Okamori Satoshi, Lee Ho, Kondo Yasushi, Akiyama Yuto, Kabata Hiroki, Kaneko Yuko, Ishii Makoto, Hasegawa Naoki, Fukunaga Koichi
Division of Pulmonary Medicine.
Division of Rheumatology, Department of Medicine.
Medicine (Baltimore). 2020 Aug 28;99(35):e21804. doi: 10.1097/MD.0000000000021804.
Pneumonia is one of the most important characteristics of coronavirus disease 2019 (COVID-19) and imaging findings of COVID-19 pneumonia are diverse and change over disease course. However, the detailed clinical course of organizing pneumonia (OP) caused by COVID-19 has not been clarified.
A 60-year-old man and a 61-year-old woman diagnosed with mild COVID-19 were admitted to our hospital. Their respiratory symptoms were deteriorating even after initiating treatment with antiviral drugs.
Chest X-rays and computed tomography scan showed a rapid progression of linear consolidation with reversed halo sign, distributed in subpleural and peri-bronchial regions. They also presented with pulmonary fibrosis findings, including traction bronchiectasis and marked lung volume reduction. They were diagnosed with rapidly progressing OP.
They were treated with systemic corticosteroids.
The patients' imaging findings and respiratory conditions improved rapidly without any adverse effects.
Physicians should carefully monitor patients with COVID-19, as they can develop rapidly progressive and fibrotic OP, which respond to corticosteroids.
肺炎是2019冠状病毒病（COVID-19）最重要的特征之一，COVID-19肺炎的影像学表现多样且随病程变化。然而，由COVID-19引起的机化性肺炎（OP）的详细临床过程尚未明确。
一名60岁男性和一名61岁女性被诊断为轻度COVID-19后入住我院。即使在开始使用抗病毒药物治疗后，他们的呼吸道症状仍在恶化。
胸部X线和计算机断层扫描显示，在胸膜下和支气管周围区域出现了伴有反晕征的线性实变快速进展。他们还出现了肺纤维化表现，包括牵拉性支气管扩张和明显的肺容积缩小。他们被诊断为快速进展性OP。
他们接受了全身糖皮质激素治疗。
患者的影像学表现和呼吸状况迅速改善，且无任何不良反应。
医生应密切监测COVID-19患者，因为他们可能会发展为快速进展性和纤维化的OP，而这种情况对糖皮质激素有反应。
