The outcome of 12-week corticosteroid therapy in COVID-19-related diffuse interstitial lung abnormalities.

Autor:	Ng BH; Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Department of Medicine, Respiratory Unit, Kuala Lumpur, Malaysia., Azmi MI; Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Department of Radiology, Kuala Lumpur, Malaysia., Abeed NNN; Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Department of Medicine, Respiratory Unit, Kuala Lumpur, Malaysia., Low HJ; Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Department of Anaesthesia and Critical Care, Kuala Lumpur, Malaysia., Soo CI; Universiti Malaya, Faculty of Medicine, Department of Medicine, Respiratory Unit, Kuala Lumpur, Malaysia., Jailaini MFM; Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Department of Medicine, Respiratory Unit, Kuala Lumpur, Malaysia., Azmel AA; Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Department of Medicine, Respiratory Unit, Kuala Lumpur, Malaysia., Osman RA; Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Department of Medicine, Respiratory Unit, Kuala Lumpur, Malaysia., Periyasamy P; Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Department of Medicine, Infectious Disease Unit, Kuala Lumpur, Malaysia., Tan HJ; Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Department of Medicine, Neurology Unit, Kuala Lumpur, Malaysia., Mukari SAM; Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Department of Radiology, Kuala Lumpur, Malaysia., Yahya WNNW; Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Department of Medicine, Neurology Unit, Kuala Lumpur, Malaysia., Hamid MFA; Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Department of Medicine, Respiratory Unit, Kuala Lumpur, Malaysia., Ban AYL; Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Department of Medicine, Respiratory Unit, Kuala Lumpur, Malaysia. andreaban@gmail.com.
Jazyk:	angličtina
Zdroj:	The Medical journal of Malaysia [Med J Malaysia] 2024 May; Vol. 79 (3), pp. 296-305.
Abstrakt:	Introduction: The efficacy of long-course corticosteroid therapy in treating COVID-19-related diffuse interstitial lung abnormalities (DILA) needs to be better understood. We aimed to investigate the benefits of 12-week corticosteroid treatment in COVID-19-related DILA by evaluating computed tomography (CT) lung severity scores. Materials and Methods: This retrospective, single-centre observational study included patients aged 18 years or older admitted with moderate to severe COVID-19 pneumonia who received 12 weeks of oral prednisolone between January 2021 and December 2021. We recorded clinical parameters, baseline CT scores and post-treatment, modified Medical Research Council (mMRC) dyspnoea scale and pulmonary function tests. Results: A total of 330 patients were analysed. The mean (standard deviation, SD) age was 54.6 (14.2) years, and 43% were females. Three-point nine per cent (3.9%) require noninvasive ventilation (NIV), while 14.6% require mechanical ventilation (MV). On follow-up at 12 weeks, the CT patterns showed improvement in ground-glass opacities, perilobular density and consolidation. There was an improvement in the mean (SD) CT score before and after prednisolone therapy, with values of 17.3 (5.3) and 8.6 (5.5), respectively (p<0.001). The median mMRC was 1 (IQR 0-1), and 98.8% had a radiological response. The common side effects of prednisolone therapy were weight gain (13.9%), hyperglycaemia (1.8%) and cushingoid habitus (0.6%). Conclusion: A 12-week treatment with prednisolone showed significant improvement in CT scores with minimal residual dyspnoea and was relatively safe. Longer duration of steroids may be beneficial in moderate to severe COVID-19- related DILA.
Databáze:	MEDLINE
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