Challenges in the Management of Post-COVID-19 Pulmonary Fibrosis for the Latin American Population

Abstract

This commentary aims to highlight some of the major issues (with possible solutions) that the Latin American region is currently dealing with in managing post-COVID-19 pulmonary fibrosis. Overall, there is little evidence for successful long-term COVID-19 follow-up treatment. The lack of knowledge regarding proper treatment is exacerbated in Latin America by a general lack of resources devoted to healthcare, and a lack of availability and access to multidisciplinary teams. The discussion suggests that better infrastructure (primarily multicenter cohorts of COVID-19 survivors) and well-designed studies are required to develop scientific knowledge to improve treatment for the increasing prevalence of pulmonary fibrosis in Latin America.

Keywords: COVID-19; Latin America; SARS-CoV-2; pandemic; pulmonary fibrosis.

Figure 1

CT scan showing abnormalities in the lungs of one patient following severe COVID-19 infection. (A) Patient is 71 years old, 1-year follow-up post-COVID-19. Bilateral cobblestone lung images predominantly in the upper lobes and the upper segments of the lower lung lobes are associated with subpleural dense linear images. (B) Same patient as Figure 1A. Two-year follow-up post-COVID-19. Pulmonary images of cobblestone pattern in the upper lobes and the upper segments of the lower lobes are associated with images of traction bronchiectasis. Septal thickening in the lower lobes is associated with subpleural dense linear images.

Figure 2

Possible risk factors for post-COVID-19 pulmonary fibrosis.

Figure 3

Model of a comprehensive post-COVID-19 monitoring program, elaborated by authors. Colors in the graph differ only for aesthetic reasons. Asterisk (*) is there to signal what criteria SARS-CoV-2 depend on.