Improvement in SARS-CoV2 lung interstitial injuries with systemic corticosteroid treatment

Introduction: Currently, more than 106 million people have been infected with the new Coronavirus. The clinical course of infection is very variable, from asymptomatic to severe pneumonia. We already know that are persistent inflammatory interstitial lung injuries following SARS-CoV2 infection, but it remains unknown if it will progress to persistent lung fibrosis. Aim of the study: To determine if the persistent inflammatory interstitial lung disease after SARS-CoV2 pneumonia evolve to lung fibrosis and to establish the efficacy of oral Methylprednisolone therapy on clinical symptoms, extension of HRCT lesions, and pulmonary function tests. Contents: We evaluate 80 patients with moderate and severe pneumonia due to SARS-CoV2 infection at 6 weeks after discharge from COVID-19 unit and at 3 months intervals in the 1st year. HRCT and pulmonary function tests (TLC and Dlco) were performed. Of these 80 patients, 54 were diagnosed with persistent inflammatory interstitial lung injuries associated with a decrease in DLco and or lung volumes and received oral corticoid treatment with methylprednisolone with tapering doses for one and a half to 3 months, depending on the extension of interstitial lesions on HRCT and/or decrease of DLco. 35 patients had good response on clinical symptoms, extension of HRCT lesions, and improvement of DLco and 19 patients had a mild response. Conclusions: Persistent inflammatory interstitial lung disease associated with persistent physiological and functional deficit post SARS-CoV2 moderate or severe pneumonia are common. Significant improvement in symptoms, extension of HRCT lesions, and improvement in DLco was seen with Methylprednisolone treatment.