Abstract
BackgroundThis study evaluated the time course of computed tomography (CT) findings of patients with COVID-19 pneumonia who required mechanical ventilation and were treated with favipiravir and steroid therapy.ResultsEleven patients with severe COVID-19 pneumonia were included. CT findings assessed at the three time points showed that all patients had ground-glass opacities (GGO) and consolidation and mixed pattern at intubation. Consolidation and mixed pattern disappeared in most of the patients whereas GGO persisted in all patients at 1-month follow-up. In addition to GGO, a subpleural line and bronchus distortion and bronchial dilatation were frequent findings. The degree of resolution of GGO varied depending on each patient. The GGO score correlated significantly with the time from symptoms onset to initiation of steroid therapy (ρ = 0.707, p = 0.015).ConclusionsAt 1-month follow-up after discharge, non-GGO lesions were absorbed almost completely, and GGO were a predominant CT manifestation. Starting steroid therapy earlier after onset of symptoms in severe COVID-19 pneumonia may reduce the extent of GGO at 1-month follow-up.
Highlights
This study evaluated the time course of computed tomography (CT) findings of patients with COVID19 pneumonia who required mechanical ventilation and were treated with favipiravir and steroid therapy
This study investigated the progression of CT manifestations of severe COVID-19-associated acute respiratory distress syndrome (ARDS) treated with favipiravir and steroid therapy
Patients We retrospectively reviewed the records of 11 patients admitted to our hospital after being transferred from other hospitals and who required mechanical ventilation for severe COVID-19 pneumonia from April 2 to 27, 2020
Summary
This study evaluated the time course of computed tomography (CT) findings of patients with COVID19 pneumonia who required mechanical ventilation and were treated with favipiravir and steroid therapy. The spread of severe acute respiratory syndrome coronavirus 2 throughout the world has created the pandemic of coronavirus disease 2019 (COVID-19). COVID-19 pneumonia is sometimes progressively presented as acute respiratory distress syndrome (ARDS) and is a definite factor of severe disease status (Marini and Gattinoni 2020). To reduce the viral genome amounts, COVID-19 needs to be treated with a complex strategy that includes antiinflammatory drugs and anticoagulants. Several drugs have been used to reduce viral genome amounts, such as chloroquine, lopinavir/ritonavir, remdesivir, and favipiravir (Wiersinga et al 2020). Favipiravir selectively and potently inhibits the RNA polymerase of RNA viruses and is expected to be a primary drug in COVID19 treatment (Furuta et al 2017)
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