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. 2023 Sep 13;40(3):e2023029.
doi: 10.36141/svdld.v40i3.14418.

Risk factors for the development of interstitial lung disease following severe COVID-19 pneumonia and outcomes of systemic corticosteroid therapy: 3-month follow-up

Sibel Günay  1 , Izzet Selcuk Parlak  2 , Habibe Hezer  3 , Ebru Şengül Şeref Parlak  4 , Melike Sanem Umut  5 , Zeynep Hancıoğlu  6 , Hülya Çelenk Ergüden  7 , Yasin Kocaman  8 , Aynil Dalkıran  9 , Ümran Sertçelik  10 , İrem Şerifoğlu  11 , Esmehan Akpınar  12 , Muhammet Furkan Göktaş  13 , Meltem Fidan  14 , Büşra Babahanoğlu  15 , Fatma Sinem Cander  16 , Esra Çıvgın  17 , Mükremin Er  18 , Hatice Kılıç  19 , Emine Argüder  20 , Tuncer Tuğ  21 , Ebru Ünsal  22 , Canan Hasanoğlu  23 , İrem Günay  24 , Muhammet Babayiğit  25 , Büşra Ağca  26 , Ayşegül Karalezli  27
Affiliations

Risk factors for the development of interstitial lung disease following severe COVID-19 pneumonia and outcomes of systemic corticosteroid therapy: 3-month follow-up

Sibel Günay et al. Sarcoidosis Vasc Diffuse Lung Dis. .

Abstract

Background: We aimed to evaluate the pulmonary involvement status, its related factors, and pulmonary function test (PFT) results in the first month follow-up in patients who were discharged for severe Covid-19 pneumonia, and to assess the efficacy of corticosteroid treatment on these parameters in severe pulmonary involvement patients.

Methods: We retrospectively analyzed all consecutive patients who applied to our COVID-19 follow-up clinic at the end of the first month of hospital discharge. Functional and radiological differences were compared after 3 months of corticosteroid treatment in severe pulmonary involvement group. Results We analyzed 391 patients with "pulmonary parenchymal involvement" (PPIG) and 162 patients with "normal lung radiology" (NLRG). 122 patients in the PPIG (corticosteroid-required interstitial lung disease group (CRILD)) had severe pulmonary involvement with frequent symptoms and required corticosteroid prescription. Pulmonary involvement was more common in males and elder patients (P<0.001, for both). Being smoker and elderly were associated with a higher risk-ratio in predicting to be in PPIG (OR:2.250 and OR:1.057, respectively). Smokers, male and elderly patients, and HFNO2 support during hospitalization were risk factors for being a patient with CRILD (OR:2.737, OR:4.937, OR:4.756, and OR:2.872, respectively). After a three-months of methylprednisolone medication, a good response was achieved on radiological findings and PFT results in CRILD.

Conclusions: In conclusion, after severe COVID-19 pneumonia, persistent clinical symptoms and pulmonary parenchymal involvement would be inevitable in elder and smoker patients. Moreover, corticosteroid treatment in patients with severe parenchymal involvement was found to be effective in the improvement of radiological and functional parameters.

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Conflict of interest statement

Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article.

Figures

Figure 1.
Figure 1.
Flowchart of our study population (PCR: polymerase chain reaction, CT: Computed tomography).
See this image and copyright information in PMC

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