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ORIGINAL RESEARCH article

Front. Microbiol.

Sec. Infectious Agents and Disease

The effect and safety of small-molecule antiviral drugs on long Prognosis of Post-COVID-19 Pulmonary Fibrosis: a real-world study in China

Provisionally accepted
Yilin XuYilin Xu1,2Ming LuMing Lu3Yawei LiYawei Li3Xiaoling DenXiaoling Den2,4Dechang PengDechang Peng5Fuqing ZhouFuqing Zhou5Anqi LiAnqi Li3Tieying HouTieying Hou6Tianxin XiangTianxin Xiang2,4,7*
  • 1Infection Control and Prevention Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
  • 2Jiangxi Provincial Key Laboratory of Prevention and Treatment of Infectious Diseases, Nanchang, China
  • 3China-Japan Friendship Jiangxi Hospital, National Regional Center for Respiratory Medicine, Nanchang, China
  • 4Jiangxi Medical Center for Critical Public Health Events, Nanchang, China
  • 5Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
  • 6Medical Expermental Center, Shenzhen Nanshan People's Hospital, Shenzhen, China
  • 7The First Affiliated Hospital of Nanchang University, Nanchang, China

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Background: Post-COVID-19 pulmonary fibrosis (PCPF) is one of the most common diagnoses after COVID-19 acute infection. However, the interventions for long-term prognosis of PCPF are relatively lacking. Aim: We aimed to observe the readmission and survival rate during a follow-up of one-year among patients with PCPF, and tried to explore the impact of small-molecule antiviral drugs (SMADs) during hospitalization on the prognosis. Method: A total of 372 patients diagnosed as PCPF enrolled. 293 of them treated with SMADs and the remaining 79 treated with NO SMADs. Readmission rate and mortality risk during the period of one-year follow-up were evaluated by multivariate analysis. Results: 16 of 372 patients died during hospitalization, an additional 19 survivors died within one-year postdischarge. 49.62% survivors were readmitted to the hospital. The SMAD group presented a lower readmission rate (45.97%vs. 63.64% , P=0.020) and decreased risks of one-year readmission rates (HR=0.65, 95% CI: 0.44 to 0.96, P=0.030). Conclusion: Nearly half of PCPF patients experienced readmission within one-year following first acute hospitalization. Importantly, SMADs during the acute infection phase was significantly associated with a reduced readmission rate.

Keywords: COVID-19, Pulmonary Fibrosis, small-molecule antiviral drug, post-COVID-19pulmonary fibrosis, PCPF Prognosis

Received: 27 Oct 2025; Accepted: 28 Nov 2025.

Copyright: © 2025 Xu, Lu, Li, Den, Peng, Zhou, Li, Hou and Xiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Tianxin Xiang

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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