在重症COVID-19肺炎患者中,长期使用皮质类固醇治疗和肺部异常
Anja Ljilja Posavec1, Daria Cvetković Kučić2, Nikola Zagorec3
1Polyclinic for the Respiratory Tract Diseases.
概括
长时间的皮质类固醇治疗没有改善严重的COVID-19肺炎患者的肺功能或CT发现. 与长期治疗组相比,对照组表现出更少的呼吸障碍症状和更好的DLCO.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 严重的COVID-19肺炎可能导致持续的呼吸系统问题,尽管治疗,但氧和率降低.
- 在COVID-19中免疫调节失调表明,长期使用皮质类固醇对滞留的肺部问题和症状有潜在的益处.
研究的目的:
- 评估葡萄糖皮质激素治疗对肺功能和高分辨率CT (HRCT) 发现在严重的COVID-19肺炎患者的影响.
- 为了比较两个不同的葡萄糖皮质体剂量方案与没有接受额外治疗的对照组.
主要方法:
- 一项前性队列研究,涉及患有长期呼吸不全后严重COVID-19肺炎的患者.
- 患者被分配接受14天或3个月的皮质类固醇治疗,或没有额外的治疗 (对照组).
- 肺功能,COVID-19后的症状和CT扫描异常在三个月的随访期被评估.
主要成果:
- 与14天治疗或对照组相比,为期三个月的皮质类固醇治疗没有产生优异的CT发现,肺功能或症状恢复.
- 对照组的呼吸障碍症状显著减少 (p=0.04) 和肺部对一氧化碳 (DLCO) 的扩散能力更高 (p=0.03).
结论:
- 补充性皮质类固醇治疗严重的COVID-19肺炎,长期呼吸不全和肺部异常并不能增强肺功能或减少CT检测到的病变.
- 目前的研究结果表明,长期使用皮质类固醇可能对治疗严重COVID-19的长期呼吸系统后续症状没有好处.
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