COVID-19 Pneumonia and Idiopathic Pulmonary Fibrosis: A Novel Combination

Abstract

Coronavirus disease 2019 (COVID-19) has become a game changer in many aspects of clinical practice. Acute exacerbations of idiopathic pulmonary fibrosis (IPF) are known as serious events, which can reach a mortality rate of 50%, where viral infections may play a role. We describe the case of a 64-year-old male patient with a diagnosis of IPF under antifibrotic treatment for 1 year; the patient tested positive for COVID-19 with polymerase chain reaction test of the nasopharyngeal swab, and his chest computed tomography results were compatible with COVID-19 pneumonia described in the literature as well as the findings compatible with interstitial lung disease. The patient was successfully treated in the pulmonology ward according to official guidelines about COVID-19 along with antifibrotic treatment and required only a short course of oxygen therapy. We experienced no drug interactions, serious side effects, or complications during treatment. The patient was discharged after 1 week, and he is still in a good condition after 3 weeks. COVID-19 pneumonia in a patient with IPF who survived under antifibrotic treatment without serious deterioration is a new experience. Such cases will probably change our perspective in treating patients with IPF.

Figure 1. a–d

Thoracic HRCT showing septal thickening, Traction bronchiectasis and honeycombing but no ground glass opacities at the time of IPF diagnosis

Figure 2. a–d

Thoracic HRCT showing ground glass densities that are more prominent in the right lung upper lobe in both lungs (compatible with Covid-19 pneumonia described in the literature) plus findings compatible with interstitial lung disease (UIP pattern).