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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...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477677/ https://www.ncbi.nlm.nih.gov/pubmed/34565246 http://dx.doi.org/10.1177/17534666211042533 |
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author | Calabrese, Cecilia Pafundi, Pia Clara Mollica, Mariano Annunziata, Anna Imitazione, Pasquale Lanza, Maurizia Polistina, Giorgio Flora, Martina Guarino, Salvatore Palumbo, Cristiana Fiorentino, Giuseppe |
author_facet | Calabrese, Cecilia Pafundi, Pia Clara Mollica, Mariano Annunziata, Anna Imitazione, Pasquale Lanza, Maurizia Polistina, Giorgio Flora, Martina Guarino, Salvatore Palumbo, Cristiana Fiorentino, Giuseppe |
author_sort | Calabrese, Cecilia |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-8477677 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-84776772021-09-29 Effectiveness of corticosteroids on chest high-resolution computed tomography features of COVID-19 pneumonia Calabrese, Cecilia Pafundi, Pia Clara Mollica, Mariano Annunziata, Anna Imitazione, Pasquale Lanza, Maurizia Polistina, Giorgio Flora, Martina Guarino, Salvatore Palumbo, Cristiana Fiorentino, Giuseppe Ther Adv Respir Dis Original Research 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. SAGE Publications 2021-09-25 /pmc/articles/PMC8477677/ /pubmed/34565246 http://dx.doi.org/10.1177/17534666211042533 Text en © The Author(s), 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Calabrese, Cecilia Pafundi, Pia Clara Mollica, Mariano Annunziata, Anna Imitazione, Pasquale Lanza, Maurizia Polistina, Giorgio Flora, Martina Guarino, Salvatore Palumbo, Cristiana Fiorentino, Giuseppe Effectiveness of corticosteroids on chest high-resolution computed tomography features of COVID-19 pneumonia |
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 |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477677/ https://www.ncbi.nlm.nih.gov/pubmed/34565246 http://dx.doi.org/10.1177/17534666211042533 |
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