Systemic corticosteroids for management of ‘long-COVID’: an evaluation after 3 months of treatment
Some patients even 4 weeks after Corona Virus Disease 2019 (COVID-19) remain to be symptomatic and are known as “long-COVID”. In the present study we performed the follow up evaluation at 3 months of long-COVID patients, after treatment with systemic steroids. During the study duration, out of the 4...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2021-11-01
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| Series: | Monaldi Archives for Chest Disease |
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| Online Access: | https://www.monaldi-archives.org/index.php/macd/article/view/1981 |
| _version_ | 1819227560692678656 |
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| author | Nitin Goel Nitesh Goyal Ravishankar Nagaraja Raj Kumar |
| author_facet | Nitin Goel Nitesh Goyal Ravishankar Nagaraja Raj Kumar |
| author_sort | Nitin Goel |
| collection | DOAJ |
| description | Some patients even 4 weeks after Corona Virus Disease 2019 (COVID-19) remain to be symptomatic and are known as “long-COVID”. In the present study we performed the follow up evaluation at 3 months of long-COVID patients, after treatment with systemic steroids. During the study duration, out of the 4,542 patients managed in the outpatient department of the particular unit, there were 49 patients of Long-COVID. The patients having abnormal computed tomography (CT) alongwith resting hypoxia or exertional desaturation were treated with systemic steroid (deflazacort) in tapering doses for 8-10 weeks. We retrospectively analysed the clinical and radiological findings of these patients at first presentation and at about 3 months of follow up visit. On follow up, all the 49 long-COVID patients showed improvement. The occurrence of breathlessness decreased from 91.83% to 44.89% (p<0.001) and cough from 77.55% to 8.16% (p<0.001). Twenty-four patients were prescribed systemic steroids. Out of these, nearly 58% patients had MMRC grade 4 breathlessness, which decreased to < 2 MMRC in about 86% of these patients. MMRC grade (median) decreased from 3 to 1 (p<0.001). Majority of patients who were tachypnoeic and hypoxic at rest (n=7) showed improvement (71%), post-treatment with corticosteroids. Occurrence of normal chest X-ray increased from 12% to 71% (p<0.001). All these patients had abnormal CT thorax initially, and post-treatment 25% had normal CT thorax. Hence, we conclude that systemic steroids are helpful in hastening recovery of select subset of long-COVID patients. Simultaneously, we should be cautious of immunosuppressive effects of steroids like tuberculosis reactivation, especially in tuberculosis endemic countries. These findings have therapeutic implications and may serve as guidance for future approach to the management of ‘long-COVID’ with pulmonary sequalae. |
| first_indexed | 2024-12-23T10:43:20Z |
| format | Article |
| id | doaj.art-57d1169b973d4e8a8aedc3e9a444b838 |
| institution | Directory Open Access Journal |
| issn | 1122-0643 2532-5264 |
| language | English |
| last_indexed | 2024-12-23T10:43:20Z |
| publishDate | 2021-11-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Monaldi Archives for Chest Disease |
| spelling | doaj.art-57d1169b973d4e8a8aedc3e9a444b8382022-12-21T17:50:07ZengPAGEPress PublicationsMonaldi Archives for Chest Disease1122-06432532-52642021-11-0110.4081/monaldi.2021.1981Systemic corticosteroids for management of ‘long-COVID’: an evaluation after 3 months of treatmentNitin Goel0Nitesh Goyal1Ravishankar Nagaraja 2Raj Kumar3Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of DelhiDepartment of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of DelhiDepartment of Biostatistics, Vallabhbhai Patel Chest Institute, University of DelhiDepartment of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of DelhiSome patients even 4 weeks after Corona Virus Disease 2019 (COVID-19) remain to be symptomatic and are known as “long-COVID”. In the present study we performed the follow up evaluation at 3 months of long-COVID patients, after treatment with systemic steroids. During the study duration, out of the 4,542 patients managed in the outpatient department of the particular unit, there were 49 patients of Long-COVID. The patients having abnormal computed tomography (CT) alongwith resting hypoxia or exertional desaturation were treated with systemic steroid (deflazacort) in tapering doses for 8-10 weeks. We retrospectively analysed the clinical and radiological findings of these patients at first presentation and at about 3 months of follow up visit. On follow up, all the 49 long-COVID patients showed improvement. The occurrence of breathlessness decreased from 91.83% to 44.89% (p<0.001) and cough from 77.55% to 8.16% (p<0.001). Twenty-four patients were prescribed systemic steroids. Out of these, nearly 58% patients had MMRC grade 4 breathlessness, which decreased to < 2 MMRC in about 86% of these patients. MMRC grade (median) decreased from 3 to 1 (p<0.001). Majority of patients who were tachypnoeic and hypoxic at rest (n=7) showed improvement (71%), post-treatment with corticosteroids. Occurrence of normal chest X-ray increased from 12% to 71% (p<0.001). All these patients had abnormal CT thorax initially, and post-treatment 25% had normal CT thorax. Hence, we conclude that systemic steroids are helpful in hastening recovery of select subset of long-COVID patients. Simultaneously, we should be cautious of immunosuppressive effects of steroids like tuberculosis reactivation, especially in tuberculosis endemic countries. These findings have therapeutic implications and may serve as guidance for future approach to the management of ‘long-COVID’ with pulmonary sequalae.https://www.monaldi-archives.org/index.php/macd/article/view/1981COVID-19CorticosteroidsSARS-CoV-2HypoxiaBreathlessness |
| spellingShingle | Nitin Goel Nitesh Goyal Ravishankar Nagaraja Raj Kumar Systemic corticosteroids for management of ‘long-COVID’: an evaluation after 3 months of treatment Monaldi Archives for Chest Disease COVID-19 Corticosteroids SARS-CoV-2 Hypoxia Breathlessness |
| title | Systemic corticosteroids for management of ‘long-COVID’: an evaluation after 3 months of treatment |
| title_full | Systemic corticosteroids for management of ‘long-COVID’: an evaluation after 3 months of treatment |
| title_fullStr | Systemic corticosteroids for management of ‘long-COVID’: an evaluation after 3 months of treatment |
| title_full_unstemmed | Systemic corticosteroids for management of ‘long-COVID’: an evaluation after 3 months of treatment |
| title_short | Systemic corticosteroids for management of ‘long-COVID’: an evaluation after 3 months of treatment |
| title_sort | systemic corticosteroids for management of long covid an evaluation after 3 months of treatment |
| topic | COVID-19 Corticosteroids SARS-CoV-2 Hypoxia Breathlessness |
| url | https://www.monaldi-archives.org/index.php/macd/article/view/1981 |
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