The effectiveness of glucocorticoid treatment in post-COVID-19 pulmonary involvement.
Corticosteroids
Post-covid syndrome
Pulmonary fibrosis
Pulmonary function
Watchful waiting
Journal
Pneumonia (Nathan Qld.)
ISSN: 2200-6133
Titre abrégé: Pneumonia (Nathan)
Pays: England
ID NLM: 101663459
Informations de publication
Date de publication:
05 Feb 2024
05 Feb 2024
Historique:
received:
03
10
2023
accepted:
02
12
2023
medline:
5
2
2024
pubmed:
5
2
2024
entrez:
4
2
2024
Statut:
epublish
Résumé
Persistent respiratory symptoms following Coronavirus Disease 2019 (COVID-19) are associated with residual radiological changes in lung parenchyma, with a risk of development into lung fibrosis, and with impaired pulmonary function. Previous studies hinted at the possible efficacy of corticosteroids (CS) in facilitating the resolution of post-COVID residual changes in the lungs, but the available data is limited. To evaluate the effects of CS treatment in post-COVID respiratory syndrome patients. Post-COVID patients were recruited into a prospective single-center observational study and scheduled for an initial (V1) and follow-up visit (V2) at the Department of Respiratory Medicine and Tuberculosis, University Hospital Olomouc, comprising of pulmonary function testing, chest x-ray, and complex clinical examination. The decision to administer CS or maintain watchful waiting (WW) was in line with Czech national guidelines. The study involved 2729 COVID-19 survivors (45.7% male; mean age: 54.6). From 2026 patients with complete V1 data, 131 patients were indicated for CS therapy. These patients showed significantly worse radiological and functional impairment at V1. Mean initial dose was 27.6 mg (SD ± 10,64), and the mean duration of CS therapy was 13.3 weeks (SD ± 10,06). Following therapy, significantly better improvement of static lung volumes and transfer factor for carbon monoxide (DLCO), and significantly better rates of good or complete radiological and subjective improvement were observed in the CS group compared to controls with available follow-up data (n = 894). Better improvement of pulmonary function, radiological findings and subjective symptoms were observed in patients CS compared to watchful waiting. Our findings suggest that glucocorticoid therapy could benefit selected patients with persistent dyspnea, significant radiological changes, and decreased DLCO.
Identifiants
pubmed: 38311783
doi: 10.1186/s41479-023-00123-7
pii: 10.1186/s41479-023-00123-7
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2Informations de copyright
© 2023. The Author(s).
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