Kimura Tomoyuki, Onitsuka Chisato, Kawahara Tomoko, Fukuda Yosuke, Homma Tetsuya, Watanabe Taro, Ohsugi Koichi, Ichikawa Yuki, Shono Atsuko, Kotani Toru, Sagara Hironori
Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo 142-0064, Japan.
Department of Intensive Care Medicine, Showa University School of Medicine, Tokyo 142-0064, Japan.
Medicina (Kaunas). 2021 Sep 25;57(10):1013. doi: 10.3390/medicina57101013.
(Background) COVID-19 is caused by SARS-CoV-2 infection and may result in unfavorable outcomes. A recent large-scale study showed that treatment with dexamethasone leads to favorable outcomes in patients with severe COVID-19, and the use of extracorporeal membrane oxygenation (ECMO) has also been shown to improve outcomes. Recently, secondary organizing pneumonia (SOP) has been reported after SARS-CoV-2 infection, but the diagnostic and treatment strategies are still unclear. (Case presentation) Here, we report a patient with severe COVID-19 who developed SOP even after the use of dexamethasone, for whom the introduction of ECMO on the 19th day after hospitalization led to a favorable outcome. (Conclusions) Life-threatening SOP may evolve even after the use of dexamethasone, and the late-phase introduction of ECMO may save such patients with COVID-19.
（背景）新型冠状病毒肺炎（COVID-19）由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染引起，可能导致不良后果。最近一项大规模研究表明，地塞米松治疗可使重症COVID-19患者获得良好预后，体外膜肺氧合（ECMO）的使用也已证明可改善预后。最近，有报告称SARS-CoV-2感染后出现继发性机化性肺炎（SOP），但其诊断和治疗策略仍不明确。（病例报告）在此，我们报告1例重症COVID-19患者，即使使用地塞米松后仍发生SOP，该患者在住院第19天开始使用ECMO后获得良好预后。（结论）即使使用地塞米松，仍可能发生危及生命的SOP，晚期使用ECMO可能挽救此类COVID-19患者。
