Glucocorticoid pulse therapy in an elderly patient with post-COVID-19 organizing pneumonia : A case report

©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved..

BACKGROUND: Pulmonary fibrosis often occurs as a sequel of coronavirus disease 2019 (COVID-19); however, in some cases, it can rapidly progress, similar to the acute exacerbation of interstitial lung disease. Glucocorticoids are the standard treatment for severe COVID-19 pneumonia requiring oxygen supply; however, the post-COVID-19 efficacy of high-dose steroid therapy remains unclear. Here, we presented a case of an 81-year-old man who developed acute respiratory failure after COVID-19 and was treated with glucocorticoid pulse therapy.

CASE SUMMARY: An 81-year-old man with no respiratory symptoms was admitted due to a diabetic foot. He had been previously treated for COVID-19 pneumonia six weeks prior. However, upon admission, he suddenly complained of dyspnea and required a high-flow oxygen supply. Initial simple chest radiography and computed tomography (CT) revealed diffuse ground-glass opacities and consolidation in both lungs. However, repeated sputum tests did not identify any infectious pathogens, and initial broad-spectrum antibiotic therapy did not result in any clinical improvement with the patient having an increasing oxygen demand. The patient was diagnosed with post-COVID-19 organizing pneumonia. Thus, we initiated glucocorticoid pulse therapy of 500 mg for three days followed by a tapered dose on hospital day (HD) 9. After three days of pulse treatment, the patient's oxygen demand decreased. The patient was subsequently discharged on HD 41, and chest radiography and CT scans have almost normalized nine months after discharge.

CONCLUSION: Glucocorticoid pulse therapy may be considered when the usual glucocorticoid dose is ineffective for patients with COVID-19 sequelae.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:11

Enthalten in:

World journal of clinical cases - 11(2023), 17 vom: 16. Juni, Seite 4152-4158

Sprache:

Englisch

Beteiligte Personen:

Park, Shinhee [VerfasserIn]
Jang, Youngeun [VerfasserIn]
Koo, So-My [VerfasserIn]
Nam, Bo Da [VerfasserIn]
Yoon, Hee-Young [VerfasserIn]

Links:

Volltext

Themen:

Case Reports
Case report
Coronavirus
Glucocorticoid
Interstitial
Lung disease
Organizing pneumonia

Anmerkungen:

Date Revised 03.07.2023

published: Print

Citation Status PubMed-not-MEDLINE

doi:

10.12998/wjcc.v11.i17.4152

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM358900549