Pulmonary function, computerized tomography features and six-minute walk test at three months in severe COVID-19 patients treated with intravenous pulsed methylprednisolone: a preliminary report.

Abstract

COVID-19 acute respiratory distress syndrome (ARDS) has a high mortality and few therapeutic options. We present a preliminaryreport on our experience using high-dose pulsed methylprednisolone in COVID-19 ARDS and three-month outcomes.We performed a retrospective analysis of all patients treated with high-dose methylprednisolone for COVID-19ARDS and three-month lung function, 6-minutes walking test (6MWT), and computerized tomography (CT) findings. Fifteenpatients were treated of which 10 survived to discharge. Reduced diffusion capacity for carbon monoxide (DLCO) was the commonestabnormality in lung function tests and had the lowest mean value. Parenchymal bands were the commonest CT findingand 50% of patients had fibrosis at three months. Mean 6-minutes walk distance (6MWD) was 65.4% predicted and wasabnormal in 62.5% of patients. In this cohort of patients with COVID-19 ARDS treated with high-dose methylprednisolonepulses, CT, lung function, and 6MWT abnormalities were unsurprisingly common at three months, although all 10 patients treatedearly in their disease course survived, a possible therapeutic effect. Further randomised controlled trials are needed to assessthe benefits of this treatment.