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The performance of artificial intelligence supported Thoracic CT to evaluate the radiologic improvement in patients with COVID-19 pneumonia: comparision pirfenidon vs. corticosteroid

Int J Clin Pract. 2021 Oct 8:e14961. doi: 10.1111/ijcp.14961. Online ahead of print.

ABSTRACT

AIM: We aimed to investigate the effect of short-term pirfenidone treatment on prolonged COVID-19 pneumonia.

METHOD: Hospital files of patients hospitalized with a diagnosis of critical COVID-19 pneumonia between November 2020 and March 2021 were retrospectively reviewed. Chest computed tomography images taken both before treatment and 2 months after treatment, demographic characteristics and laboratory parameters of patients receiving pirfenidone+methylprednisolone (n=13) and only methylprednisolones (n=9) were recorded. Pulmonary function tests were performed after the second month of the treatment. CT involvement rates were determined by machine learning.

RESULTS: A total of 22 patients, 13 of whom (59.1%) were using methylprednisolone + pirfenidone and 9 of whom (40.9%) were using only methylprednisolone were included. When the blood gas parameters and pulmonary function tests of the patients were compared at the end of the second month, it was found that the FEV1, FEV1%, FVC, and FVC% values were statistically significantly higher in the methylprednisolone + pirfenidone group compared to the methylprednisolone group (p=0.025, p=0.012, p=0.026, and p=0.017, respectively). When the rates of change in CT scans at diagnosis and second month of treatment were examined, it was found that the involvement rates in the methylprednisolone + pirfenidone group were statistically significantly decreased (p<0.001).

CONCLUSION: Antifibrotic agents can reduce fibrosis that may develop in the future. These can also help dose reduction and/or non-use strategy for methylprednisolone therapy, which has many side effects. Further large series and randomized controlled studies are needed on this subject.

PMID:34624155 | DOI:10.1111/ijcp.14961

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