Persistent Post–COVID-19 Interstitial Lung Disease. An Observational Study of Corticosteroid Treatment

• DOI: 10.1513/annalsats.202008-1002oc
• Publication Date: 2021-01-12T18:44:52Z
• Authors: Katherine Jane Myall; Bhashkar Mukherjee; Ana Margarida Cas...; Jodie L. Lam; Giulia Benedetti; Sze Mun Mak; Rebecca Preston; Muhunthan Thillai; Amy Dewar; Philip L. Molyneaux; Alex G. West
• Keywords: Prednisolone; Pneumonitis; Diffuse alveolar damage

Rationale: The natural history of recovery from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains unknown. Because fibrosis with persistent physiological deficit is a previously described feature patients recovering similar coronaviruses, treatment represents an early opportunity to modify the disease course, potentially preventing irreversible impairment.Objectives: Determine incidence and describe progression inflammatory interstitial lung (ILD) following SARS-CoV-2 when treated prednisolone.Methods: A structured assessment protocol screened for sequelae pneumonitis. Eight hundred thirty-seven were assessed by telephone 4 weeks after discharge. Those ongoing symptoms had outpatient at 6 weeks. Thirty diagnosed changes multidisciplinary team meeting reviewed in service offered treatment. These persistent, nonimproving symptoms.Results: At discharge, 39% reported (325/837) assessed. Interstitial disease, predominantly organizing pneumonia, significant functional was observed 35/837 survivors (4.8%). these received steroid treatment, resulting mean relative increase transfer factor 31.6% (standard deviation [SD] ± 27.6, P < 0.001), forced vital capacity 9.6% (SD 13.0, = 0.014), symptomatic radiological improvement.Conclusions: Following pneumonitis, cohort are left both deficit. Early corticosteroids well tolerated associated rapid improvement. preliminary data should inform further study into potential ILD infection.