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Arai T, Kurahara Y, Moda M, Kobayashi T, Matsuda Y, Kagawa T, Sugawara R, Tsuyuguchi K, Inoue Y. COVID-19 in Patients with Pre-Existing Interstitial Lung Disease: Potential Value of a Steroid-Based Treatment Strategy. J Clin Med 2023; 12:4940. [PMID: 37568341 PMCID: PMC10419957 DOI: 10.3390/jcm12154940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
The prognosis of patients with coronavirus disease 2019 (COVID-19) and pre-existing interstitial lung disease (preILD) is poor, and no effective treatment strategy has been determined. The aim of this study was to assess the effectiveness of a steroid-based treatment strategy for patients with COVID-19 and preILD. We retrospectively reviewed the medical records of 610 consecutive patients with COVID-19 treated at our institution between 1 March 2020 and 30 October 2021 and identified 7 patients with preILD, all of whom were treated with corticosteroids and remdesivir. All the patients were men with a median age of 63 years. Three of four patients with severe disease required invasive positive-pressure ventilation (n = 2) or nasal high-flow therapy (n = 1). All three patients could be weaned from respiratory support; however, one died in hospital. The remaining patient with severe COVID-19 had a do-not-resuscitate order in place and died while hospitalized. All three patients with moderate COVID-19 were discharged. The 30-day mortality was 0%, and the mortality rate during the entire observation period was 28.5%. The prognosis of our patients with COVID-19 and preILD has been better than in previous reports. Our management strategy using corticosteroids may have improved these patients' prognosis.
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Affiliation(s)
- Toru Arai
- Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City 591-8555, Osaka Prefecture, Japan; (Y.K.); (T.K.); (Y.M.); (T.K.); (K.T.); (Y.I.)
| | - Yu Kurahara
- Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City 591-8555, Osaka Prefecture, Japan; (Y.K.); (T.K.); (Y.M.); (T.K.); (K.T.); (Y.I.)
- Department of Infectious Diseases, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City 591-8555, Osaka Prefecture, Japan
| | - Mitsuhiro Moda
- Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City 591-8555, Osaka Prefecture, Japan; (M.M.); (R.S.)
| | - Takehiko Kobayashi
- Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City 591-8555, Osaka Prefecture, Japan; (Y.K.); (T.K.); (Y.M.); (T.K.); (K.T.); (Y.I.)
| | - Yoshinobu Matsuda
- Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City 591-8555, Osaka Prefecture, Japan; (Y.K.); (T.K.); (Y.M.); (T.K.); (K.T.); (Y.I.)
- Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City 591-8555, Osaka Prefecture, Japan; (M.M.); (R.S.)
| | - Tomoko Kagawa
- Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City 591-8555, Osaka Prefecture, Japan; (Y.K.); (T.K.); (Y.M.); (T.K.); (K.T.); (Y.I.)
- Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City 591-8555, Osaka Prefecture, Japan; (M.M.); (R.S.)
| | - Reiko Sugawara
- Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City 591-8555, Osaka Prefecture, Japan; (M.M.); (R.S.)
| | - Kazunari Tsuyuguchi
- Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City 591-8555, Osaka Prefecture, Japan; (Y.K.); (T.K.); (Y.M.); (T.K.); (K.T.); (Y.I.)
- Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City 591-8555, Osaka Prefecture, Japan; (M.M.); (R.S.)
| | - Yoshikazu Inoue
- Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City 591-8555, Osaka Prefecture, Japan; (Y.K.); (T.K.); (Y.M.); (T.K.); (K.T.); (Y.I.)
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Omote N, Kanemitsu Y, Inoue T, Yonezawa T, Ichihashi T, Shindo Y, Sakamoto K, Ando A, Suzuki A, Niimi A, Ito S, Imaizumi K, Hashimoto N. Successful Treatment with High-dose Steroids for Acute Exacerbation of Idiopathic Pulmonary Fibrosis Triggered by COVID-19. Intern Med 2022; 61:233-236. [PMID: 34744107 PMCID: PMC8851168 DOI: 10.2169/internalmedicine.8163-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
We herein report a case of acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) triggered by COVID-19. An 87-year-old woman tested positive for COVID-19 on a polymerase chain reaction test, and computed tomography revealed ground-glass opacity (GGO) superimposed on a background pattern consistent with usual interstitial pneumonia. Considering these data, we diagnosed her with AE-IPF. She experienced worsening of dyspnea and expansion of the GGO. Therefore, we introduced high-dose steroids (methylprednisolone 250 mg/day for 3 days). After the treatment, the pulmonary infiltrates improved. She was discharged from our hospital without severe disability. High-dose steroids can be a viable treatment option for AE-IPF triggered by COVID-19.
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Affiliation(s)
- Norihito Omote
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan
- Department of Internal Medicine, Aichi Prefectural Hospital, Japan
| | - Yoshihiro Kanemitsu
- Department of Internal Medicine, Aichi Prefectural Hospital, Japan
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Takahiro Inoue
- Department of Internal Medicine, Aichi Prefectural Hospital, Japan
- Department of Respiratory Medicine, Fujita Health University School of Medicine, Japan
| | - Toshiyuki Yonezawa
- Department of Internal Medicine, Aichi Prefectural Hospital, Japan
- Department of Respiratory Medicine and Allergology, Aichi Medical University, Japan
| | - Takuji Ichihashi
- Department of Internal Medicine, Aichi Prefectural Hospital, Japan
| | - Yuichiro Shindo
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan
- Department of Internal Medicine, Aichi Prefectural Hospital, Japan
| | - Koji Sakamoto
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan
| | - Akira Ando
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan
| | - Atsushi Suzuki
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan
| | - Akio Niimi
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Satoru Ito
- Department of Respiratory Medicine and Allergology, Aichi Medical University, Japan
| | - Kazuyoshi Imaizumi
- Department of Respiratory Medicine, Fujita Health University School of Medicine, Japan
| | - Naozumi Hashimoto
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan
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