Effectiveness of high-dose steroid treatment on pulmonary fibrosis in severe COVID-19 pneumonia

Aims: Corticosteroid therapy has been proposed as a therapeutic strategy to mitigate pulmonary inflammation and fibrosis in severe COVID-19 pneumonia. This study aimed to evaluate the effects of high-dose methylprednisolone (MP) and dexamethasone (DEX) on clinical and radiological outcomes. Methods: In this retrospective study, hospitalized patients with severe COVID-19 pneumonia were categorized into three groups: MP, DEX, and control. Demographic, clinical, and laboratory data were analyzed, and radiological outcomes were assessed using baseline and follow-up chest computed tomography (CT) scans. Univariate and multivariate logistic regression analyses were performed to identify factors associated with radiological improvement. Results: Age and sex distributions differed among groups, and the control group consisted of older and predominantly male participants. Steroid-treated groups had longer hospital and intensive care unit (ICU) stays, while mechanical ventilation rates were similar across groups. Laboratory parameters including levels of glucose, creatinine, alanine transferase (ALT), aspartate transferase (AST), lactate dehydrogenase (LDH), D-dimer, and C-reactive protein (CRP) differed significantly among groups. Baseline CT findings more frequently showed extensive and severe fibrosis in the control group, whereas moderate involvement predominated in the DEX group. Follow-up CT scans revealed radiological improvements in at least two categories in 70.8% of MP, 58.5% of DEX, and 35.4% of control patients (p