The effect of Pirfenidone on pulmonary function parameters in post recovery COVID-19 patients with pulmonary fibrosis compared to placebo in a Government Medical College, West Bengal

Abstract

Introduction and Aim: The recent COVID 19 pandemic has created an unprecedented challenge to the entire global healthcare system by affecting many people worldwide. Post COVID complications are multi-systemic, but pulmonary post COVID complications are most common. Involvement of the lung parenchyma ultimately leads to pulmonary fibrosis in many of the patients. Pirfenidone is a widely used antifibrotic medication in the field of idiopathic pulmonary fibrosis (IPF) management. Our study has assessed the effect of Pirfenidone on spirometry parameters in post recovery COVID 19 patients with diagnosed pulmonary fibrosis as compared to those that received placebo. Materials and Methods: After obtaining approval from Institutional Ethics Committee, 70 adult patients of COVID-19 with established pulmonary fibrosis in the post recovery phase were chosen and allocated into two groups by randomization in 1:1 ratio. All other factors remaining same, one group was administered the recommended dose of Pirfenidone and the other group received a placebo. Spirometry parameters such as FEV1, FEV1 /FVC ratio, FVC, PEFR of both the groups were recorded on Day 0 and Day 90 and compared using standard statistical tests. Results: It was found that on Day 0, PFT parameters of the two groups was comparable (P value>0.05). PFT parameters of the group receiving Pirfenidone showed significant improvement on day 90 (P value<0.05). In addition, on day 90, the PFT parameters of the group receiving Pirfenidone showed significantly better values than the group receiving placebo, P value <0.05. Conclusion: As there is a significant improvement in the PFT parameters of post recovery COVID-19 patients suffering from pulmonary fibrosis, we conclude that Pirfenidone is helpful to improve the pulmonary function parameters in post recovery COVID -19 patients with established lung fibrosis as compared to placebo.