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

Q3 Medicine

Medical Journal of Malaysia Pub Date : 2024-05-01

B H Ng, M I Azmi, N N N Abeed, H J Low, C I Soo, M F M Jailaini, A A Azmel, R A Osman, P Periyasamy, H J Tan, S A M Mukari, W N N W Yahya, M F A Hamid, A Y L Ban

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引用次数: 0

Abstract

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.

本刊更多论文

对 COVID-19 相关弥漫性肺间质异常进行为期 12 周的皮质类固醇治疗的结果。

简介长期皮质类固醇治疗对治疗COVID-19相关弥漫性肺间质异常（DILA）的疗效有待进一步了解。我们旨在通过评估计算机断层扫描（CT）肺部严重程度评分，研究为期12周的皮质类固醇治疗对COVID-19相关DILA的益处：这项回顾性单中心观察研究纳入了年龄在18岁或18岁以上的中重度COVID-19肺炎患者，他们在2021年1月至2021年12月期间接受了12周的口服泼尼松龙治疗。我们记录了临床参数、基线CT评分和治疗后情况、改良医学研究委员会（mMRC）呼吸困难量表和肺功能测试：共对 330 名患者进行了分析。平均（标准差，SD）年龄为 54.6（14.2）岁，女性占 43%。3.9%的患者（3.9%）需要无创通气（NIV），14.6%的患者需要机械通气（MV）。在 12 周的随访中，CT 显示磨玻璃不透光、肺周密度和巩固性均有所改善。泼尼松龙治疗前后的平均（标清）CT评分有所改善，分别为17.3（5.3）和8.6（5.5）分（p结论：泼尼松龙治疗12周后，CT评分明显改善，呼吸困难残留极少，且相对安全。对于中度至重度 COVID-19 相关 DILA 患者，延长类固醇治疗时间可能会有所帮助。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Journal of Malaysia Medicine-Medicine (all)

CiteScore

1.20

自引率

0.00%

发文量

165

期刊介绍： Published since 1890 this journal originated as the Journal of the Straits Medical Association. With the formation of the Malaysian Medical Association (MMA), the Journal became the official organ, supervised by an editorial board. Some of the early Hon. Editors were Mr. H.M. McGladdery (1960 - 1964), Dr. A.A. Sandosham (1965 - 1977), Prof. Paul C.Y. Chen (1977 - 1987). It is a scientific journal, published quarterly and can be found in medical libraries in many parts of the world. The Journal also enjoys the status of being listed in the Index Medicus, the internationally accepted reference index of medical journals. The editorial columns often reflect the Association''s views and attitudes towards medical problems in the country. The MJM aims to be a peer reviewed scientific journal of the highest quality. We want to ensure that whatever data is published is true and any opinion expressed important to medical science. We believe being Malaysian is our unique niche; our priority will be for scientific knowledge about diseases found in Malaysia and for the practice of medicine in Malaysia. The MJM will archive knowledge about the changing pattern of human diseases and our endeavours to overcome them. It will also document how medicine develops as a profession in the nation. We will communicate and co-operate with other scientific journals in Malaysia. We seek articles that are of educational value to doctors. We will consider all unsolicited articles submitted to the journal and will commission distinguished Malaysians to write relevant review articles. We want to help doctors make better decisions and be good at judging the value of scientific data. We want to help doctors write better, to be articulate and precise.