Objective To investigate the therapeutic efficacy of pirfenidone on pulmonary fibrosis in patients with severe COVID-19 pneumonia.Methods A total of 80 patients with severe COVID-19 pneumonia were selected as participants.They were divided into 2 groups,with 40 patients in each group.The patients who underwent oral n-acetylcysteine when pulmonary interstitial fibrosis occurred were assigned into the control group,whereas the patients who underwent oral pirfenidone when pulmonary interstitial fibrosis occurred were assigned into the treatment group.The inflammatory cytokines related to pulmonary fibrosis(serum KL-6,plasma IL-6,TGF-β1 and TNF-α),arterial blood gas,chest HRCT,lung function,6-minute walking distance and dyspnea score were dynamically measured at the initiation of oral antifibrotic regimen,after 2 weeks,1 month,3 months,and months were compared.Results There were no statistically significant differences in serum KL-6,plasma IL-6,TGF-β1,TNF-α,PaO2,oxygenation index,chest HRCT score,FEV1,FVC,6-minute walking distance or dyspnea score at the initiation of oral antifibrotic treatment between two groups(P>0.05).The differences of the aforementioned variables two weeks,1 month,3 months and 6 months after the antifibrotic treatment were statistically significant between two groups(P<0.05).Pairwise comparison of the abovementioned variables showed statistically significant differences between the patients 3 or 6 months after the antifibrotic treatment and the patients at the initiation of antifibrotic treatment,2 weeks and 1 month after the antifibrotic treatment(P<0.05).Conclusion Pirfenidone can inhibit inflammatory cytokines,improve oxygenation and lung function,prolong 6-minute walking distance,and reduce dyspnea score in patients with severe COVID-19 pneumonia.It has certain therapeutic efficacy on pulmonary fibrosis in patients with severe COVID-19 pneumonia.
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