{"title":"尼达尼布对covid -19后肺纤维化的影响:一项观察性研究","authors":"Narongkorn Saiphoklang, Pimchanok Patanayindee, Pitchayapa Ruchiwit","doi":"10.1155/2022/9972846","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Lung fibrosis is a sequela of COVID-19 among patients with severe pneumonia. Idiopathic pulmonary fibrosis and lung fibrosis due to COVID-19 may share many similar features. There are limited data on effects of antifibrotic treatment of infection-related lung fibrosis. This study aimed to evaluate the effect of nintedanib on patients' post-COVID-19 lung fibrosis.</p><p><strong>Methods: </strong>A retrospective, matched case-control study was performed on hospitalized patients with COVID-19 pneumonia. Patients who received nintedanib treatment for COVID-19 pulmonary fibrosis (nintedanib group) were compared to patients with standard treatment (control group). The primary outcome was oxygen improvement. The secondary outcomes were chest X-ray improvement, SpO<sub>2</sub>/FiO<sub>2</sub> ratio improvement, mortality rates at 60 days, and adverse events.</p><p><strong>Results: </strong>A total of 42 patients with COVID-19 pneumonia were included (21 in each group). Mean age was 64.43 ± 14.59 years, and 54.8% were men. At baseline, SpO<sub>2</sub>/FiO<sub>2</sub> ratio before treatment was 200.57 ± 105.77 in the nintedanib group and 326.90 ± 137.10 in the control group (<i>P</i> = 0.002). Oxygen improvement and chest X-ray improvement were found in 71.4% and 71.4% in the nintedanib group and in 66.7% and 66.7% in the control group (<i>P</i> = 0.739). The nintedanib group had more improvement in SpO<sub>2</sub>/FiO<sub>2</sub> ratio than in the control group (144.38 ± 118.05 vs 55.67 ± 75.09, <i>P</i> = 0.006). The 60-day mortality rates of the nintedanib and the control groups were 38.1% vs 23.8%, <i>P</i> = 0.317. Hepatitis and loss of appetite were common adverse events (9.5% and 9.5%), while the incidence of diarrhea was 4.8%.</p><p><strong>Conclusions: </strong>Nintedanib as add-on treatment in post-COVID-19 lung fibrosis did not improve oxygenation, chest X-ray findings, or the 60-day mortality. However, this antifibrotic drug improved SpO<sub>2</sub>/FiO<sub>2</sub> ratio in our patients. Further randomized controlled trials are needed to determine the efficacy of nintedanib for treatment of patients with post-COVID-19 lung fibrosis. <i>Trial Registration</i>. This study was registered in TCTR20220426001.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":" ","pages":"9972846"},"PeriodicalIF":1.8000,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9529527/pdf/","citationCount":"5","resultStr":"{\"title\":\"The Effect of Nintedanib in Post-COVID-19 Lung Fibrosis: An Observational Study.\",\"authors\":\"Narongkorn Saiphoklang, Pimchanok Patanayindee, Pitchayapa Ruchiwit\",\"doi\":\"10.1155/2022/9972846\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Lung fibrosis is a sequela of COVID-19 among patients with severe pneumonia. Idiopathic pulmonary fibrosis and lung fibrosis due to COVID-19 may share many similar features. There are limited data on effects of antifibrotic treatment of infection-related lung fibrosis. This study aimed to evaluate the effect of nintedanib on patients' post-COVID-19 lung fibrosis.</p><p><strong>Methods: </strong>A retrospective, matched case-control study was performed on hospitalized patients with COVID-19 pneumonia. Patients who received nintedanib treatment for COVID-19 pulmonary fibrosis (nintedanib group) were compared to patients with standard treatment (control group). The primary outcome was oxygen improvement. The secondary outcomes were chest X-ray improvement, SpO<sub>2</sub>/FiO<sub>2</sub> ratio improvement, mortality rates at 60 days, and adverse events.