Antifibrotic Therapy in the Treatment of Patients with Pulmonary Manifestations in Complicated COVID-19

The study assessed the efficacy and safety of Longidaza® (bovhyaluronidase azoximer, 3000 IU) in patients with lung damage after complicated COVID‑19. Two groups of 30 patients each were compared: the first received Longidaza® via intramuscular injections (3000 IU every five days, 15 injections total); the second was under dynamic observation without active therapy. The trial ran from August to December 2023. Participants were over 18 years old, had lung manifestations after severe COVID‑19, started outpatient treatment within two months after hospital discharge, and provided informed consent. Exclusion criteria included pregnancy, lactation, severe comorbidities, etc. Key parameters after 10 weeks (day 71) were changes in: resting capillary blood oxygen saturation (SpO 2 ,%); laboratory markers (lymphocytes, C‑reactive protein [CRP], D-dimer, fibrinogen). Statistical analysis used Stata 14.0 (significance level: p < 0,05; Mann‑Whitney test). Mean age was 59.8 ± 15.2 years (Longidaza group) and 56.06 ± 13.7 years (observation group). Common comorbidities: hypertension and coronary heart disease. Results: CRP levels decreased more than twofold in both groups (to 3.66 ± 3.84 mg/L and 1.24 ± 0.7 mg/L, respectively). Blood oxygen saturation stayed ≥ 96% in most patients. In the Longidaza group, some parameters were statistically significantly lower — possibly indicating antifibrotic activity. No adverse effects were reported. Conclusion: Longidaza® is safe and potentially effective for preventing and treating early pneumofibrosis and managing established lung fibrosis.