Subedi Deepak, Parajuli Binod Raj, Bista Neha, Rauniyar Somee, Banstola Anish, Sharma Ashish, Gurung Monika
Nepalese Army Institute of Health Sciences College of Medicine Kathmandu Nepal.
Kathmandu University School of Medical Sciences Dhulikhel Nepal.
Clin Case Rep. 2024 Sep 19;12(9):e9445. doi: 10.1002/ccr3.9445. eCollection 2024 Sep.
This case illustrates sarcoidosis as a potential complication of COVID-19, highlighting the need for a comprehensive diagnostic approach, including histopathology and prolonged monitoring, to distinguish it from post-COVID fibrosis. Further research is crucial to elucidate these associations and understand their underlying mechanisms.
Severe Acute Respiratory Syndrome Coronavirus- 2 (SARS-CoV-2), a positive-sense single-stranded RNA virus, causes COVID-19 and has been linked to autoimmune disorders. Sarcoidosis is a multi-system disease that is frequently triggered by infections. It is characterized by non-necrotizing granulomas in multiple organs. We present a case of sarcoidosis as rare sequelae of COVID-19. A 26-year-old man presented with mild COVID-19 symptoms, followed by prolonged fever and cough despite initial therapy, prompting a provisional diagnosis of post-COVID fibrosis. A subsequent assessment at a tertiary hospital revealed dyspnea, weight loss, and abnormal chest imaging, all of which were consistent with pulmonary sarcoidosis with pulmonary tuberculosis as a differential diagnosis. A biopsy taken during bronchoscopy confirmed pulmonary sarcoidosis and treatment with inhalation steroids resulted in symptom relief, which was followed by remission with oral steroid therapy. Sarcoidosis is a systemic disease of unknown etiology, characterized by non-necrotizing granulomas in multiple organs. It may be triggered by infections and involves an abnormal immune response. COVID-19 can potentially initiate sarcoidosis, with both sharing common immune mechanisms. Diagnosis involves imaging and biopsy, and treatment typically includes glucocorticoids and regular monitoring. This case report emphasizes the potential link between COVID-19 and autoimmune conditions like sarcoidosis, highlighting the need for a comprehensive diagnostic approach and long-term observation to distinguish between sarcoidosis and post-COVID fibrosis.
该病例表明结节病是新冠病毒病（COVID-19）的一种潜在并发症，强调需要采用包括组织病理学和长期监测在内的综合诊断方法，以将其与COVID-19后纤维化相区分。进一步的研究对于阐明这些关联并了解其潜在机制至关重要。
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）是一种正链单股RNA病毒，可引起COVID-19，并与自身免疫性疾病有关。结节病是一种多系统疾病，常由感染引发。其特征是多个器官出现非坏死性肉芽肿。我们报告一例结节病作为COVID-19罕见后遗症的病例。一名26岁男性出现轻度COVID-19症状，尽管初始治疗后仍持续发热和咳嗽，初步诊断为COVID-19后纤维化。随后在一家三级医院进行的评估显示有呼吸困难、体重减轻和胸部影像学异常，所有这些都与肺结节病相符，需与肺结核进行鉴别诊断。支气管镜检查期间所取活检证实为肺结节病，吸入类固醇治疗后症状缓解，随后口服类固醇治疗病情缓解。结节病是一种病因不明的全身性疾病，特征是多个器官出现非坏死性肉芽肿。它可能由感染引发，并涉及异常免疫反应。COVID-19可能引发结节病，二者具有共同的免疫机制。诊断包括影像学检查和活检，治疗通常包括糖皮质激素和定期监测。本病例报告强调了COVID-19与结节病等自身免疫性疾病之间的潜在联系，突出了采用综合诊断方法和长期观察以区分结节病和COVID-19后纤维化的必要性。
