotic drug he is currently taking is not working well, so the doctor can add any other anti-fibrotic drug to his regimen. Please consult with a pulmonologist about his disease progression. After assessing your husband, the pulmonologist will find a solution for your husband. Always keep in touch with a doctor.

I hope this helps.

Please feel free to reach out in case of further queries.

Thank you.