Corticosteroids and pulmonary rehabilitation reducing long-term morbidity in a patient with post-COVID-19 pneumonitis: A case study.

2021 
Background Whilst research efforts have focussed on treatment during the acute phase, little work has focussed on the long-term sequelae of COVID-19 infection. This case described a patient who remained symptomatic several weeks after discharge from hospital with what was diagnosed as a COVID-19 infection. There were significant deficits shown in his functional exercise testing, his pulmonary functions testing and there was evidence of fibrotic changes on his radiology. Methods As part of a multidisciplinary clinic, he was started on steroids and a tailored pulmonary rehabilitation course over a course of 6-8 weeks. Thereafter, his exercise testing, pulmonary function tests and radiology were all repeated to see progress. Results On completing the course of corticosteroids and concurrent personalised pulmonary rehabilitation, there was a dramatic improvement in the patient's symptom severity, radiology and pulmonary function. The most significant improvement noted was in his exercise testing, namely a 6-min walk test and 1 min of sit-to-stands. Before treatment, he had a Medical Reserch Council (MRC) score of 2, and after it returned to his baseline of 0. Discussion Using corticosteroids and exercise training that allowed quantitative evaluation throughout the stages of recovery was a valuable tool to gauge progress and response to treatment. These therapies present opportunity to prevent the development of irreversible pulmonary fibrosis that could prove to be a major breakthrough in reducing long-term morbidity and improving the quality of life of those affected.
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