Progress in the Application of Pirfenidone in Post-COVID-19 Pulmonary Fibrosis: A Review

Pulmonary fibrosis following infection with the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has emerged as a significant long-term complication among survivors of coronavirus disease 2019 (COVID-19), profoundly affecting their quality of life and clinical outcomes. This review provides a comprehensive overview of the pathophysiological mechanisms underlying post-COVID-19 pulmonary fibrosis and elucidates the pharmacological actions of pirfenidone, a multi-targeted antifibrotic agent in this context. We summarize the current clinical evidence on the efficacy and safety of pirfenidone for managing fibrosis secondary to SARS-CoV-2 infection, drawing on recent advances in basic and clinical research. Furthermore, we discuss existing challenges, unresolved questions, and prospective directions for optimizing antifibrotic therapy in COVID-19 convalescents. By systematically analyzing these aspects, this article aims to offer theoretical support and practical guidance to clinicians and researchers addressing the management of post-COVID-19 pulmonary fibrosis.