Respiratory Unit, Department of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Respiratory Unit, Department of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
BMJ Case Rep. 2021 Oct 29;14(10):e246119. doi: 10.1136/bcr-2021-246119.
Acute COVID-19 usually lasts 4 weeks from the onset of symptoms. We report two cases of COVID-19-associated organising pneumonia (OP) occurring beyond 4 weeks from the acute onset of symptoms. Both tested positive for SARS reverse transcription-PCR 2 months before presentation with a resolution of respiratory symptoms. The first case presented with residual fatigue and worsening exertional dyspnoea. Chest CT revealed an OP pattern. The second case presented with worsening cough and new-onset pleuritic chest pain with persistent radiological consolidation. A transbronchial lung biopsy confirmed OP. Both patients responded well to 12 weeks of steroid therapy. This case illustrates the rare presentation of OP as a late sequela of COVID-19 and the good response to steroid therapy.
急性 COVID-19 通常从症状出现开始持续 4 周。我们报告了两例 COVID-19 相关的机化性肺炎（OP），其发生在症状急性发作后超过 4 周。这两例均在出现呼吸道症状前 2 个月 SARS 逆转录-PCR 检测呈阳性，且呼吸症状已缓解。第一例患者表现为残留疲劳和进行性运动性呼吸困难加重。胸部 CT 显示 OP 模式。第二例患者表现为咳嗽加重和新出现的伴有持续性影像学实变的胸膜炎性胸痛。经支气管肺活检证实为 OP。这两例患者均对 12 周的类固醇治疗反应良好。该病例说明了 OP 作为 COVID-19 的罕见后遗症，以及对类固醇治疗的良好反应。
