# The effect and safety of small-molecule antiviral drugs on long prognosis of post-COVID-19 pulmonary fibrosis: a real-world study in China

**Authors:** Yilin Xu, Ming Lu, Yawei Li, Xiaoling Den, Dechang Peng, Fuqing Zhou, Anqi Li, Tieying Hou, Tianxin Xiang

PMC · DOI: 10.3389/fmicb.2025.1733465 · Frontiers in Microbiology · 2026-01-06

## TL;DR

This study finds that using small-molecule antiviral drugs during acute COVID-19 may reduce future hospital readmissions for post-COVID-19 pulmonary fibrosis.

## Contribution

The study provides real-world evidence that small-molecule antiviral drugs improve long-term outcomes in post-COVID-19 pulmonary fibrosis patients.

## Key findings

- Nearly 50% of PCPF patients were readmitted within one year after discharge.
- SMAD-treated patients had a 45.97% readmission rate versus 63.64% in the non-SMAD group.
- SMAD treatment was associated with a 35% reduced risk of one-year readmission.

## Abstract

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.

We aimed to observe one-year readmission and mortality rates among patients with PCPF, and tried to explore the impact of small-molecule antiviral drugs (SMADs) during hospitalization on the prognosis.

A total of 372 patients diagnosed as PCPF were enrolled. 293 of them treated with SMADs and the remaining 79 treated with NO SMADs. One-year readmission and mortality rates were evaluated via regression analysis.

During hospitalization, 16 of the 372 patients died. An additional 19 survivors died within one-year postdischarge. Among survivors, 49.62% were readmitted. Compared to the NO-SMAD group, the SMAD group presented a lower one-year readmission rate (45.97%vs. 63.64%, p = 0.020) and a reduced risk of one-year readmission (HR = 0.65, 95% CI: 0.44 to 0.96, p = 0.030).

Nearly half of PCPF patients experienced readmission within one-year following their initial hospitalization for acute COVID-19. Importantly, treatment with SMADs during the acute infection phase was significantly associated with a reduced readmission rate.

## Linked entities

- **Diseases:** COVID-19 (MONDO:0100096)

## Full-text entities

- **Diseases:** COVID-19 (MESH:D000086382), infection (MESH:D007239), COVID-19 acute infection (MESH:D000094024), died (MESH:D003643)
- **Chemicals:** NO (MESH:D009614)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

_Full body text omitted from this summary view._ Fetch the complete paper as Markdown: https://tomesphere.com/paper/PMC12816351/full.md

## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12816351/full.md

## References

21 references — full list in the complete paper: https://tomesphere.com/paper/PMC12816351/full.md

---
Source: https://tomesphere.com/paper/PMC12816351