ABSTRACT
Background: Some patients present persistent ground glass opacities (GGO) and/or consolidations after an acute episode of SARS-CoV-2 pneumonia (COVID19). Risk factors for persistent pneumonitis (PPN) and potential response to corticosteroids remain unclear. Objective(s): To evaluate the clinical characteristics of patients with PPN, as well as to detect possible risk factors and the role of corticosteroids. Method(s): We conducted a prospective, controlled, multicenter analysis of patients hospitalized because of COVID19 with (n=152) or without (n=140) PPN. PPN was defined by the persistence of pulmonary opacities in a chest CT scan >14 days after admission. Characteristics of participants were obtained from their medical records. A CT score was used to quantify parenchymal abnormalities when PPN was suspected. Result(s): Compared to controls, patients with PPN were older and suffered more comorbidities, also D-dimer and Creactive protein levels were higher. The most frequent features observed in CT scans were GGO (97%), consolidation (95%), bronchial dilatation (93%) and reticular pattern (92%) with a CT score of 16.12+/-4.26. Multivariate logistic regression identified age and C-reactive protein levels on admission as independent risk factors for PPN. No significant differences were observed in thoracic CT scan one-month after discharge in patients treated with higher corticosteroids doses (>50 mg/day after discharge) compared to lower doses. Conclusion(s): Age and raised C-reactive protein levels on admission are significant risk factors of PPN after COVID19. Treatment with high doses of corticosteroids does not seem to add benefit.
ABSTRACT
In late December 2019, a novel coronavirus emerged and had a rapid and worldwide spread, resulting in an ongoing pandemic. This virus, designated SARS-CoV-2, causes a respiratory disease named COVID-19 which can range in severity, depending not only on the viral infection but also conditioned by the immune system and the host's response. COVID-19 is often associated with aggressive and uncontrolled inflammation that may lead to acute respiratory distress syndrome (ARDS), multiorgan damage and failure, and death. In this chapter, we review the general characteristics of SARS-CoV-2 infection, its interaction with target cells and the resulting immune response, as well as current and potential therapeutic interventions. © 2022 Elsevier B.V.