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机化性肺炎与 COVID-19。

Organizing pneumonia and COVID-19.

机构信息

Internal Medicine Department, Botucatu Medical School, Sao Paulo State University, UNESP, Sao Paulo, Brazil.

Pneumology Division, Heart Institute (InCor), Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil.

出版信息

Am J Med Sci. 2023 Dec;366(6):458-463. doi: 10.1016/j.amjms.2023.09.023. Epub 2023 Sep 30.

Abstract

Organizing pneumonia (OP) is an interstitial lung disease, and can be cryptogenic, if no cause is identified, or secondary to several conditions. COVID-19-induced persistent inflammation can be associated with interstitial lung disease. We present a review of literature of OP and COVID-19-induced OP with an illustrative case. A 38-year-old man was admitted with COVID-19 that required mechanical ventilation for 56 days. Initial chest computed tomography (CT) revealed diffuse bilateral ground-glass opacities in the lungs with consolidation areas involving 75 % of the parenchyma. After weaning from MV, the patient still required oxygen supplementation. A new chest CT scan also showed extensive diffuse areas of consolidation and ground-glass opacity. OP was hypothesized and 40 mg/day prednisone initiated and continued for six months with resolution of lung functional and image abnormalities. Organizing pneumonia should be included in the differential diagnosis of COVID-19 patients with respiratory symptoms after partial pulmonary recovery.

摘要

机化性肺炎(OP)是一种间质性肺疾病,如果未发现病因,则为特发性,如果由多种情况引起,则为继发性。COVID-19 引起的持续炎症可能与间质性肺疾病有关。我们回顾了 OP 和 COVID-19 引起的 OP 的文献,并附有一个说明性病例。一名 38 岁男性因 COVID-19 入院,需要机械通气 56 天。初始胸部计算机断层扫描(CT)显示肺部弥漫性双侧磨玻璃影,实变区累及 75%的实质。从 MV 脱机后,患者仍需要吸氧。新的胸部 CT 扫描还显示广泛弥漫性实变和磨玻璃影。假设为 OP,开始每天服用 40mg 泼尼松,并持续服用六个月,肺部功能和影像异常得到缓解。在部分肺部恢复后出现呼吸系统症状的 COVID-19 患者中,应将机化性肺炎纳入鉴别诊断。

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