Journal of Medical Physiology
Volume:7 Issue: 1, Spring 2022

Emerging evidence suggests elevated rates of mood disorders such as agitation, confusion, post-traumatic stress disorder (PTSD), depression and psychosis in the general population during the coronavirus pandemic. In this review, we discussed the etiologic factors and pathophysiology underlying mood disorders development during the COVID-19 pandemic. Based on present evidence, the main pathophysiological mechanisms involved in the association of COVID-19 infection with mood disorders can be considered as the direct effect of coronavirus infection on the brain, and the effect of immune system response induced-inflammation on the brain. Moreover, psychological stresses including social isolation, fear of infection, fear of family members' infection, conflicting messages and instructions about public health measures and economic problems can lead to mood disorders. It seems that virus-immune system interaction-induced or stress-induced inflammation can play the most effective role in the promotion of mood disorders via structural and functional impairments in different areas of the brain, especially in limbic structure. Due to the incidence of mood disorders in the coronavirus pandemic, it seems necessary to pay attention to preventive or therapeutic interventions to management of neuropsychiatric manifestations parallel with therapeutic interventions of other clinical symptoms.

Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease (ILD) that is very fatal due to its unpredictability, various symptoms, irreversible complications, and poor prognosis. Oxidative stress is an important factor in the pathogenesis of IPF. Therefore, the use of antioxidant compounds can be a good option for the treatment of pulmonary fibrosis. Since selenium has antioxidant effects, the aim of this study was to evaluate the effectiveness of combination therapy with pirfenidone and selenium supplementation in patients with idiopathic pulmonary fibrosis.

The study was an observational study. Ten patients who were referred to Hazrat-e-Rasoul Hospital were recruited. According to the inclusion and exclusion criteria, patients were randomly divided into two equal groups (5 patients in each group) including treatment group who in addition to pirfenidone (200 mg three times a day), also received selenium supplement (200 mg once a day) orally, and the control group, who received just pirfenidone (200 mg three times a day) orally. The duration of this study was 24 weeks. At the beginning of the study, at 12 weeks and 24 weeks, respiratory indices including FVC, FEV, PO2 and FEF25 were measured.

Ten patients were able to complete the experimental procedures. The results showed that treatment with selenium supplementation did not cause a significant change in any of the mentioned variables.

It seems that more studies are needed to reveal the different aspects of the role of selenium supplementation in patients with fibrosis. It is recommended that future studies be performed with a larger sample size. Also lung imaging and evaluating the inflammatory factors are recommended as well.