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