Effectiveness of corticosteroids on chest high-resolution computed tomography features of COVID-19 pneumonia
Objective: The aim of our study was to assess the effect of a short-term treatment with low-moderate corticosteroid (CS) doses by both a quantitative and qualitative assessment of chest HRCT of COVID-19 pneumonia. Methods: CORTICOVID is a single-center, cross-sectional, retrospective study involving...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2021-09-01
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| Series: | Therapeutic Advances in Respiratory Disease |
| Online Access: | https://doi.org/10.1177/17534666211042533 |
| _version_ | 1831540059177746432 |
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| author | Cecilia Calabrese Pia Clara Pafundi Mariano Mollica Anna Annunziata Pasquale Imitazione Maurizia Lanza Giorgio Polistina Martina Flora Salvatore Guarino Cristiana Palumbo Giuseppe Fiorentino |
| author_facet | Cecilia Calabrese Pia Clara Pafundi Mariano Mollica Anna Annunziata Pasquale Imitazione Maurizia Lanza Giorgio Polistina Martina Flora Salvatore Guarino Cristiana Palumbo Giuseppe Fiorentino |
| author_sort | Cecilia Calabrese |
| collection | DOAJ |
| description | Objective: The aim of our study was to assess the effect of a short-term treatment with low-moderate corticosteroid (CS) doses by both a quantitative and qualitative assessment of chest HRCT of COVID-19 pneumonia. Methods: CORTICOVID is a single-center, cross-sectional, retrospective study involving severe/critical COVID-19 patients with mild/moderate ARDS. Lung total severity score was obtained according to Chung and colleagues. Moreover, the relative percentages of lung total severity score by ground glass opacities, consolidations, crazy paving, and linear bands were computed. Chest HRCT scores, P/F ratio, and laboratory parameters were evaluated before (pre-CS) and 7–10 days after (post-CS) methylprednisolone of 0.5–0.8 mg/kg/day. Findings: A total of 34 severe/critical COVID-19 patients were included in the study, of which 17 received Standard of Care (SoC) and 17 CS therapy in add-on. CS treatment disclosed a significant decrease in HRCT total severity score [median = 6 (IQR: 5–7.5) versus 10 (IQR: 9–13) in SoC, p < 0.001], as well in single consolidations [median = 0.33 (IQR: 0–0.92) versus 6.73 (IQR: 2.49–8.03) in SoC, p < 0.001] and crazy paving scores [mean = 0.19 (SD = 0.53) versus 1.79 (SD = 2.71) in SoC, p = 0.010], along with a significant increase in linear bands [mean = 2.56 (SD = 1.65) versus 0.97 (SD = 1.30) in SoC, p = 0.006]. GGO score instead did not significantly differ at the end of treatment between the two groups. Most post-CS GGO, however, derived from previous consolidations and crazy paving [median = 1.5 (0.35–3.81) versus 2 (1.25–3.8) pre-CS; p = 0.579], while pre-CS GGO significantly decreased after methylprednisolone therapy [median = 0.66 (0.05–1.33) versus 1.5 (0.35–3.81) pre-CS; p = 0.004]. CS therapy further determined a significant improvement in P/F levels [median P/F = 310 (IQR: 235.5–370) versus 136 (IQR: 98.5–211.75) in SoC; p < 0.001], and a significant increase in white blood cells, lymphocytes, and neutrophils absolute values. Conclusion: The improvement of all chest HRCT findings further supports the role of CS adjunctive therapy in severe/critical COVID-19 pneumonia. |
| first_indexed | 2024-12-16T23:51:53Z |
| format | Article |
| id | doaj.art-e9b33c8a50e6482880266736cd367531 |
| institution | Directory Open Access Journal |
| issn | 1753-4666 |
| language | English |
| last_indexed | 2024-12-16T23:51:53Z |
| publishDate | 2021-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Respiratory Disease |
