Prolonged corticosteroid therapy and lung abnormalities in patients after severe COVID-19 pneumonia
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Keywords
CT scan, COVID-19, Pneumonia, viral, Spirometry, Capacity, pulmonary diffusing, Lung function tests, Corticosteroid, Dyspnea
Abstract
Background: Some of the hospitalized patients after severe COVID-19 pneumonia experience significant fall in peripheral saturation despite optimal treatment. Because of immune dysregulation in COVID-19 there are indications that prolonged corticosteroids could be considered in treating patients for persistent radiological sequelae and respiratory symptoms.
Objectives: to investigate lung function and lung sequelae on high-resolution CT (HRCT) im COVID-19 patients who were treated with glucocorticoid therapy in two dose regimens with a control group of patients who did not receive additional glucocorticoid therapy.
Methods: In this prospective cohort research we studied patients who suffered from prolonged respiratory insufficiency after severe COVID-19 pneumonia. Patients received corticosteroid therapy in two dose regimens: for 14 days and for 3 months after discharge from the hospital. Control group of patients did not receive additional corticosteroid therapy. Lung function, post-COVID-19 symptoms, and lung abnormalities on CT scans were analyzed in three months follow-up and compared with the control group of patients.
Results: Patients who received prolonged corticosteroid therapy for three months did not have better CT findings of lung abnormalities, lung function, or symptoms recovery in comparison to the patients with 14 days of therapy and control group of patients. Onwards, control group had significantly fewer dyspnea symptoms (Chi-square test, p=0,04) and higher DLCO (Kruskal Wallis test, p=0,03).
Conclusions:
Supplementary corticosteroid therapy for patients after severe pneumonia and prolonged respiratory insufficiency with lung abnormalities after COVID-19 did not improve lung function or lung lesions on CT.
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Daria Cvetković Kučić, Clinical Department of Diagnostic and Interventional Radiology, University Hospital Dubrava
Clinical Department of Diagnostic and Interventional Radiology, radiology specialist
Nikola Zagorec, Department of Nephrology, University Hospital Dubrava
Department of Nephrology, MD
Linda Malnar, Department of Pulmonology, University Hospital Dubrava
Department of Pulmonology, MD
Kristina Lalić, Department of Pulmonology, University Hospital Dubrava
Department of Pulmonology, pulmonology specialist
Marina Zelenika, Department of Pulmonology, University Hospital Dubrava
Department of Pulmonology, MD
Ivona Kovačevič, Department of Pulmonology, University Hospital Dubrava
Department of Pulmonology, MD
Dinka Kušter, Department of Nuclear Medicine, University Hospital Dubrava
Department of Nuclear Medicine, nuclear medicine specialist
Andreja Mutvar, Department of Nuclear Medicine, University Hospital Dubrava
Department of Nuclear Medicine, nuclear medicine specialist, PhD
Nevenka Piskač Živković, Special Hospital Radiochirurgia Zagreb
Special Hospital Radiochirurgia Zagreb, specialist internist, subspecialist pulmonologist, PhD
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