{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T19:29:35Z","timestamp":1786562975719,"version":"build-2736575974"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T00:00:00Z","timestamp":1693353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T00:00:00Z","timestamp":1693353600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Coronavirus disease 2019 (COVID\u201019) can lead to pulmonary fibrosis due to the inflammatory process in the lung, resulting in a series of respiratory consequences. Patients with underlying systemic diseases or pre\u2010existing pulmonary diseases are particularly at risk of severe respiratory distress and persistent pulmonary abnormalities. Pirfenidone, a well\u2010known anti\u2010fibrotic agent recognized for its therapeutic effect on idiopathic pulmonary fibrosis, could be a feasible option in severe COVID\u201019 cases given the similar pathophysiological features shared with interstitial lung diseases. In this paper, we share our experience of early administration of pirfenidone in combination with tofacitinib in a 61\u2010year\u2010old female patient with severe COVID\u201019 pneumonia. Pirfenidone was initiated because of persistent dependence on high\u2010flow oxygen support and even the requirement for mechanical ventilation due to disease progression after initial standard COVID\u201019 treatment. The patient was successfully extubated 15\u2009days after the initiation of pirfenidone, and 13\u2009days after extubation, she was completely weaned off supplemental oxygen. A series of chest radiographs and computed tomography scans demonstrated notable improvements in her lung condition. We propose a strategy of using pirfenidone plus tofacitinib as a rescue therapy in the management of patients with severe COVID\u201019.<\/jats:p>","DOI":"10.1111\/1756-185x.14890","type":"journal-article","created":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T22:39:25Z","timestamp":1693435165000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Tofacitinib and pirfenidone as rescue therapies for severe\n                    <scp>COVID<\/scp>\n                    \u201019 in a patient with previously stable interstitial lung disease associated with Sj\u00f6gren syndrome"],"prefix":"10.1111","volume":"27","author":[{"given":"Yu\u2010Chuan","family":"Tsao","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Taichung Armed Forces General Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih\u2010Han","family":"Chuang","sequence":"additional","affiliation":[{"name":"Institute of Medicine Chung Shan Medical University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5948-7306","authenticated-orcid":false,"given":"Chih\u2010Wei","family":"Tseng","sequence":"additional","affiliation":[{"name":"Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine Taichung Veterans General Hospital  Taichung Taiwan"},{"name":"Department of Public Health, College of Medicine National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,30]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"World Health Organization.Coronavirus Disease (COVID\u201019) Situation Reports[Internet].2023. WHO TEAM Emergency Response. Emergency Situational Updates. Accessed March 22 2023.https:\/\/www.who.int\/emergencies\/diseases\/novel\u2010coronavirus\u20102019\/situation\u2010reports"},{"issue":"3","key":"e_1_2_10_3_1","article-title":"Post\u2010COVID\u201019 pulmonary fibrosis","volume":"14","author":"Mohammadi A","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.26634"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.26424"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-021-01647-6"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2021.108145"},{"key":"e_1_2_10_8_1","unstructured":"COVID\u201019 Treatment Guidelines Panel.Coronavirus Disease 2019 (COVID\u201019) Treatment Guidelines[Internet].2023. National Institutes of Health. Therapeutic Management of Hospitalized Adults With COVID\u201019. Accessed May 9 2023.https:\/\/www.covid19treatmentguidelines.nih.gov\/"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2101643"},{"issue":"9","key":"e_1_2_10_10_1","article-title":"Effectiveness and safety of pirfenidone and nintedanib for pulmonary fibrosis in COVID\u201019\u2010induced severe pneumonia: an interventional study","volume":"14","author":"Choudhary R","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medcli.2022.12.021"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-020-02947-4"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11926-021-01023-9"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.14516"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.14563"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2022.109418"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10787-022-01027-6"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-021-01730-6"}],"container-title":["International Journal of Rheumatic Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1756-185X.14890","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1756-185X.14890","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1756-185X.14890","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T18:55:56Z","timestamp":1786560956000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1756-185X.14890"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,30]]},"references-count":17,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1111\/1756-185X.14890"],"URL":"https:\/\/doi.org\/10.1111\/1756-185x.14890","archive":["Portico"],"relation":{},"ISSN":["1756-1841","1756-185X"],"issn-type":[{"value":"1756-1841","type":"print"},{"value":"1756-185X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,30]]},"assertion":[{"value":"2023-05-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14890"}}