Case Report: Potential Role of Corticosteroids in the Management of Post-COVID-19 Pneumonia

Abstract

Certain patients who recover from severe pneumonia due to coronavirus disease 2019 (COVID-19) remain symptomatic in the post-infectious period, either clinically, radiologically, or respiratory. The post-COVID-19 period is characterized by clinical symptoms of varying duration from one subject to another and does not seem to depend on the severity of initial pneumonia. The persisting inflammatory and/or immune reactions in the post-COVID-19 period may play a role in the development of pulmonary lesions. Here, we report the case of a 61-year-old man with severe COVID-19 pneumonia, complicated by acute respiratory distress syndrome and pulmonary embolism, which required the patient's admission to the intensive care unit and high-flow oxygen therapy. The patient was hospitalized for 23 days for the management of his severe COVID-19 pneumonia. Afterwards, he was discharged home following a negative SARS-CoV-2 PCR test. The post-COVID-19 period was characterized by a complex respiratory symptomatology associating cough, resting dyspnea, and exertional dyspnea requiring oxygen therapy for several weeks. Surprisingly, the follow-up chest CT scan performed 4 weeks after discharge revealed bilateral interstitial lung lesions. After ruling out pulmonary superinfection, the patient was treated with oral corticosteroid for 3 months at a digressive dose. In our case, the use of corticosteroid therapy in the post-COVID19 phase had improved the outcome of the lung disease. These benefits are characterized by a rapid symptomatic improvement, accelerated repair of pulmonary images, rapid oxygen withdrawal, and rapid return to daily activities.

A Systematic Review of Chest Imaging Findings in Long COVID Patients

“…Frequency of lung imaging abnormalities per different evaluation setting. References [ 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ] are cited in the Supplementary Materials…”

Challenges in the Management of Post-COVID-19 Pulmonary Fibrosis for the Latin American Population

“…Persistent inflammatory and immune reactions in the post-COVID-19 period may play a role in the development of lung lesions. Although some patients recover from severe COVID-19 pneumonia, they remain symptomatic in the post-infectious period, with clinical, radiological, or respiratory abnormalities despite a negative SARS-CoV-2 control test [39]. The persistence of residual inflammation or immune response, repair, and remodeling mechanisms in the post-COVID-19 period may influence the development of new lung lesions, or the worsening of pre-existing lesions.…”