Experience of using systemic glucocorticoids during reconvalescence of patients after a new coronavirus infection of moderate severity

Abstract

Introduction. Part of the reconvalescents after new coronavirus infection (NCI), have residual respiratory structural and functional abnormalities.Aim. To evaluate the efficacy and safety of low-dose systemic glucocorticoids (SSG) in patients with respiratory symptoms and residual “fibrosis-like” changes in lung tissue after a moderately severe NCI with up to 50% lesion volume.Materials and methods. Reconvalescents with moderate NKI who had respiratory symptoms and residual fibrosis-like changes in lung tissue at the time of discharge were randomly divided into two groups: those receiving systemic glucocorticoids (n = 15) and those not (n = 27). Complaint assessment, 6-minute walk test (6-MHT), spirometry, and high-resolution computed tomography (HRT) were performed at baseline, 2, and 9 months later. The primary endpoint of the study was complete disappearance of pathological changes in the lungs according to CTVR. Secondary endpoints of the study were: disappearance of respiratory complaints, increase in the distance traveled in 6-MCG test, regression of functional ventilatory disturbances according to spirometry data.Results and discussion. In both groups by the 9th month of the study there was a significant positive dynamics: respiratory symptoms regressed, tolerance to physical activity improved, residual changes of lung tissue according to CTBPR decreased and in most cases completely disappeared. However, respiratory symptoms and residual changes in lung tissue remained in 9% of cases. Significant improvement of ventilatory lung function and exercise tolerance by the 9th month of follow-up was established in the systemic glucocorticoids group, with no adverse events detected.Conclusions. In the acute phase of moderate NKI, both spontaneous resolution of respiratory symptoms and residual lung tissue changes and their effective and safe resolution due to the use of systemic glucocorticoids can be assumed.