Is using inhaled corticosteroid effective against COVID-19 pneumonia severity and mortality?

Introduction: It is known that the use of inhaled corticosteroids increases the incidence of pneumonia in patients followed up with the diagnosis of chronic asthma and chronic obstructive pulmonary disease (COPD). This study aimed to investigate the contribution of inhaled steroid use to pneumonia severity and mortality in cases with COVID-19 pneumonia. Materials and Methods: The study is a retrospective, observational study. Among the cases admitted to the pandemic clinic, patients diagnosed with COVID-19 pneumonia were included. The plan was to compare cases who received and did not receive inhaled corticosteroids in terms of pneumonia severity and mortality. In order to define risk factors for mortality, univariate and multivariable negative binomial regression analyses were performed. Result: In our study, it was observed that n= 540 (75%) cases did not receive inhaled corticosteroids (group 1), and 180 (25%) cases used inhaled corti costeroids (group 2). Group 1 and group 2 cases were compared in terms of pneumonia severity with no significant difference between the two groups (p= 0.11). Then, risk factors affecting mortality in all cases were examined with univariate analyses. Increasing age, applying mechanical ventilation, having severe pneumonia, having interstitial lung disease, and applying prone position were found to be statistically significant factors in mortality (p < 0.05). Conclusions: In conclusion, in our study, it was observed that the use of inhaled corticosteroids did not increase the severity of pneumonia and mortality. It was thought that the treatment they received could be continued when the patients treated with inhaled corticosteroids due to asthma and COPD had COVID-19 pneumonia.

Risk factors for the development of interstitial lung disease following severe COVID-19 pneumonia and outcomes of systemic corticosteroid therapy: 3-month follow-up.

BACKGROUND: We aimed to evaluate the pulmonary involvement status, its related factors, and pulmonary function test (PFT) results in the first month follow-up in patients who were discharged for severe Covid-19 pneumonia, and to assess the efficacy of corticosteroid treatment on these parameters in severe pulmonary involvement patients. METHODS: We retrospectively analyzed all consecutive patients who applied to our COVID-19 follow-up clinic at the end of the first month of hospital discharge. Functional and radiological differences were compared after 3 months of corticosteroid treatment in severe pulmonary involvement group. Results We analyzed 391 patients with "pulmonary parenchymal involvement" (PPIG) and 162 patients with "normal lung radiology" (NLRG). 122 patients in the PPIG (corticosteroid-required interstitial lung disease group (CRILD)) had severe pulmonary involvement with frequent symptoms and required corticosteroid prescription. Pulmonary involvement was more common in males and elder patients (P<0.001, for both). Being smoker and elderly were associated with a higher risk-ratio in predicting to be in PPIG (OR:2.250 and OR:1.057, respectively). Smokers, male and elderly patients, and HFNO2 support during hospitalization were risk factors for being a patient with CRILD (OR:2.737, OR:4.937, OR:4.756, and OR:2.872, respectively). After a three-months of methylprednisolone medication, a good response was achieved on radiological findings and PFT results in CRILD. CONCLUSIONS: In conclusion, after severe COVID-19 pneumonia, persistent clinical symptoms and pulmonary parenchymal involvement would be inevitable in elder and smoker patients. Moreover, corticosteroid treatment in patients with severe parenchymal involvement was found to be effective in the improvement of radiological and functional parameters.

Are all granulomatous lesions tuberculosis?

INTRODUCTION: Granulomatous reactions are seen in a wide variety of diseases. METHODS: We present 3 cases referred to our clinic with presumptive diagnosis of tuberculosis (TB) were diagnosed as nontuberculous granulomatous diseases. RESULTS: Three cases were diagnosed as Tularemia, Cat-Scratch Disease (CSD) and idiopathic granulomatous mastitis (IGM) respectively. CONCLUSION: In countries with high incidence of TB, TB is considered firstly in differential diagnosis of granulomatous diseases. Detailed anamnesis and physical examinations should be done in differential diagnosis of granulomatous diseases, and TB must be excluded.