Sugino Keishi, Ono Hirotaka, Haraguchi Shuji, Igarashi Seiji, Hebisawa Akira, Tsuboi Eiyasu
Department of Respiratory Medicine Tsuboi Hospital Koriyama City Japan.
Department of Chest Surgery Tsuboi Hospital Koriyama City Japan.
Respirol Case Rep. 2021 Oct 28;9(12):e0871. doi: 10.1002/rcr2.871. eCollection 2021 Dec.
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, has become a global pandemic. Many survivors of serious COVID-19 pneumonia have long-term residual pulmonary disease. However, there is little documentation of the histopathological characteristics of lung sequelae post-COVID-19 and effective treatments. We present two Japanese cases of lung sequelae post-COVID-19. The patients were histopathologically diagnosed with organizing pneumonia (OP) or OP with fibrosis and no diffuse alveolar damage on video-assisted thoracoscopic surgery. Case 1, who had been diagnosed with OP, was successfully treated with corticosteroid and other immunosuppressive agents over a 6-month period. Although case 2, who had been diagnosed with OP with fibrosis, had a partial and unsatisfactory response to immunosuppressive agents, the patient responded to antifibrotic treatment including nintedanib.
由严重急性呼吸综合征冠状病毒2引起的2019冠状病毒病（COVID-19）已成为全球大流行疾病。许多重症COVID-19肺炎幸存者患有长期的肺部后遗症。然而，关于COVID-19后肺部后遗症的组织病理学特征及有效治疗方法的文献报道较少。我们报告了两例日本COVID-19后肺部后遗症病例。在电视辅助胸腔镜手术中，这两名患者经组织病理学诊断为机化性肺炎（OP）或伴有纤维化的OP，且无弥漫性肺泡损伤。病例1被诊断为OP，在6个月的时间里接受皮质类固醇和其他免疫抑制剂治疗，效果良好。病例2被诊断为伴有纤维化的OP，对免疫抑制剂治疗部分有效但效果不理想，不过该患者对抗纤维化治疗（包括尼达尼布）有反应。
