Tuberk Toraks 2020;68(4):419-429Türktaş H, Oğuzülgen İK.419COVID-19 sonrası akciğer sekelleri: uzun dönem takip ve tedavi

COVID-19 pnömonisi geçiren hastalarda uzun dönemde İPF, kronik hiper-sensitivite pnömonisi ve otoimmun hastalıklarda gördüğümüz hızlı FVC kaybı, tomografide yaygın fibrozis, yaşam kalitesinde azalma ve artmış mor-talite ile karakterize progresif irreversible akciğer fibrozisinin gelişip gelişme-yeceği konusunda henüz yeterli kanıt bulunmamaktadır. Ancak yaşlı hasta-larda daha az ve non-progresif fibrozisler bile ciddi morbidite ve mortalite nedeni olabilir. Dolayısıyla COVID-19’dan etkilenen milyonlarca insanın varlığı düşünüldüğünde nadir görülen bir komplikasyon bile toplum düzeyin-de ciddi bir sağlık sorunu olarak karşımıza çıkabilecektir. Konunun önemi nedeniyle COVID-19 sonrası akciğer fibrozisi ve COVID ilişkili trombozis için risk faktörleri, koruyucu önlemler ve tedavisi konusunda çalışmalar hızla planlanıp hayata geçirilmelidir (1). Bu derlemede COVID-19 pnömonisi geçiren hastalarda uzun dönemde oluşabilecek pulmoner fibrozis ve vaskü-ler komplikasyonların (pulmoner emboli, pulmoner hipertansiyon) sıklığı, klinik önemi, korunma ve tedavisi tartışılmıştır.

Post-COVID-19 pulmonary sequla: longterm follow up and management

Though it has been 8 months since the beginning of COVID-19 pandemic, number of cases and deaths are still seriously increasing. We still don’t have enough evidence about the prognosis of patients who had COVID-19 pneu-monia. In long term follow up we wonder if they will have rapid FVC decline, widespread fibrosis in computed tomography, loss in quality of life or increased mortality that we experience in idiopathic pulmonary fibrosis, chronic hypersensitivity pneumonia or autoimmune interstitial lung diseases. However, in elderly patients less severe dysfunction or non-progressive-fibro-sis can cause morbidity and mortality. Therefore, if we consider millions of people who are affected by COVID-19, even a rare complication can cause serious health problem in social scale. Because of the importance of this issue randomized controlled trials should be rapidly planned on post-COVID fibrosis, COVID associated throm-bosis, risk factors, prevention and treatment (1). In this review, the frequency, clinical importance, prevention and treatment of pos-sible long-term sequels of COVID-19 pneumonia (pulmonary fibrosis, pulmonary embolism and pulmonary hypertension) will be discussed.

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