The Journal of Internal Korean Medicine (대한한방내과학회지)

The Society of Internal Korean Medicine (대한한방내과학회)
권호 표지
DOI QR코드

DOI QR Code

Korean Medicine Treatment for a Patient with Post-COVID-19 Pulmonary Fibrosis: A Case Report

코로나 19 후 폐섬유화(Post COVID-19 pulmonary fibrosis)에 대한 복합 한의치험 1례

  • Jeong-Won Shin (Division of Allergy, Immune & Respiratory System, Dept. of Internal Medicine, Graduate School, Kyung Hee University) ;
  • Jiwon Park (Division of Allergy, Immune & Respiratory System, Dept. of Internal Medicine, Graduate School, Kyung Hee University) ;
  • Su-Hyun Chin (Division of Allergy, Immune & Respiratory System, Dept. of Internal Medicine, Graduate School, Kyung Hee University) ;
  • Kwan-Il Kim (Division of Allergy, Immune & Respiratory System, Dept. of Internal Medicine, Graduate School, Kyung Hee University) ;
  • Hee-Jae Jung (Division of Allergy, Immune & Respiratory System, Dept. of Internal Medicine, Graduate School, Kyung Hee University) ;
  • Beom-Joon Lee (Division of Allergy, Immune & Respiratory System, Dept. of Internal Medicine, Graduate School, Kyung Hee University)
  • 신정원 (경희대학교 대학원 임상한의학과 폐계내과학교실) ;
  • 박지원 (경희대학교 대학원 임상한의학과 폐계내과학교실) ;
  • 진수현 (경희대학교 대학원 임상한의학과 폐계내과학교실) ;
  • 김관일 (경희대학교 대학원 임상한의학과 폐계내과학교실) ;
  • 정희재 (경희대학교 대학원 임상한의학과 폐계내과학교실) ;
  • 이범준 (경희대학교 대학원 임상한의학과 폐계내과학교실)
  • Received : 2023.08.31
  • Accepted : 2023.12.29
  • Published : 2023.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Post-COVID-19 pulmonary fibrosis (PCPF) is a common complication in severe COVID-19 cases, often associated with acute respiratory distress syndrome or mechanical ventilation. Patients with PCPF frequently experience a decline in their quality of life due to persistent COVID-19 sequelae, including cough and chest pain. However, there is currently no established standard treatment, and the efficacy of existing medications remains uncertain. Case Report: A 65-year-old female patient presenting with cough, dyspnea, chest pain, and fatigue due to PCPF received Korean medicine treatment for 25 days. Symptom evaluation utilized the modified Medical Research Council scale, the Leicester Cough Questionnaire, and the Numeral Rating Scale. Quality of life and functional status were assessed using the Post-COVID-19 Functional Status and the EuroQol 5-Dimensional 5-Level. The extent of pulmonary fibrosis was assessed by comparing chest computed tomography (chest CT) scans before and after hospitalization. Following treatment, the patient demonstrated clinically meaningful improvement in clinical symptoms, enhanced quality of life, and decreased fibrotic lesions on CT scans. Conclusion: This case report suggests that Korean medicine treatment may be effective in improving clinical symptoms, such as cough and dyspnea caused by PCPF, while also enhancing post-COVID-19 quality of life and ameliorating pulmonary fibrotic lesions.

Keywords

Acknowledgement

이 논문은 2023년도 한의기반융합기술개발사업의 지원을 받아 수행된 다빈도 난치성 천식 협진치료 연구(No. HI20C120501)의 지원을 받아 수행된 과제입니다.