| spelling | doaj.art-e9b33c8a50e6482880266736cd3675312022-12-21T22:11:18ZengSAGE PublishingTherapeutic Advances in Respiratory Disease1753-46662021-09-011510.1177/17534666211042533Effectiveness of corticosteroids on chest high-resolution computed tomography features of COVID-19 pneumoniaCecilia CalabresePia Clara PafundiMariano MollicaAnna AnnunziataPasquale ImitazioneMaurizia LanzaGiorgio PolistinaMartina FloraSalvatore GuarinoCristiana PalumboGiuseppe FiorentinoObjective: The aim of our study was to assess the effect of a short-term treatment with low-moderate corticosteroid (CS) doses by both a quantitative and qualitative assessment of chest HRCT of COVID-19 pneumonia. Methods: CORTICOVID is a single-center, cross-sectional, retrospective study involving severe/critical COVID-19 patients with mild/moderate ARDS. Lung total severity score was obtained according to Chung and colleagues. Moreover, the relative percentages of lung total severity score by ground glass opacities, consolidations, crazy paving, and linear bands were computed. Chest HRCT scores, P/F ratio, and laboratory parameters were evaluated before (pre-CS) and 7–10 days after (post-CS) methylprednisolone of 0.5–0.8 mg/kg/day. Findings: A total of 34 severe/critical COVID-19 patients were included in the study, of which 17 received Standard of Care (SoC) and 17 CS therapy in add-on. CS treatment disclosed a significant decrease in HRCT total severity score [median = 6 (IQR: 5–7.5) versus 10 (IQR: 9–13) in SoC, p < 0.001], as well in single consolidations [median = 0.33 (IQR: 0–0.92) versus 6.73 (IQR: 2.49–8.03) in SoC, p < 0.001] and crazy paving scores [mean = 0.19 (SD = 0.53) versus 1.79 (SD = 2.71) in SoC, p = 0.010], along with a significant increase in linear bands [mean = 2.56 (SD = 1.65) versus 0.97 (SD = 1.30) in SoC, p = 0.006]. GGO score instead did not significantly differ at the end of treatment between the two groups. Most post-CS GGO, however, derived from previous consolidations and crazy paving [median = 1.5 (0.35–3.81) versus 2 (1.25–3.8) pre-CS; p = 0.579], while pre-CS GGO significantly decreased after methylprednisolone therapy [median = 0.66 (0.05–1.33) versus 1.5 (0.35–3.81) pre-CS; p = 0.004]. CS therapy further determined a significant improvement in P/F levels [median P/F = 310 (IQR: 235.5–370) versus 136 (IQR: 98.5–211.75) in SoC; p < 0.001], and a significant increase in white blood cells, lymphocytes, and neutrophils absolute values. Conclusion: The improvement of all chest HRCT findings further supports the role of CS adjunctive therapy in severe/critical COVID-19 pneumonia.https://doi.org/10.1177/17534666211042533 |
| spellingShingle | Cecilia Calabrese Pia Clara Pafundi Mariano Mollica Anna Annunziata Pasquale Imitazione Maurizia Lanza Giorgio Polistina Martina Flora Salvatore Guarino Cristiana Palumbo Giuseppe Fiorentino Effectiveness of corticosteroids on chest high-resolution computed tomography features of COVID-19 pneumonia Therapeutic Advances in Respiratory Disease |
| title | Effectiveness of corticosteroids on chest high-resolution computed tomography features of COVID-19 pneumonia |
| title_full | Effectiveness of corticosteroids on chest high-resolution computed tomography features of COVID-19 pneumonia |
| title_fullStr | Effectiveness of corticosteroids on chest high-resolution computed tomography features of COVID-19 pneumonia |
| title_full_unstemmed | Effectiveness of corticosteroids on chest high-resolution computed tomography features of COVID-19 pneumonia |
| title_short | Effectiveness of corticosteroids on chest high-resolution computed tomography features of COVID-19 pneumonia |
| title_sort | effectiveness of corticosteroids on chest high resolution computed tomography features of covid 19 pneumonia |
| url | https://doi.org/10.1177/17534666211042533 |
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