RATIONALE: Persistent respiratory symptoms following Coronavirus Disease 2019 (COVID-19) are associated with residual radiological changes in lung parenchyma, with a risk of development into lung fibrosis, and with impaired pulmonary function. Previous studies hinted at the possible efficacy of corticosteroids (CS) in facilitating the resolution of post-COVID residual changes in the lungs, but the available data is limited. AIM: To evaluate the effects of CS treatment in post-COVID respiratory syndrome patients. PATIENTS AND METHODS: Post-COVID patients were recruited into a prospective single-center observational study and scheduled for an initial (V1) and follow-up visit (V2) at the Department of Respiratory Medicine and Tuberculosis, University Hospital Olomouc, comprising of pulmonary function testing, chest x-ray, and complex clinical examination. The decision to administer CS or maintain watchful waiting (WW) was in line with Czech national guidelines. RESULTS: The study involved 2729 COVID-19 survivors (45.7% male; mean age: 54.6). From 2026 patients with complete V1 data, 131 patients were indicated for CS therapy. These patients showed significantly worse radiological and functional impairment at V1. Mean initial dose was 27.6 mg (SD ± 10,64), and the mean duration of CS therapy was 13.3 weeks (SD ± 10,06). Following therapy, significantly better improvement of static lung volumes and transfer factor for carbon monoxide (DLCO), and significantly better rates of good or complete radiological and subjective improvement were observed in the CS group compared to controls with available follow-up data (n = 894). CONCLUSION: Better improvement of pulmonary function, radiological findings and subjective symptoms were observed in patients CS compared to watchful waiting. Our findings suggest that glucocorticoid therapy could benefit selected patients with persistent dyspnea, significant radiological changes, and decreased DLCO.

Center for Digital Health Faculty of Medicine and Dentistry Palacky University Olomouc Hnevotinska 976 3 Olomouc 779 00 Czech Republic

Department of Medical Biophysics Faculty of Medicine and Dentistry Palacky University Olomouc Olomouc Czech Republic

Department of Respiratory Medicine and Tuberculosis Faculty of Medicine and Dentistry Masaryk University Hospital Brno University Brno Brno Czech Republic

Department of Respiratory Medicine and Tuberculosis Faculty of Medicine and Dentistry Palacky University Olomouc University Hospital Olomouc Olomouc Czech Republic

Department of Respiratory Medicine and Tuberculosis L Pasteur University Hospital and Faculty of Medicine P J Safarik University Kosice Kosice Slovakia

Dept of Telecommunications Faculty of Electrical Engineering and Communication Brno University of Technology Brno Czech Republic

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