Abstract
From May 30, 2020 to January 30, 2021, we visited 152 outpatients for persistence of respiratory symptoms after healing of severe bilateral interstitial pneumonia-Covid-19.
We proposed complete blood count, CRP, LDH, ferritin and dimer-D, liver and kidney function. If elevated dimer-D, chest CT CMDC was performed to rule out pulmonary embolism. If the D-dimer was normal, the pts underwent HR chest CT, chest ultrasound, spirometry and carbon monoxide diffusion.
If chest CT showed ground glass, we use oral steroid therapy: 1 mg per kg per day for 5 days, and then gradually decreased over not less than 1 month. If the PFR showed a flow reduction pattern and in the small pathways with normal Dlco therapy, LABA-LAMA therapy was set. If the Dlco was reduced we add ICS, preferably in a "triple" association.
Results: 68 women and 84 men, mean age 62.6 years.
Normal chest CT scan, spirometry and Dlco mean 98.22%, (15 pts, 9.8%).
Other with CT scan alterations: 22 pulmonary fibrosis, 115 ground glass (137 pts, 90,13%).
Initial Dlco 64.72%, after the first month of steroid therapy, 81.92%.
Inizial PFR flow reduction from 46% to 65%.
We emphasize the importance of Dlco in the study of pts with COVID-19 outcomes, spirometry alone may not be sufficient to reveal lung damage.
ICS therapy be enough? The utility of the association with an LABA-LAMA for each pts to avoid fibrosis expecially in small pathways obstruction, found in 26,97%pts.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA2532.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021