https://doi.org/10.4081/monaldi.2021.1811
Pulmonary function, computerized tomography features and six-minute walk test at three months in severe COVID-19 patients treated with intravenous pulsed methylprednisolone: a preliminary report
Submitted: February 19, 2021
Accepted: April 28, 2021
Published: July 19, 2021
Accepted: April 28, 2021
Abstract Views: 2091
PDF: 851
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
COVID-19 acute respiratory distress syndrome (ARDS) has a high mortality and few therapeutic options. We present a preliminary report on our experience using high-dose pulsed methylprednisolone in COVID-19 ARDS and three-month outcomes. We performed a retrospective analysis of all patients treated with high-dose methylprednisolone for COVID-19 ARDS and three-month lung function, 6-minutes walking test (6MWT), and computerized tomography (CT) findings. Fifteen patients were treated of which 10 survived to discharge. Reduced diffusion capacity for carbon monoxide (DLCO) was the commonest abnormality in lung function tests and had the lowest mean value. Parenchymal bands were the commonest CT finding and 50% of patients had fibrosis at three months. Mean 6-minutes walk distance (6MWD) was 65.4% predicted and was abnormal in 62.5% of patients. In this cohort of patients with COVID-19 ARDS treated with high-dose methylprednisolone pulses, CT, lung function, and 6MWT abnormalities were unsurprisingly common at three months, although all 10 patients treated early in their disease course survived, a possible therapeutic effect. Further randomised controlled trials are needed to assess the benefits of this treatment.
Vetter P, Lan Vu D, L’Hullier AG, et al. Clinical features of COVID-19. BMJ 2020;369:m1470.
DOI: https://doi.org/10.1136/bmj.m1470
Grasselli G, Tonetti T, Protti A, et al. Pathophysiology of COVID-19-associated acute respiratory distress syndrome: a multicentre prospective observational study. Lancet Respir Med 2020 8:1201-08.
DOI: https://doi.org/10.1016/S2213-2600(20)30370-2
Jordan RE, Adab P, Cheng KK. COVID-19: risk factors for severe disease and death. BMJ 2020;368:m1198.
DOI: https://doi.org/10.1136/bmj.m1198
Bompard F, Monnier H, Saab I, et al. Pulmonary embolism in patients with COVID-19 pneumonia. Eur Respir J 2020;56:2001365.
DOI: https://doi.org/10.1183/13993003.01365-2020
Wang L, Chen F, Bai L, Yi Q, Peng Y. In situ pulmonary thrombosis in patients with COVID-19 pneumonia: different phenotypes may exist. Thromb Res 2020;196:S41-2.
DOI: https://doi.org/10.1016/j.thromres.2020.10.022
McGonagle D, O’Donnel JS, Sharif K, et al. Immune mechanisms of pulmonary intravascular coagulopathy in COVID-19 pneumonia. Lancet Rheumatol 2020;2:e437-45.
DOI: https://doi.org/10.1016/S2665-9913(20)30121-1
Tay MZ, Poh CM, Renia L, et al. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol 2020;20:363-74.
DOI: https://doi.org/10.1038/s41577-020-0311-8
UK Government. Selected NHS patients to access coronavirus treatment Remdesivir. Accessed: 11/10/2020. Available from: https://www.gov.uk/government/news/selected-nhs-patients-to-access-coronavirus-treatment-remdesivir
UK Government. World first coronavirus treatment approved for NHS use by Government. Accessed: 11/10/2020. Available from: https://www.gov.uk/government/news/world-first-coronavirus-treatment-approved-for-nhs-use-by-government
Ngai JC, Ko FW, Ng SS, et al. The long-term impact of severe acute respiratory syndrome on pulmonary function, exercise capacity and health status. Respirology 2010;15:543-50.
DOI: https://doi.org/10.1111/j.1440-1843.2010.01720.x
Ahmed H, Patel K, Greenwood DC, et al. Long-term clinical outcomes in survivors of severe acute respiratory syndrome and Middle East respiratory syndrome coronavirus outbreaks after hospitalization and ICU admission: a systematic review and meta-analysis. J Rehab Med 2020;52:jrm00063.
DOI: https://doi.org/10.2340/16501977-2694
Mo X, Jian W, Su Z, et al. Abnormal pulmonary function in COVID-19 patients at time of hospital discharge. Eur Respir J 2020;55:20011217.
DOI: https://doi.org/10.1183/13993003.01217-2020
Frija-Masson J, Debray M-P, Gilbert M, et al. Functional characteristics of patients with SARS-CoV-2 pneumonia at 30 days post-infection. Eur Respir J 2020;56:2001754.
DOI: https://doi.org/10.1183/13993003.01754-2020
Huang Y, Tan G, Wu J, et al. Impact of Coronavirus 2019 disease on pulmonary function in early convalescence phase. Respir Res 2020;21:163.
