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Respir Med Case Rep . Combination treatment of short-course systemic corticosteroid and favipiravir in a successfully treated case of critically il

tetano

Editor, Senior Moderator
Respir Med Case Rep


. 2020 Aug 27;101200.
doi: 10.1016/j.rmcr.2020.101200. Online ahead of print.
Combination treatment of short-course systemic corticosteroid and favipiravir in a successfully treated case of critically ill COVID-19 pneumonia with COPD


Hideki Inoue[SUP] 1 [/SUP], Megumi Jinno[SUP] 1 [/SUP], Shin Ohta[SUP] 1 [/SUP], Yasunari Kishino[SUP] 1 [/SUP], Tomoko Kawahara[SUP] 1 [/SUP], Hatsuko Mikuni[SUP] 1 [/SUP], Haruna Sato[SUP] 1 [/SUP], Mayumi Yamamoto[SUP] 1 [/SUP], Yoko Sato[SUP] 1 [/SUP], Chisato Onitsuka[SUP] 1 [/SUP], Yuiko Goto[SUP] 1 [/SUP], Hitoshi Ikeda[SUP] 1 [/SUP], Hiroki Sato[SUP] 1 [/SUP], Tomoki Uno[SUP] 1 [/SUP], Yoshitaka Uchida[SUP] 1 [/SUP], Tomoyuki Kimura[SUP] 1 [/SUP], Yoshito Miyata[SUP] 1 [/SUP], Kuniaki Hirai[SUP] 1 [/SUP], Tetsuya Homma[SUP] 1 [/SUP], Yoshio Watanabe[SUP] 1 [/SUP], Sojiro Kusumoto[SUP] 1 [/SUP], Shintaro Suzuki[SUP] 1 [/SUP], Issei Tokimatsu[SUP] 2 [/SUP], Akihiko Tanaka[SUP] 1 [/SUP], Hironori Sagara[SUP] 1 [/SUP]



Affiliations

Abstract

Use of systemic corticosteroids for the treatment for coronavirus disease 2019 (COVID-19) among chronic obstructive pulmonary disease (COPD) patients is not well described. A 58-year-old man with fever and progressive dyspnea was admitted to the Showa University Hospital, and showed severe respiratory failure which needed mechanical ventilation. His chest computed tomography scanning showed emphysema and bilateral ground-glass opacity caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. He received 30 mg prednisolone for five days with antiviral drug of favipiravir, and was successfully extubated on day five. A SARS-CoV-2 polymerase chain reaction (PCR) test became negative on day 15. He was discharged on day 21. Serum IgM and IgG antibodies against SARS-CoV-2 converted to positive on day 7 and they kept positive on day 54 for both IgM and IgG. Combination treatment of short-course systemic corticosteroid and favipiravir might improve the prognosis for critically ill COVID-19 pneumonia with COPD without negative influence on viral clearance or antibody production.

Keywords: ARDS, acute respiratory distress syndrome; COPD; COPD, chronic obstructive pulmonary disease; COVID-19; COVID-19, coronavirus disease 2019; CRP, C-reactive protein; CT, computed tomography; GOLD, The Global Initiative for Chronic Obstructive Lung Disease; ICU, intensive care unit; MERS, middle east respiratory syndrome; PCR, polymerase chain reaction; RSV, respiratory syncytial virus; SARS-CoV-2; SFTSV, severe fever with thrombocytopenia syndrome virus; SRAS-CoV-2, severe acute respiratory syndrome coronavirus 2; SpO2, peripheral capillary oxygen saturation; WBC, white blood cell; favipiravir; pneumonia; systemic corticosteroid.
 
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