UNDERSTANDING INTERSTITIAL LUNG DISEASE IN POST COVID-19 PATIENTS AS A NEW FIBROINFLAMMATORY DISEASE

Abstract

Introduction: The COVID-19 pandemic has revealed a spectrum of pulmonary complications, ranging from acute respiratory distress syndrome (ARDS) to long-term sequelae such as interstitial lung disease (ILD). Post-COVID ILD presents a novel challenge, characterized by a broinammatory process that differs from traditional ILDs. This article aims to provide a comprehensive understanding of post-COVID ILD, exploring its pathogenesis, clinical manifestations, diagnostic approaches, and therapeutic considerations. We delve into the interplay between viral infection, dysregulated immune responses, and brotic pathways, shedding light on the mechanisms underlying disease progression. Clinical phenotypes and radiological patterns of post-COVID ILD are elucidated, emphasizing the importance of multidisciplinary collaboration for accurate diagnosis and management. By synthesizing current evidence and clinical insights, this article aims to enhance clinicians' understanding of post-COVID ILD, facilitating optimized care for affected individuals in the post-pandemic era. The Material and Methods: study was a retrospective, observational cross-sectional study conducted in JNUIMSRC, Jaipur, Rajasthan. A total of 15 patient cases who presented to the Outpatient Department of JNUIMSRC, Jaipur from August 2022 to March 2023, with symptoms of cough, shortness of breath, chest pain and dyspnea with symptom history of more than 3 months were evaluated using High resolution computed tomography. We assessed the clinical symptoms and radiological patterns of the cases to determine the trajectory of the disease. This study included patients of all ages and genders who presented with symptoms of dyspnea, cough and chest pain with symptom duration > 3 months with a clinic-radiological diagnosis of COVID-19 infection who consented to be a part of this study. The proposition that post-COVID-19 syndrome contr Results- ibutes to Interstitial Lung Disease suggests that tissue damage occurs directly, potentially inciting autoimmunity, and is compounded by exposure to neoantigens, as well as the generation of antibodies whose identities remain elusive. This phenomenon arises from a complex interplay involving immunological responses, genetic predispositions, tissue damage resulting from COVID-19 infection, the impact of acute respiratory distress syndrome, and the inltration of macrophages during the acute phase of the disease. These factors collectively instigate a broproliferative cascade, culminating in the recruitment of broblasts and myobroblasts, alongside excessive extracellular matrix deposition within the pulmonary interstitium. This process ultimately leads to brosis and architectural damage within the lung tissue. Conclusion- After experiencing SARS-CoV-2 pneumonitis, a subset of patients develop interstitial lung disease, resulting in enduring functional impairment of the lungs. Even a minor proportion of individuals affected by this condition is poised to impose a considerable burden of disease, underscoring the critical importance of promptly identifying this specic medical condition.