References

  1. Alkodaymi MS, Omrani OA, Fawzy NA, Shaar BA, Almamlouk R, Riaz M, et al. Prevalence of post-acute COVID-19 syndrome symptoms at different follow-up periods: a systematic review and meta-analysis. Clin Microbiol Infect 2022;28(5):657-66. https://doi.org/10.1016/j.cmi.2022.01.014
  2. Kim YJ. COVID-19 and Long-Term Sequelae. The Korean Journal of Medicine 2022;97(1):23-7. https://doi.org/10.3904/kjm.2022.97.1.23
  3. Ambardar SR, Hightower SL, Huprikar NA, Chung KK, Singhal A, Collen JF. Post-COVID-19 Pulmonary Fibrosis: Novel Sequelae of the Current Pandemic. J Clin Med 2021;10(11):2452.
  4. Michalski JE, Kurche JS, Schwartz DA. From ARDS to pulmonary fibrosis: the next phase of the COVID-19 pandemic?. Transl Res 2022;241:13-24. https://doi.org/10.1016/j.trsl.2021.09.001
  5. Patrucco F, Solidoro P, Gavelli F, Apostolo D, Bellan M. Idiopathic Pulmonary Fibrosis and Post-COVID-19 Lung Fibrosis: Links and Risks. Microorganisms 2023;11(4):895.
  6. Mohammadi A, Balan I, Yadav S, Matos WF, Kharawala A, Gaddam M, et al. Post-COVID-19 Pulmonary Fibrosis. Cureus 2022;14(3):e22770.
  7. Saiphoklang N, Patanayindee P, Ruchiwit P. The Effect of Nintedanib in Post-COVID-19 Lung Fibrosis: An Observational Study. Critical Care Research and Practice 2022;2022:9972846.
  8. Farghaly S, Badedi M, Ibrahim R, Sadhan MH, Alamoudi A, Alnami A, et al. Clinical characteristics and outcomes of post-COVID-19 pulmonary fibrosis: A case-control study. Medicine (Baltimore) 2022;101(3):e28639.
  9. Lancaster LH, de Andrade JA, Zibrak JD, Padilla ML, Albera C, Nathan SD, et al. Pirfenidone safety and adverse event management in idiopathic pulmonary fibrosis. Eur Respir Rev 2017;26(146):170057.
  10. Lu ZH, Yang CL, Yang GG, Pan WX, Tian LG, Zheng JX, et al. Efficacy of the combination of modern medicine and traditional Chinese medicine in pulmonary fibrosis arising as a sequelae in convalescent COVID-19 patients: a randomized multicenter trial. Infect Dis Poverty 2021;10(1):31.
  11. Rumende CM, Susanto EC, Sitorus TP. The Management of Pulmonary Fibrosis in COVID-19. Acta Med Indones 2021;53(2):233-41.
  12. Hama Amin BJ, Kakamad FH, Ahmed GS, Ahmed SF, Abdulla BA, Mohammed SH, et al. Post COVID-19 pulmonary fibrosis; a meta-analysis study. Ann Med Surg (Lond) 2022;77:103590.
  13. Kim YJ, Kim SE, Kim T, Yoon KW, Lee SH, Lee EJ, et al. Preliminary Guidelines for the Clinical Evaluation and Management of Long COVID. Infect Chemother 2022;54(3):566-97. https://doi.org/10.3947/ic.2022.0141
  14. 전국한의과대학본초학교실. 본초학. 서울: 영림사; 2004, p. 154-6.
  15. Ahn J, Joo H, Park J, Park JW, Kim KI, Jung HJ, et al. The Effects of Lung-moistening Herbal Medicines on Bleomycin-induced Pulmonary Fibrosis Mouse Model. Processes 2020;8(1):102.
  16. Mathers CD, Loncar D. Projections of Global Mortality and Burden of Disease from 2002 to 2030. PLoS Med 2006;3(11):e442.
  17. Spinou A, Birring SS. An update on measurement and monitoring of cough: what are the important study endpoints? J Thorac Dis 2014;6(Suppl 7):S728-34.
  18. Kim JW, Lee MY. Validity Evidences of VAS Pain Scale Utilizing Objective Physical Activity Measures in Middle-Aged Females with Low-Back Pain. The Korean Journal of Measurement and Evaluation in Physical Education and Sport Science 2013;15(2):29-39. https://doi.org/10.21797/ksme.2013.15.2.003
  19. Devlin N, Roudijk B, Ludwig K. Value Sets for EQ-5D-5L: A Compendium, Comparative Review & User Guide. Cham (CH): Springer; 2022, p. 1-12.
  20. Park JI, Kim YJ, Cho MJ. Factor Structure of the 12-Item General Health Questionnaire in the Korean General Adult Population. J Korean Neuropsychiatr Assoc 2012;51(4):178-84. https://doi.org/10.4306/jknpa.2012.51.4.178
  21. Bazdyrev E, Rusina P, Panova M, Novikov F, Grishagin I, Nebolsin V. Lung Fibrosis after COVID-19: Treatment Prospects. Pharmaceuticals (Basel) 2021;14(8):807.
  22. Doane JJ, Hirsch KS, Baldwin JO, Wurfel MM, Pipavath SN, West TE. Progressive Pulmonary Fibrosis After Non-Critical COVID-19: A Case Report. Am J Case Rep 2021;22:e933458.