DOI: https://doi.org/10.1186/s12931-020-01429-6
Zhao Y-M, Shang Y-M, Song W-B, et al. Follow-up study of the pulmonary function and related physiological characteristics of COVID-19 survivors three months after recovery. EClinicalMedicine 2020;25:100463.
DOI: https://doi.org/10.1016/j.eclinm.2020.100463
Yam L Y-C, Lau A C-W, Lai F Y-L et al. Corticosteroid treatment of severe acute respiratory syndrome in Hong Kong. J Infecti 2007;57:28-39.
DOI: https://doi.org/10.1016/j.jinf.2006.01.005
Edalatifard M, Akhtari M, Salehi M, et al. Intravenous methylprednisolone pulse as a treatment for hospitalised severe COVID-19 patients: results from a randomized control trial. Eur Respir J 2020;56:2002808.
DOI: https://doi.org/10.1183/13993003.02808-2020
The Pharmaceutical Journal. Everything you need to know about the COVID-19 therapy trials. Royal Pharmaceutical Society. Accessed: 2/12/2020. Available from: https://www.pharmaceutical-journal.com/news-and-analysis/features/everything-you-need-to-know-about-the-covid-19-therapy-trials/20208126.article?firstPass=false
Asad A, Ramos-Bascon N, Barnes N, Madden B. A specialised cardiorespiratory team approach in the intensive care management of COVID-19 patients: benefit on mortality, diagnosis and management. Clin Med (Lond) 2021;12:101-6.
DOI: https://doi.org/10.7861/clinmed.2020-0788
Madden BM, Hodson ME, Tsang V, et al. Intermediate-term results of heart-lung transplantation for cystic fibrosis. Lancet 1992;339:1583-7.
DOI: https://doi.org/10.1016/0140-6736(92)91842-V
Vij R, Strek ME. Diagnosis and treatment of connective tissue disease-associated interstitial lung disease. Chest 2013;143:814-24.
DOI: https://doi.org/10.1378/chest.12-0741
National Institutes of Health. Clinical Presentation of People with SARS-CoV-2 Infection. Accessed: 2/12/2020. Available from: https://www.covid19treatmentguidelines.nih.gov/overview/clinical-presentation
World Health Organisation, Clinical Management of severe respiratory infection (SRI) when COVID-19 disease is suspected. Accessed: 2/12/2020. Available from: https://apps.who.int/iris/bitstream/handle/10665/331446/WHO-2019-nCoV-clinical-2020.4-eng.pdf?sequence=1&isAllowed=y
Liu D, Zhang W, Pan F, et al. The pulmonary sequelae in discharged patients with COVID-19: a short-term observational study. Respir Res 2020;21:125.
DOI: https://doi.org/10.1186/s12931-020-01385-1
Wang Q, Jiang H, Xie Y, et al. Long-term clinical prognosis of human infections with avian influenza A (H7N9) viruses in China after hospitalization. EClinicalMedicine 2020;20:100282.
DOI: https://doi.org/10.1016/j.eclinm.2020.100282
Hanley B, Naresh KN, Roufosse C, et al. Histopathological findings and viral tropism in UK patients with severe fatal COVID-19: a post-mortem study. Lancet Microbe 2020;1:e245-53.
DOI: https://doi.org/10.1016/S2666-5247(20)30115-4
RECOVERY Collaborative Group, Horby P, Lim WS, et al. Dexamethasone in Hospitalized Patients with COVID-19 – Preliminary Report. N Engl J Med 2021;384:693-704.
DOI: https://doi.org/10.1056/NEJMoa2021436
Fernandez-Cruz A, Ruiz-Antorán B, Muñoz-Gómez A, et al. A Retrospective controlled cohort study of the impact of glucocorticoid treatment in SARS-CoV-2 infection mortality. Antimicrob Agents Chemother 64:e01168-20.
DOI: https://doi.org/10.1128/AAC.01168-20
Cellajs Rubio JL, Luna del Castillo JD, de la Hera Fernandéz J, et al. Effectiveness of corticoid pulses in patient with cytokine storm syndrome induced by SARS-CoV-2 infection. Med Clin (Barc) 2020;155:159-61.
DOI: https://doi.org/10.1016/j.medcle.2020.07.002
So C, Ro S, Murakami M, et al. High-dose, short-term corticosteroids for ARDS caused by COVID-19: a case series. Respirol Case Rep 2020;8:e00596.