</p><p><strong>Results: </strong>A total of 42 patients with COVID-19 pneumonia were included (21 in each group). Mean age was 64.43 ± 14.59 years, and 54.8% were men. At baseline, SpO<sub>2</sub>/FiO<sub>2</sub> ratio before treatment was 200.57 ± 105.77 in the nintedanib group and 326.90 ± 137.10 in the control group (<i>P</i> = 0.002). Oxygen improvement and chest X-ray improvement were found in 71.4% and 71.4% in the nintedanib group and in 66.7% and 66.7% in the control group (<i>P</i> = 0.739). The nintedanib group had more improvement in SpO<sub>2</sub>/FiO<sub>2</sub> ratio than in the control group (144.38 ± 118.05 vs 55.67 ± 75.09, <i>P</i> = 0.006). The 60-day mortality rates of the nintedanib and the control groups were 38.1% vs 23.8%, <i>P</i> = 0.317. Hepatitis and loss of appetite were common adverse events (9.5% and 9.5%), while the incidence of diarrhea was 4.8%.</p><p><strong>Conclusions: </strong>Nintedanib as add-on treatment in post-COVID-19 lung fibrosis did not improve oxygenation, chest X-ray findings, or the 60-day mortality. However, this antifibrotic drug improved SpO<sub>2</sub>/FiO<sub>2</sub> ratio in our patients. Further randomized controlled trials are needed to determine the efficacy of nintedanib for treatment of patients with post-COVID-19 lung fibrosis. <i>Trial Registration</i>. This study was registered in TCTR20220426001.</p>\",\"PeriodicalId\":46583,\"journal\":{\"name\":\"Critical Care Research and Practice\",\"volume\":\" \",\"pages\":\"9972846\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2022-09-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9529527/pdf/\",\"citationCount\":\"5\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Critical Care Research and Practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1155/2022/9972846\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Critical Care Research and Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2022/9972846","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
The Effect of Nintedanib in Post-COVID-19 Lung Fibrosis: An Observational Study.
Background: Lung fibrosis is a sequela of COVID-19 among patients with severe pneumonia. Idiopathic pulmonary fibrosis and lung fibrosis due to COVID-19 may share many similar features. There are limited data on effects of antifibrotic treatment of infection-related lung fibrosis. This study aimed to evaluate the effect of nintedanib on patients' post-COVID-19 lung fibrosis.
Methods: A retrospective, matched case-control study was performed on hospitalized patients with COVID-19 pneumonia. Patients who received nintedanib treatment for COVID-19 pulmonary fibrosis (nintedanib group) were compared to patients with standard treatment (control group). The primary outcome was oxygen improvement. The secondary outcomes were chest X-ray improvement, SpO2/FiO2 ratio improvement, mortality rates at 60 days, and adverse events.
Results: A total of 42 patients with COVID-19 pneumonia were included (21 in each group). Mean age was 64.43 ± 14.59 years, and 54.8% were men. At baseline, SpO2/FiO2 ratio before treatment was 200.57 ± 105.77 in the nintedanib group and 326.90 ± 137.10 in the control group (P = 0.002). Oxygen improvement and chest X-ray improvement were found in 71.4% and 71.4% in the nintedanib group and in 66.7% and 66.7% in the control group (P = 0.739). The nintedanib group had more improvement in SpO2/FiO2 ratio than in the control group (144.38 ± 118.05 vs 55.67 ± 75.09, P = 0.006). The 60-day mortality rates of the nintedanib and the control groups were 38.1% vs 23.8%, P = 0.317. Hepatitis and loss of appetite were common adverse events (9.5% and 9.5%), while the incidence of diarrhea was 4.8%.
Conclusions: Nintedanib as add-on treatment in post-COVID-19 lung fibrosis did not improve oxygenation, chest X-ray findings, or the 60-day mortality. However, this antifibrotic drug improved SpO2/FiO2 ratio in our patients. Further randomized controlled trials are needed to determine the efficacy of nintedanib for treatment of patients with post-COVID-19 lung fibrosis. Trial Registration. This study was registered in TCTR20220426001.
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