  23. Rai DK, Sharma P, Kumar R. Post covid 19 pulmonary fibrosis. Is it real threat? Indian J Tuberc 2021;68(3):330-3. https://doi.org/10.1016/j.ijtb.2020.11.003
  24. Hirawat R, Jain N, Aslam Saifi M, Rachamalla M, Godugu C. Lung fibrosis: Post-COVID-19 complications and evidences. Int Immunopharmacol 2023;116:109418.
  25. Zou JN, Sun L, Wang BR, Zou Y, Xu S, Ding YJ, et al. The characteristics and evolution of pulmonary fibrosis in COVID-19 patients as assessed by AI-assisted chest HRCT. PLoS One 2021;16(3):e0248957.
  26. Gulati A, Lakhani P. Interstitial lung abnormalities and pulmonary fibrosis in COVID-19 patients: a short-term follow-up case series. Clin Imaging 2021;77:180-6. https://doi.org/10.1016/j.clinimag.2021.03.030
  27. Lazar M, Barbu EC, Chitu CE, Tiliscan C, Stratan L, Arama SS, et al. Interstitial Lung Fibrosis Following COVID-19 Pneumonia. Diagnostics (Basel) 2022;12(8):2028.
  28. 전국한의과대학 폐계내과학교실. 肺系內科學. 서울: 도서출판 나도; 2019, p. 464.
  29. Lee KY, Jeong SH, Jeong MJ, Choi YM, Song MD, Jang IS. Review on Herbal Medicine Treatment for Late Complications of COVID-19 Patients. J Int Korean Med 2021;42(1):53-66. https://doi.org/10.22246/jikm.2021.42.1.53
  30. Ryu NH, Park SM, Kang H, Shim BS, Kim SH, Choi SH, et al. Effect of Samsoeum on Cytokine Regulation of Mouse T cell. Korean journal of oriental physiology & pathology 2008;22(4):856-62.
  31. Lyu Y, Kim KI, Yang CS, Jung SY, Kwon O, Jung HJ, et al. Efficacy and Safety of Ojeok-San Plus Saengmaek-San for Gastroesophageal Reflux-Induced Chronic Cough: A Pilot, Randomized, Double-Blind, Placebo-Controlled Trial. Frontiers in Pharmacology 2022;13:787860.
  32. 남산당편집국. 對譯 證脈,方藥合編. 서울: 남산당; 2003, p. 136-7.
  33. Kim JH, Lee DH, Kim JH, Jung SE, Ham SH, Yang WM, et al. Anti-inflammatory Effects of Ojeok-san in LPS-induced Inflammatory Rat Model. J Korean Med 2021;42(2):21-30. https://doi.org/10.13048/jkm.21012
  34. Shin IS, Lee MY, Jeon WY, Kim JC, Shin HK. Ojeok-san, a Traditional Korean Herbal Medicine Attenuates Airway Inflammation and Pulmonary Fibrosis Induced by Repeated Ovalbumin challenge. J Ethnopharmacol 2013;149(1):281-7. https://doi.org/10.1016/j.jep.2013.06.036
  35. Ji K, Ma J, Wang L, Li N, Dong S, Shi L. Efficacy and safety of traditional Chinese medicine in idiopathic pulmonary fibrosis: a meta-analysis. Evidence-Based Complementary and Alternative Medicine 2020;2020:1-11. https://doi.org/10.1155/2020/1752387
  36. Li F, Lv YN, Tan YS, Shen K, Zhai KF, Chen HL, et al. An integrated pathway interaction network for the combination of four effective compounds from ShengMai preparations in the treatment of cardio-cerebral ischemic diseases. Acta Pharmacologica Sinica 2015;36(11):1337-48. https://doi.org/10.1038/aps.2015.70
  37. Jang SB, Kim DS, Yi EH, Choi GH, Son MD, Lee EK, et al. Telemedicine and the Use of Korean Medicine for Patients With COVID-19 in South Korea: Observational Study. JMIR Public Health and Surveillance 2021;7(1):e20236.
  38. Chiang SC, Park J, Bae J, Joo H, Lee D, Kim KI, et al. Antifibrotic effects of lilii bulbus extract in a mouse model of bleomycin-induced pulmonary fibrosis. Pharmacognosy Magazine 2021;17(76):679-83. https://doi.org/10.4103/pm.pm_117_21
  39. Liu WH, Guo SN, Fang W, Yang H. Understanding of guidance for acupuncture and moxibustion interventions on COVID-19 issued by CAAM. World journal of acupuncture-moxibustion 2020;30(1):1-4. https://doi.org/10.1016/j.wjam.2020.03.005
  40. 침구경혈학교실. 침구학. 서울: 집문당; 1988.
  41. Li B, Zhang Y, Yang QM. Umbilical moxibustion for patients with idiopathic pulmonary fibrosis complicated with gastroesophageal reflux of lung-spleen qi deficiency. Chinese Acupuncture & Moxibustion 2019;39(3):241-5..
  42. Cheng L, Li R, Zhou M, Li F, Chang Q, Li C, et al. Moxibustion has a positive effect on pulmonary fibrosis:an alternative approach. Afr J Tradit Complement Altern Med 2017;14(2):125-9. https://doi.org/10.21010/ajtcam.v14i2.13
  43. Lechowicz K, Drozdzal S, Machaj F, Rosik J, Szostak B, Zegan-Baranska M, et al. COVID-19: The Potential Treatment of Pulmonary Fibrosis Associated with SARS-CoV-2 Infection. J Clin Med 2020;9(6):1917.