High-dose<i>versus</i>low-dose prednisolone in symptomatic patients with post-COVID-19 diffuse parenchymal lung abnormalities: an open-label, randomised trial (the COLDSTER trial)
Sahajal Dhooria, Shivani Chaudhary, Inderpaul Singh Sehgal, Ritesh Agarwal, Siddhant Arora, Mandeep Garg, Nidhi Prabhakar, Goverdhan Dutt Puri, Ashish Bhalla, Vikas Suri, Lakshmi Narayana Yaddanapudi, Valliappan Muthu, Kuruswamy Thurai Prasad, Ashutosh N. Aggarwal
Abstract
In some patients, respiratory symptoms and imaging abnormalities persist after acute coronavirus disease 2019 (COVID-19) pneumonia [1–3]. Chest computed tomography (CT) scans generally show diffuse parenchymal lung abnormalities consistent with organising pneumonia [4]. It has been proposed that the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could act as a trigger to exalt the presence of pre-existing interstitial lung abnormalities encountered in the general population, especially in smokers. Previous observational studies reported improvement with glucocorticoids in symptomatic patients with post-COVID-19 diffuse parenchymal lung abnormalities (PC-DPLAS) [4–6]. A recent guideline recommended glucocorticoids for treating PC-DPLAS [3]. However, there are no randomised controlled trials on therapies for this condition. High-dose prednisolone may not be superior to a low-dose 6-week regimen in improving clinical, physiological and radiological outcomes, or health-related quality of life, in patients with symptomatic post-COVID-19 diffuse parenchymal lung abnormalities <https://bit.ly/32zqnXt>