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J Clin Med
. 2023 Jul 27;12(15):4940.
doi: 10.3390/jcm12154940. COVID-19 in Patients with Pre-Existing Interstitial Lung Disease: Potential Value of a Steroid-Based Treatment Strategy
Toru Arai 1 , Yu Kurahara 1 2 , Mitsuhiro Moda 3 , Takehiko Kobayashi 1 , Yoshinobu Matsuda 1 3 , Tomoko Kagawa 1 3 , Reiko Sugawara 3 , Kazunari Tsuyuguchi 1 3 , Yoshikazu Inoue 1
Affiliations
The prognosis of patients with coronavirus disease 2019 (COVID-19) and pre-existing interstitial lung disease (preILD) is poor, and no effective treatment strategy has been determined. The aim of this study was to assess the effectiveness of a steroid-based treatment strategy for patients with COVID-19 and preILD. We retrospectively reviewed the medical records of 610 consecutive patients with COVID-19 treated at our institution between 1 March 2020 and 30 October 2021 and identified 7 patients with preILD, all of whom were treated with corticosteroids and remdesivir. All the patients were men with a median age of 63 years. Three of four patients with severe disease required invasive positive-pressure ventilation (n = 2) or nasal high-flow therapy (n = 1). All three patients could be weaned from respiratory support; however, one died in hospital. The remaining patient with severe COVID-19 had a do-not-resuscitate order in place and died while hospitalized. All three patients with moderate COVID-19 were discharged. The 30-day mortality was 0%, and the mortality rate during the entire observation period was 28.5%. The prognosis of our patients with COVID-19 and preILD has been better than in previous reports. Our management strategy using corticosteroids may have improved these patients' prognosis.
Keywords: COVID-19; acute exacerbation; corticosteroids; interstitial lung disease; prognosis; treatment strategy.
. 2023 Jul 27;12(15):4940.
doi: 10.3390/jcm12154940. COVID-19 in Patients with Pre-Existing Interstitial Lung Disease: Potential Value of a Steroid-Based Treatment Strategy
Toru Arai 1 , Yu Kurahara 1 2 , Mitsuhiro Moda 3 , Takehiko Kobayashi 1 , Yoshinobu Matsuda 1 3 , Tomoko Kagawa 1 3 , Reiko Sugawara 3 , Kazunari Tsuyuguchi 1 3 , Yoshikazu Inoue 1
Affiliations
- PMID: 37568341
- DOI: 10.3390/jcm12154940
The prognosis of patients with coronavirus disease 2019 (COVID-19) and pre-existing interstitial lung disease (preILD) is poor, and no effective treatment strategy has been determined. The aim of this study was to assess the effectiveness of a steroid-based treatment strategy for patients with COVID-19 and preILD. We retrospectively reviewed the medical records of 610 consecutive patients with COVID-19 treated at our institution between 1 March 2020 and 30 October 2021 and identified 7 patients with preILD, all of whom were treated with corticosteroids and remdesivir. All the patients were men with a median age of 63 years. Three of four patients with severe disease required invasive positive-pressure ventilation (n = 2) or nasal high-flow therapy (n = 1). All three patients could be weaned from respiratory support; however, one died in hospital. The remaining patient with severe COVID-19 had a do-not-resuscitate order in place and died while hospitalized. All three patients with moderate COVID-19 were discharged. The 30-day mortality was 0%, and the mortality rate during the entire observation period was 28.5%. The prognosis of our patients with COVID-19 and preILD has been better than in previous reports. Our management strategy using corticosteroids may have improved these patients' prognosis.
Keywords: COVID-19; acute exacerbation; corticosteroids; interstitial lung disease; prognosis; treatment strategy.