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; Favipiravir; GOLD, The Global Initiative for Chronic Obstructive Lung Disease; ICU, intensive care unit; MERS, middle east respiratory syndrome; PCR, polymerase chain reaction; Pneumonia; 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; Systemic corticosteroid; WBC, white blood cell.
© 2020 The Authors.