Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG · 2026
Methylprednisolone in the management of post-COVID-19 interstitial lung disease: A randomized trial (STERCOV-ILD).
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Yüksel Aycan, Karadoğan Dilek, Hürsoy Nur, Telatar Tahsin Gökhan, Köse Kabil Neslihan, Marım Feride, Kaya İlknur, Er Aslıhan Banu, Erçelik Merve, Polat Yuluğ Demet, Yumrukuz Şenel Merve, İlgar Ceren, Gültekin Ökkeş, Çakmakcı Karakaya Selin, Yılmaz Kara Bilge, Özçelik Neslihan, Selimoğlu İnci, Uyar Er Kübra, Kotan Abdurrahman, Keskin Hasan Veysel, Akgün Metin
Аннотация
BACKGROUND AND AIM: Post-COVID-19 Interstitial Lung Disease (ILD) is controversial and need for treatment is unclear.The aim of this study was to investigate the efficacy of methylprednisolone in the management of post-COVID-19 ILD in comparison to standard of care.
METHODS: In this multicentre, randomized controlled clinical trial, patients with post-COVID ILD were assigned to two groups: the steroid group received oral methylprednisolone at a dose of 0.5 mg/kg/day, while the control group received supportive therapy. The primary outcome was proportion of patients with functional improvement (defined as the absence of hypoxemia/desaturation during 6MWT) at twelve-weeks.
RESULTS: A total of 229 patients with post-COVID ILD patients (124 in the steroid group and 104 in the control group) completed the study. At 12-weeks, functional improvement rate was higher in the steroid group compared to the control group (74.2% vs. 55.2%, OR:2.33 [95% CI:1.34-4.06], p=0.0041). Radiological improvement was observed in 61.3% of the steroid group compared to 46.7% of the controls (OR:1.81 [95% CI:1.07-3.06], p=0.037). The mean increase in FVC (7.2% vs 3.7%, p=0.03), 6MW distance (91 vs 41 meters, p<0.001), and SpO2 (2.33 vs 1.21, p=0.002) was significantly higher in the steroid group. Multivariate regression analysis revealed that the following variables were associated with poorer outcomes: smoking (OR:0.932 [95% CI:0.875-0.992], p=0.028), older age (OR:0.951 [95% CI:0.912-0.99], p=0.035), and severe COVID-19 (OR:0.233 [95% CI:0.068-0.799], p=0.029.
CONCLUSIONS: Methylprednisolone improved oxygen saturation, FVC, exercise capacity, and radiological resolution in patients with post-COVID-19 ILD compared to the natural course of the disease.
METHODS: In this multicentre, randomized controlled clinical trial, patients with post-COVID ILD were assigned to two groups: the steroid group received oral methylprednisolone at a dose of 0.5 mg/kg/day, while the control group received supportive therapy. The primary outcome was proportion of patients with functional improvement (defined as the absence of hypoxemia/desaturation during 6MWT) at twelve-weeks.
RESULTS: A total of 229 patients with post-COVID ILD patients (124 in the steroid group and 104 in the control group) completed the study. At 12-weeks, functional improvement rate was higher in the steroid group compared to the control group (74.2% vs. 55.2%, OR:2.33 [95% CI:1.34-4.06], p=0.0041). Radiological improvement was observed in 61.3% of the steroid group compared to 46.7% of the controls (OR:1.81 [95% CI:1.07-3.06], p=0.037). The mean increase in FVC (7.2% vs 3.7%, p=0.03), 6MW distance (91 vs 41 meters, p<0.001), and SpO2 (2.33 vs 1.21, p=0.002) was significantly higher in the steroid group. Multivariate regression analysis revealed that the following variables were associated with poorer outcomes: smoking (OR:0.932 [95% CI:0.875-0.992], p=0.028), older age (OR:0.951 [95% CI:0.912-0.99], p=0.035), and severe COVID-19 (OR:0.233 [95% CI:0.068-0.799], p=0.029.
CONCLUSIONS: Methylprednisolone improved oxygen saturation, FVC, exercise capacity, and radiological resolution in patients with post-COVID-19 ILD compared to the natural course of the disease.