Investigating the effect of pirfenidone on lung CT scans in patients with severe COVID-19 Hospitalized at Shahid Sadoughi Hospital, Yazd, Iran.

Background: This study aimed to evaluate the effect of pirfenidone on lung CT scan lesions in patients with severe COVID-19. Methods: In this cross-sectional study, data were extracted from the electronic medical records of patients with severe COVID-19 who received one of the following treatments: pirfenidone alone (n= 40), prednisolone alone (n= 55), pirfenidone combined with methylprednisolone (n= 18), or supportive care only (n= 32). Chest CT images taken at baseline and two months post-treatment were assessed by a trained radiologist. p< 0.05 was considered statistically significant. Results: The distribution of initial CT scan findings, Comparison of CT scan findings at admission and two months post-discharge, as well as the extent of pulmonary fibrosis and ground-glass opacity (GGO) grades across the groups, showed no statistically significant differences. However, significant differences were observed in CT scan findings and GGO grades between the four study groups at two months post-discharge. Moreover, in both the pirfenidone (p= 0.00) and supportive care (p= 0.01) groups, the extent of pulmonary fibrosis between admission and two months post-discharge showed statistically significant changes. Conclusion: In summary, although antifibrotic agents such as pirfenidone may not lead to significant improvement in lung CT scan findings in patients with severe COVID-19, they may help slow the progression of pulmonary fibrosis following the acute phase of the disease.