COVID-19, A and Hypersensitivity Pneumonitis

Dear Editor,

We found that the article “COVID-19, A Clinical Syndrome Manifesting as Hypersensitivity Pneumonitis” is very interesting [1]. Song and Shin noted that “Prophylactic and therapeutic low dose steroid oral tablets/inhalers at the earlier stage of COVID-19 and high dose steroid treatment according to the severity of the disease can play important roles in decreasing the fatality and pulmonary fibrosis” [1]. We would like to share ideas from our country, the second country in the timeline of COVID-19 pandemic [2]. Here, the steroid has never been used for management of the patients. The general management is usually based on choloroquine and anti human immunodeficiency virus drugs. For the patients with mild symptom, the complete recovery can be seen in a short period. At present (3th March 2020), there are 1,978 COVID patients in Thailand. Of these cases, 7 had underlying asthma and on high dose steroid therapy. It is apparently that the patients still have poor clinical course despite the use of steroid. The role of steroid in COVID-19 should be further evaluated.