在COVID-19肺炎后,长期类固醇治疗可能对某些患者有益。

IF 1.8 Q3 RESPIRATORY SYSTEM European Clinical Respiratory Journal Pub Date : 2021-06-24 DOI:10.1080/20018525.2021.1945186
Sabina Kostorz-Nosal, Dariusz Jastrzębski, Michał Chyra, Piotr Kubicki, Michał Zieliński, Dariusz Ziora
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引用次数: 13

摘要

简介:本报告介绍两例长期口服类固醇治疗的冠状病毒肺炎患者在治疗过程中出现相当大的放射学改变。病例:第一例涉及一名仅在传染病医院住院期间接受类固醇治疗的男性。出院后,患者呼吸困难加重,住院治疗肺病科。与疾病早期检查相比,HRCT显示双侧、中部和基底磨玻璃影进展。给予辅助氧疗和类固醇治疗,随后延长强的松治疗至出院后2个月。随访HRCT显示磨玻璃影几乎完全吸收。第二个病例涉及一名男性,仅在传染病医院住院期间接受类固醇治疗。胸部CT示广泛性双侧磨玻璃影伴实变。出院后未经治疗,患者出现严重的呼吸困难和运动障碍,于第7天住院。从那时起,持续的类固醇治疗导致临床、肺活量和放射学的改善。结论:基于这些观察结果,covid -肺炎后患者可能从长期类固醇治疗中获益。因此,在SARS-CoV-2患者中应考虑这类药物,特别是对于持续放射学改变和需要补充氧气治疗的呼吸困难患者。然而,需要随机对照试验来建立这组患者的类固醇治疗指南。
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A prolonged steroid therapy may be beneficial in some patients after the COVID-19 pneumonia.

INTRODUCTION: This report introduces two cases presenting absorption of considerable radiological changes in the course of the coronavirus pneumonia in patients treated with prolonged oral steroids.CASES: The first case concerns a male receiving steroids only during hospitalisation in the Infectious Disease Hospital. After discharge, the patient experienced increasing dyspnoea resulting in hospitalisation in our Department of Lung Diseases. HRCT revealed progression of a bilateral, middle, and basal ground-glass opacity when compared to the examination performed at the early stage of the disease. The supplementary oxygen therapy and steroids were administered, followed by extended prednisone consumption up to 2 months after discharge. Follow-up HRCT revealed an almost complete absorption of the ground-glass opacity. The second case concerns a male treated with steroids only during hospitalisation in the Infectious Disease Hospital. Chest CT revealed widespread bilateral ground-glass opacities with consolidations. After discharge with no treatment, he suffered from severe dyspnoea and exercise intolerance, resulting in hospitalisation on the 7th day of home stay. Since then, a continued steroid treatment was administered resulting in a clinical, spirometric, and radiological improvement.CONCLUSIONS: Based on these observations, patients after the COVID-pneumonia may derive benefits from a prolonged steroid treatment. Therefore, this class of medications should be considered in SARS-CoV-2 patients, especially in patients with persistent radiological changes and dyspnoea requiring the supplementary oxygen therapy. However, randomised controlled trials are required to establish guidelines for the steroid treatment in this group of patients.

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CiteScore
3.80
自引率
0.00%
发文量
15
审稿时长
16 weeks
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