Chonnam Med J.  2024 Sep;60(3):166-173. 10.4068/cmj.2024.60.3.166.

Corticosteroid Therapy Duration and Dosage According to the Timing of Treatment Initiation for Post-COVID-19 Organizing Pneumonia

• Yoon CS
• Park HK
• Lee JK
• Kho BG
• Kim TO
• Shin HJ
• Kwon YS
• Lim SC
• Kim YI

• KMID: 2559825
• DOI: http://doi.org/10.4068/cmj.2024.60.3.166

Abstract

COVID-19 can lead to pulmonary complications, including organizing pneumonia. Steroids are essential in treating post-COVID-19 organizing pneumonia. However, research on the clinical benefits of initiating steroid treatment early for this condition is limited. To investigate the steroid initiation time in its association with treatment duration and corticosteroid dose for treating post-COVID-19 organizing pneumonia, we analyzed the data of 91 patients with post-COVID-19 organizing pneumonia at Chonnam National University Hospital between October 2020 and December 2022. Patients were categorized into early and late groups based on time from COVID-19 diagnosis to steroid initiation time for organizing pneumonia. The mean time interval between COVID-19 infection and steroid initiation time for treating organizing pneumonia, was 18.4±8.6 days. Within the early treatment group (treatment initiated ＜18.4 days after COVID-19), which included 55 patients, the mean duration of steroid treatment was 43.1±18.3days. In contrast, the late treatment group (initiated ≥18.4 days after COVID-19), which consisted of 36 patients, had a longer mean duration of steroid treatment 59.1±22.6 days) (p＜0.01). Regarding corticosteroid dosing, the early treatment group had an average dosage of 0.5±0.3 mg/kg/day, in contrast to the late group, which averaged 0.8±0.3 mg/kg/day (p＜0.01). Regression analysis showed steroid initiation time significantly influenced treatment duration (=0.80 , p＜0.01) and dosage (=0.03, p＜0.01). The clinical benefits of early steroid treatment for post-COVID-19 organizing pneumonia may lie in its association with reduced steroid treatment duration and dosage.

Keyword

Post-COVID-19 Organizing Pneumonia; Corticosteroid Therapy; Early Therapeutic Initiation