Outcomes of Covid-19 organizing pneumonia in critically ill patients.

Efficacy of corticosteroids in COVID-19 pneumonia has been reported in numerous studies.1The WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working GroupAssociation between administration of systemic corticosteroids and mortality among critically Ill patients with COVID-19 a meta-analysis.JAMA. 2020; 324: 1330-1341https://doi.org/10.1001/jama.2020.17023Crossref PubMed Scopus (427) Google Scholar However, Yang et al. concluded that corticosteroids have a negative impact, suggesting that not all patients benefit from the therapy.2Yang Z. Liu J. Zhou Y. Zhao X. Zhao Q. Liu J. The effect of corticosteroid treatment on patients with coronavirus infection: a systematic review and meta-analysis.J Infect. 2020; 81 (JulEpub 2020 Apr 10. PMID: 32283144; PMCID: PMC7195158): e13-e20https://doi.org/10.1016/j.jinf.2020.03.062Abstract Full Text Full Text PDF PubMed Scopus (141) Google Scholar Features of organizing pneumonia (OP) have been observed in radiological and histopathological studies from these patients.3Bao C. Liu X. Zhang H. Li Y. Liu J. Coronavirus disease 2019 (COVID-19) CT findings: a systematic review and meta-analysis.J Am Coll Radiol. 2020; 17: 701-709Abstract Full Text Full Text PDF PubMed Scopus (114) Google Scholar, 4Polak S.B. Van Gool I.C. Cohen D. von der Thusen J.H. van Paassen J A systematic review of pathological findings in COVID-19: a pathophysiological timeline and possible mechanisms of disease progression.Mod Pathol. 2020; ([published online ahead of print, 2020 Jun 22]): 1-11https://doi.org/10.1038/s41379-020-0603-3Crossref PubMed Scopus (90) Google Scholar, 5Wang Y. Jin C. Wu C.C. Zhao H. Liang T. Liu Z. et al.Organizing pneumonia of COVID-19: time-dependent evolution and outcome in CT findings.PLoS ONE. 2020; 15e0240347https://doi.org/10.1371/journal.pone.0240347Crossref PubMed Scopus (7) Google Scholar OP has usually a good response to corticosteroids. The possible correlation between the radiological pattern and clinical evolution has important implications. This study provides information on patient selection and clinical application of corticosteroids.