DOI: https://doi.org/10.1002/rcr2.596
How to Cite
van Zeller, Cristiano, Asad Anwar, Nordita Ramos-Bascon, Natalie Barnes, and Brendan Madden. 2021. “Pulmonary Function, Computerized Tomography Features and Six-Minute Walk Test at Three Months in Severe COVID-19 Patients Treated With Intravenous Pulsed Methylprednisolone: A Preliminary Report”. Monaldi Archives for Chest Disease 91 (4). https://doi.org/10.4081/monaldi.2021.1811.
Copyright (c) 2021 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Kenan Yalta, Ugur Ozkan, Tülin Yalta, Ertan Yetkin, Cardiac myxoma as a potential trigger of takotsubo cardiomyopathy: A brief review on mechanistic and clinical perspectives , Monaldi Archives for Chest Disease: Vol. 92 No. 1 (2022)
- Afrah Alsomali, Abdullah Eltayeb, Sarah Aldosari, Maie AlShahid, Aly AlSanei, Ali AlEnazy, Olga Vriz, Recurrence of left ventricular pseudoaneurysm after multiple mitral valve replacements , Monaldi Archives for Chest Disease: Vol. 92 No. 2 (2022)
- Berardo Sarubbi, Gabriella Farina, Diego Colonna, Anna Correra, Emanuele Romeo, Giovanni Domenico Ciriello, Guido Oppido, Maria Giovanna Russo, Subcutaneous finger cardioverter-defibrillator in low weight paediatric patients: a case series , Monaldi Archives for Chest Disease: Vol. 93 No. 1 (2023)
- Naji Kholaif, Lin Batha, Isra Elmahi, Sulaiman Alnaser, Sultan Alzaher, Norah Almallohi , Mosaad Alhussein, Dana Alhalees, Ahmed Alshehri, Transplantation of heterozygous familial hypercholesterolemia living donor liver resulting in early myocardial infarction: a possible dangerous link , Monaldi Archives for Chest Disease: Early Access
- Immacolata Ambrosino, Elena Barbagelata, Elena Ortona, Anna Ruggieri, Grace Massiah, Orazio Valerio Giannico, Cecilia Politi, Anna Maria Moretti, Gender differences in patients with COVID-19: a narrative review , Monaldi Archives for Chest Disease: Vol. 90 No. 2 (2020)
- Navdeep Kaur, Amandeep Kaur, Harvinder Singh Chhabra, Bull’s eye sign – A diagnostic clinch in COVID-19 pneumonia , Monaldi Archives for Chest Disease: Vol. 92 No. 1 (2022)
- Shyam Kanhaiya Saroj, Tushti Bhardwaj, Non-pharmacological interventions for tobacco cessation: A systematic review of existing practices and their effectiveness , Monaldi Archives for Chest Disease: Vol. 92 No. 4 (2022)
- Kostiantyn Dmytriiev, Yuriy Mostovoy, Nataliia Slepchenko, Yuliia Smereka, Clinical course of COPD in patients with Arg16Gly (rs1042713) polymorphism of ADRB2 gene , Monaldi Archives for Chest Disease: Vol. 93 No. 2 (2023)
- Francesca Gatta, Yama Haqzad, George Gradinariu, Pietro Giorgio Malvindi, Zubair Khalid, Rona L. Suelo-Calanao, Nader Moawad, Aladdin Bashir, Luke J. Rogers, Clinton Lloyd, Bao Nguyen, Karen Booth, Lu Wang, Nawwar Al-Attar, Neil McDowall, Stuart Watkins, Rana Sayeed, Saleh Baghdadi, Andrea D’Alessio, Maria Monteagudo-vela, Jasmina Djordjevic, Matej Goricar, Solveig Hoppe, Charlotte Bocking, Azar Hussain, Betsy Evans, Salman Arif, Christopher Malkin, Mark Field, Kully Sandhu, Amer Harky, Ahmed Torky, Mauin Uddin, Muhammad Abdulhakeem, Ayman Kenawy, John Massey, Neil Cartwright, Nathan Tyson, Niki Nicou, Kamran Baig, Mark Jones, Firas Aljanadi, Colum G. Owens, Tunde Oyebanji, Joseph Doyle, Mark S. Spence, Paul F. Brennan, Ganesh Manoharan, Taha Ramadan, Sunil Ohri, Mahmoud Loubani, Redo aortic valve replacement versus valve-in-valve trans-catheter aortic valve implantation: a UK propensity-matched analysis , Monaldi Archives for Chest Disease: Vol. 94 No. 1 (2024)
- Sergio C. Conte, Giulia Spagnol, Marco Biolo, Marco Confalonieri, A retrospective study of endobronchial ultrasound transbronchial needle aspiration versus conventional transbronchial needle aspiration in diagnosis/staging of hilar/mediastinal lymph node in lung cancer: Which role in clinical practice? , Monaldi Archives for Chest Disease: Vol. 89 No. 1 (2019)
You may also start an advanced similarity search for this article.
