Systemic corticosteroid therapy in the post-acute period of COVID-19 pneumonia with torpid clinical and radiological evolution

ABSTRACT

Abstract COVID-19 pneumonia generates both immediate damage due to the viral effects and distant damage due to inflammatory immune deregulation. Systemic corticosteroid therapy has proven to be beneficial in the first part of the process, but its usefulness in post-acute damage is still unclear. The number of affected patients makes it imperative to find a treatment that reduces potential pulmonary sequelae. This series of cases included 18 patients admitted to polyvalent private medical institutions of Buenos Aires City 15 were male and 3 were female; age 58.4 ± 13.6 years. History of most common comorbidities AHT (4 patients), obesity (6 patients) and smoking (4 patients). Five patients had no medical history. All patients showed dyspnea, oxygen desaturation, and persistent or progressive tomo graphic abnormalities 14 days after their infection. All of them received dexamethasone according to current regulations. Subsequently, given the poor evolution, they were administered oral and/or intravenous corticosteroids with the same treatment used for secondary organizing pneumonia (OP). A transbronchial biopsy was performed in 6 of the patients, showing an OP pattern in 3 of them. Four weeks after the beginning of the treatment, all of the patients showed clinical improvement expressed by decreased dyspnea and the fact that they didn't require oxygen anymore and that all chest tomographies showed clearly reduced pulmonary parenchymal involve ment. Systemic corticosteroids administered in the post-acute period of COVID-19 have a clinical and radiological beneficial effect.