Respiratory Medicine Case Reports (Jan 2020)

Combination treatment of short-course systemic corticosteroid and favipiravir in a successfully treated case of critically ill COVID-19 pneumonia with COPD

  • Hideki Inoue,
  • Megumi Jinno,
  • Shin Ohta,
  • Yasunari Kishino,
  • Tomoko Kawahara,
  • Hatsuko Mikuni,
  • Haruna Sato,
  • Mayumi Yamamoto,
  • Yoko Sato,
  • Chisato Onitsuka,
  • Yuiko Goto,
  • Hitoshi Ikeda,
  • Hiroki Sato,
  • Tomoki Uno,
  • Yoshitaka Uchida,
  • Tomoyuki Kimura,
  • Yoshito Miyata,
  • Kuniaki Hirai,
  • Tetsuya Homma,
  • Yoshio Watanabe,
  • Sojiro Kusumoto,
  • Shintaro Suzuki,
  • Issei Tokimatsu,
  • Akihiko Tanaka,
  • Hironori Sagara

Journal volume & issue
Vol. 31
p. 101200

Abstract

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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.

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