ABSTRACT
Introduction: Secondary organizing pneumonia (OP) has been reported in the clinical course of SARS-CoV2 pneumonia. Based on data from cryptogenic OP, it might be treated with corticosteroids (CS) but there is no recommendation regarding the best steroid regimen and whether extending the duration of steroids could provide a benefit for patients with secondary OP after COVID-19. Aims and objectives: Our main objective was to evaluate the impact of a prolonged CS therapy in patients with COVID-19 secondary OP. Method(s): Between March 2020 and March 2021, we included patients hospitalized for COVID-19 pneumonia and for whom OP was described on CT scan. We collected data regarding steroid regimens and clinical, functional and radiological outcomes after 4 months of follow-up. Result(s): Among the 129 included patients, 26.4% received no CS (during to the beginning of the first COVID-19 wave), 38.0% had CS <=10 days and 35.7% had >10 days. The median follow-up time was 129.5 [101.2-151] days. The duration of CS was not different in patients hospitalized in intensive care units compared to those treated in conventional units (22.2 versus 22.8 days;p=0.94). At the time of follow-up, patients who received >10 days of CS had no improvement on dyspnea (p=0.33) and no significant change on pulmonary fibrosis features (p=0.09) but had a significantly more impaired diffusing capacity of lung for carbon monoxide (mean value 61.8%, p <0.005). Conclusion(s): Based on this retrospective analysis of a real-world cohort, the use of a prolonged corticosteroid regimen >10 days does not appear to provide any benefit on clinical, functional and radiological outcomes in patients with COVID-19 secondary OP.