A Delphi consensus statement for the management of post-COVID interstitial lung disease

Expert Rev Respir Med. 2022 Sep;16(9):983-995. doi: 10.1080/17476348.2022.2128770. Epub 2022 Sep 30.

Abstract

Introduction: As millions of people worldwide recover from COVID-19, a substantial proportion continue to have persistent symptoms, pulmonary function abnormalities, and radiological findings suggestive of post-COVID interstitial lung disease (ILD). To date, there is limited scientific evidence on the management of post-COVID ILD, necessitating a consensus-based approach.

Areas covered: A panel of experts in pulmonology and thoracic radiology was constituted. Key questions regarding the management of post-COVID ILD were identified. A search was performed on PubMed and EMBASE and updated till 1 March 2022. The relevant literature regarding the epidemiology, pathophysiology, diagnosis and treatment of post-COVID ILD was summarized. Subsequently, suggestions regarding the management of these patients were framed, and a consensus was obtained using the Delphi approach. Those suggestions which were approved by over 80% of the panelists were accepted. The final document was approved by all panel members.

Expert opinion: Dedicated facilities should be established for the care of patients with post-COVID ILD. Symptom screening, pulmonary function testing, and thoracic imaging have a role in the diagnosis. The pharmacologic and non-pharmacologic options for the management of post-COVID ILD are discussed. Further research into the pathophysiology and management of post-COVID ILD will improve our understanding of this condition.

Keywords: COVID-19; interstitial lung disease; long COVID; post-COVID ILD; pulmonary fibrosis.

MeSH terms

  • COVID-19* / complications
  • Consensus
  • Delphi Technique
  • Humans
  • Lung / diagnostic imaging
  • Lung Diseases, Interstitial* / diagnosis
  • Lung Diseases, Interstitial* / epidemiology
  • Lung Diseases, Interstitial* / etiology