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机化性肺炎:COVID-19 的晚期并发症,对皮质类固醇反应剧烈。

Organizing pneumonia: A late phase complication of COVID-19 responding dramatically to corticosteroids.

机构信息

Internal Medicine Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.

Radiology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.

出版信息

Braz J Infect Dis. 2021 Jan-Feb;25(1):101541. doi: 10.1016/j.bjid.2021.101541. Epub 2021 Feb 6.

Abstract

Organizing pneumonia emerges as a late phase complication of COVID-19. Corticosteroids are standard therapy for organizing pneumonia, but the question of whether an approach with high dose corticosteroids would be beneficial for patients with organizing pneumonia secondary to COVID-19 remains to be answered. Herein we report a series of three patients, one male and two females, mean age 58.3 years old, admitted for COVID-19 with severe pulmonary disease requiring ventilatory support. The patients underwent chest computed tomography scans due to maintained hypoxemia, which showed a pattern compatible with organizing pneumonia. The patients were treated with a high dose of corticosteroids (prednisone 1 mg/kg PO), showing marked clinical improvement, and decreasing oxygen flow ratio demand. They were discharged after a mean period of 6.3 days of hospitalization. Our report suggests that patients with COVID-19 with organizing pneumonia might benefit from high dose corticosteroids as an adjuvant therapy.

摘要

机化性肺炎是 COVID-19 的晚期并发症。皮质类固醇是机化性肺炎的标准治疗方法,但对于 COVID-19 继发机化性肺炎患者,高剂量皮质类固醇治疗是否有益的问题仍有待解答。在此,我们报告了三例患者,1 例男性,2 例女性,平均年龄 58.3 岁,因 COVID-19 导致严重肺病需要通气支持而入院。由于持续低氧血症,患者接受了胸部计算机断层扫描,结果显示符合机化性肺炎的模式。患者接受了高剂量皮质类固醇(泼尼松 1mg/kg PO)治疗,临床症状明显改善,减少了氧气流量需求。他们在平均住院 6.3 天后出院。我们的报告表明,COVID-19 合并机化性肺炎的患者可能受益于高剂量皮质类固醇作为辅助治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb56/9394544/064d106235bd/gr1.jpg

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